NOT RECOMMENDED FOR FULL-TEXT PUBLICATION File Name: 17a0418n.06
No. 16-2520
UNITED STATES COURT OF APPEALS FOR THE SIXTH CIRCUIT PATRICIA ESCH, as Personal, Representative of the Estate of Stephen Stiles, Plaintiff-Appellant, ON APPEAL FROM THE UNITED STATES DISTRICT COURT FOR THE v. WESTERN DISTRICT OF MICHIGAN COUNTY OF KENT, MICHIGAN; LAWRENCE A. STELMA; NASIM A. YACOB, M.D.; CLAIRE EVERSON, L.P.N.; CORIZON HEALTH, INC.; and DORIS LEMMEN, L.P.N., Defendants,
& DAVID SOVA, D.O.; JIM MCFADDEN, R.N.; MINERVA BOOKER, R.N.; and ESTHER WEST, R.N. Defendants-Appellees. ____________________________________/ BEFORE: SILER, CLAY, and McKEAGUE, Circuit Judges. CLAY, Circuit Judge. Plaintiff Patricia T. Esch (“Plaintiff”), the personal representative of the Estate of Stephen Stiles, appeals from the judgment entered by the district court on September 27, 2016, granting summary judgment to Defendants Jim McFadden, R.N., Esther West, R.N., Minerva Booker, R.N., and David Sova , D.O. (collectively, “Defendants”). Stephen Stiles (“Stiles”) died of a seizure shortly afte r he was taken into custody on an outstanding warrant for failure to pay child support. Defendant s are medical officials at the county jail where16-2520

2 Stiles was being detained. Plaintiff alleges th at Defendants caused Stiles’ death through their failure to give him his anti-seizure medication in a timely manner. The district court granted Defendants’ motions for summary judgment, reasoning that there was no evidence suggesting that Defendants were deliberately indifferent to Stile s’ serious medical needs. Plaintiff asks us to reverse the district court’s grant of summary judgm ent, and remand her claims for trial. We have subject matter jurisdiction over this appeal pursuant to 28 U.S.C. § 1291. For the reasons set forth below, we AFFIRM the district court’s judgment. BACKGROUND I. Factual History On May 31, 2011, at approximately 4:48 a. m., the Grand Rapids Police Department arrested Stiles on an outstanding warrant for fail ure to pay child support. Stiles was taken for holding at the nearby Kent County Corre ction Facility (“ the jail”). Once Stiles arrived at the jail at approximately 4:55 a.m., he was taken to a medical intake screening conducted by Defendant Jim McFadden (“Nurse McFadden”). Nurse McFadden noted that Stiles suffered from epil epsy, grand mal seizures, and hypertension, and was also under the influence of alcohol, which can exacerbate the risk of seizures. Stiles also told Nurse McFadden that he had suffered a serious seizure two weeks prior to his arrest. Stiles provided nurse McFadden with th e name of his treating physic ian and a phone number for his pharmacy so that Nurse McFadden could verify Stiles’ prescription for an anti-seizure medication known as Dilantin. St iles was prescribed to take Dilantin twice daily—once in the morning, and once in the evening. At the time Stiles entered the jail, he had not taken his previous night’s Dilantin dose, but Nurse McFadden failed to ask him when he had last taken his medication. Nurse McFadden entered Stiles’ information into the jail’s computer system, and then placed his chart in a stack for the next duty nurse to revi ew. Nurse McFadden’s shift ended sometime between 6:00 a.m. and 7:00 a.m. The next nurse on duty was Defendant Esther West. Nurse West started her shift at roughly 6:00 a.m. and worked un til roughly 2:30 p.m. At roughl y 10:42 a.m., Nurse West called16-2520

