Source: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-alnd-5_14-cv-01309/USCOURTS-alnd-5_14-cv-01309-0/pdf.json

Nature of Suit Code: 440
Nature of Suit: Other Civil Rights
Cause of Action: 42:1983 Civil Rights Act

---

UNITED STATES DISTRICT COURT

NORTHERN DISTRICT OF ALABAMA

NORTHEASTERN DIVISION

ROBERT ELLIOTT, as )

personal representative of the )

Estate of Nikki Listau, deceased, )

)

Plaintiff, )

)

vs. ) Civil Action No. 5:14-cv-1309-CLS

)

MADISON COUNTY, ALABAMA,)

et al., )

)

Defendants. )

MEMORANDUM OPINION AND ORDER

Plaintiff, Robert Elliott, commenced this action in his representative capacity

as personal representative of the Estate of Nikki Listau, deceased, who died while she

wasincarcerated in the Madison County, Alabama, Jail. Plaintiff’s Second Amended

Complaint asserts claims against eighteen defendants: i.e., (1) Madison County,

Alabama; (2) Advanced Correctional Healthcare, Inc. (“ACH”), an entity that is

described as “a private for-profit corporation that is under a contractual obligation to

provide medical care for inmates in the Madison County Jail”;1

(3) Norman R.

Johnson, M.D., ACH’s Chief Executive Officer; (4) Arthur M. Williams, M.D., “a

physician who was employed by ACH to provide physician medical services and to

1

 Doc. no. 53 (Second Amended Complaint) ¶ 6.

FILED

 2015 Mar-09 AM 10:51

U.S. DISTRICT COURT

N.D. OF ALABAMA

Case 5:14-cv-01309-CLS Document 89 Filed 03/09/15 Page 1 of 40
be the director of the medical program for inmates at the Madison County Jail”;2

(5)

Janice Robinson, “a Licensed Practical Nurse who was employed by ACH as the

health services administrator and oversaw medical care at the jail on a day-to-day

basis”;3

 (6) Blake Dorning, the Sheriff of Madison County; (7) Steve Morrison, the

Administrator of the Madison County Jail; (8) Pamela Batie, a correctional officer at

the Madison County Jail; (9) Jessica Pothier, a correctional officer at the Madison

County Jail; (10) Christine Collier, a correctional officer at the Madison County Jail;

(11) Vanessa Fields, a correctional officer at the Madison County Jail; (12) Nick

Wallace, a correctional officer at the Madison County Jail; (13) Roslyn Guyton, a

correctional officer at the Madison County Jail; (14) Randy Hooper, a correctional

officer at the Madison County Jail; (15) Michele Kirk, a Licensed Practical Nurse

employed by ACH to provide nursing servicesto inmates at the Madison County Jail;

(16) Deondra Montgomery, a Registered Nurse employed byACH to provide nursing

services to inmates at the Madison County Jail; (17) Tanya Jones, a Licensed

Practical Nurse employed by ACH to provide nursing services to inmates at the

Madison County Jail; and (18) Tina Adams, a Licensed Practical Nurse employed by

ACH to provide nursing medical services for inmates at the Madison County Jail.

4

2

Id. ¶ 8. 

3

Id. ¶ 9. 

4

Id. ¶¶ 5-22. 

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Case 5:14-cv-01309-CLS Document 89 Filed 03/09/15 Page 2 of 40
All of the individual defendants were sued in their individual capacities only. 

The Second Amended Complaint asserts two claims. The first claim, for

deliberate indifference to serious medical needs in violation of the Fourteenth

Amendment to the United States Constitution, appears to be asserted against all

individual defendants,

5

 as well as against defendant Madison County.

6

 The second

claim, for negligence and/or wantonness under Alabama law, is asserted against

defendant ACH, as well as against all individual defendants who were employed by

ACH, including Johnson, Williams, Robinson, Kirk, Montgomery, Jones, and

5

Id. ¶ 163 (“The individual defendants except Dorning and Johnson, acting under color of

state law within the meaning prescribed by 42 U.S.C. § 1983, were deliberately indifferent to

Listau’s serious medical needs as described above.”), ¶ 164 (“Defendants Dorning, Morrison,

Johnson, Wiliams, and Robinson are supervisory officials for the jail and were responsible for

development and implementation of policies and procedures for medical care at the jail and byaction

and inaction established the unconstitutional customs and policies described above.”). 

6 Doc. no. 53 (Second Amended Complaint) ¶ 165 (“Defendant MadisonCountyintentionally

refused to adequatelyfundmedical care as described above with deliberate indifference to the serious

medical needs of inmates such as Listau . . . .”). The Eleventh Circuit has held that 

[d]eliberate indifference to a prisoner’s serious medical needs is a violation of the

Eighth Amendment. See Estelle v. Gamble, 429 U.S. 97, 104, 97 S. Ct. 285, 291, 50

L. Ed. 2d 251 (1976). Correctional officers are, of course, bound by the Eighth

Amendment’s prohibition against cruel and unusual punishment. Id. Technically, the

Fourteenth Amendment Due Process Clause, not the Eighth Amendment prohibition

on cruel and unusual punishment, governs pretrial detainees like [Lisau]. Snow ex rel.

Snow v. City of Citronelle, Ala., 420 F.3d 1262, 1268 (11th Cir. 2005). However, the

standards under the Fourteenth Amendment are identical to those under the Eighth.

Cook ex rel. Estate of Tessier v. Sheriff of Monroe County, Fla., 402 F.3d 1092, 1115

(11th Cir. 2005).

Goebert v. Lee County, 510 F.3d 1312, 1326 (11th Cir. 2007) (alterations supplied).

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Case 5:14-cv-01309-CLS Document 89 Filed 03/09/15 Page 3 of 40
Adams.

7

The case currently is before the court on the following motions: (1) the motion

to dismiss plaintiff’s Second Amended Complaint filed by defendant Madison

County, Alabama;8

(2) the motion to dismiss plaintiff’s Second Amended Complaint

filed by defendant Sheriff Blake Dorning;

9

(3) the motion to dismiss plaintiff’s

Second AmendedComplaintfiled by correctional officer defendants Steve Morrison,

Pamela Batie, Jessica Pothier, Vanessa Fields, Nick Wallace, Roslyn Guyton, and

Randy Hooper;10

and, (4) the motion to dismiss plaintiff’s Second Amended

Complaint filed by defendant Arthur M. Williams, M.D.11 Upon consideration of

those motions, the movants’ briefs, and plaintiff’sresponses, the court concludesthat

all motions are due to be denied. 

I. STANDARD OF REVIEW

Federal Rule of Civil Procedure 12(b) permits a party to move to dismiss a

complaint for, among other reasons, “failure to state a claim upon which relief can be

granted.” Fed. R. Civ. P. 12(b)(6). This rule must be read together with Rule 8(a),

which requires that a pleading contain only a “short and plain statement of the claim

7

 Doc. no. 53 (Second Amended Complaint) ¶¶ 168-69. 

8

 Doc. no. 60. 

9

 Doc. no. 62. 

10

 Doc. no. 64. 

11

 Doc. no. 67. 

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Case 5:14-cv-01309-CLS Document 89 Filed 03/09/15 Page 4 of 40
showing that the pleader is entitled to relief.” Fed. R. Civ. P. 8(a)(2). While that

pleading standard does not require “detailed factual allegations,” Bell Atlantic Corp.

v. Twombly, 550 U.S. 544, 550 (2007), it does demand “more than an unadorned,

the-defendant-unlawfully-harmed-me accusation.” Ashcroft v. Iqbal, 556 U.S. 662,

678 (2009) (citations omitted). As the Supreme Court stated in Iqbal:

A pleading that offers “labels and conclusions” or “a formulaic

recitation of the elements of a cause of action will not do.” [Twombly,

550 U.S., at 555]. Nor does a complaint suffice if it tenders “naked

assertion[s]” devoid of “further factual enhancement.” Id., at 557. 

