UNPUBLISHED

UNITED STATES COURT OF APPEALS 

FOR THE FOURTH CIRCUIT 

No. 08-1937

ANGELIC BROWN, Individually and as Personal Representative 

of the Estate of Travone L. Bell, decedent; TROJAN BELL, 

Individually and as Personal Representative of the Estate 

of Travone L. Bell, decedent, 

 Plaintiffs - Appellants, 

 v. 

OFFICER MIDDLETON, Individually; OFFICER HOLT, Individually; 

OFFICER KRAMITZ, Individually; E. BERNARDI, Officer, 

Individually; DETENTION OFFICER BROWN, Individually; AL 

CANNON, Sheriff of Charleston County in his official and 

individual capacities, 

 Defendants – Appellees, 

 and 

OFFICER VALENTINE, Individually; CHARLESTON COUNTY DETENTION 

CENTER; CITY OF NORTH CHARLESTON POLICE DEPARTMENT, 

 Defendants. 

Appeal from the United States District Court for the District of 

South Carolina, at Charleston. Margaret B. Seymour, District 

Judge. (2:06-cv-02454-MBS) 

Argued: October 27, 2009 Decided: January 15, 2010 

Before KING, Circuit Judge, HAMILTON, Senior Circuit Judge, and 

Anthony J. TRENGA, United States District Judge for the Eastern 

District of Virginia, sitting by designation. 
Affirmed by unpublished per curiam opinion. 

ARGUED: Michele Patrao Forsythe, Michael W. Sautter, QUERY, 

SAUTTER, GLISERMAN & PRICE, LLC, Charleston, South Carolina, for 

Appellants. Robin Lilley Jackson, SENN, MCDONALD & LEINBACK, 

LLC, Charleston, South Carolina; Gordon Wade Cooper, BUYCK LAW 

FIRM, Charleston, South Carolina, for Appellees. ON BRIEF: 

Stephanie P. McDonald, SENN, MCDONALD & LEINBACK, LLC, 

Charleston, South Carolina, for Appellees Officer Middleton, 

Individually, Officer Holt, Individually, Officer Kramitz, 

Individually, E. Bernardi, Officer, Individually; Darren K. 

Sanders, BUYCK & SANDERS, LLC, Mount Pleasant, South Carolina, 

for Appellees Detention Officer Brown, Individually, Al Cannon, 

Sheriff of Charleston County, in his official and individual 

capacities. 

Unpublished opinions are not binding precedent in this circuit. 

2 
PER CURIAM: 

 On February 18, 2005, approximately four and a half hours 

after being arrested and while still in custody, Travone Bell 

(“Bell”), age 16, suddenly collapsed into unconsciousness while 

taking a shower at the Charleston County Detention Center (the 

“Detention Center”). He received immediate medical attention and 

was taken to a nearby hospital. He died approximately ten days 

later without ever regaining consciousness. The underlying cause 

of his collapse was attributed to acute cocaine intoxication. 

Following their son’s death, Appellants Angelic Brown and 

Trojan Bell (“Appellants”), acting individually and as personal 

representatives of the Estate of Travone Bell, filed a claim 

under 42 U.S.C. § 1983 against the City of North Charleston 

Police Department (the “Department”), Al Cannon, the Sheriff of 

Charleston County, Officers Tony Middleton, Justin Holt, Alan 

Kramitz, Ethan Bernardi, George Valentine,1 who were involved in 

their son’s arrest, and Officer Hans Brown, who processed their 

son at the Detention Center (collectively referred to as the 

“Appellees”). Appellants allege that Appellees violated their 

son’s federal constitutional rights when his urgent medical 

 1

 Although Officer Valentine was named as a defendant in the 

District Court and is included among the Appellees, the 

Appellants have not pressed their claim against Officer 

Valentine on appeal. 

3 
needs were not attended to following his arrest on February 18, 

2005. The District Court entered summary judgment against the 

Appellants. Because the evidence does not support a reasonable 

inference that Appellees had actual knowledge that Bell was in 

need of medical attention before his sudden collapse, we must 

affirm. 

I. Background 

 At approximately 12:30 a.m. on February 18, 2005, Officer 

Holt stopped a vehicle driven by Bell for speeding. Bell was 

arrested at the scene, handcuffed, and placed in the back of 

Officer Holt’s police vehicle. Officers Middleton, Kramitz, 

Bernardi, and Schmidt arrived to provide back up and assistance. 

