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Parties Involved:
James Travis Adkins
Appellee
Morgan County, Tennessee

Kyle Schubert
Appellant

Document Text:

NOT RECOMMENDED FOR FULL-TEXT PUBLICATION

File Name: 20a0007n.06

Case No. 19-5252

UNITED STATES COURT OF APPEALS

FOR THE SIXTH CIRCUIT

JAMES TRAVIS ADKINS,

Plaintiff-Appellee,

v.

MORGAN COUNTY, TENNESSEE,

Defendant,

KYLE SCHUBERT,

Defendant-Appellant.

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ON APPEAL FROM THE 

UNITED STATES DISTRICT 

COURT FOR THE EASTERN 

DISTRICT OF TENNESSEE

O P I N I O N

BEFORE: COLE, Chief Judge; SILER and MURPHY, Circuit Judges.

COLE, Chief Judge. During all times relevant to this case, Appellee James Travis Adkins 

was an inmate at the Morgan County Jail in Morgan County, Tennessee. Throughout the late 

spring and early summer of 2016, Adkins began experiencing back pain, which escalated in 

severity until he became incontinent and unable to move his legs. Alleging that jail officials were 

deliberately indifferent to his serious medical needs, Adkins sued Morgan County and several 

officers in their individual and representative capacities for violation of his constitutional rights 

under 42 U.S.C. § 1983. The district court granted qualified immunity to each defendant officer 

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except for Appellant Kyle Schubert, who now appeals that decision. We conclude that the district 

court correctly denied qualified immunity as a matter of law and, therefore, affirm.

I. BACKGROUND

A. Factual Background

Adkins’s detention at the Morgan County Jail began on April 28, 2016, when he was 

sentenced for a probation violation. Starting in early June of that year, Adkins began experiencing 

minor back pain. Then, in July, that pain intensified to the point where he required medical 

attention, which he received at a hospital on July 15, 2016. After being examined by medical 

professionals, Adkins was prescribed medication to be taken four times per day to address the back 

pain and discharged. Upon his return to the jail, however, Adkins’s pain did not subside. He was 

temporarily transferred to a different jail cell where jail officials might be better able to address 

the pain before being ultimately returned to his normal cell.

Adkins does not argue that any of the events up until this point amount to a constitutional 

violation. But then, when Adkins returned to his normal cell, his pain intensified, spreading to 

Adkins’s stomach and causing him difficulty with moving his legs. Adkins also testified that he 

spent an entire night unable to sleep as a result of the pain. James Bridges, a fellow inmate, testified 

that Adkins became unable to walk and was incontinent shortly after returning to his cell on July 

17, 2016. Bridges testified that, using the jail’s intercom system, he advised an officer of Adkins’s 

condition and stated that Adkins needed to be taken to the hospital. Bridges further testified that 

the officer responded to this information by saying that Adkins was “faking it” and did not take 

any additional action to address Adkins’s medical condition at that time. (R. 92-5, PageID 572.) 

When asked to identify the officer to whom he spoke, Bridges testified that he was not positive, 

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but that he “believe[d] it might have been an officer named Kyle.” (Id.) Bridges also testified that 

he informed the same officer of Adkins’s condition face-to-face. (Id.)

When Adkins awoke the following morning, his legs were “completely numb” and he was 

unable to move them. (R. 92-2, PageID 520.) At that point, a jail officer brought Adkins to the 

hospital. At the hospital, doctors determined that he was “critically ill” and diagnosed him with a 

spinal abscess. (R. 92-2, PageID 552–53.) Adkins was then transferred to a different hospital for 

acute treatment. Doctors initially predicted that Adkins would never walk again, but after a twomonth hospitalization, Adkins is once again ambulatory.

B. Procedural History

Following these events, Adkins sued several jail guards, including Schubert, and Morgan 

County. Relevant here, he asserted claims against the various jail guards under 42 U.S.C. § 1983 

for violation of his constitutional rights by exhibiting deliberate indifference to his serious medical 

needs and asked for attorneys’ fees. All defendants moved for summary judgment and requested 

that the district court grant qualified immunity. The district court granted qualified immunity to 

all defendants except for Schubert. With regard to Schubert, the district court determined that the 

record reflected genuine disputes of material fact as to whether Schubert was entitled to qualified 

immunity. The district court found that the testimony from Bridges detailing his reports of 

Adkins’s condition to an officer named “Kyle”—Schubert’s first name—and the officer’s response 

that Adkins was faking his condition created a genuine dispute of material fact as to whether 

Schubert was entitled to qualified immunity. Schubert then appealed. 