To survive a motion to dismiss founded upon Federal Rule of

Civil Procedure 12(b)(6), [for failure to state a claim upon which relief

can be granted], a complaint must contain sufficient factual matter,

accepted as true, to “state a claim for relief that is plausible on its face.” 

Id., at 570. A claim has facial plausibility when the plaintiff pleads

factual content that allows the court to draw the reasonable inference

that the defendant is liable for the misconduct alleged. Id., at 556. The

plausibility standard is not akin to a “probability requirement,” but it

asks for more than a sheer possibility that a defendant has acted

unlawfully. Ibid. Where a complaint pleads facts that are “merely

consistent with” a defendant’s liability, it “stops short of the line

between possibility and plausibility of ‘entitlement to relief.’” Id., at

557 (brackets omitted). 

Two working principles underlie our decision in Twombly. First,

the tenet that a court must accept as true all of the allegations contained

in a complaint is inapplicable to legal conclusions. Threadbare recitals

of the elements of a cause of action, supported by mere conclusory

statements, do not suffice. Id., at 555 (Although for the purposes of a

motion to dismiss we must take all of the factual allegations in the

complaint astrue, we “are not bound to accept astrue a legal conclusion

couched as a factual allegation” (internal quotation marks omitted)). 

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Case 5:14-cv-01309-CLS Document 89 Filed 03/09/15 Page 5 of 40
Rule 8marks a notable and generous departure fromthe hyper-technical,

code-pleading regime of a prior era, but it does not unlock the doors of

discovery for a plaintiff armed with nothing more than conclusions. 

Second, only a complaint that states a plausible claim for relief survives

a motion to dismiss. Id., at 556. Determining whether a complaint

states a plausible claim for relief will, asthe Court of Appeals observed,

be a context-specific task that requires the reviewing court to draw on

its judicial experience and common sense. 490 F.3d, at 157-158. But

where the well-pleaded facts do not permit the court to infer more than

the mere possibility of misconduct, the complaint has alleged — but it

has not “show[n]” — “that the pleader is entitled to relief.” Fed. Rule

Civ. Proc. 8(a)(2). 

In keeping with these principles a court considering a motion to

dismiss can choose to begin by identifying pleadings that, because they

are no more than conclusions, are not entitled to the assumption of truth. 

While legal conclusions can provide the framework of a complaint, they

must be supported by factual allegations. When there are well-pleaded

factual allegations, a court should assume their veracity and then

determine whether they plausibly give rise to an entitlement to relief. 

Iqbal, 556 U.S. at 678-79 (emphasis supplied) (first alteration supplied, other

alteration in original). 

II. FACTUAL ALLEGATIONS OF PLAINTIFF’S SECOND AMENDED

COMPLAINT

Plaintiff’s Second Amended Complaint contains 140 paragraphs of factual

allegations, spanning approximately 24 pages.

12 There is no need to reiterate all of

those factual allegations here. Instead, this section will contain a summary of the

underlying facts that form the basis for plaintiff’s claims, and other facts will be

12

See doc. no. 53 (Second Amended Complaint) ¶¶ 23-162. 

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Case 5:14-cv-01309-CLS Document 89 Filed 03/09/15 Page 6 of 40
addressed, as necessary, in the context of discussing the various defendants’ motions

to dismiss.

Plaintiff’s decedent, Nikki Listau, was arrested from her home on the morning

of March 10, 2013, and was booked into the Madison County Jail that same day.

13

At the time of booking, she “was not ambulatory without assistance, required a

wheelchair to get to her cell, exhibited strange behavior, was not even able to dress

herself, had poor hygiene, wasidentified assuffering fromadvanced deliriumtremens

(DT’s) due to alcohol withdrawal, and was placed in a medical watch cell.”14 From

past jail admissions, Listau was known to be an alcoholic with a history of DT’s and

seizures during alcohol withdrawal.

15 At booking, Listau reported that she normally

consumed vodka daily, but her last use had been four days earlier, on March 6th.

16

All of the individual defendants, other than Sheriff Dorning, eventuallybecame

aware of Listau’s medical condition. They also were aware of the symptoms and

seriousness of DT’s due to their prior training and experience.17

At approximately 9:40 a.m. on March 10, defendant Kirk identified Listau as

13

Id. ¶ 23.

14

Id. ¶ 24.

15

Id. ¶ 28.

16

Id. ¶ 29.

17

Id. ¶¶ 34, 37. 

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Case 5:14-cv-01309-CLS Document 89 Filed 03/09/15 Page 7 of 40
suffering from severe DT’s and placed her under medical watch.

18 Correctional

officers checked Listau every fifteen minutes thereafter.19 Defendants Robinson,

Montgomery, Jones, Adams, and Williams also became aware of Listau’s condition

on March 10.

20 There are no other allegations about anything that occurred or did not

occur on March 10: the date of her entry to the jail.

Listau was seen by ACH nurses “multiple times” between 8:00 and 9:00 a.m.

on March 11.

21 At approximately 8:15 a.m., Listau also was seen by an unnamed

mental health clinician, who observed her on the floor of her cell, rambling

incoherently and unable to stand.

22 Some unidentified nurses and correctional

officers picked up Listau and laid her on her bunk, but no one took her vital signs.

23

At approximately 8:42 a.m., defendant Collier entered Listau’s cell and again

found Listau on the floor, rambling incoherently and unable to stand.

24 Collier

informed defendants Fields, Wallace, Batie, Williams, Robinson, Montgomery,

Adams, and Jones of Listau’s condition.

25 Batie, in turn, informed defendant

18

 Doc. no. 53 (Second Amended Complaint) ¶ 38. 

19

Id. ¶ 41. 

20

Id. ¶ 42. 

21

Id. ¶ 43. 

22

Id. ¶¶ 44-45. 

23

Id. ¶¶ 46, 48. 

24

 Doc. no. 53 (Second Amended Complaint) ¶ 49. 

25

Id. ¶¶ 50-51. 

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Case 5:14-cv-01309-CLS Document 89 Filed 03/09/15 Page 8 of 40
Morrison.

26 Despite the obviousness of Listau’s medical condition, no correctional

officer or health professional took her vital signs, took her to the hospital, or did

anything else to treat her.27

 Instead, Listau was written up as refusing to cooperate

with officers to prepare for a court appearance.28

At 9:00 a.m., defendants Montgomery and Guyton entered Listau’s cell to

verify her reported condition.

29 Montgomery’s notesfromthat encounter falsely state

that Listau refused to allow the medical staff to check her vital signs.

30 By that point,

Listau was physically unable to communicate her medical needs, and she obviously

needed to go to the hospital.

31 All of the individual defendants, other than Sheriff

Dorning, were aware of Listau’s condition by this time.32

At 9:40 a.m., Wallace, Hooper, and Guyton again found Listau on the floor of

her cell. Listau was barely responsive, although she was still breathing. Wallace,

Hooper, and Guyton again picked up Listau, placed her on her bunk, and reported

Listau’s condition to Batie. Batie, in turn, reported it to Morrison and unidentified

26

Id. ¶ 52. 

27

Id. ¶¶ 53-55. 

28

Id. ¶¶ 55-56. 

29

Id. ¶ 57.

30

 Doc. no. 53 (Second Amended Complaint) ¶ 58. 

31

Id. ¶¶ 59-60. 

32

Id. ¶ 61. 

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Case 5:14-cv-01309-CLS Document 89 Filed 03/09/15 Page 9 of 40
ACH personnel.

33 Listau did not receive any further treatment, including having her

vital signs checked.

