RECOMMENDED FOR FULL-TEXT PUBLICATION Pursuant to Sixth Circuit I.O.P. 32.1(b) File Name: 17a0235p.06 

### UNITED STATES COURT OF APPEALS

FOR THE SIXTH CIRCUIT

16-2761
B ARBARA B AYS and J EFFREY B AYS , as Co-Personal Representatives of the Estate of Shane Bays, Deceased, Plaintiffs-Appellees ,

v

. M ONTMORENCY C OUNTY , M ICH ., et al., Defendants , D ONNA S IGLER , R.N., Defendant-Appellant

. 17-1215
B ARBARA B AYS and J EFFREY B AYS , as Co-Personal Representatives of the Estate of Shane Bays, Deceased, Plaintiffs-Appellants ,

v

. M ONTMORENCY C OUNTY , M ICH ., et al., Defendants-Appellees

. ┐ │ │ │ │ │ │ │ │ │ │ │ │ │ │ │ │ │ │ │ │ │ ┘ Nos. 16-2761/17-1215

Appeal from the United States District Court for the Eastern District of Michigan at Detroit. No. 2:15-cv-10534—Robert H. Cleland, District Judge. Argued: October 3, 2017
Decided and Filed: October 20, 2017
Before: CLAY, ROGERS, and SUTTON, Circuit Judges.

_________________ COUNSEL

ARGUED: Douglas J. Curlew, CUMMINGS, MCCLOREY, DAVIS & ACHO, P.L.C., Livonia, Michigan, for Appellant in 16-2761 and Appellees in 17-1215. Matt L. Turner, 

### >Nos. 16-2761/17-1215 Bays, et al. v. Montmore ncy Cty., Mich., et al. Page 2

SOMMERS SCHWARTZ, P.C., Southfield, Michig an, for Appellees in 16-2761 and Appellants in 17-1215. ON BRIEF: Douglas J. Curlew, CUMMINGS, MCCLOREY, DAVIS & ACHO, P.L.C., Livonia, Michigan, for Appellant in 16- 2761 and Appellees in 17-1215. Matt L. Turner, Ramona C. Howard, SOMMERS SCHWARTZ, P.C., Southfield, Michigan, for Appellees in 16- 2761 and Appellants in 17-1215.

_________________ OPINION

_________________ SUTTON, Circuit Judge. In the spri ng of 2013, Shane Bays walked into the Montmorency County Jail to await tr ial for driving a car with a su spended license. While there, he described symptoms of a mental illness to D onna Sigler, the jail nurse. Several weeks after arriving, he killed himself. In response, Shan e’s parents filed this § 1983 action against Sigler and Montmorency County. The district court denied summary judgment to Sigler but granted it to the County. Sigler appealed and the Bays cr oss-appealed. Because a triable issue of fact remains over whether Sigler violated Shane’s clea rly established Fourteen th Amendment right to sufficient treatment for a serious medical proble m, we affirm the district court’s qualifiedimmunity ruling. Because the Bays’ cross-appeal of the summary judgment decision in favor of the County is not inextricably intertwined with Sigler’s appeal, we dismiss it.

I.
As this case comes to us, the government defe ndants are required to accept these facts as true. On March 28, 2013, the Montmorency County Sheriff’s Department arrested Bays, then 28 years old, for driving with a suspended licen se. He was placed in the Montmorency County Jail. On April 9, jail nurse Donna Sigler interviewed Sh ane as part of the ja il’s inmate health screening policy. During his interview, Shane co mplained of a host of psychological ailments. He reported that he was “bipolar,” “paranoid,” “angry,” and that he suffered from “panic attack[s]” and had a history of s ubstance abuse. Sigler wrote that she needed to follow up with a mental health evaluation. On the portion of th e form asking whether Shane needed a referral for “emergency treatment, which may include Mental Health,” she circled “YES” and wrote “on discharge.” She returned Shan e to the general prison population.Nos. 16-2761/17-1215 Bays, et al. v. Montmore ncy Cty., Mich., et al. Page 3