During a search of Bell’s vehicle, the officers found 

several empty plastic baggies in the driver’s side door. There 

was no evidence that these baggies previously contained any 

material. Each officer asked Bell whether he was in possession 

of anything illegal, including drugs or guns, and Bell responded 

in the negative each time. Officers Bernardi and Middleton 

noticed that Bell appeared to have an object in his mouth and 

removed from Bell’s mouth a baggie containing an off white 

substance, which field tested positive for crack-cocaine. The 

Appellants contend this baggie had holes in it and that the 

crack-cocaine in the baggie was moist from Bell’s saliva at the 

4 
time it was taken from his mouth,2 while the Appellees maintain 

that Officer Middleton made the holes in the baggie himself in 

order to field test the substance inside, and the substance 

inside the baggie became moist from the saliva on the baggie’s 

exterior during that procedure. 

After removing the baggie from Bell’s mouth, Officers Holt, 

Middleton, and Kramitz each asked Bell several times whether he 

had swallowed any drugs. Bell denied doing so each time, even 

after Officer Kramitz cautioned Bell that if he had swallowed 

any drugs, he needed to be treated and that he would not face 

any additional charges for narcotics that he had consumed. Bell 

was also offered immediate medical attention as well as the 

services of an ambulance, but Bell continued to deny swallowing 

any drugs or any need for medical attention. Bell did admit to 

smoking earlier in the day several marijuana cigars laced with 

cocaine, known as “blunts,” but Bell appeared calm, acted in a 

normal manner, and carried on friendly conversation with the 

officers. 

 2

 The evidence offered to support this contention is a 

statement in Officer Holt’s supplemental arrest report that 

describes the cocaine in the baggie as moist. Officer Holt later 

testified, however, that it was the baggie that was moist, and 

the contents of the baggie became moist when exposed to the 

saliva on the outside after the baggie was removed from Bell’s 

mouth. 

5 
Because Bell was being charged as an adult, he was 

transported to the South Precinct of the North Charleston Police 

Department to complete paper work and then to the Detention 

Center, where he arrived at 2:48 a.m. At the Detention Center, 

Bell was taken to the Juvenile Unit, where Officer Brown 

performed a strip search on Bell. Brown was provided with a copy 

of the incident report that referenced the drugs taken from 

Bell’s mouth.3 During his processing of Bell, Officer Brown asked 

Bell if he had swallowed any drugs. Bell again denied swallowing 

drugs, but again admitted having smoked up to five cocaine laced 

marijuana cigars earlier in the day. Officer Brown checked 

Bell’s mouth for any additional hidden drugs, without finding 

any. He also observed that Bell was acting calm and compliant, 

without the abnormal behavior that is normally associated with 

cocaine use. 

 After Officer Brown’s search, Bell was taken to the shower 

room, where he began taking a shower. At approximately 3:53 

a.m., a little over an hour after his arrival at the Detention 

Center, Bell fell out of the shower stall and suffered a series 

 3

 Officer Holt contends that he told Officer Brown, the 

processing officer, that a plastic baggie of crack-cocaine had 

been removed from Bell’s mouth, and that Bell could be hiding 

additional drugs in his mouth, behind his gold teeth. Officer 

Brown, however, denies receiving this information from Officer 

Holt. 

6 
of seizures that rendered him unconscious. The officers and 

medical staff immediately responded and summoned emergency 

medical services that transported Bell to nearby St. Francis 

Xavier Hospital emergency room. In the emergency room, Bell’s 

urine tested positive for marijuana and cocaine, although no 

blood tests were conducted to determine the exact amount of 

drugs in his system. Bell never regained consciousness and died 

on March 1, 2005. The cause of death was listed as cerebral 

hypoxia due to subacute myocardial infarction secondary to acute 

cocaine intoxication. 

II. Procedural History/Standard of Review 

On August 3, 2006, Appellants filed a complaint against 

Appellees in the Court of Common Pleas for Charleston County, 

South Carolina, alleging both federal claims under 42 U.S.C. § 

1983 and state law claims pursuant to the South Carolina Torts 

Claims Act, S.C. Code Ann. §§ 17-78-10, et seq. On September 1, 

2006, the Appellees removed the case to federal court. On July 

22, 2008, the District Court granted the Appellees’ motion for 

summary judgment and remanded the remaining state law claims 

after refusing to exercise supplemental jurisdiction. The 

Appellants have appealed the District Court’s summary judgment 

ruling as to their Section 1983 claims. We review a grant of 

summary judgment de novo, viewing the facts in the light most 

7 
favorable to the non-prevailing party, here, the Appellants. See

Holland v. Washington Homes, Inc., 487 F.3d 208, 213 (4th Cir. 

2007). 

III. Analysis 

Section 1983, by its own terms, prohibits constitutional 

violations under color of state law. In this case, Appellants 

claim that the Appellees violated their son’s constitutional 

rights under the Fourteenth and Eighth Amendments when they 

failed to properly attend to his urgent medical needs following 

his arrest. 