34

At 11:19 a.m., Listau was found in her cell, completely unresponsive. 

Emergency personnel were contacted, and Listau was transported to the hospital,

where she died the following day, March 12.

35 An autopsy revealed that Listau died

from severe blunt force injuries, including a broken left femur and multiple rib

fractures.

36 According to the Second Amended Complaint, “Listau most likely

suffered these injuries as a result of one or more falls, presumably from her bunk,

while in her medical watch cell at the jail.”37 Her falls were the result of seizures

related to DT’s.

38

Plaintiff alleges that five other inmates have died in the Madison County Jail

since 2010. In August of 2010, Julie Jean died as a result of lithium toxicity.

39

In

December of 2011, Emanuel Patterson also died of lithium toxicity.

40

In May of

2012, Frederick Foster died of unspecified causes.

41

In August of 2013, Deundrez

33

Id. ¶ 62. 

34

 Id. ¶¶ 63-64.

35

Id. ¶¶ 23, 32, 65.

36

 Doc. no. 53 (Second Amended Complaint) ¶ 25.

37

Id. ¶ 26. 

38

Id. ¶ 27.

39

Id. ¶ 101.

40

Id. ¶ 103. 

41

Id. ¶ 105.

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Case 5:14-cv-01309-CLS Document 89 Filed 03/09/15 Page 10 of 40
Woods died from a blood clot that was a complication of untreated gangrene in his

foot.

42

 In October of 2013, Tanisha Jefferson died from a ruptured intestine.43

To support his Fourteenth Amendment claim, plaintiff asserts that the

individual defendants, other than Dorning and Johnson, were deliberately indifferent

to Listau’s serious medical needs because, despite being aware of those needs, they

took no action, or insufficient action, to secure her treatment.

44 Plaintiff also asserts

that Dorning, Morrison, Johnson, Williams, and Robinson, as supervisory officials

at the Madison County Jail, “were responsible for development and implementation

of policies and procedures for medical care at the jail and by action and inaction

established the unconstitutional customs and policies” that resulted in Listau’s

death.

45 Sheriff Dorning also is alleged to be liable for the acts of ACH and its

agents, because he delegated his final policymaking authority to those individuals.

46

Finally, plaintiff allegesthat defendant Madison County should be held liable for the

other defendants’ deliberate indifference to Listau’s serious medical needs because

it had a policy of inadequately funding inmate medical care.47

42

 Doc. no. 53 (Second Amended Complaint) ¶¶ 80-81. 

43

Id. ¶¶ 82-83. 

44

Id. ¶ 163.

45

Id. ¶ 164.

46

 Id. ¶ 166. 

47

Id. ¶ 165.

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Case 5:14-cv-01309-CLS Document 89 Filed 03/09/15 Page 11 of 40
To support his claimfor negligence and/or wantonness, plaintiff assertsthat all

the ACH employees who were named as defendants failed to meet the standard of

care applicable to inmates, thereby resulting in Listau’s death.

48 He also asserts that

ACH is liable for its employees’ failure to satisfy the applicable standard of care,

because those employees were acting within the scope of their employment at all

relevant times.

49

III. DISCUSSION

A. Motion to Dismiss of Defendant Arthur M. Williams, M.D.

Defendant Arthur M. Williams, M.D., asks this court to dismiss the claim for

negligence and/or wantonness asserted against him in Count Two of plaintiff’s

Second Amended Complaint. That claim essentially is one for medical malpractice. 

Accordingly, it is governed by the Alabama Medical Liability Act. See Ala. Code §

6-5-551 (“In any action for injury, damages, or wrongful death, whether in contract

or in tort, against a health care provider for breach of the standard of care, whether

resulting from acts or omissions in providing health care, or the hiring, training,

supervision, retention, or termination of care givers, the Alabama Medical Liability

Act shall govern the parameters of discovery and all aspects of the action.”). The

48

 Doc. no. 53 (Second Amended Complaint) ¶ 168.

49

Id. ¶ 169.

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Alabama Act requires a complaint to include “a detailed specification and factual

description of each act and omission alleged by plaintiff to render the health care

provider liable to plaintiff and shall include when feasible and ascertainable the date,

time, and place of the act or acts.” Id. Courts have interpreted that statutory

provision as requiring a plaintiff to give his defendant “‘fair notice of the allegedly

negligent act.’” Betts v. Eli Lilly and Co., 435 F. Supp. 2d 1180, 1188 (S.D. Ala.

2006) (quoting Mikkelsen v. Salama, 619 So. 2d 1382, 1384 (Ala. 1993)). “Any

complaint which fails to include such detailed specification and factual description

of each act and omission shall be subject to dismissal for failure to state a claim upon

which relief may be granted.” Id. 

According to Dr. Williams, plaintiff’s Second Amended Complaint does not

contain a sufficiently detailed specification and factual description of his alleged acts

and/or omissions, including the relevant dates, times, and places. This court

disagrees. All of Dr. Wiliams’s alleged acts and/or omissions occurred at the

Madison County Jail between the morning of March 10, 2013, when Listau was

booked, and approximately 11:19 a.m. on March 11, 2013, when the decision was

made to transport her to the hospital. During that well-defined time period, plaintiff

alleges that Williams was aware of Listau’s obviously severe medical condition, but

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Case 5:14-cv-01309-CLS Document 89 Filed 03/09/15 Page 13 of 40
that he did not take any action to provide her with treatment.

50 He also alleges that

Williams’ treatment of Listau (as well as that of all the other health care providers

who were named as defendants) fell below the applicable standard of correctional

health care.51 Finally, plaintiff alleges that Listau suffered and died as a result of

Williams’ failure to provide adequate care.52 These allegations are more than

sufficient to place Williams on fair notice of plaintiff’s claim against him. 

Accordingly, Williams’ motion to dismiss is due to be denied. 

B. Motion to Dismiss of the CorrectionalOfficer Defendants Steve Morrison,

Pamela Batie, Jessica Pothier, Vanessa Fields, Nick Wallace, Roslyn

Guyton, and Randy Hooper

The motion to dismiss addressed in this section was filed by the correctional

officers who were on duty during Listau’s incarceration (hereinafter collectively

referred to as the “correctional defendants”), as well as by Steve Morrison, the Jail

Administrator.53 All of these defendants assert that plaintiff’s claim against them for

their actual participation in deliberate indifference to serious medical needs should

be dismissed because they are entitled to qualified immunity. Morrison additionally

50

See id. ¶¶ 34-36, 42, 51, 53-55, 60-61, 63, 66. 

51

Id. ¶ 70. 

52

Id. ¶¶ 66-67, 71. 

53 Defendant Christine Collier did not file a motion to dismiss or other responsive pleading,

despite apparently having been served with a copy of plaintiff’s original complaint. See doc. no. 5,

at 7. Defendant Steve Morrison filed a motion on February 27, 2015, to quash service on Christine

Collier. Doc. no. 85. That motion remains pending. See doc. no. 87 (text order requiring plaintiff’s

response to the motion to quash by March 13, 2015). 

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Case 5:14-cv-01309-CLS Document 89 Filed 03/09/15 Page 14 of 40
asserts that he cannot be held liable as a policymaker or supervisor, and that plaintiff

has not asserted sufficient facts to satisfy the standard for pleading supervisory

liability.

1. Personal participation claims – correctional defendants and

Morrison

The correctional defendants and Morrison assert that they are entitled to

qualified immunity. The doctrine of qualified immunity protects governmental

officials who are sued under 42 U.S.C. § 1983 for money damages in their personal,

or individual, capacities, but only so long as “their conduct violates no clearly

established statutory or constitutionalrights of which a reasonable person would have

known.” Harlow v. Fitzgerald, 457 U.S. 800, 818 (1982). Courts generally apply a

two-part test for evaluating whether a defendant is entitled to qualified immunity. 