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II. ANALYSIS

A. Standard and Scope of Review

Our jurisdiction to hear an interlocutory appeal challenging a district court order denying 

qualified immunity is limited. The Supreme Court has held that the district court’s denial of a 

claim of qualified immunity is an appealable final decision under 28 U.S.C. § 1291 “to the extent 

that it turns on an issue of law . . . notwithstanding the absence of a final judgment.” Mitchell v. 

Forsyth, 472 U.S. 511, 530 (1985). A district court’s determination that the summary judgment 

record raises genuine issues of material fact concerning the movant’s entitlement to qualified 

immunity, however, is not an appealable final order. Johnson v. Jones, 515 U.S. 304, 313 (1995). 

We have previously noted that allowing appeals of the district court’s determination that the record 

could support a finding for the plaintiff would essentially result in courts of appeals rendering an 

assessment of the plaintiff’s claims on the merits. Berryman v. Rieger, 150 F.3d 561, 563 (6th Cir. 

1998). 

Thus, a defendant bringing an interlocutory appeal of the denial of qualified immunity must 

do one of two things: (1) not dispute the facts alleged by the plaintiff for purposes of the appeal; 

or (2) if disputing the plaintiff’s version of the story, concede the most favorable view of the facts 

to the plaintiff for purposes of appeal. Bishop v. Hackel, 636 F.3d 757, 764–65 (6th Cir. 2011). If 

the defendant refuses to accept the plaintiff’s factual allegations for purposes of summary 

judgment or concede the most favorable view of the facts to the plaintiff on appeal, the court may 

still nonetheless ignore the defendant’s attempt to impermissibly dispute the factual allegations 

and resolve any “purely legal” issues that remain, rather than simply dismissing the appeal for lack 

of jurisdiction. Estate of Carter v. City of Detroit, 408 F.3d 305, 310 (6th Cir. 2005). When we 

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turn to those issues of law, we conduct our review de novo. Harrison v. Ash, 539 F.3d 510, 516 

(6th Cir. 2008).

Schubert offers arguments concerning the reliability of Bridges’s testimony and criticizes 

the district court’s decision to credit that testimony for the purpose of its qualified immunity 

analysis. The limits on our jurisdiction at this stage in the proceedings, however, prohibit us from 

taking up these arguments. We are not permitted to engage with any attempts to litigate factual 

disputes, and we must view the testimony in the light most favorable to Adkins. See Bishop, 

636 F.3d at 764–65. Similarly, we will not revisit the district court’s weighing of the factual 

record. Kirby v. Duva, 530 F.3d 475, 480–81 (6th Cir. 2008). We may only review the legal 

underpinnings of the district court’s qualified immunity determination given the facts before it. 

See Harrison, 539 F.3d at 517; Estate of Carter, 408 F.3d at 310. We do so below.

B. Qualified Immunity Analysis

Our central inquiry is whether, given the facts viewed in the light most favorable to Adkins, 

the district court erred in denying Schubert qualified immunity. Qualified immunity is a personal 

defense that applies to government officials in their individual capacities, which shields said 

officials “from personal 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.” 

Everson v. Leis, 556 F.3d 484, 493 (6th Cir. 2009) (citation omitted). It exists to insulate 

government officials from “undue interference with their duties and from potentially disabling 

threats of liability.” Harlow v. Fitzgerald, 457 U.S. 800, 806 (1982). When this court is confronted 

with an appeal of the denial of qualified immunity, it must decide two questions in the plaintiff’s 

favor in order to affirm the denial of qualified immunity. First, do the facts, viewed in the light 

most favorable to the plaintiff, demonstrate that the defendant has violated a constitutional right? 

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Second, was the right in question clearly established at the time of the violation? Morgan v. 

Fairfield Cty., 903 F.3d 553, 560 (6th Cir. 2018). Here, we answer both questions in the 

affirmative. 

i. Constitutional Violation

The Eighth Amendment protects individuals against the infliction of “cruel and unusual 

punishments.” U.S. Const. amend. VIII. Jail officials violate a post-conviction inmate’s Eighth 

Amendment rights when they “unnecessarily and wantonly inflict[] pain on an inmate by acting 

with deliberate indifference toward the inmate’s serious medical needs.” Blackmore v. Kalamazoo 

Cty., 390 F.3d 890, 895 (6th Cir. 2004) (quoting Estelle v. Gamble, 429 U.S. 97, 104 (1976)) 

(internal quotation marks omitted). Under this court’s precedent, a plaintiff claiming that prison 

or jail officials have violated the Eighth Amendment by way of deliberate indifference to serious 

medical needs “must satisfy an objective and a subjective component.” Baynes v. Cleland, 

799 F.3d 600, 618 (6th Cir. 2015) (internal citation omitted); see also Farmer v. Brennan, 511 

U.S. 825, 834 (1994).