3 Stiles’ pharmacy and was able to verify his Dilantin prescription. After verifying the prescription and updating Stiles’ chart, Nurse West apparently took no furt her actions to assure that Stiles received his Dilantin beyond placing th e chart in a place where it would be viewed by a physician capable of is suing prescriptions. At some time between 2:00 p.m. and 3:00 p.m ., Stiles asked a guard to inquire how long it would be before he received his anti-seizure me dication. The guard relayed the inquiry to an unidentified person in the ja il’s medical office. At roughly 12:00 p.m., Defendant David Sova (“Dr. Sova”) arrived for his shift as the attending physician at the jail. Dr. Sova’s sh ift ran from 12:00 p.m. to 6:00 p.m., but Stiles’ medical records reflect that his prescription fo r Dilantin was noted at 6:45 p.m. Dr. Sova testified during his deposition th at one of the nurses on call s hould have identified Stiles as a must-see patient because of his se izure condition. Nevertheless, after prescribing Dilantin to Stiles, Dr. Sova apparently took no further step s to assure that Stiles received his anti-seizure medication immediately. From roughly 2:30 p.m. to 10:30 p.m., De fendant Minerva Booker (“Nurse Booker”) took over for Nurse West as the nurse on call at the jail. Although Nurse Booker hypothetically would have received Stiles’ chart in a stack of intake paperwork from Nu rse West, there is no evidence in the record that Nurse Booker ever sa w Stiles’ chart, or was involved in his medical care in any way. At 8:00 p.m., jail medical staff sent a cart ar ound to deliver prescrip tions to the inmates, including Stiles. At 8:18 p.m., when Stiles did not come to the cart or respond to a call made over the jail’s loudspeaker system, jail staff a pproached his cell. Stiles was found unconscious therein. He was pronounced dead at 8:41 p.m. from a fatal seizure.16-2520

4 II. Procedural History On May 2, 2013, Plaintiff brought suit on behalf of Stiles’ estate in the Western District of Michigan, asserting claims pursuant to 42 U.S.C. § 1983 for: (i) Monell 1 liability against Kent County, the County Sheriff, and Coriz on Health, Inc. (the jail’s hea lth care contractor) for failing to have adequate policies in place to assure that inmates with acute medical needs received prescription medication in a timely fashion; and (ii) individual li ability against Dr. Sova and the numerous nurses that had worked in the jail on the day Stiles died. Th e claims for individual liability alleged that the jail medical staff had been deliberately indifferent to Stiles’ serious medical needs in violation of the Eighth and Fourteenth Amendments. On March 24, 2016, after discovery, the various defendants in this suit moved for summary judgment against all of Plaintiff’s cl aims. On September 27, 2016, the district court granted the summary judgment motions in their entirety. Esch v. County of Kent , No. 1:13-cv478, 2016 WL 5387860, at *1 (W.D. Mich. Sept. 27, 2016). The district court first determined that Kent County, the County Sheriff, and Coriz on maintained policies requiring that inmates receive any valid prescriptions wi thin 24 hours of intake, and that these policies were flexible enough in practice to permit inma tes to receive medication soone r in emergency situations. Id. at *2–4. The district court determined that in this case, Stiles di d not receive his medication until roughly fifteen hours after his intake because ther e was nothing in his chart to suggest that he was facing an acute medical emergency, and therefore dismissed Plaintiff’s Monell claims. Id. With respect to the various individual defendants, the district court conc luded that while Stiles was definitely suffering from an objectively se rious medical condition, a nd may have received deficient care, there was no evidence in the reco rd that any defendant s ubjectively appreciated the risk to Stiles and chose to ignore it. Id. at *4–7. In brief, the dist rict court found that each doctor and nurse did their part to advance Stiles’ request for D ilantin, and he was ultimately

1 See Monell v. Dep’t of Social Servs. of City of N.Y. , 436 U.S. 658 (1978) (creating a framework for assessing § 1983 liability against local governments that cause harm through unconstitutional policies or practices).16-2520

5 prescribed the drug. Id. Although the jail medical staff pe rhaps should have taken steps to assure that Stiles received his Dilantin prescr iption more quickly, the district court concluded that there was no evidence that Defendants were s ubjectively aware of the need to act any faster than they did. Id. The district court entere d a judgment terminating all active claims on September 27, 2016. On October 27, 2016, Plaintiff filed a timel y notice of appeal. Although there were a number of individual defendants named in Plainti ff’s complaint, Plaintiff only presses her claims against Nurse McFadden, Nurse West, Nurse Booker, and Dr. Sova in this appeal. DISCUSSION I. Standard of Review We review de novo the district court’s gran t of summary judgment. See, e.g. , Kelly Servs., Inc. v. Creative Harbor, LLC , 846 F.3d 857, 862 (6th Cir. 2017). A movant is entitled to “summary judgment if the movant shows that ther e is no genuine dispute as to any material fact and the movant is entitled to j udgment as a matter of law.” Fed. R. Civ. P. 56(a). “When evaluating a summary judgment motion, the reviewi ng court must construe the facts in the light most favorable to the non-movant.” Gillis v. Miller , 845 F.3d 677, 683 (6th Cir. 2017). A “genuine issue of material fact exists when there is sufficient ev idence for a trier of fact to find for the non-moving party.” Brown v. Battle Creek Police Dep’t , 844 F.3d 556, 565 (6th Cir. 2016). “[T]he mere existence of some alleged factual dispute between the parties will not defeat an otherwise properly supported motion for summary judgment; the requirement is that there be