The “threshold question” for a district court to ask is whether the facts, viewed “in the

light most favorable to the party asserting the injury,” show that “the officer’s

conduct violated a constitutional right?” Saucier v. Katz, 533 U.S. 194, 201 (2001).54

If the threshold question is answered affirmatively, the court will proceed to analyze

54 The defendant claiming immunity must also “prove that ‘he was acting within the scope

of his discretionary authority when the allegedlywrongful acts occurred.’” Lee v. Ferraro, 284 F.3d

1188, 1194 (11th Cir. 2002) (quoting Courson v. McMillian, 939 F.2d 1479, 1487 (11th Cir. 1991)). 

Here, it cannot reasonably be disputed that the correctional defendants and Morrison were acting

within the scope of their discretionary authority during all of the events that form the basis of

plaintiff’s claims. 

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the second aspect of the two-part inquiry: i.e., “whether the right was clearly

established.” Id.

55

In determining whether the unlawfulness of an official’s actions was clearly

established, “‘the salient question is whether the state of the law [at the time of the

unconstitutional act] gave respondents fair warning that their alleged treatment of [the

plaintiff] was unconstitutional.’” Williams v. Consolidated City of Jacksonville, 341

F.3d 1261, 1270 (11th Cir. 2003) (alterations in original) (quoting Hope v. Pelzer,

536 U.S. 730, 741 (2002)). The Supreme Court has rejected the requirement that the

facts of previous cases must always be “materially similar” to those facing the

plaintiff. Hope, 536 U.S. at 739. Instead, 

[f]or a constitutional right to be clearly established, its contours “must

be sufficiently clear that a reasonable official would understand that

what he is doing violates that right. This is not to say that an official

action is protected by qualified immunity unless the very action in

question has previously been held unlawful, see Mitchell [v. Forsyth,

472 U.S. 511,] 535, n. 12, 105 S. Ct. 2806, 86 L. Ed. 2d 411; but it is to

say that in the light of pre-existing law the unlawfulness must be

apparent.” Anderson v. Creighton, 483 U.S. 635, 640, 107 S. Ct. 3034,

97 L. Ed. 2d 523 (1987).

55 The Supreme Court has relieved lower courts from mandatory adherence to the order of

the two-part analysis articulated in Saucier. See Pearson v. Callahan, 555 U.S. 223, 236 (2009)

(“On reconsidering the procedure required in Saucier, we conclude that, while the sequence set forth

there is often appropriate, it should no longer be regarded as mandatory.”). It is now within this

court’s discretion to, in appropriate cases, assume that a constitutional violation occurred for the

purpose of addressing, in the first instance, whether such a violation would be “clearly established.” 

Id. That said, and under the circumstances of the present case, the tested sequence of analysis of

Saucier will be followed. 

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Hope, 536 U.S. at 741 (alterations in original).

An officer can receive “fair notice” of his or her unlawful conduct in various

ways. 

First, the words of the pertinent federal statute or federal

constitutional provision in some cases will be specific enough to

establish clearly the law applicable to particular conduct and

circumstances and to overcome qualified immunity, even in the total

absence of case law. This kind of case is one kind of “obvious clarity”

case. For example, the words of a federal statute or federal

constitutional provision may be so clear and the conductso bad that case

law is not needed to establish that the conduct cannot be lawful.

Second, if the conduct is not so egregious as to violate, for

example, the Fourth Amendment on its face, we then turn to case law. 

When looking at case law, some broad statements of principle in case

law are not tied to particularized facts and can clearly establish law

applicable in the future to different sets of detailed facts. See Marsh [v.

Butler County, Ala.], 268 F.3d [1014,] 1031-32 n.9 [11th Cir. 2001]. 

For example, if some authoritative judicial decision decides a case by

determining that “X Conduct” is unconstitutional without tying that

determination to a particularized set of facts, the decision on “X

Conduct” can be read as having clearly established a constitutional

principle: put differently, the precise factssurrounding “X Conduct” are

immaterial to the violation. These judicial decisions can control “with

obvious clarity” a wide variety of later factual circumstances. These

precedents are hard to distinguish from later cases because so few facts

are material to the broad legal principle established in these precedents;

thus, this is why factual differences are often immaterial to the later

decisions. But for judge-made law, there is a presumption against wide

principles of law. And if a broad principle in case law is to establish

clearly the law applicable to a specific set of facts facing a governmental

official, it must do so “with obvious clarity” to the point that every

objectively reasonable government official facing the circumstances

would know that the official’s conduct did violate federal law when the

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Case 5:14-cv-01309-CLS Document 89 Filed 03/09/15 Page 17 of 40
official acted. 

Third, if we have no case law with a broad holding of “X” that is

not tied to particularized facts, we then look at precedent that is tied to

the facts. That is, we look for cases in which the Supreme Court or we,

or the pertinent state supreme court has said that “Y Conduct” is

unconstitutional in “Z Circumstances.” We believe that most judicial

precedents are tied to particularized facts and fall into this category. .

. . When fact-specific precedents are said to have established the law, a

case that is fairly distinguishable from the circumstances facing a

government official cannot clearly establish the law for the

circumstances facing that government official; so, qualified immunity

applies. On the other hand, if the circumstances facing a government

official are not fairly distinguishable, that is, are materially similar, the

precedent can clearly establish the applicable law. 

Vinyard v. Wilson, 311 F.3d 1340, 1350-52 (11th Cir. 2002) (emphasis in original,

alterations supplied).

Pursuant to this framework, the court must first determine whether the

allegations of plaintiff’s Second Amended Complaint demonstrate that the

correctional defendants and Morrison violated Listau’s right to be free from

deliberate indifference to her medical needs. Such a claim requires allegations of:

(1) a serious medical need; (2) defendants’ deliberate indifference to that need; and

(3) a causal link between the defendants’ indifference and the plaintiff’s resulting

injury. Mann v. Taser International, Inc., 588 F.3d 1291, 1306-07 (11th Cir. 2009). 

In order to establish the deliberate indifference element, a plaintiff must show: “(1)

subjective knowledge of a risk of serious harm; (2) disregard of that risk; (3) by

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conduct that is more than gross negligence.” Townsend v. Jefferson County, 601 F.3d

1152, 1158 (11th Cir. 2010) (internal quotation marks and alteration omitted). 

With respect to the “subjective knowledge” component, the Eleventh Circuit

has held that a defendant “must both be aware of factsfrom which the inference could

be drawn that a substantial risk of serious harm exists, and must also draw the

inference.” Bozeman v. Orum, 422 F.3d 1265, 1272 (11th Cir. 2005) (emphasis in

original) (citation, internal quotation marks, and alteration omitted). “No liability

arises for ‘an official’s failure to alleviate a significant risk that he should have

perceived but did not . . . .’” Burnette v. Taylor, 533 F.3d 1325, 1331 (11th Cir.

2008) (omission in original) (quoting Farmer v. Brennan, 511 U.S. 825, 825 (1994)). 

In determining whether a delay in treatment rises to the level of deliberate

indifference, in the sense that the defendant had a “sufficiently culpable state of

mind,” Farmer, 511 U.S. at 834 (citation and internal quotation marks omitted) — in

other words, the question of whether the defendant’s actions or omissions constituted

“more than gross negligence” — relevant factors include: “(1) the seriousness of the

medical need; (2) whether the delay worsened the medical condition; and (3) the

reason for the delay.” Goebert v. Lee County, 510 F.3d 1312, 1327 (11th Cir. 2007). 

The defendants’ response to indications that a prisoner may need medical attention

must have been “poor enough to constitute ‘an unnecessary and wanton infliction of

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Case 5:14-cv-01309-CLS Document 89 Filed 03/09/15 Page 19 of 40
pain,’ and not merely accidental inadequacy, ‘negligen[ce] in diagnosi[s] or

treat[ment],’ or even ‘[m]edical malpractice’ actionable under state law.” Taylor v.