To satisfy the objective component of the deliberate indifference standard, a plaintiff must 

show “the existence of a sufficiently serious medical need, meaning that he is incarcerated under 

conditions posing a substantial risk of serious harm.” Baynes, 799 F.3d at 618 (internal citation 

and quotation marks omitted). The seriousness requirement can be met either by a medical need 

“that has been diagnosed by a physician as mandating treatment” or by a medical need “that is so 

obvious that even a lay person would easily recognize the necessity for a doctor’s attention.” 

Harrison, 539 F.3d at 518 (internal citation and quotation marks omitted).

The testimony from Bridges brings this case within our holding that a medical need can be 

sufficiently serious to satisfy the objective component when it is so obvious that even a lay person 

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would recognize the need for medical attention. See, e.g., id. Based on the testimony that Bridges 

informed Schubert of Adkins’s condition, a jury could find that Schubert was made aware of 

Adkins’s severe back and stomach pain, inability to walk, and incontinence and declined to take 

action until Adkins awoke completely unable to move his legs. We have previously held that 

symptoms similar in severity are indicative of a medical need obvious enough that a lay person 

should recognize the need for medical attention. See Blackmore, 390 F.3d at 897–900.

Turning to the subjective component, Adkins must show that the defendant both knew of 

and disregarded a substantial risk to the plaintiff’s health. Harrison, 539 F.3d at 518. Again, we 

review the factual record in the light most favorable to Adkins. In doing so, we encounter evidence 

that Schubert was made aware of Adkins’s difficulty walking and incontinence prior to Adkins 

awakening unable to move his legs and responded that he believed Adkins was “faking it.” 

Our precedent dictates that these facts, which suggest that Schubert was directly informed 

of Adkins’s medical issues and did not act upon that information to ensure the provision of 

adequate medical care, are sufficient to satisfy the subjective component. In Blackmore, the court 

held that the “subjective component ‘should be determined in light of the prison authorities’ 

current attitudes and conduct.’” 390 F.3d at 895 (citing Helling v. McKinney, 509 U.S. 25, 36 

(1993)). The district court found that, based on the testimony from Bridges, a jury could find that 

Schubert “had knowledge of a substantial risk of serious harm to Mr. Adkins.” (R. 151, PageID 

909.) This determination is supported by the record read in the light most favorable to Adkins. 

Thus, Adkins satisfies the subjective component of the deliberate indifference test.

Schubert advances several arguments to counter the conclusion that the record viewed in 

the light most favorable to Adkins could support a finding of a constitutional violation, none of 

which is persuasive. First, Schubert argues that he could not have been deliberately indifferent to 

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Adkins’s serious medical need because Adkins was taken to the hospital on July 15, 2016, after 

complaining of back pain. Adkins was prescribed medication to address his pain, but his condition 

then worsened after his return to the jail. We decline to adopt an approach whereby an official’s 

provision of medical care to an inmate in one instance shields that official from liability when he 

or she is deliberately indifferent to a later medical need that arises for the inmate. A prior 

examination by a doctor who had not considered the symptoms Adkins experienced when he 

returned to the jail does not excuse Schubert from an obligation to act upon reports of new 

symptoms that indicate the escalation of Adkins’s condition.

Second, Schubert argues that because the underlying cause of Adkins’s symptoms was a 

spinal abscess and a lay person would be unable to diagnose such an abscess, his condition was 

not readily apparent to a lay person. We have never held that a lay person must be able to medically 

diagnose the cause of obvious symptoms for a medical need to be sufficiently obvious for the 

objective component. To the contrary, we have routinely found that the objective component of 

the deliberate indifference test can be satisfied by record evidence of the symptoms that the 

plaintiff was experiencing. See, e.g., Taylor v. Franklin Cty., 104 F. App’x 531, 538 (6th Cir. 

2004) (finding that “incontinence and debilitating mobility were clear symptoms of a serious 

problem”); Dominguez v. Correctional Med. Serv., 555 F.3d 543, 550–51 (6th Cir. 2009) (finding 

a constitutional violation based on a failure to act in light of “the apparent severity of [the inmate’s] 

symptoms”); Phillips v. Roane Cty., 534 F.3d 531, 540 (6th Cir. 2008) (finding that the symptoms 

experienced by the plaintiff were sufficient to satisfy the objective component of the deliberate 

indifference test).

