UNITED STATES COURT OF APPEALS
FOR THE TENTH CIRCUIT

________________ _________________ GARY HEIDEL, individually; MICHELE ASCHBACHER, individually; CAMILLE ROWELL, individually; KERSTEN HEIDEL, individually; MICHAEL ROWELL, individually and as the personal representative of the Estate of Catherine Rowell, Plaintiffs - Appellants,

v. SHERIFF ANTHONY MA ZZOLA, in his individual and official capacity; SERGEANT JEREMY MUXLOW, in his individual capacity; DEPUTY KIM COOK, in his individual capacity; DEPUTY CLINTON KILDUFF, in his individual capacity; DEPUTY JOHNNY MURRAY, in his individual capacity, Defendants - Appellees. No. 20-1067 (D.C. No. 1:18-CV -00378-REB-GPG) (D. Colo.)

________________ _________________ ORDER AND JUDGMENT *

________________ _________________ Before TYMKOVICH , Chief Judge, KELLY , and PHILLIPS , Circuit Judges. **

________________ _________________

* This order and judgment is not bi nding precedent, except under the doctrines of law of the case, res judica ta, and collateral estoppel. It may be cited, however, for its persuasive value consiste nt with Fed. R. App. P. 32.1 and 10th Cir. R. 32.1.

** After examining the briefs and appellate record, th is panel has determined unanimously that oral argument would not ma terially assist in the determination of this appeal. See Fed. R. App. P. 34(a)(2); 10th Cir. R. 34.1(G). The case is therefore ordered submitted without oral argument. FILED United States Court of Appeals Tenth Circuit 

### March 23, 2021 Christopher M. Wolpert Clerk of Court2 Plaintiffs-Appellants Gary Heidel, Mi chele Aschbacher, Camille Rowell, Kersten Heidel, and Michael Rowell (collec tively, “the Estate”) , appeal from the district court’s grant of su mmary judgment in favor of De fendants-Appellees in their civil rights action. Plaintif fs’ decedent, Catherine Rowe ll, committed suicide while a pretrial detainee at the Rio Blanco County Detention Cent er. On appeal, the Estate argues there is ample evidence showing the jail officials’ deliberate indifference, in violation of the Fourteenth Amendment, toward Ms. Rowell’s risk of suicide. Exercising jurisdiction under 28 U.S.C. § 1291, we affirm. Background 1 On February 12, 2016, Ms. Rowell was arrested in Rangely, Colorado, and booked into the Rio Blanco County Detenti on Center (“the jail”). Ms. Rowell had also been confined at the ja il a few days earlier as well as in February and August of 2015. Ms. Rowell spent most of her time sleeping and refused to go outside during recreation time. Although she ate some of her meals, Ms . Rowell showed signs of a loss of appetite by either refusing to eat or not finishing her meals. Officers believed this behavior was consistent with their pr evious interactions with Ms. Rowell. On February 15, an officer checked on Ms. Rowell around 1:55 p.m. and discovered her in the day room with a 33-inch armored telephone cord wra pped around her neck. They were unable to revive her.

1 Because the parties are fa miliar with the case, we provide only a limited factual recitation.3 Sheriff Mazzola was in charge of the jail . For its part, the jail’s suicide policy largely consisted of moving suicidal inmates for more fre quent observation and contacting a mental health organization that provided services. Jail officers received on-the-job suicide training bu t nothing more formal than that. The policy manual also instructed offi cers to conduct cell checks ev ery hour, but the evidence shows they occasionally waited longe r. In fact, the parties c ontest whether officers checked on Ms. Rowell at 1:00 p.m. — an hour befo re her suicide — and the district court appeared to accept that they did not check on her for the purpose of its analysis. See 5 Aplt. App. 1295. The Estate brought this ac tion against the sheriff in his individual and official capacities and the othe r officers in their individual capacities, raising federal and state-law claims. The district court granted Defendants’ motion for summary judgment on the federal claims concluding, inter alia , that the Estate failed to establish an underlying cons titutional violation or deliber ate indifference by Sheriff Mazzola. 2 The district court dismissed the supplemental state la w claims without prejudice.

