Source: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-ca10-89-05080/USCOURTS-ca10-89-05080-0/pdf.json

Nature of Suit Code: 440
Nature of Suit: Other Civil Rights
Cause of Action: 

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PUBLISH 

UNITED STATES COURT OF APPEALS 

TENTH CIRCUIT · 

LEONA SAWYER, as Personal Representative 

of the Estate of Johnnie Curtis Sawyer, 

deceased, and on her own behalf, 

Plaintiff-Appellee, 

v. 

) 

) 

) 

) 

) 

) 

) 

) 

COUNTY OF CREEK, a Political Supdivision of ) 

the State of Oklahoma; ROBERT J. WHITWORTH, ) 

individually and in his official capacity as ) 

Sheriff of Creek County; MICHAEL E. BIRD, and) 

other unknown persons, individually and in ) 

their official capacity as Deputy Sheriffs or) 

employees of Creek County; J.D. NUNEZ, M.D., ) 

Defendants, 

and 

) 

) 

) 

). 

) 

RODRIGO RAMIREZ, M.D., individually and as an) 

employee of the State of Oklahoma, ) 

Defendant-Appellant. 

) 

) 

FILED 

United &ar~ tAJ,m: 0 £ Appeals 

Temh C!rcuit 

J!JL 18 ·j@@O 

ROBERT L. HOECKER 

Clerk 

No. 89-5080 

APPEAL FROM THE UNITED STATES DISTRICT COURT 

FOR THE NORTHERN DISTRICT OF OKLAHOMA 

(D.C. No. 88-C-444-E) 

Robert A. Nance (Robert H. Henry, Attorney General, and Randy J. 

Malone, Assistant Attorney General, of Oklahoma, with him on the 

briefs), Assistant Attorney General, Chief, Federal Division, of 

Oklahoma, for the defendants-appellants. 

Michael Salem (Louis w. Bullock, of Bullock and Bullock, Tulsa, 

Oklahoma, with him on the brief), Salem Law Offices, Norman, 

Oklahoma, for the plaintiff-appellee. 

Appellate Case: 89-5080 Document: 01019570495 Date Filed: 07/18/1990 Page: 1 
Before TACBA and BRORBY, Circuit Judges, and VAN BEBBER, District 

Judge . * 

TACHA, Circuit Judge. 

* Honorable G. Thomas Van Bebber, United States District Judge 

for the District of Kansas, sitting by designation. 

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Appellate Case: 89-5080 Document: 01019570495 Date Filed: 07/18/1990 Page: 2 
This action arises out of the death of Johnnie Curtis Sawyer 

at the Eastern State Hospital in Vinita, Oklahoma. Leona Sawyer, 

mother of the decedent, filed suit against Rodrigo Ramirez, M.D., 

a state employee of Eastern State Hospital, alleging that Ramirez 

den~ed Johnnie Sawyer his rights under: (1) the first, fourth, 

fifth, sixth, seventh, ninth, and fourteenth amendments, U.S. 

Const. amends. I, IV, v, VI, VII, IX, XIV; and (2) various state 

laws. Ramirez moved to dismiss the state claims on jurisdictional 

grounds and the federal claims on the basis of absolute and 

qualified immunity. The district court denied the motion, and 

Ramirez appeals. We reverse. 

I. 

Because we are reviewing a motion to ~ismiss, we assume that 

the following facts alleged in the complaint are true. See 

Estelle YL Gamble, 429 U.S. 97, 99 (1976). On May 12, 1987, 

Johnnie Curtis Sawyer, decedent and the son of plaintiff Leona 

Sawyer, was arrested on charges of disturbing the peace. He was 

detained at the Creek County Jail in Sapulpa, Oklahoma. During 

his week-long term in the jail, Sawyer's behavior was erratic. He 

drank from the toilet, refused to wear any clothing, and set 

portions of his cell on fire. After the state instituted mental 

health proceedings on May 19, the court remanded Sawyer to the 

custody of the county sheriff, pending a heari ng relating to his 

mental health set for May 22. The sheriff transported Johnnie 

Sawyer to the Eastern State Hospital in Vinita, Oklahoma. Ramirez 

was one of the decedent's treating physicians at the hospital. 

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Appellate Case: 89-5080 Document: 01019570495 Date Filed: 07/18/1990 Page: 3 
While at the hospital, the decedent's medical condition 

deteriorated. The plaintiff states that Ramirez failed to take 

steps necessary to halt Johnnie Sawyer's "declining condition 

relating to his mental condition, diabetes and hypertension all of 

which resulted in the death of the decedent on May 20, 1988." 

II. 

Ramirez seeks to dismiss Leona Sawyer's claim under Federal 

Rule of Civil Procedure 12(b)(6) for "failure to state a claim 

upon which relief can be granted." Fed. R. Civ. P. 12(b)(6). 