Later that day, Shane requested another m eeting because he was “becoming a personal disaster.” Sigler interviewed him again. She wrote that Shan e described himself as anxious, paranoid, tense, unable to sleep, and experiencing “severe rage.” They discussed his mental health and his request for treatmen t at a mental health center.
At some point that day, Sigler telephoned Amy Pilarski, a registered nurse specializing in
mental health issues who worked with several Mi chigan jails. Sigler mentioned that Shane was “having some issues with anxiety.” P ilarski recommended Benadryl and a follow-up appointment.
On April 11, Sigler scheduled Shane for an appointment on May 2. Though the mental health center offered an earlier appointment, she turned it down because a deputy would be on vacation during the offered time and “transporting [S hane] would be more difficult” than usual. That same day she recorded in her medical notes that Shane “denies suicide at this time.”
Shane remained in the jail’ s general population area. On April 17, he requested another meeting with Sigler. She noted th at he was more relaxed and less anxious than he had been the week before. By Friday, April 19, his condition had deteriorated. He again reported anxiety, agitation, paranoia, and troubling th oughts. He also reported that he was afraid he would hurt others and that he had scraped his hands punching the wall. Sigler again noted that Shane denied being suicidal. Hopi ng to schedule an earlier appointment, Sigler made two calls to Pilarski but could not reach her. Sigler left a message as king Pilarski to call her should any cancellations free up an earlier appointment.
Shane hanged himself in the jail shower s sometime between 11:00 PM on April 22 and 1:30 AM on April 23. Bays v. Montmorency Cty. , No. 15-10534, 2016 WL 1728569 (E.D. Mich. May 2, 2016).
Shane’s parents Barbara and Jeffrey filed a § 1983 action, claiming th at Sigler violated Shane’s right to receive care for a serious medical need and that the County failed to train its personnel to provide proper health care to its in mates. Both sides moved for summary judgment.
The district court denied the Ba ys’ motion and granted summary j udgment to the County. SiglerNos. 16-2761/17-1215 Bays, et al. v. Montmore ncy Cty., Mich., et al. Page 4

filed an interlocutory appeal challenging the de nial of qualified immunity. The Bays filed a cross-appeal as to their cl aim against the County.

II.
Sigler’s appeal. In a qualified-immunity case, we ask two questions: Did the officer violate the injured party’s const itutional rights? If so, was the right clearly established at the
time? Pearson v. Callahan , 555 U.S. 223, 232 (2009). In considering these questions, we assume the truth of all record-supported alle gations by the non-movant, here the Bays. Plumhoff
v. Rickard , 134 S. Ct. 2012, 2017 (2014).
Prison officials violate the Eighth Ame ndment when they act with “deliberate indifference” to the “serious medical needs” of inmates committed to their charge. Estelle v.
Gamble , 429 U.S. 97, 105 (1976). The Due Process Clause of the Fourteenth Amendment provides the same guarantee to pretrial detainees. City of Revere v. Mass. Gen. Hosp. , 463 U.S. 239, 243–44 (1983). Two inquiries loom over ever y deliberate indifference case: Was the ailment a serious one? And was the official “subjective[ly] reckless[],” such that she was actually “aware of facts from which the inferen ce could be drawn that a substantial risk of serious harm exist[ed], and . . . also [drew] the inference”? Farmer v. Brennan , 511 U.S. 825, 837–40 (1994); see Clark-Murphy v. Foreback , 439 F.3d 280, 286 (6th Cir. 2006).
Shane’s mental illness was obj ectively serious, for starters. Throughout his incarceration, Shane described severe psychological symptoms to Sigler: paranoia, anxiety, anger, troubling thoughts, self-destructive wall-punching, the hear ing of voices, and violent impulses directed towards other inmates. He did so repeatedly, in ever more strident language, up until the Friday before he took his own life. These facts would pe rmit a jury to conclude that a reasonable nurse would recognize that Shane needed prompt medical help. See Harris v. City of Circleville , 583 F.3d 356, 368 (6th Cir. 2009).
In addition, Sigler subjectivel y understood Shane’s plight. Si gler was a trained medical professional. Her actions, notes, and words suggest that she recognized Shane’s distress. She interviewed Shane when he arrived on April 9 a nd recorded his litany of symptoms. In a portion of the form asking whether Shane should be refe rred “to appropriate heal th care service forNos. 16-2761/17-1215 Bays, et al. v. Montmore ncy Cty., Mich., et al. Page 5