Persons within state police custody enjoy the protections 

afforded by the Fourteenth and Eighth Amendments, which include 

the right to obtain adequate medical care. Martin v. Gentile, 

849 F.2d 863, 866 (4th Cir. 1988) (explaining that the denial of 

medical care by state officials can give rise to claims under 

the Fourteenth Amendment’s due process clause); see also City of 

Revene v. Massachusetts Gen. Hosp., 463 U.S. 239, 266 (1983) 

(holding that pretrial detainees have at least the same 

protections under the Fourteenth Amendment as post-trial 

detainees have under the Eighth Amendment); Belcher v. Oliver, 

898 F.2d 32, 34 (4th Cir. 1990) (“[T]he Fourteenth Amendment 

right of pretrial detainees, like the Eighth Amendment right of 

convicted prisoners, requires that government officials not be 

8 
deliberately indifferent to any serious medical needs of the 

detainee."); Mitchell v. Aluisi, 872 F.2d 577, 581 (4th Cir. 

1989) (“A violation of the Eighth Amendment standard . . . may 

be used, however, to determine a due process violation.”) 

(citing Whisenant v. Yuam, 739 F.2d 160, 163 n.4 (4th Cir. 

1984)). 

“[O]nly the unnecessary and wanton infliction of pain 

implicates the Eighth Amendment" and a prison official must 

therefore have a “sufficiently culpable state of mind.” Wilson

v. Seiter, 501 U.S. 294, 298, 302-303 (1991). Failure to provide 

adequate medical care to a detained individual rises to the 

level of a constitutional violation when there is “deliberate 

indifference” to an individual’s serious medical needs. See

Estelle v. Gamble, 429 U.S. 97, 105 (1976) (“[D]eliberate 

indifference to serious medical needs of prisoners constitutes 

the ‘unnecessary and wanton infliction of pain,’ proscribed by 

the Eighth Amendment.”) (quoting Gregg v. Georgia, 428 U.S. 153, 

173 (1976)). In order to establish “deliberate indifference,” 

the Appellants must show that the arresting or processing 

officers were “aware of facts from which the inference could be 

drawn that a substantial risk of serious harm exists,” and also 

that the officers “must also [have drawn] the inference.” Farmer 

v. Brennan, 511 U.S. 825, 837 (1994) (defining “deliberate 

indifference”). 

9 
In summary, in order to establish liability under Section 

1983 based on a claim of inadequate medical care, Appellants 

must show the officers had actual knowledge that Bell had an 

urgent medical need because of a known risk. Conduct that is 

merely negligent, or even reckless, is insufficient. Farmer, 511 

U.S. at 537 (rejecting the notion that that the common law 

definition of “reckless” in civil cases meets the deliberate 

indifference standard).4 For these reasons, “[i]f an officer 

fails to act in the face of an obvious risk of which he should 

have known, but did not, the officer has not violated the Eighth 

or Fourteenth Amendments.” Watkins v. City of Battle Creek, 273 

F.3d 682, 686 (6th Cir. 2001) (citing Farmer, 511 U.S. at 837-

838). 

In assessing whether these officers had the required level 

of awareness necessary to establish “deliberate indifference” to 

Bell’s urgent medical needs, the Court must consider, based on 

the summary judgment record, whether Bell’s need for medical 

attention was both “apparent and serious.” Grayson v. Reed, 195 

F.2d. 692, 695 (4th Cir. 1999). A medical need is “serious” if 

 4

 The District Court remanded Appellants’ claims under the 

South Carolina Torts Claims Act, S.C. Code Ann. §§ 15-78-10, et 

seq. The Act waives the state’s immunity for losses “proximately 

caused by a tort of the State,” id. at 15-78-50, and is not 

subject to the “deliberate indifference” standard applied to 

claims under Section 1983. 

10 
it is one that has been “diagnosed by a physician as mandating 

treatment or one that is so obvious that even a lay person would 

easily recognize the necessity for a doctor's attention.” Iko v. 

Shreve, 535 F.3d 225, 241 (4th Cir. 2008) (quoting Henderon v. 

Sheahan, 196 F.3d 839, 846 (7th Cir. 1999)). 

A. 

Looking at the facts in the light most favorable to the 

Appellants, the evidence offered to support Appellants’ claim 

does not support the inference that the arresting officers knew 

that Bell was in need of urgent medical attention as a result of 

cocaine consumption. It is undisputed that the Officers did not 

see Bell ingest any cocaine and Bell did not have any tell-tale 

signs in or around his mouth of cocaine ingestion when the 

baggie was removed. Even if the substance inside the baggie were 

moist following its extraction from Bell’s mouth, there was no 

indication, from residue on the outside of the baggie or 

otherwise, that the baggie had lost any of its contents. 