Adams, 221 F.3d 1254, 1258 (11thCir. 2000) (alterationsin original) (quotingEstelle

v. Gamble, 429 U.S. 97, 105-06 (1976)).

Here, plaintiff alleges that Listau’s serious medical condition was obvious to

everyone at the jail, including Morrison and the correctional defendants.

56 Listau

suffered such apparent symptoms asinability to ambulate without assistance, strange

behavior, inability to dress herself, and poor hygiene, and she became increasingly

incoherent and unresponsive as the hours passed.

57

 Listau was placed in a medical

watch cell, and she was monitored by correctional officers every fifteen minutes.

58

Thus, Morrison and the correctional defendants “had numerous opportunitiesto save

Listau’s life by sending her to the hospital.”

59 They did not do so, however. Instead,

they took no action, or grossly inadequate action, to address Listau’s obviously

serious needs.

60

Instead of acknowledging and addressing Listau’s condition, the

correctional officers falsely documented in jail records that she refused to cooperate

56

 Doc. no. 53 (Second Amended Complaint) ¶¶ 34-37, 40, 49-53, 60, 61.

57

Id. ¶¶ 24, 45, 49, 62, 65. 

58

Id. ¶¶ 24, 41.

59

Id. ¶ 33.

60

Id. ¶¶ 34, 54, 63.

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Case 5:14-cv-01309-CLS Document 89 Filed 03/09/15 Page 20 of 40
with their efforts to take her vital signs and dress her for a court appearance.61

These allegations are sufficient to state a claim that Morrison and the

correctional defendants were subjectively aware of Listau’s serious medical needs,

but deliberately disregarded those needs, thereby resulting in Listau’s pain, suffering,

and eventual death. Moreover, plaintiff’s allegations, if proven to be true, will

demonstrate violations of Listau’s clearly established Fourteenth Amendment right

to be free from deliberate indifference to serious medical needs. Accordingly,

plaintiff has stated a viable Fourteenth Amendment claim for deliberate indifference

to a pretrial detainee’s serious medical needs, and Morrison and the correctional

defendants are not entitled to qualified immunity from that claim at this stage. 

The court is not persuaded by defendants’ arguments to the contrary. 

Defendants assert that plaintiff’s claim against them is not viable because they

reported Listau’s medical condition to ACH personnel, who were contractually

responsible for the health care of all inmates at the jail. It is true, as a general rule,

that “‘supervisory [correctional] officials are entitled to rely on medical judgments

made by medical professionals responsible for prisoner care.’” Cameron v. Allen,

525 F. Supp. 2d 1302, 1307 (M.D. Ala. 2007) (quoting Durmer v. O’Carroll, 991

F.2d 64, 69 (3d Cir. 1993); White v. Farrier, 849 F.2d 322, 327 (8th Cir. 1988);

61

Id. ¶¶ 55-58. 

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Case 5:14-cv-01309-CLS Document 89 Filed 03/09/15 Page 21 of 40
Williams v. Limestone County, Ala., 198 F. App’x 893, 897 (11th Cir. 2006))

(alteration in original). Even so, correctional officers cannot ignore an inmate’s

obviously dire medical situation, regardless of whether medical personnel also are

aware of the condition. See, e.g., Townsend v. Jefferson County, 601 F.3d 1152, 1159

(11th Cir. 2010) (correctional officers were entitled to qualified immunity where the

inmate had not “presented evidence that her situation was so obviously dire that two

lay deputiesmust have known that a medical professional had grosslymisjudged [her]

condition”) (alteration supplied, citations omitted). As United States District Judge

Myron Thompson stated in an unpublished, but nevertheless well-reasoned and

highly persuasive opinion, “reporting medical concerns may or may not be enough

to avoid deliberate-indifference liability, depending on the circumstances.” McCall

v. Houston County, No. 1:11cv559-MHT, 2014 WL 3045552, *7 (M.D. Ala. July 3,

2014) (slip copy). In the McCall case, Judge Thompson found that a correctional

officer named West was not deliberately indifferent to an inmate’s serious medical

needs. 

Rather, [West’s] failure to do more appears to be a combination of a

misappraisal of the situation, in that he believed there was a medical

problem but no emergency, along with dedication to following protocol

and being satisfied with notifying other authorities. That West was

wrong, and was perhaps negligent, is insufficient to show deliberate

indifference. Goebert, 510 F.3d at 1327 (conduct must constitute more

than gross negligence). West and Dye [another correctional officer] did

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Case 5:14-cv-01309-CLS Document 89 Filed 03/09/15 Page 22 of 40
something to try to aid McCall: they alerted the medical unit and their

supervisor. While that might be insufficient under other circumstances,

for example if McCall was visibly bleeding to death on the ground, in

this case his symptoms were more ambiguous as to the urgency of the

situation; it was somewhat difficult to tell where mental illness ended

and physical illness began. 

McCall, 2014 WL 3045552, at *8 (alterations and emphasis supplied). 

Here, in contrast, plaintiff has alleged that the seriousness of Listau’s medical

problems was obvious to everyone who saw her, including Morrison and all of the

correctional defendants. There was no ambiguity as to the urgency of her medical

situation, which, construed in the light most favorable to plaintiff, was akin to

“visibly bleeding to death on the ground.” Assuming those allegations are true, as

the court must at the motion to dismiss stage, the failure of Morrison and the

correctional defendants to personally take any action, other than informing medical

personnel, to treat Listau constituted deliberate indifference to Listau’s serious

medical needs. 

2. Morrison’s liability as a policymaker/supervisor

Plaintiff’s Second Amended Complaint seeks to hold Morrison liable for

Listau’s death not only due to his personal participation in the alleged failure to

provide Listau with adequate medical care, but also due to his supervisory and

policymaking role as Administrator of the MadisonCounty Jail.

62 Morrison correctly

62 Doc. no. 53 (Second Amended Complaint) ¶ 11 (“Dorning has delegated his statutory

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Case 5:14-cv-01309-CLS Document 89 Filed 03/09/15 Page 23 of 40
points out that he cannot be held liable under § 1983 on the basis of respondeat

superior, or vicariousliability. See, e.g., Belcher v. City of Foley, 30 F.3d 1390, 1396

(11th Cir. 1994). Even so, supervisor liability under § 1983 can rest

when the supervisor personally participatesin the alleged constitutional

violation or when there is a causal connection between actions of the

supervising official and the alleged constitutional deprivation. The

causal connection can be established when a history of widespread

abuse puts the responsible supervisor on notice of the need to correct the

alleged deprivation, and he fails to do so. The deprivations that

constitute widespread abuse sufficient to notify the supervising official

must be obvious, flagrant, rampant, and of continuing duration, rather

than isolated occurrences.

Brown v. Crawford, 906 F.2d 667, 671 (11th Cir. 1990). The causal connection may

also be established “when the supervisor’s improper ‘custom or policy . . . resulted

in deliberate indifference to constitutionalrights.’” Dalrymple v. Reno, 334 F.3d 991,

996 (11th Cir. 2003) (quoting Rivas v. Freeman, 940 F.2d 1491, 1495 (11th Cir.

1991)).

Here, plaintiff’s Second Amended Complaint alleges that Morrison is the

individual to whom Sheriff Blake Dorning “has delegated his statutory duties

regarding medical care.”63 He also alleges that “Listau’s serious medical needs were

duties regarding medical care to Morrison.”), ¶ 73 (“Listau’s serious medical needs were ignored

because of the customs or policies of . . . Morrison . . . .”), ¶ 131 (reiterating that Morrison is the

person “to whom Dorning has delegated responsibility for managing the jail”).