no genuine issue of material fact.” Anderson v. Liberty Lobby, Inc. , 477 U.S. 242, 247–48 (1986) (emphasis in original). II. Does the Fourth or the Fourteenth Amendment Govern Plaintiffs’ Claims? Plaintiff alleges that Defendant s provided Stiles inadequate medical care during his brief time in custody. However, the parties disput e which constitutional amendment supplies the correct analytical framework for assessing Plai ntiffs’ claims: the Fourth Amendment or the Fourteenth Amendment. Plaintiff argues that the Fourth Amendment applies, while Defendants16-2520

6 argue that this case is governed by the Fourteen th Amendment. “This is not a purely academic question as the standards of liabi lity vary significantly according to which amendment applies.” Lanman v. Hinson , 529 F.3d 673, 679–80 (6th Cir. 2008). If the Fourth Amendment applies, we must evaluate whether Defendants’ conduct was “objectively reasonable.” Aldini v. Johnson , 609 F.3d 858, 865 (6th Cir. 2010). T hus, Defendants’ “subj ective intentions are irrelevant to the Fourth Amendment inquiry.” Id. However, if the Fourteenth Amendment applies, we must evaluate whether a jury could find that Defendants were deliberately indifferent to Stiles’ serious medical needs. See Estelle v. Gamble , 429 U.S. 97, 104 (1976). Delib erate indifference has both subjective and objective components, and require s proof that: (i) Defendants were “aware of facts from which the inference could be drawn that a substantial risk of serious harm exist[ed];” and (ii) Defendants actually drew that inference. See, e.g. , Mattox v. Edelman , 851 F.3d 583, 597 (6th Cir. 2017) (quoting Farmer v. Brennan , 511 U.S. 825, 837 (1994)). “The Fourth Amendment objective reasonableness te st is an ‘easier standard for [a] plaintiff to meet’ than the Fourteenth Amendment deliberate indifference test.” Smith v. Erie Cty. Sheriff’s Dep’t , 603 F. App’x 414, 419 (6th Cir. 2015) (quoting Darrah v. City of Oak Park , 255 F.3d 301, 307 (6th Cir. 2001)). In the context of excessive force claims, we have “held that ‘[w]hich amendment applies depends on the status of the plaintiff at the tim e of the incident, whether free citizen, convicted prisoner, or something in between.’” Lanman , 529 F.3d at 680 (quoting Phelps v. Coy , 286 F.3d 295, 299 (6th Cir. 2002)). “If the plaintiff was a convicted prisoner at the time of the incident, then the Eighth Amendment deliberate indifference standard sets the standard for an excessive force claim.” Id. (citing Graham v. Connor , 490 U.S. 386, 395 n.10 (1989). “But if the plaintiff was a free person, and the use of force occurred in the course of an arrest or other seizure, then the plaintiff's claim arises under the Fourth Amendment and its reasonableness standard.” Id. (citing Graham , 490 U.S. at 395). If the plaintiff is a pretrial detainee who has had a probable cause hearing, the Fourteenth Amendment (and by extension, the Eighth Amendment’s deliberate indifference standa rd) governs her claims. Aldini , 609 F.3d at 866.16-2520