Ramirez argues that Leona Sawyer has plead insufficient facts to 

overcome Ramirez's absolute and qualified immunity from suit. 1 

We turn first to Ramirez's claim of qualified immunity. 

"[G]overnment officials performing discretionary functions 

generally are shielded from liability for civil damages insofar as 

their conduct does not violate clearly established statutory or 

constitutional rights of which a reasonable person would have 

known." Harlow Y-!.. Fitzgerald, 457 u.s. 800, 818 (1982). Unlike 

other affirmative defenses, qualified immunity is not merely a 

defense to liability; it is also an immunity from suit. Qualified 

immunity protects a defendant from discovery, trial, and the other 

burdens of litigation. For this reason, prior to filing an 

affirmative defense, a defendant can challenge a complaint by 

filing either a motion to dismiss or a motion for summary judgment 

1 We have jurisdiction over this appeal because a district 

court's denial of a motion to dismiss based on qualified immunity 

is an appealable "final decision" within the ambit of 28 u.s.c. 

section 1291. See Mitchell Y-!.. Forsyth, 472 u.s. 511, 527-30 

(1985). 

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Appellate Case: 89-5080 Document: 01019570495 Date Filed: 07/18/1990 Page: 4 
if the plaintiff has failed to come forward with facts or 

allegations that establish that the defendant has violated clearly 

established law. See Mitchell, 472 u.s. at 526; Pueblo 

Neighborhood Health Centers, Inc. ~ Losavio, 847 F.2d 642, 646 

(lOth Cir. 1988). Following a defendant's motion to dismiss, the 

district judge should permit the plaintiff to come forward with 

any additional allegations showing that the defendant violated 

clearly established law. Pueblo Neighborhood, 847 F.2d at 646. 

The court must then determine whether the complaint includes "all 

of the factual allegations necessary to sustain a conclusion that 

defendant violated clearly established law." Powell~ Mikulecky, 

891 F.2d 1454, 1457 (lOth Cir. 1989). 

In addition to coming forward with the necessary factual 

allegations, the plaintiff must demonstrate that the right in 

question was clearly established at the time of the defendant's 

conduct. Pueblo Neighborhood, 847 F.2d at 646. The plaintiff 

cannot meet this burden merely by identifying a clearly 

established right and then alleging that the defendant has 

violated it. The contours of the right must be sufficiently clear 

that a reasonable official would understand that what he is doing 

violates that right. Anderson ~ Creighton, 483 u.s. 635, 640 

(1987). Unless and until the plaintiff both demonstrates a 

clearly established right and comes forward with the necessary 

factual allegations, the "government official is properly spared 

the burden and expense of proceeding any further," Powell, 891 

F.2d at 1457. 

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Appellate Case: 89-5080 Document: 01019570495 Date Filed: 07/18/1990 Page: 5 
With these considerations in mind, we turn to Leona Sawyer's 

argument that Ramirez is not entitled to qualified immunity 

because he deprived Johnnie Sawyer of adequate medical treatment. 

Leona Sawyer contends that Johnnie Sawyer enjoyed a clearly 

established right to adequate medical treatment under the due 

process clause of the fourteenth amendment. 2 We disagree. 

In determining the scope of the decedent's clearly 

established substantive due process rights under the fourteenth 

amendment, we find that Daniels ~ Gilbreath, 668 F.2d 477 (lOth 

Cir. 1982), controls the outcome of this case. Daniels, like the 

instant case, involved a claim against a medical doctor for 42 

u.s.c. section 1983 damages for conduct surrounding the 

unexplained death of a detainee at Eastern State Hospital. Like 

Johhnie Sawyer, the decedent in Daniels was under observation and 

had not yet undergone either a trial or a commitment proceeding. 

The Daniels court stated that the plaintiff could prevail on his 

claim against the doctor only by demonstrating "a violation of a 

constitutional or fundamental right guaranteed by the fourteenth 

amendment or perhaps of the eighth amendment3 incorporated into 

2 Although Leona Sawyer argues that Ramirez violated rights of 

Johnnie Sawyer arising under "various clauses" of the 

Constitution, the only provision she specifically mentions on 

appeal is the fourteenth amendment. Because Leona Sawyer has thus 

chosen not to renew her earlier argument to the trial court 

resting on the first, fourth, fifth, sixth, seventh, and_ ninth 

amendments to the U.S. Constitution, we do not reach these issues. 

3 The Supreme Court has cast doubt on our suggestion that the 

eighth amendment might be applicable to a pre-trial or precommitment detainee. See City of Revere ~ Massachusetts Gen. 

Hasp., 463 u.s. 239, 244 (1983) ("Because there had been no formal 

adjudication of guilt against [the suspect] at the time he 

required medical care, the Eighth Amendment has no application"). 