63

Id. ¶ 11. See also id. ¶ 131 (reiterating that Morrison is the person “to whom Dorning has

delegated responsibility for managing the jail”).

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Case 5:14-cv-01309-CLS Document 89 Filed 03/09/15 Page 24 of 40
ignored because of the customs or policies of defendants Dorning, Morrison,

Johnson, Williams, Robinson, and ACH . . . .”

64 More specifically, Morrison,

Dorning, Johnson, Williams, Robinson, and ACH allegedly “failed to develop and

implement adequate policies and proceduresfor the handling of inmates with serious

health conditions and failed to adequately train correctional officers andmedicalstaff,

with the foreseeable result that inmates such as Listau would not receive appropriate

treatment.”65 Those defendants also “have established deliberately-indifferent

customs or policies concerning inmate medical care, including but not limited to a

customor policy of delaying or denying necessarymedical treatment to avoid liability

for inmate medical bills.”66

 Those defendants also were

part of an explicit or implicit agreement or plan to delay or deny

necessary medical care to avoid having to pay for medical care for the

inmate. This plan included a custom or policy of delaying or denying

necessary medical treatment by outside providers. Defendants were

aware this policy created a substantial risk of serious harm and inflicted

unnecessary pain and suffering on inmates.

67

Finally, those defendants

were on notice that the above-described customs or policies regarding

medical care for inmates were harmful to the health of inmates and

caused them to experience unnecessary pain and suffering due to delay

64

Id. ¶ 73.

65

Id. ¶ 74. 

66

Id. ¶ 75. 

67

 Doc. no. 53 (Second Amended Complaint) ¶ 76. 

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Case 5:14-cv-01309-CLS Document 89 Filed 03/09/15 Page 25 of 40
and denial of necessary medical care. Defendants had such knowledge

from prisoner complaints, communications from correctional officers,

from their own observations, from common sense, from other deaths,

from other lawsuits, and in other ways.68

Additionally, Morrison “was hired to cut costs at the jail.”69

 As such, he and

Dorning “made it clear to correctional officers that inmate healthcare costs were a

problem at the jail, that one trip to the hospital could potentially blow the county’s

healthcare budget, and that they needed to cooperate with ACH to control costs.”70

Morrison even discussed the need to control costs, and the potential “crippling” effect

of inmate medical costs, in an April 2014 newspaper article.71 Morrison and Dorning

also have established a longstanding practice of failing to investigate inmate

grievances related to medical care and, instead, turning the grievances over to ACH,

which is known to also not investigate.72In fact, all aspects of jail healthcare are

treated as being “solely within the discretion of ACH personnel.”

73 Morrison and

Dorning have never requested ACH to make changes or improve the care of inmates,

and they have never even requested that ACH report to them regarding the quality of

68

Id. ¶ 77. 

69

Id. ¶ 97. 

70

Id. ¶ 93. 

71

Id. ¶¶ 94, 121, and Exhibit 2. 

72

Id. ¶¶ 110-12.

73

 Doc. no. 53 (Second Amended Complaint) ¶ 113.

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Case 5:14-cv-01309-CLS Document 89 Filed 03/09/15 Page 26 of 40
care being provided to inmates.

74 Morrison and Dorning have “failed and refused to

evaluate the quality of inmate medical care and address the obvious systemic

problems that led to at least 6 deaths over the course of just over three years.”75 They

also have a longstanding practice of failing to investigate health-care-related incidents

at the jail, including even those that have resulted in the death of inmates.

76

Importantly, plaintiff also assertsthat “[t]he deferral of correctional officersto

ACH decisions to delay and deny necessary medical care in the name of cost control

is not only a matter of longstanding practice, it is also a matter of contract.”77

Plaintiff’s allegationsin thisregard are essential to histheory of supervisory liability,

and so they will be set out here in full:

123. Deferral by correctional officers to ACH deliberate

indifference is caused by both the letter of the contract and the structure

of the contractual relationship.

124. ACH has had the Madison County contract since before

2010.

125. ACH underbid other competitors to get the contract.

126. ACH got the contract by touting its ability to control the

expenses MadisonCounty would incur for outside medical care like that

needed by Listau, Woods, and Jefferson.

74

Id. ¶¶ 118-19.

75

Id. ¶ 114. 

76

Id. ¶¶ 95-96.

77

Id. ¶ 122.

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Case 5:14-cv-01309-CLS Document 89 Filed 03/09/15 Page 27 of 40
127. ACH, Madison County, and Dorning negotiated a $200,000

per quarter cap on outside medical care.

128. If outside medical care costs exceeded $200,000 in a

quarter, Madison County would be responsible.

129. Based on historical healthcare expenditure numbers for the

Madison County Jail and reasonable predictions based on data for the

inmate population at the jail, the $200,000 per quarter number was

designed to give ACH a financial incentive to control outside medical

costs, which in turn has led ACH to delay and deny referrals to outside

providers.

130. Under the contract, if ACH beats the cap, ACH gets to keep

the difference between actual outside costs and the cap as profit.

131. As Morrison, to whomDorning has delegated responsibility

for managing the jail, has stated publically, hospitalizations can quickly

deplete the quarterly budget . . . .

132. Pursuant to this agreement, correctional officers are trained

to defer to ACH regarding medical matters regardless of the severity of

the inmate’s condition.

78

Correctional officers also are trained to defer to ACH on all medical matters,

and not to contact outside emergency personnel.

79 Officers can be disciplined if they

contact outside emergency personnel, and they are indemnified by ACH’s insurance

company only if they defer to ACH.80 Because of the ACH agreement and its

indemnity provisions, “Dorning and Morrison have failed and refused to address

78

Id. ¶¶ 123-32. 

79

 Doc. no. 53 (Second Amended Complaint) ¶¶ 132-33.

80

Id. ¶¶ 134-38.

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Case 5:14-cv-01309-CLS Document 89 Filed 03/09/15 Page 28 of 40
known systemic deficiencies regarding medical care at the Madison County Jail.”81

Instead, Dorning and Morrison cooperated with ACH in controlling costs, even

though they knew that doing so resulted in the denial of medical care to inmates.

82

The cost control measures implemented by ACH, and approved by Dorning and

Morrison, included “staff[ing] the Madison County Jail inadequately, hir[ing] substandard medical personnel willing to put costs over inmate health and safety,

den[ying] inmates medications, and delay[ing] or den[ying] medically-necessary

referrals to outside providers, including necessary medical treatment like that denied

Listau, Woods, and Jefferson.”83 Additionally, Morrison, along with Dorning,

Williams, and Robinson, 

developed a policy and practice regarding treatment of inmates

withdrawing fromalcohol and drugs. While defendants were aware that

severe withdrawal symptoms, including DT’s, could only be safely

treated in a hospital, these defendants established a customor policy that

withdrawal would always be managed inside the jail or by getting the

person released from jail, regardless of the severity of the symptoms.84

Morrison argues that, in spite of these detailed allegations, no claim against

him as a supervisor or policymaker can stand, because he “is not authorized or

81

Id. ¶ 143.

82

Id. ¶¶ 144-45.

83

Id. ¶ 151 (alterations supplied). 

84

Id. ¶ 155 (emphasis in original). 

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Case 5:14-cv-01309-CLS Document 89 Filed 03/09/15 Page 29 of 40
charged with creating or implementing jail policy.”85

 Morrison relies upon Section

14-6-1 of the Alabama Code, which states:

The sheriff has the legal custody and charge of the jail in his or

her county and all prisoners committed thereto, except in cases

otherwise provided by law. The sheriff may employ personsto carry out

his or her duty to operate the jail and supervise the inmates housed

therein for whose acts he or she is civilly responsible. Persons so

employed by the sheriff shall be acting for and under the direction and

supervision of the sheriff and shall be entitled to the same immunities

and legal protections granted to the sheriff under the general laws and

the Constitution of Alabama of 1901, as long as such persons are acting

within the line and scope of their duties and are acting in compliance

with the law.