7 Plaintiff argues that the exte nt of Stiles’ rights was governed by the Fourth Amendment at the time of his death, because he had not had a probable cause hearing, and was thus akin to a free person. Defendants argue th at Plaintiff waived any applic ation of the Fourth Amendment because Plaintiff failed to raise that Amendment’ s potential application befo re the district court. 2 We have never squarely decided whet her the Fourth Amendment’s objective reasonableness standard can ever apply to a plain tiff’s claims for inadequate medical treatment. See Boone v. Spurgess , 385 F.3d 923, 934 (6th Cir. 2004) ( noting the uncertainty regarding whether the Fourth Amendment applies to inad equate medical care cas es, but declining to resolve the question); Estate of Carter v. City of Detroit , 408 F.3d 305, 311 n.3 (6th Cir. 2005) (same). The Seventh and Ninth Circuits ha ve held that such claims are cognizable, see, e.g. , Currie v. Chhabra , 728 F.3d 626, 630 (7th Cir. 2013) (collecting cases); Tatum v. City and County of San Francisco, 441 F.3d 1090, 1099 (9th Cir. 2006), while the Tenth Circuit has held that all claims for inadequate medical care are governed by the Eighth Amendment’s deliberate indifference standard. See Barrie v. Grand Cty. , 119 F.3d 862, 868–69 (10th Cir. 1997) (“[W]e conclude that in this circuit a prisoner, whethe r he be an inmate in a penal institution after conviction or a pre-trial detainee in a county jail, does not have a claim against his custodian for failure to provide adequate medical attention unless the custodian knows of the risk involved, and is ‘deliberately indifferent’ th ereto.”). We have implied in dicta that inadequate medical

2 At oral argument, Defendants also argued that Stiles did in fact receive a probable cause hearing after his arrest, but before he was taken to the jail, and thus that Plaintiff’s claims should be governed by the Fourteenth Amendment because Stiles was not akin to a free person. Aldini , 609 F.3d at 866. However, the record does not clea rly delineate what judi cial process, if any, Stiles received before being taken to the jail. And of course, representations made during oral argument are not part of the record, and are generally not sufficient to support a motion for summary judgment. See, e.g. , EOTT Energy Operating Ltd. P’ship v. Winterthur Swiss Ins. Co. , 257 F.3d 992, 999 (9th Cir. 2001) (“[S]tatements ma de by counsel at oral argument are not evidence and not part of the record.”); McDonald’s Corp. v. Robertson , 147 F.3d 1301, 1308 n.4 (11th Cir. 1998) (“[A]ttorneys’ statements at oral argumen t do not constitute record evidence[.]”); see also Charles A. Wright & Arthur R. Miller et al., Federal Practice & Procedure § 2723 n.2 (4th ed. Supp. 2017) (collecting cases for the proposition that oral testimony is sparingly considered on summary judgment moti ons). Accordingly, we will not consider Defendants’ oral argument statements in adjudicating this appeal.16-2520

8 treatment claims are just as c ognizable under the Fourth Amendment as excessive force claims. Boone , 385 F.3d at 934. After carefully reviewing the re cord and the parties’ arguments , we conclude that it is not necessary to decide whether th e Fourth or the Fourteenth Amendment supplies the basis for Plaintiff’s claims, because her claims fail und er both the deliberate indifference and objective reasonableness standards. We will therefore assume arguendo that the Fourth Amendment’s more forgiving objective reasonableness standard governs this appeal, be cause “behavior that does not rise to the level of a Fourth Amendm ent violation cannot offend the Fourteenth.” See Smith , 603 F. App’x at 418–19 (adop ting the same approach). 3 As recited earlier, under the Fourth Amendment, Defendants may be liable for failing to provide Stiles adequate medical treatment if their treatment deci sions were objectively unreasonable. Aldini , 609 F.3d at 865. As the Seventh Ci rcuit has explained, in inadequate medical care cases,
Four factors inform our determination of whether an [official’s] response to [a plaintiff’s] medical needs was objectiv ely unreasonable: (1) whether the officer has notice of the detainee's medical need s; (2) the seriousness of the medical need; (3) the scope of the requested trea tment; and (4) police interests, including administrative, penological, or investigatory concerns. [ Williams v. Rodriguez , 509 F.3d 392, 403 (7th Cir. 2007)]. [The pl aintiff] must also show that the defendants’ conduct caused the harm of which she complains. See Gayton v. McCoy, 593 F.3d 610, 620 (7th Cir.2010) . . . . “[T]he severity of the medical condition under this standard need not, on its own, rise to the level of objective seriousness required under the Eighth and Fourteenth Amendments. Instead, the Fourth Amendment's reasonableness an alysis operates on a sliding scale, balancing the seriousness of the medical ne ed with the third factor—the scope of the requested treatmen t.” 509 F.3d at 403. Ortiz v. City of Chicago , 656 F.3d 523, 530–31 (7th Cir. 2011). In performing this inquiry, we must review “the totality of the circumstances , analyzing the facts ‘fro m the perspective of a reasonable [official in Defendants’ position], rather than with th e 20/20 vision of hindsight.’” Darrah v. City of Oak Park , 255 F.3d 301, 307 (6th Cir. 2001) (quoting Graham , 490 U.S. at 396).