emergency treatment, which may include Mental H ealth,” she circled “YES.” She responded to two requests for treatment that Shane made after his initial interview. She was concerned enough to check whether Shane was thinking about hurting himself on April 11 and April 19. She later admitted that she thought the prison should have added Shane to a watch list for his own safety. And she repeatedly tried to expedi te his mental health appointment because “the inmate need[ed] to be seen.” These facts take n together would permit a jury to conclude that Sigler subjectively thought there was a “risk of serious harm.” Farmer , 511 U.S. at 837.
Other evidence shows that Sigler disregar ded that risk in a way that goes beyond negligence. See id. at 835–37. When she spoke with Nurse P ilarski, her primary point of contact for psychiatric questions, she knew that Shane thought he had bipolar disorder and suffered from severe psychiatric symptoms. Yet she failed to tell Pilarski about any symptom other than anxiety, causing Pilarski to misdiagnose Shane’s illn ess and prescribe only a dose of Benadryl. After treating Shane for several days, she r ealized that she needed to reschedule his psychological treatment for an earlier date. Yet she passed on an earlier appointment because the absence of a prison guard would have made movi ng Shane “difficult,” then chose not to use the emergency resources at her dispos al before she left for the week end. When she considered his condition as of mid-April, she believed he needed to be placed on a special watch list. Yet she did not arrange for him to be added to one.
Sigler admitted in her deposition that the care she provided fell short of what Shane
needed:
[ATTORNEY]: So as of April 19th w ith just about two weeks before his appointment do you acknowledge that [Sha ne] needed to be seen sooner? [SIGLER]: Yes. [ATTORNEY]: But you were not able to get him in sooner because you did not get ahold of Amy [Pilarski] at [the mental health clinic]? [SIGLER]: Correct. [ATTORNEY]: Why didn’t you call an ambulance? [SIGLER]: I don’t know. [ATTORNEY]: Could you have? [SIGLER]: Yes. [ATTORNEY]: Should you have? [SIGLER]: Yes.Nos. 16-2761/17-1215 Bays, et al. v. Montmore ncy Cty., Mich., et al. Page 6

R. 49-6 at 20–21. A jury could reasonably conclude that Sigler deliberat ely disregarded Shane’s
serious medical need.
This constitutional right also was clearly established. The Supreme Court has long recognized that inmates have the right to reasonable me dical care under the Eighth and
Fourteenth Amendment. See Estelle , 429 U.S. at 103–04. And severa l circuits, including this one, have held that the right extends to psychol ogical treatment for serious mental illnesses. See Clark-Murphy , 439 F.3d at 292 (listing cases).
Sigler’s counterarguments are unconvinci ng. She argues that the evidence does not
establish that Shane suffered from a seri ous medical condition, no ting that no physician diagnosed Shane and that he did not face “any subs tantial or immediate risk of harm” that would prompt a layman to seek help. Appellant’s Br. at 21. The former is true but not dispositive. The latter is wrong. The record describes a paranoid, angry, depr essed, self-des tructive, and potentially violent man desperately asking for he lp. Any reasonable nurse would have known to look for medical help. See Clark-Murphy , 439 F.3d at 290–91.
Sigler adds that nothing in th e record shows that she subjectively knew, then disregarded,
that Shane was at risk of suicide. But the rele vant question is not whethe r Sigler recognized that Shane might kill himself. It is whether Sigler recognized that Shane was suffering from a serious mental illness creating a host of risks and requiring immediate treatment during the fourteen days that Sigler treated him. Blackmore v. Kalamazoo Cty. , 390 F.3d 809, 899 (6th Cir. 2004).
Sigler argues that while she may have committed malpractice, her conduct was not deliberately indifferent to Shane’ s plight. If a prison medical o fficial provides treatment, it is true, constitutional liability att aches only if the treatment is “so cursory as to amount to a conscious disregard for [t he inmate’s] needs.” Rouster v. Cty. of Saginaw , 749 F.3d 437, 448 (6th Cir. 2014). Taking the Bays’ allegations as true, Sigler’s care fell below this admittedly low bar. She scheduled an appointment weeks in the future despite symp toms that she, Nurse Pilarski, and the Bays’ expert now all agree required immediate or near-immediate care.Nos. 16-2761/17-1215 Bays, et al. v. Montmore ncy Cty., Mich., et al. Page 7