Ala. Code § 14-6-1 (emphasis supplied). According to Morrison, if the Sheriff had

sole authority over the jail, then he (Morrison) could have had no authority. See Doe

v. School Bd. of Broward County, Fla., 604 F.3d 1248, 1264 (11th Cir. 2010)

(“[F]inal policymaking authority over a particular subject matter does not vest in an

official whose decisions are ‘subject to meaningful administrative review.’”) (quoting

Scala v. City of Winter Park, 116 F.3d 1396, 1399, 1401 (11th Cir.1997)) (alteration

supplied). 

Morrison relies upon the decision of the Middle District of Alabama in McCall

v. Houston County, supra. There, the plaintiff sought to hold Reed, the Houston

85 Doc. no. 65 (Brief in Support of Motion to Dismiss Second Amended Complaint of

Defendants Steve Morrison, Pamela Batie, Jessica Pothier, Vanessa Fields, Nick Wallace, Roslyn

Guyton, and Randy Hooper), at 20 (emphasis in original). 

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Case 5:14-cv-01309-CLS Document 89 Filed 03/09/15 Page 30 of 40
County Jail Administrator, liable for deliberate indifference under a policymaker

theory. Reed advanced the same argument Morrison has advanced here: i.e., “that

he had the authority only to implement policy, not the authority to create it. The latter

power, he argues, is vested in the sheriff alone.” McCall, 2014 WL 3045552, at *12. 

Reed’s deposition testimony revealed that, while he did sometimes make changes to

jail policies, he always had to obtain the Sheriff’s approval first. Id. Because there

was no evidence that any policies were attributable to Reed, instead of the Sheriff,

Reed could not be held liable in his supervisory capacity for any constitutional

violations caused by those policies. Id. 

The Reed decision suggests that there are certain circumstances under which

a Jail Administrator may be absolved from policymaking liability because the Sheriff

retains the final policymaking authority. It cannot, however, stand for the broad

proposition that a Jail Administrator in Alabama can never be held liable, as a

policymaker, for constitutional violations. Indeed, the Eleventh Circuit has allowed

such claims against Jail Administrators in the past. See, e.g., Harper v. Lawrence

County, Ala., 592 F.3d 1227, 1236-37 (11th Cir. 2010); Danley v. Allen, 540 F.3d

1298, 1313-16 (11th Cir. 2008). Thus, plaintiff’ssupervisory/policymaking liability

claimagainst Morrison will not be dismissed under Alabama Code § 14-6-1. Plaintiff

is at least entitled to conduct discovery on that claim to determine the extent of

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Morrison’s supervisory and policymaking authority.

Morrison also argues that plaintiff has not pled sufficient facts to state a claim

against him for supervisory or policymaking liability. That argument is without

merit. To the contrary, as set forth above, plaintiff has alleged plentiful facts

demonstrating that Morrison’s customs and/or policies caused the alleged violations

of Listau’s constitutional rights. Morrison cites to the County’s health care services

agreement with ACH in an attempt to demonstrate that, because the contract calls for

adequate health care to be provided to inmates, Morrison cannot be held responsible

for any constitutionally inadequate care. Stated slightly differently, Morrison asserts

that the ACH contract is a facially constitutional policy, and as long as Morrison

followed it, he cannot be held liable. Plaintiff’s complaint alleges more than that,

however. He asserts that the contract has been manipulated and evaded in attempts

to reduce costs, thereby resulting in constitutionally inadequate medical care for

inmates. 

Plaintiff also alleged that Morrison was on notice that the County’s policies

and customs regarding inmate medical care caused the denial and/or delay of care. 

Contrary to Morrison’s suggestion, plaintiff did not make that allegation based on

Morrison’s knowledge of past inmate deaths alone. Instead, Morrison’s knowledge

also came fromprisoner complaints, communications fromother correctional officers,

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his own observations, common sense, other lawsuits, and in other ways. If discovery

reveals that Morrison did not, in fact, have any such knowledge, he will not be held

liable on that basis. For the time being, however, plaintiff has pled sufficient facts

to state a claimfor violation of Listau’s clearly established rights and to consequently

move plaintiff’s supervisory/policymaker liability claim against Morrison past the

motion to dismiss stage. 

C. Motion to Dismiss of Defendant Blake Dorning

Plaintiff’s claim against defendant Blake Dorning for the most part mirrorsthe

supervisory/policymaker liability claim asserted against Morrison, except that

plaintiff hasincluded a few additional factual allegations with regard to Dorning. He

allegesthat Dorning has a “general practice” of failing and refusing to investigate all

serious incidents — not just health-care-related ones — involving his deputies.

86

Dorning has also commented to the media that he believes ACH will make changes

in the jail healthcare system as a result of other inmate deaths, but in truth, he knows

that ACH has a history of failing to respond to inmate deaths and other health-carerelated incidents.

87 Dorning was aware that ACH’s business model elevated cost

control over inmate safety, but he, nonetheless, retained ACH as the jail health care

86

 Doc. no. 53 (Second Amended Complaint) ¶¶ 98-99. 

87

Id. ¶¶ 115-17.

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Case 5:14-cv-01309-CLS Document 89 Filed 03/09/15 Page 33 of 40
contractor, and rejected other, competing contractors because of the cost savings

ACH provided.

88

Plaintiff also alleges that, while “Alabama law vests final policymaking

authority for inmate medical care in Dorning,” Dorning delegated that authority to

ACH via the County’s agreement with ACH and “longstanding practice.”89

According to plaintiff, this renders Dorning liable for ACH’s decisions.

90

Additionally:

While the agreement [between the County and ACH] gives

Dorning and Madison County the authority to hold ACH accountable

regarding the costs of inmate healthcare, it provides no mechanism for

reporting and accountability regarding the quality of inmate healthcare,

and neither Dorning nor Madison County have made any effort to hold

ACH accountable for how it handles inmate healthcare.91

Dorning argues that plaintiff’s allegations are too conclusory, and lacking in

sufficient factual detail, to satisfy the pleading standard for supervisory/policymaker

liability claims. He also asserts that he cannot be held liable for constitutional

violations resulting from Madison County’s facially constitutional contract with

ACH. These are the same arguments advanced by Morrison. As with Morrison, the

court is not persuaded by those arguments, and findsthat plaintiff hasstated sufficient

88

Id. ¶¶ 147-48. 

89

Id. ¶¶ 152-53. 

90

Id. ¶ 153. 

91

Id. ¶ 154 (alteration supplied). 

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Case 5:14-cv-01309-CLS Document 89 Filed 03/09/15 Page 34 of 40
facts which, if proven to be true, would demonstrate Dorning’s violations of Listau’s

clearly established rights. 

Dorning also asserts that he cannot be held liable for his delegation of

policymaking authority to ACH. Plaintiff has effectively alleged that, because

Dorning delegated final policymaking authority to ACH, he has become the final

decisionmaker or policymaker for all of ACH’s actions and policies and is liable for

any constitutional violations resulting therefrom. The Eleventh Circuit has

strictly interpreted “Monell’s policy or custom requirement to preclude

§ 1983 liability for a subordinate official’s decisions when the final

policymaker delegates decisionmaking discretion to the subordinate, but

retainsthe power to review the exercise of that discretion.” Scala v. City

of Winter Park, 116 F.3d 1396, 1399 (11th Cir. 1997). In other words,

final policymaking authority over a particular subject matter does not

vest in an official whose decisions are “subject to meaningful

administrative review.” Id. at 1401. Compare Hill v. Clifton, 74 F.3d

1150, 1152 (11th Cir. 1996) (accepting concession that city police chief

was not final policymaker with respect to employment decisions where

police chief’s decisions could be reversed by the city manager) with

Martinez v. City of Opa–Locka, Fla., 971 F.2d 708, 714-15 (11th Cir.