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Appellate Case: 89-5080 Document: 01019570495 Date Filed: 07/18/1990 Page: 6 
the fourteenth." Id. at 487. In determining the proper standard 

under the fourteenth amendment, the Daniels court referred to 

Estelle, which held that to prevail under the eighth amendment, a 

prisoner must demonstrate "deliberate indifference to serious 

medical needs," not mere negligence. Estelle, 429 U.S. at 106. 

Daniels adopted the same deliberate indifference standard for a 

detainee's claim of insufficient medical care under the fourteenth 

amendment. See Daniels, 668 F.2d at 481-82. Our decision in 

Daniels clearly established that a government doctor violated the 

fourteenth amendment only by exhibiting deliberate indifference to 

the serious medical needs of a detainee. 

Contrary to the contention of Leona Sawyer, subsequent 

Supreme Court cases do not clearly establish that there is a 

violation of the fourteenth amendment upon a lesser showing than 

deliberate indifference. In City of Revere ~ Massachusetts 

General Hospital, 463 U.S. 239 (1983), the Supreme Court reserved 

the question of whether pretrial detainees might enjoy more 

extensive rights under the fourteenth amendment than prisoners do 

under the eighth amendment. The Court stated that a suspect 

injured by the police in the course of apprehension enjoys due 

process rights "at least as great as the Eighth Amendment 

protections available to a convicted prisoner." City of Revere, 

463 u.s. at 244. The Court went on to note that it "need not 

define, in this case, [the government's] due process obligation to 

pretrial detainees or to other persons in its care who require 

medical attention." Id. 

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Appellate Case: 89-5080 Document: 01019570495 Date Filed: 07/18/1990 Page: 7 
In Youngberg~ Romeo, 457 U.S. 307 (1982), the Supreme Court 

acknowledged that an involuntarily committed mentally retarded 

person enjoys a substantive due process right to adequate medical 

care. See id. at 315. However, the plaintiff in Youngberg did 

not allege that he was deprived of adequate medical care and, 

therefore, the Court had no opportunity to state whether the 

plaintiff could prove that he received constitutionally inadequate 

medical care upon a lesser showing than deliberate indifference. 4 

Even had the Court reached this issue, its holding would have been 

in the context of involuntarily committed mentally retarded 

persons, not detainees under observation pending commitment 

proceedings. Because institutionalized persons are "wholly 

dependent on the state," see Youngberg, 457 u.s. at 317, it is 

possible that the state owes such persons greater care to meet its 

fourteenth amendment obligations than it does to detainees who 

have not yet been determined to be appropriate for commitment. 

We conclude that neither City of Revere nor Youngberg clearly 

establish that a detainee can demonstrate a violation of 

substantive due process upon a lesser showing than deliberate 

indifference to serious medical needs. We hold that to defeat 

Ramirez's qualified immunity defense, Leona Sawyer must allege 

4 In the context of defining the contours of the plaintiff's 

substantive due process right to safety and freedom from bodily 

restraint, the Court did suggest that an involuntarily committed 

retarded person enjoys more extensive rights than a prisoner. See 

Youngberg, 457 U.S. at 321-22 ("Persons who have been 

involuntarily committed are entitled to more considerate treatment 

and conditions of confinement than criminals whose conditions of 

confinement are designed to punish"). However, neither the right 

to safety nor the right to freedom from bodily restraint is at 

issue in this case. 

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Appellate Case: 89-5080 Document: 01019570495 Date Filed: 07/18/1990 Page: 8 
that Ramirez exhibited deliberate indifference to the serious 

medical needs of Johnnie Sawyer. 

We now turn to Leona Sawyer's complaint to determine whether 

it alleges that Ramirez manifested deliberate indifference. 

Normally, a complai nt should not be dismissed for failure to state 

a claim "unless it appears beyond doubt that the plaintiff can 

prove no set of facts in support of his claim which would entitle 

him to relief." Conley~ Gibson, 355 U.S. 41, 45-46 (1957). 

Once a qualified immunity defense has been raised, however, the 

plaintiff is held to a heightened standard of pleading. The 

complaint must include "all the factual allegations necessary to 

sustain a conclusion that defendant violated clearly established 

law." Pueblo Neighborhood, 847 F.2d at 646 (quoting Dominique, 

831 F.2d at 676) . 

In her amended complaint, Leona Sawyer states: 

The examination, diagnosis and treatment of Decedent 

Sawyer by Defendants NUNEZ and RAMIREZ departed and fell 

below the accepted standard of medical care in that 

these Defendants, among other matters, did not exercise 

a required degree of skill, technique, learning and 

expertise in failing to recognize and diagnose the 

existing physical and mental condition at the time of 

admission and subsequent thereto of Decedent SAWYER or 

prescribe a proper and correct treatment under the 

circumstances and take necessary corrective action to 

arrest and stop the declining conditi on rel ating to his 

mental condition, diabetes and hypertension all of which 

resulted in the death of the Decedent on May 20, 1988. 