Yes, she eventually did try to schedule an earlier appointment. But the sum total of her efforts were two phone calls and a message, all while she had the option of getting immediate emergency room treatment or at least putting him on a watch list, and yet she chose to do neither.
Sigler looks to Taylor v. Burkes , which held that inmates have no clearly established right to the proper implementation of suicide prev ention procedures. 135 S. Ct. 2042, 2044 (2015). But the Bays do not argue that Sigler violated Shane’s right to procedures that might have prevented his suicide. They argue that Sigl er violated Shane’s right to have a serious psychological illness treated seriously. And that right is clearly established. See Clark-Murphy , 439 F.3d at 292.
A comparison illustrates the pitfal ls of Sigler’s position. In Blackmore v. Kalamazoo County , an inmate suffered a burst appendix. County officials were deliberately indifferent to this severe physical ailment and delayed his treatment. Though he survived the illness and made a full recovery, we found that the severe pain he endured during the delay could entitle him to damages under § 1983. Blackmore , 390 F.3d at 900. The same is true for Shane. Defendants must accept at this stage the Bays’ fact-based a llegations that he suffered severe psychological pain in the weeks leading up to his suicide and had a clearly established right to treatment for that serious medical need that Sigler failed to provide. Shane’s parents deserve the same chance to take their case to a jury.

III.
The Bays’ cross-appeal . In challenging the district co urt’s decision dismissing their failure-to-train claim against Montmorency Count y, the Bays face a narrow path. A ruling that disposes of one party or claim typically is not considered an appealable “final” decision. 28 U.S.C. § 1291; see Flanagan v. United States , 465 U.S. 259, 263 (1984). Unlike Sigler, the Bays have no stand-alone right to an interlocutory appeal of the di strict court’s grant of summary judgment in favor of the County. See Floyd v. City of Detroit , 518 F.3d 398, 410 (6th Cir. 2008). And while the Bays might have asked the district court to enter final j udgment with respect to this claim, they did not do so. See Civil Rule 54(b).Nos. 16-2761/17-1215 Bays, et al. v. Montmore ncy Cty., Mich., et al. Page 8

Even so, the Bays claim that we should re ly on our pendent appellate jurisdiction to consider their cross-appeal in connection with Sigl er’s appeal of the dist rict court’s denial of qualified immunity. To do that, we must find that the failure-to -train claim is “inextricably intertwined” with the qualified immunity claim. A claim is “inextricably intertwined” if it is “coterminous with, or subsumed in” the claim on co llateral appeal such th at “appellate resolution of the collateral appeal necessarily resolves the pendent claim as well.” Mattox v. City of Forest
Park , 183 F.3d 515, 524 (6th Cir. 1999) (quotations omitted); see Swint v. Chambers Cty.
Comm’n , 514 U.S. 35, 51 (1995).
Given our rejection of Nurse Sigler’s appe al, the Bays’ failure-t o-train claim does not
meet this test. Our decision to affirm the dist rict court’s denial of qualified immunity does not necessarily decide the question wh ether the district court erred in granting summary judgment to the County on the failure-to-train claim. That th e Bays have a cognizable claim against Sigler by no means shows that they have a cognizable claim against the C ounty. That Sigler may have
shown deliberate indifference to Shane’s medical needs does not show that the County failed to train its employees in this area or had a policy designed to violate such rights. See Hidden Village, LLC v. City of Lakewood , 734 F.3d 519, 524 (6th Cir. 2013); see also, e.g. , Hudson v.
Hall , 231 F.3d 1289, 1292 n.1 (11th Cir. 2000).
Mattox v. City of Forest Park does not change our minds. 1 83 F.3d 515 (6th Cir. 1999).
The district court in that case denied the officer and the city summary judgment in a § 1983 suit.
We overturned the district court’s summary judgment against the officer after finding that he had not violated any constitutional right a nd thus deserved qualified immunity. Id. at 517. Because a municipality cannot be held liable if none of its officers violated a constitutional right, our qualified immunity decision necessa rily subverted the district c ourt’s summary judgment against the city. That meant the city’s appeal was inextricably intertwined with the qualified immunity appeal, which in turn meant we could exercise pendent jurisdiction over it. Id. at 523–24.
The Bays’ claim differs materially. Our re view of Sigler’s qua lified-immunity claim does not necessarily decide wh ether the Bays produced enough ev idence to save their claim against the County. It could be th at the district court correctly he ld that the Bays failed to carryNos. 16-2761/17-1215 Bays, et al. v. Montmore ncy Cty., Mich., et al. Page 9

their burden. Or it could be that the district court e rred and the County is liable. The question remains open for appeal after the district c ourt renders final judgment in the case.

For these reasons, we affirm the district c ourt’s denial of qualifie d immunity to Donna Sigler and dismiss the Bays’ appe al for lack of jurisdiction.