1992) (finding final policymaking authority where “the City Manager’s

decision to hire or fire administrative personnel is completely insulated

from review”). 

Doe v. School Bd. of Broward County, Fla., 604 F.3d 1248, 1264 (11th Cir. 2010).

Here, Dorning asserts that he never delegated final policymaking authority to

ACH because the County’s contract with that entity requires ACH to be accountable

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Case 5:14-cv-01309-CLS Document 89 Filed 03/09/15 Page 35 of 40
to the County for certain performance, staffing, and reporting requirements.

92

Plaintiff has not relied solely upon those formal contractual requirements, however. 

Plaintiff also assertsthat Dorning’s delegation of authority to ACH has been a matter

of long-standing practice, and that the written terms of the contract have been

disregarded in actual practice. Moreover, plaintiff has alleged that Dorning has not

made any effort to hold ACH accountable for the manner in which it handles inmate

health care under the contract. These allegations, if eventually supported by the

evidence, could demonstrate violations of Listau’s clearly established rights. 

Accordingly, this claim will not be dismissed for failure to state a claim upon which

relief can be granted, and Dorning is not entitled to qualified immunity from this

claim at the motion to dismiss stage. 

D. Motion to Dismiss of Defendant Madison County, Alabama

Plaintiff’s claim against Madison County is based solely upon the County’s

alleged failure to adequately fund its jail.

93

It is well-established that the County’s

sole responsibility with regard to jails is to fund them. See Turquitt v. Jefferson

County, Ala., 137 F.3d 1285, 1289-90 (11th Cir. 1998) (“ We recognize that Alabama

92

 Doc. no. 63 (Brief of Blake Dorning in Support of Motion to Dismiss Second Amended

Complaint), at 26-27 (citing the contract between the County and ACH, which was attached to the

Second Amended Complaint as Exhibit 1, at ¶¶ 6(G), (I), (L), & (Q)).

93 Doc. no. 70 (Plaintiff’s Response to Madison County’s Motion to Dismiss), at 2 (“Plaintiff

only seeks to hold Madison County liable for its failure to adequately fund medical care, which the

Eleventh Circuit has recognized as a viable claim.”) (citations omitted). 

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Case 5:14-cv-01309-CLS Document 89 Filed 03/09/15 Page 36 of 40
counties possess some duties with respect to county jails. However, none of these

duties relates to the daily operation of the jails or to the supervision of inmates. The

duties of the counties with respect to the jails ‘are limited to funding the operation of

the jail and to providing facilities to house the jail.’”) (quoting Stark v. Madison

County, 678 So.2d 787, 787 (Ala. Civ. App. 1996)). Moreover, a 

County’s liability cannot be dependent on the scant likelihood that its

budget decisions would trickle down the administrative facets and

deprive a person of his constitutional rights. Instead, liability must be

premised on a finding that “this” budget decision was “highly likely to

inflict the particular injury” [the plaintiff] suffered.

McDowell v. Brown, 392 F.3d 1283, 1292 (11th Cir. 2004) (quoting Board of County

Commissioners v. Brown, 520 U.S. 397, 412 (1997)) (emphasisin original, alteration

supplied). To ensure that the causation requirement is satisfied, the court should

“look to whether a complete review of the budget decision . . . reveals that the

[County] should have known that [the plaintiff’s] injuries were a ‘plainly obvious

consequence’ of that decision.” McDowell, 392 F.3d at 1292 (quoting Brown, 520

U.S. at 412) (alterations supplied). 

Here, plaintiff’s failure-to-fund claim against the County rests upon the

following allegations:

145. Defendants Madison County and ACH and all individual

defendants were aware [that] the cost control measures implemented at

the Madison County Jail by ACH resulted in the denial of

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Case 5:14-cv-01309-CLS Document 89 Filed 03/09/15 Page 37 of 40
constitutionally-required medical care for inmates with serious medical

needs.

146. ACH’s business model, reflected in the agreement,

succeeds by underbidding the competition and implementing severe cost

control measures, the necessary result of which is unnecessary inmate

suffering and liability claims (dealt with through liability insurance).

147. Defendants Dorning and Madison County were aware of

ACH’s business model, were aware [that] ACH put cost control over

inmate health and safety, yet retained ACH as the contractor (initially

and via contract renewals) because it saved the county money.

148. Madison County and Dorning rejected other contractors

because they believed ACH saved them money.

149. Thus, Madison County caused or contributed to the abovedescribed customs or policies by not providing adequate funds for

inmate medical care.94

Plaintiff also alleges that Madison County

intentionally refused to adequately fundmedical care as described above

with deliberate indifference to the seriousmedical needs of inmatessuch

as Listau, had a policy of not adequately funding inmate medical care,

and did thereby contribute to cause Listau’ssuffering and eventual death

and the individual defendants’ denial of necessarymedical treatment for

Listau’s serious medical needs.

95

The County contends that it cannot be held liable for failing to adequately fund

health care at the jail because the County’s contract with ACH does not include any

kind of monetary cap for the county’s liability. Indeed, the only cap is the $200,000

94

 Doc. no. 53 (Second Amended Complaint) ¶¶ 145-49 (alterations supplied). 

95

Id. ¶ 165. 

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Case 5:14-cv-01309-CLS Document 89 Filed 03/09/15 Page 38 of 40
quarterly cap on ACH’s liability for outside medical costs. Even so, a contractual

monetary cap on the County’s liability to fund medical care at the jail is not the basis

of plaintiff’s failure-to-fund theory. Instead, plaintiff’s theory is that “the structure

of the contract with ACH, including the $200,000 quarterly cap on outside healthcare

expenses and the indemnification of correctional officers by ACH, encourages all

partiesinvolved to deny inmates outside medical care.”96 More specifically, plaintiff

asserts that Listau’s death (and the suffering experienced by other inmates) was the

result of the County’s acts of

1) hiring the cheapest contractor based on promises by the contractor

regarding its ability to control outside medical care costs; 2) delegating

to that contractor complete authority over outside medical referrals; 3)

using a quarterly cap on outside services to give the contractor a strong

economic incentive to deny outside medical care to inmates; 4)

evaluating the contractor’s performance based on cost-control only; 5)

ignoring and refusing even to investigate known incidents of deliberate

indifference by the contractor, including at least 6 deaths over roughly

3 years; and 6) continuing to retain the contractor despite knowledge of

its unconstitutional practices.

97

Essentially, plaintiff asserts the contract encourages exploitation by ACH, which

increases its profit margin if it keeps quarterly outside medical care costs under

$200,000, and that the County knew about that exploitation but was deliberately

indifferent to it. Those allegations are sufficient to state a claim for deliberate

96

 Doc. no. 70 (Plaintiff’s Response to Madison County’s Motion to Dismiss), at 2. 

97

Id. at 4 (citing doc. no. 53 (Second Amended Complaint) ¶¶ 124-54). 

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Case 5:14-cv-01309-CLS Document 89 Filed 03/09/15 Page 39 of 40
indifference to Listau’s serious medical needs. 

IV. CONCLUSION AND ORDERS

In accordance with the foregoing, all pending motions to dismiss are DENIED. 

It is further ORDERED that the stay on discovery is LIFTED,98and all parties are

directed to proceed forthwith to conduct discovery in accordance with the Uniform

Initial Order. 

DONE this 9th day of March, 2015.

______________________________

United States District Judge 

98

See doc. no. 75 (order granting motion to stay discovery pending a ruling on the motions

to dismiss).

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