Further, the actions of the Defendant NUNEZ and RAMIREZ 

after SAWYER's admission to the hospital and subsequent 

to his death deprived the Decedent of his constitutional 

rights and due process as provided under the First, 

Fourth, Fifth, Sixth, Seventh, Ninth, and Fourteenth 

Amendments of the United States Constitution. As a 

result of the negligence of these Defendants and the 

violation of Decedent's civil rights by the Defendants, 

Decedent SAWYER was deprived of any chance of survival 

or recovery from his physical and mental i l lness to a 

stable a~d considered condition. 

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Appellate Case: 89-5080 Document: 01019570495 Date Filed: 07/18/1990 Page: 9 
The allegations in the complaint that Ramirez's conduct fell below 

the accepted standard of medical care by failing to exercise the 

required level of competence establishes a cause of action only 

for negligence. The factual allegations simply do not allege that 

Ramirez acted with deliberate indifference. The complaint does 

not allege, for instance, that Ramirez knowingly ignored the 

decedent's condition. We hold that the complaint does not contain 

the factual allegations necessary to sustain a conclusion that 

Ramirez acted with deliberate indifference. 5 

In her brief to this court, Leona Sawyer complains that, 

prior to discovery, she cannot allege more specific facts relating 

to the death of the decedent, because information relating to the 

decedent's death lies exclusively within Ramirez's control. The 

plaintiff laments that she is caught between the prohibition on 

ungrounded factual assertions contained in Federal Rule of Civil 

Procedure 11 and the requirement of explicit factual pleadings 

imposed on a plaintiff seeking to overcome a qualified immunity 

defense. We perceive no injustice in the plaintiff's dilemma. In 

this case Leona Sawyer failed to identify properly a clearly 

established right. Moreover, under the clearly established right 

that we have delineated, Leona Sawyer has failed to allege facts 

that would "sustain a conclusion that the defendant violated a 

5 Our ruling is consistent with our disposition of Garrett ~ Radar, 831 F.2d 202 (lOth Cir. 1987). In Garrett, we affirmed the 

district court where it held that although the allegations in the 

plaintiff's complaint were couched in terms of negligence, at 

trial the plaintiff might be able to meet the requirement of 

showing more than negligence. Id. at 205 n.3. Unlike Leona 

Sawyer, the plaintiff in Garrett alleged specific facts suggesting 

that the defendants knowingly violated the law. Id. at 205. 

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Appellate Case: 89-5080 Document: 01019570495 Date Filed: 07/18/1990 Page: 10 
clearly established right." Pueblo, 847 F.2d at 646 (quoting 

Dominique, 831 F.2d at 676). A federal lawsuit is not a fishing 

expedition. Were we to permit Leona Sawyer's complaint to 

continue in its present form, we would defeat the rationale for 

the qualified immunity defense. See Mitchell, 472 u.s. at 526 

(government officials enjoy immunity from the burdens of suit, 

rather than a mere defense to liability, in the absence of a 

showing that they have violated a clearly established right):~ 

also Patty Precision~ Brown~ Sharpe Mfg. Co., 742 F.2d 1260, 

1264 (lOth Cir. 1984) (mere assertion that evidence supporting 

plaintiff is in the hands of the defendant is insufficient to 

justify, under Federal Rule of Civil Procedure 56(f), a denial of 

a motion for summary judgment). 

III. 

We hold tbat Leona Sawyer's federal cause of action against 

Ramirez should be dismissed under Federal Rule of Civil Procedure 

12(b)(6) for a failure to allege sufficient facts showing a 

violation of a clearly established right. Because the plaintiff 

states that she cannot significantly amend her complaint without 

discovery, we dismiss with prejudice and we do not consider the 

issue of whether it would be appropriate to remand to the district 

court to permit the plaintiff to file a motion for leave to amend. 

Cf. Union Planters National Leasing, Inc. ~Woods, 687 F.2d 117, 

121 (5th Cir. 1982) (after considering prejudice to movant and 

judicial economy, court may refuse leave to amend where amendment 

would be futile). We do not reach Ramirez's argument 

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Appellate Case: 89-5080 Document: 01019570495 Date Filed: 07/18/1990 Page: 11 
that he is entitled to absolute immunity. Because we dismiss the 

federal causes of action prior to trial, we hold that the state 

claims should be dismissed without prejudice for lack of pendent 

jurisdiction. See United Mine Workers ~ Gibbs, 383 u.s. 715, 726 

(1966); Central Nat'l Bank~ Rainbolt, 720 F.2d 1183, 1187 (lOth 

Cir. 1983). The order of the district court is REVERSED and 

REMANDED with instructions to dismiss all claims against Ramirez. 

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