Third, Schubert argues that Adkins is at fault for creating his medical need because his 

intravenous drug use, in Schubert’s view, caused the medical condition that Schubert allegedly 

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ignored. Setting aside the lack of record evidence supporting this assertion, it is irrelevant to 

Adkins’s constitutional claim at this stage. In assessing qualified immunity, we are asking only 

whether Schubert violated a clearly established constitutional right by being deliberately 

indifferent to Adkins’s serious medical condition. Our inquiry does not encompass the 

complicated medical reason that may have given rise to a particular condition, as we are illequipped to make this determination and the cause of an ailment has no bearing on the 

appropriateness of a defendant’s response to it. For instance, we have previously denied qualified 

immunity to defendants who failed to act upon an inmate’s symptoms brought about by alcohol 

withdrawal when those symptoms were sufficiently serious to demand medical attention. See 

Kindl v. City of Berkley, 798 F.3d 391, 401–03 (6th Cir. 2015). 

Fourth, Schubert emphasizes that this is a case about the delay, not denial, of medical 

treatment. As such, he contends that our holding in Napier v. Madison Cty., 238 F.3d 739, 742–

43 (6th Cir. 2001), requires Adkins to place verifying medical evidence that the delay caused by 

Schubert’s failure to respond to the report of Adkins’s symptoms made Adkins’s condition worse. 

This argument relies on a misinterpretation of Napier. The requirement that a plaintiff present 

verifying medical evidence is limited “to those claims involving minor maladies or non-obvious 

complaints of a serious need for medical care.” Blackmore, 390 F.3d at 898. Incontinence and 

inability to walk are hardly minor maladies or non-obvious complaints. 

The court in Blackmore also raised an additional basis for rejecting Schubert’s arguments. 

It held that “the test for deliberate indifference is whether there exists a ‘substantial risk of serious 

harm,’ and does not require actual harm to be suffered[]” and that “[w]here the seriousness of a 

prisoner’s needs for medical care is obvious even to a lay person, the constitutional violation may 

arise.” Id. at 899 (internal citation omitted, emphasis in original). The court went on to hold that:

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This violation is not premised upon the “detrimental effect” of the delay, but rather 

that the delay alone in providing medical care creates a substantial risk of serious 

harm. When prison officials are aware of a prisoner’s obvious and serious need for 

medical treatment and delay medical treatment of that condition for non-medical 

reasons, their conduct in causing the delay creates the constitutional infirmity. In 

such cases, the effect of the delay goes to the extent of the injury, not the existence 

of a serious medical condition.

Id. (emphasis added). Put simply, a lack of verifying medical evidence concerning the effect of 

any delay does not support Schubert’s assertion of qualified immunity.

ii. Clearly Established Right

Finally, we ask whether the constitutional violation at issue in this case was of a clearly 

established right. For a right to be clearly established, “[t]he contours of the right must be 

sufficiently clear that a reasonable official would understand that what he is doing violates the 

right.” Anderson v. Creighton, 483 U.S. 635, 640 (1987). The Supreme Court has held that 

precedent directly on point with the factual circumstances of the instant case is not required for a 

right to be considered clearly established. Ashcroft v. al-Kidd, 563 U.S. 731, 741 (2011). Existing 

precedent does, however, need to have “placed the statutory or constitutional question beyond 

debate.” Id. A constitutional right can be placed beyond debate “from direct holdings, from 

specific examples described as prohibited, or from the general reasoning that a court employs.” 

Hensley v. Gassman, 693 F.3d 681, 687 (6th Cir. 2012) (internal citation and quotation marks 

omitted).

We have encountered the denial of proper medical treatment to inmates on several 

occasions, many of which are analogous to this case. As an initial matter, it is clearly established 

that, generally, a failure to provide necessary medical treatment to those who are incarcerated can 

constitute a violation of the Eighth Amendment. See, e.g., West v. Atkins, 487 U.S. 42, 56–57 

(1988). 

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Moreover, we have repeatedly held that an official who knows of, but does not respond to, 

serious medical needs similar to those exhibited by Adkins here violates the Eighth Amendment. 

In Harris v. City of Circleville, we held that a jury could conclude that a prison official was aware 

of facts indicating that an inmate had a serious medical need when the inmate was unable to move 

extremities and cried out in pain, among other indications. 583 F.3d 356, 368–69 (6th Cir. 2009). 

In Taylor v. Franklin Cty., we found that an inmate’s “obvious signs of recurring incontinence and 

debilitating immobility were clear symptoms of a serious problem, even if Defendants did not 

[choose] to believe Plaintiff.” 104 F. App’x 531, 538 (6th Cir. 2004). We cited the holding in 

Taylor in Blackmore, when we held that officers were deliberately indifferent when they did not 

act upon an inmate’s report of severe stomach pains resulting from appendicitis. 390 F.3d at 897; 

899–900. Thus, we find that Adkins’s constitutional right to receive adequate medical care given

the symptoms he exhibited was clearly established.

III. CONCLUSION

For these reasons, we affirm the district court’s denial of qualified immunity.

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