2 After Defendants filed their motion for summary judgment, the Estate voluntarily withdrew all of its claims except the official-cap acity claim against Sheriff Mazzola and the indi vidual-capacity claim agains t Sergeant Jeremy Muxlow. 5 Aplt. App. 1283. In its order, the distri ct court also granted summary judgment in favor of Sergeant Muxlow. Id. at 1299. Th e Estate did not appeal that decision.4 Discussion We review the district court’s grant of summary judgment de novo, “drawing all reasonable inferences and re solving all factual disputes in favor of [the Estate].” Murphy v. City of Tulsa, 950 F.3d 641, 64 3 (10th Cir. 2019) (citation omitted). The Estate’s claim against Sheriff Mazzola in his official capaci ty is equivalent to a suit against a governmental entity; thus, our muni cipal-liability cases apply. See Cox v. Glanz, 800 F.3d 1231, 1254 (1 0th Cir. 2015). For the Estate to succeed against Sheriff Mazzola, it must show (1) an official government policy or custom, (2) that caused a constitutional injury, a nd (3) requisite state of mind. Schneider v. City of Grand Junction Police Dep’t, 717 F.3d 760, 769 (10th Cir. 2013). Claims based on a jail suicide usually im plicate an alleged “failure of jail officials to provide medical care for those in their cust ody.” Cox, 800 F.3d at 1248 (citation omitted). Therefore, recovery re quires a showing of de liberate indifference, id., which requires establishing an objectiv e and subjective component. Strain v. Regalado, 977 F.3d 984, 989 (10th Cir. 2020). 3 Suicide satisfies the objective component. Collins v. Seeman, 462 F.3d 757, 760 (7th Cir. 2006); see Martinez v. Beggs, 563 F.3d 1082, 1088 (10t h Cir. 2009). For the subjective component, the Estate must show that jail officials “knew [Ms. Rowell] faced a substantial risk of harm and disregarded that risk, by failing to take reasonable measures to abate it.”