3 We express no view as to the broader legal question of whether inadequate medical care claims are ever cognizable unde r the Fourth Amendment.16-2520

9 III. Analysis A. Nurse McFadden Nurse McFadden handled Stiles’ intake paperw ork on the morning of his arrest. After completing Stiles’ intake questionnaire, Nurse Mc Fadden knew that: (i) Stiles had a history of seizures, including a seizure two weeks prior; (ii) Stiles was on Dilantin to control those seizures; and (iii) Stiles was under the influence of alc ohol upon intake, which increased his risk of a seizure occurring. Nurs e McFadden failed to ask when Stiles had last taken Di lantin, and also failed to personally follow-up to insure that Stiles received his medication. Plaintiff argues that a jury could find this conduct objectively unreasonable because Nurse McFadden “knew everything necessary to provide [Mr.] Stile s with proper medical care,” and did not. 4 (App. R. 26, Appellant’s Br., at 35.) We disagree. Although Stiles unquestionably suffered from a serious medical condition requiring treatment, 5 and informed Nurse McFadden of his Dilantin prescription, Nurse McFadden was not aware of any facts suggesting that Stiles could not wa it for the jail to complete its ordinary prescripti on verification procedures. Duri ng his intake procedures, there was no sign that Stiles was in any acute physical distress. See Florek v. Village of Mundelein , 649 F.3d 594, 600 (7th Cir. 2011) (officers’ failure to provide more aggressive medical care not unreasonable where “the medical need did not appear to be great”); Legg v. Pappas , 383 F.

4 Plaintiff also alleges that Nurse McFadde n deliberately chose not to give Stiles his Dilantin prescription because Stil es came to the jail near the e nd of Nurse McFadden’s shift, and Nurse McFadden did not want to shoulder the res ponsibility of getting Stiles his medication. We accord this argument no weight, because Plaintiff does not point to any evidence in the record that supports an inference that Nurse McFadd en consciously chose not to provide Stiles additional medical care out of sloth or indolence. 5 We reject Defendants’ argument that Stil es was not suffering from an objectively serious medical condition. A plai ntiff can show that she suffers from an objectively serious condition for Eighth Amendment purposes by showi ng that she has an ailment “that has been diagnosed by a physician as mandating treatment.” Mattox , 851 F.3d at 598 (quoting Blackmore v. Kalamazoo Cty. , 390 F.3d 890, 897 (6th Cir. 2004)). Stiles’ seizure condition indisputably met this qualification, and if a condition is ob jectively serious for Eighth Amendment purposes, it is necessarily serious enough to require care for Fourth Amendment purposes as well. Ortiz , 656 F.3d at 530–31.16-2520

10 App’x 547, 551 (7th Cir. 2010) (failure to provide medical care not unreas onable where plaintiff “was not in serious medical need at the time” he was arrested). In fact, Stiles did not die until more than fifteen hours after he interacted w ith Nurse McFadden. More over, uncontested record evidence shows that Nurse McFadden noted Stiles ’ need for Dilantin on his chart, and followed jail procedures by turning St iles’ paperwork over to the da y shift nurse (Nurse West) for verification. See, e.g. , Moreland v. Roscko , 254 F. App’x 361, 362 (5th Cir. 2007) (per curiam) (holding that “nurses’ complia nce with prison policy” was not “objectively unreasonable”). Nurse McFadden also called Stiles’ pharmacy and left a message inquiring into the status of Stiles’ Dilantin prescription. This was appropriate because prison medical staff generally must take additional steps to veri fy a prisoner’s need for medication before dispensing it. Florek , 649 F.3d at 600 (officers’ failure to provide medication reasonable where administrative concerns counseled in favor of de lay, and the plaintiff’s medical need did not appear to be great). In light of the facts known to Nurse McFadden during Stiles’ intake, no reasonable jury could find that Nurse McFadden acted unreasonably. Plaintiff additionally argues that a reasonable jury could accept the expert report offered by Valerie Tennessen, R.N., who opined that Nurs e McFadden acted with deliberate indifference to Stiles’ serious medical needs. We give this expert report very little weight. Nurse Tennessen’s brief analysis was based on: (i) he r assessment of Nurse McFadden’s credibility; (ii) her belief that Nurse Mc Fadden should have followed up with Stiles’ pharmacy regarding his Dilantin prescription; and (iii) her opinion th at Nurse McFadden should have issued Stiles Dilantin from the 24-hour pharmacy at his dis posal. Expert witnesses are generally not permitted to base their conclusions on an evaluati on of a witness’s credibi lity, because credibility determinations are not an appropria te subject for expert testimony. See, e.g. , Greenwell v. Boatwright , 184 F.3d 492, 496 (6th Cir. 1999); United States v. Hill , 749 F.3d 1250, 1258 (10th Cir. 2014). Further, Nurse McFadden’s failure to follow-up with Stiles’ pharmacy was not unreasonable—Nurse McFadden’s shift ended very early in the morning, before most pharmacies would be open, and Nurse West (t he next nurse on duty ) followed up with the16-2520