3 The Estate argued that only the objectiv e component needs to be established under Kingsley v. Hendricks on, 576 U.S. 389 (2015). Ap lt. Br. at 31–35. As the parties recognize in their supplemental aut hority letters, this argument has been foreclosed by our recent decision in Strain. See 977 F.3d at 989–91.5 Quintana v. Santa Fe Cnty. Bd. of Comm’ rs, 973 F.3d 1022, 1029 (10th Cir. 2020) (citation omitted). On appeal, the Estate argues that va rious jail officers were deliberately indifferent because they failed to inquire about Ms. Rowell’s suicidal tendencies, and they failed to regularly check on her despite the risk of suicide. The Estate also contends that, when viewed collectively, th e officers’ actions and other deficiencies at the jail are enough to establish its delib erate-indifference claim. We disagree. To start, the Estate cannot establis h an underlying cons titutional violation by any of the jail’s officers because they did not have subjective awareness of Ms. Rowell’s risk of suicide. Although excessive sleeping, signs of diminished appetite, and refusing to go outside for recreation time can arguably be viewed as suicidal characteristics, they can be “susceptible to a number of in terpretations.” See Cox, 800 F.3d at 1253. Officers viewed this behavior as commo n among inmates and consistent with Ms. Rowell’s previous time at the jail. No evidence suggests that Ms. Rowell mentioned her suicidal thoughts to an officer. Although the Estate argues that the subjective componen t can be shown by a risk of harm to the inmate population as a whole, our cas es have typically required knowledge about a specific inmate’s risk of suicid e. Id. at 1249–51. Moreover, the officers’ failure to follow jail procedures does not equate with a constitutional violation. The Estate alle ges that the booking questionnaire was not properly administered and that officers failed to conduct hourly cell checks. However, an officer’s failure to follow internal jail po licies does not automatically6 mean he or she acted with deliberate indi fference. See Hovate r v. Robinson, 1 F.3d 1063, 1068 n.4 (10th Cir. 1993). Especially when co nsidering the lack of evidence regarding the officers’ subjec tive awareness, the alleged deviations from timely cell checks and proper booking do not amount to deliberate indifference in these circumstances. The Estate’s comparison of th e officers in this case to the defendants in Lemire v. Cal. Dep’t of Corrs. and Rehab., 726 F.3d 1062 (9th Cir. 2013), is not persuasive because Lemire is readily di stinguishable. In that case, defendants violated jail policy by pulling all floor staff from a unit to attend a staff meeting. Id. at 1070–71. The unit — which housed mentally-ill pa tients taking psychot ropic medication — was left unmonitored for three-and-a-half hours, which resulted in an inmate’s suicide. Id. There was a triable issue on deliberate indifference because the defendants knew the specific risks posed to the inmates and they knew it was the “primary” duty of floor staff to prevent suicide attempts. Id. at 1078–79. Thus, the Lemire defendants had far more speci fic knowledge about the risks posed by inadequate supervision of inmates. The Estate next attempts to show a cognizable injury by aggregating every officers’ conduct with various other shortc omings at the jail to show a systemic failure. Even recognizing that combined actions or omissions pursuant to a governmental policy or custom may violate constitutional ri ghts, see Garcia v. Salt Lake Cnty., 768 F.2d 303, 310 (10th Cir. 198 5), the fact remains that the officers lacked knowledge of Ms. Rowell’s risk of su icide. As for any deficiencies in the7 jail’s training and policies, we do not think that they am ount to a systemic failure given the reasonable efforts to “protect th e prisoners’ safety a nd bodily integrity.” Cox, 800 F.3d at 1248 (citation omitted). The Estate’s arguments about the jail’s facilities “all sound remarkably like the tort of negligent de sign, a state remedy, not a constitutional violation.” Bame v. Iron Cnty., 566 F. App’x 731, 740 (10th Cir. 2014); see Farmer v. Brennan, 511 U.S. 825, 835 (1994) (“[D]eliberate indifference entails something more than mere neglig ence . . . .”). The Seventh Circuit decision relie d upon by the Estate is readily distinguishable. See Woodward v. Corr. Med. Servs. of Ill., Inc., 368 F.3d 917 (7th Cir. 2004). In Woodward, the court upheld a jury verdict that a defendant was deliberately indifferent to an inmate’s risk of suicide. Id. at 919. But there, the defendant failed to train st aff, condoned violating polic ies meant to help suicidal inmates, and ignored the inma te’s explicit warnings ab out his mental health and thoughts of suicide. Id. at 927–29. We also note that the Estate cannot show state of mind, an essential element of a municipal-liability claim. See Schneider, 717 F.3d at 770–71. In the context of an official-capacity claim, a plaintiff must show: the municipality has actual or construc tive notice that its action or failure to act is substantially certain to resu lt in a constitutional violation, and it consciously or deliberately chooses to disregard the ri sk of harm. In most instances, notice can be established by proving the existence of a pattern of tortious conduct. In a narr ow range of circumstances, however, deliberate indifference may be found absent a pattern of unconstitutional behavior if a violation of federal ri ghts is a highly pred ictable or plainly obvious consequence of a munici pality’s action or inaction[.]8 Id. at 771 (quoting Barney v. Pulsiphe r, 143 F.3d 1299, 1307 (1 0th Cir. 1998)). Here, the jail has had one suicide-by- hanging from decades ago and one recent attempted suicide-by-drowning. While tragic, this is not a pattern of conduct that would establish actual notice of a substantially high risk of suicide. Nor is this one of those rare circumstances where the jail’s operating pro cedures were so deficient, or the risk of the telephone cord was so obvious, that it would “be liable under § 1983 without proof of a pre-existing pattern of violations.” Connick v. Thompson, 563 U.S. 51, 64 (2011).
AFFIRMED.

Entered for the Court
Paul J. Kelly, Jr. Circuit Judge