11 pharmacy a few hours later. Finally, because Stile s did not appear to be in any acute medical distress, it was not unreasonable for Nurse McFadde n to follow the jail’s prescription verification procedure rather than seeking an emergenc y prescription from a 24-hour pharmacy. We likewise decline to give significant weight to Plaintiff’s other experts, whose reports are in tension with one another. Dr. Neil Farbe r’s conclusory letter opining that Defendants were negligent in failing to immediatel y give Stiles Dilantin upon his entr y into the jail did not analyze how and why any specific individual Defe ndant acted negligently. Moreover, Dr. Farber’s opinion was mostly based on the heighten ed risk Stiles faced fo r a seizure as a result of his alcohol consumption, even though Dr. Karl Newman’s review of Stiles’ medical records showed an absence of alcohol in his body fluids at the time of his death. Accordingly, we hold that the district court correctly granted summary judgment to Nurse McFadden because the facts available to Nurse McFa dden at the time did not suggest that Stiles’ medical needs were so urgent that the Fourth Amendment required a departure from the jail’s ordinary prescription verification and dispensation procedures. B. Nurse West At roughly 10:40 a.m. on the morning of Stil es’ death, Nurse West took over for Nurse McFadden, verified Stiles’ prescription through his pharmacy, a nd placed Stiles’ chart in a stack for Dr. Sova to review so that he could order th e prescription. Plaintiff argues that this conduct was objectively unreasonable because once Nurse West verified Stiles’ Dilantin prescription, she should have sought out a doctor and made sure th at Stiles received his medication as soon as possible. We disagree. The “Fourth Amendment reason ableness inquiry necessarily takes into account the sufficiency of the steps that officers did take.” Florek , 649 F.3d at 600. Stiles did not enter the jail with any symptoms or patholog y that would suggest that he was suffering from an acute medical emergency. Nurse West thus acted reasonably by verifying Stiles’ Dilantin prescription and forwarding the file for phys ician review, because there were no obvious exigencies that demanded that she depart from es tablished jail procedures. “Just as the Fourth16-2520

12 Amendment does not require a police officer to us e the least intrusive method of arrest, neither does it require an officer to prov ide what hindsight reveals to be the most effective medical care for an arrested suspect.” Tatum , 441 F.3d at 1098 (citations omitted) (police acted reasonably when they promptly summoned necessary medical assistance, even if they did not administer CPR). Although Nurse West could ha ve acted to make sure Stiles received his Dilantin more expeditiously, nothing in the medical file that was handed to her made it obvious that she was required to do more to preserve Stiles’ well-being. See Sallenger v. City of Springfield , 630 F.3d 499, 504 (7th Cir. 2010) (“The Fourth Amendment requires reasonableness, not immediacy.”). We therefore affirm the distri ct court’s grant of summary j udgment as to Nurse West. C. Nurse Booker Nurse Booker took over for Nurse West as the nurse on duty at 2:30 p.m. Plaintiff asserts that at some unspecified point between 2: 30 p.m. and 6:00 p.m., Nurse Booker would have received Dr. Sova’s Dilantin prescription, and should have immediately dispensed the Dilantin rather than waiting for it to be dispense d during the scheduled medical rounds at 8:00 p.m. However, there is no evidence whatsoever in the record that Nurse Booker ever saw Stiles’ Dilantin prescription, or that she was invo lved in Stiles’ medical care in any way prior to his death. We therefore affirm the district court’s grant of su mmary judgment to Nurse Booker as well. D. Dr. Sova Dr. Sova was the physician on duty at the jail between 2:30 p.m. and 6: 00 p.m. on the day of Stiles’ death. He prescribed Stiles Dila ntin at some point during that period (Stiles’ records show that the prescription came at 6:45 p.m., despite that time being after Dr. Sova’s shift had ended). In response to hypothetical questions fro m Plaintiff during his deposition, Dr. Sova testified that if he had b een made aware of specific warning signs showing Stiles’ urgent need for Dilantin, he would have ordered that it be given immediately. Plaintiff argues that this is sufficient to show that Dr . Sova’s conduct was obj ectively unreasonable. However, there is no evidence in the record that Dr. Sova ever became aware of the extent or16-2520

13 urgency of Stiles’ medical needs. The chart that the jail nurses provided Dr. Sova did not indicate that Stiles needed D ilantin urgently, and no staff memb er told Dr. Sova as much. Ortiz , 656 F.3d at 530–31 (defendant’s notice a crit ical component in evaluating objective reasonableness). Dr. Sova reviewed Mr. Stiles’ records, approved his Di lantin prescription, and ordered that he receive Dilantin during the jail’s next scheduled time for dispensing prescriptions at 8:00 p.m. We hold that no reasonable ju ry could find Dr. Sova’s conduct objectively unreasonable in light of the inform ation that was provided to him. CONCLUSION For the foregoing reasons, we AFFIRM the district court’s judgment.16-2520

14 McKEAGUE, Circuit Judge, with whom Judge SILER joins, concurring. I am in full agreement with the result reached today. Stephen Stiles’ death in custody is a regrettable tragedy that, with the benefit of hindsight, would seem to have been easily avoided. However, the facts of record simply do not show such wrongful conduct by any defendant as would support a finding of liability for violation of Stiles’ constitutionally protected rights. I write separately to explain why the district court’s assessment of th e Estate’s claim for de liberate indifference to
serious medical needs under the Fourteen th Amendment was not erroneous. The majority posits that the Sixth Circuit ha s “never squarely deci ded whether the Fourth Amendment’s objective reasonableness standard can ever apply to a plaintiff’s claim for inadequate medical treatment.” In deed, it is fair to say that so me decisions of our court have purported to leave the question op en as to whether a pretrial detainee’s claim for denial of
needed medical care should be evaluated u nder the Fourteen Amendment’s deliberateindifference standard or the Fourth Amendment’ s objective-unreasonablen ess standard. Yet, while we have never held that the objective-un reasonableness standard applies to a denial-ofmedical-care claim of a detainee under circumstances like Stiles’—arrested pursuant to an arrest warrant (which necessarily issued only after a judicial officer’s probable cause determination)—

we have held that the deliberate-indi fference standard applies. That is, where the court has identified the governing standard, it has uniformly applied
the deliberate-indifference standard. See Burgess v. Fischer , 735 F.3d 462, 476 (6th Cir. 2013) (applying deliberate-indifference st andard to detainee’s denial -of-medical-care claim stemming from booking process); Harris v. City of Circleville , 583 F.3d 356, 367 (6th Cir. 2009) (detainee’s claim for denial of medical care assessed under deli berate-indifference standard); Guy v. Metropolitan Gov’t of Nashville , --- F. App’x ---, 2017 WL 1476896 at *5–6 (6th Cir.16-2520

15 Apr. 25, 2017) (assessing deta inee’s claim for post-arrest denial-of-medical-care under deliberate-indifference standard and noting that, because the dividing line between the Fourth and Fourteenth Amendment zones of protection is the probable-cause he aring, the plaintiff’s arrest pursuant to a judicially approved warrant rendered the Fourth Amendment not applicable);
Morabito v. Holmes , 628 F. App’x 353, 358 (6th Cir. 2015) (d etainee’s denial-of medical-care
claim evaluated under deliberat e-indifference standard); Jackson v. Wilkins , 517 F. App’x 311, 317 (6th Cir. 2013) (same). Respectfully, I would hold that we are bound by this line of cases. Evaluation of the
Estate’s denial-of-medical-care claim under this more demanding standard leads even more clearly and surely to the same conclusion reache d by the majority: the district court’s summary judgment ruling was proper. I therefore concur in the decision to affirm.