Importantly, Bell repeatedly and consistently denied swallowing 

any drugs, while admitting to drug use earlier in the day.5

During the several hours that he was under police observation 

after his arrest, but before his collapse, Bell acted normally 

 5

 Appellants do not contend that the officers were 

“deliberately indifferent” based on their knowledge of his 

smoking the cocaine laced marijuana. 

11 
throughout his interactions with the officers without showing 

any of the behavioral symptoms associated with cocaine 

ingestion. While the arresting officers were rightfully 

concerned that Bell may have swallowed drugs, there is no 

evidence from which a fact finder could infer that they in fact 

knew that Bell had consumed cocaine or that Bell evidenced the 

need for medical attention. 

 The Appellants claim that the evidence is sufficient to 

make the required showing for the purposes of surviving summary 

judgment when one considers Bell’s age and the special 

protections that South Carolina law provides to juvenile 

detainees, but which Bell allegedly did not receive.6 Whether 

Bell was properly treated as a juvenile under South Carolina law 

does not affect the constitutional standard by which the 

Appellees’ conduct is to be judged; and Appellants still must 

show, even if Bell is considered a juvenile for the purposes of 

 6

 Specifically, Appellants allege that the Detention 

Center’s own procedures prohibit juveniles from being admitted 

to the Detention Center if there is any doubt about their 

medical condition. Appellants also contend that under S.C. Code 

§ 63-19-810(B), Officer Holt was required to inform an 

authorized representative of the State Department of Juvenile 

Justice of Bell’s arrest and location, and that Bell’s parents 

were required to be notified that he was in custody under S.C. 

Code § 63-19-810(A), which also places any child under the age 

of seventeen within the jurisdiction of the South Carolina 

Family Court. 

12 
their constitutional claims, that the officers were deliberately 

indifferent to a known need for urgent medical attention. 

 The facts presented to the District Court, when viewed in 

the light most favorable to the Appellants, do not create a 

triable issue of fact concerning whether the arresting officers 

in fact knew that Bell was in need of urgent medical attention. 

For these reasons, the evidence did not sufficiently support the 

claim that the arresting officers violated Bell’s constitutional 

rights.7 

B. 

 With respect to Officer Brown, who processed and 

searched Bell at the Detention Center several hours after his 

vehicle was initially stopped, it is uncontested that Officer 

Brown searched Bell’s mouth for drugs without finding anything 

and asked Bell if he had swallowed any drugs, which Bell again 

denied. He also observed that Bell was acting normally, without 

showing the signs or symptoms of cocaine ingestion. When Bell 

collapsed while taking a shower, Officer Brown acted immediately 

to provide him with medical attention. 

 7

 As Appellants did not raise the issue on appeal, we will 

not address the District Court’s finding that the level of force 

used by the arresting officers to retrieve the baggie from 

Bell’s mouth did not violate Bell’s Fourth Amendment rights. 

13 
Even assuming for purposes of summary judgment that Officer 

Brown knew that a baggie of crack-cocaine had been retrieved 

from Bell’s mouth and that Officer Holt had specifically told 

him to search Bell’s mouth, the evidence remains insufficient to 

support the inference that Officer Brown knew that Bell was in 

need of urgent medical attention. Accordingly, the evidence is 

insufficient to create a triable issue of fact as to whether 

Officer Brown was “deliberatively indifferent.” 

C. 

 Appellants base their claim against Al Cannon, the Sheriff 

of Charleston County, not on his actual involvement in the 

arrest or processing of Bell, but rather on his supervisory 

responsibilities. Under Section 1983, a supervisory official may 

be held liable in his personal capacity in certain circumstances 

for constitutional injuries inflicted by his subordinates if 

those actions were premised on a recognition that supervisory 

indifference or tacit approval of the misconduct could cause the 

constitutional injury. Shaw v. Stroud, 13 F.3d 791, 798 (4th 

Cir. 1994). In this case, however, since we have found that none 

of the officers violated Bell’s constitutional rights, there is 

no basis for Sheriff Cannon’s liability under any theory.8

 8

 The District Court also correctly concluded that Sheriff 

Cannon cannot be held liable under Section 1983 in his official 

capacity. See Will v. Michigan Dept. of State Police, 491 U.S. 

(Continued) 

14 
Likewise, because we have found that none of the officers 

violated Bell’s constitutional rights, there is no basis for the 

Appellants’ claim against the Department itself. 

D. 

The District Court was also correct in concluding that the 

officers were entitled to qualified immunity for any 

constitutional violation they may have committed. When 

government officers are performing a discretionary function, 

they are entitled to a defense of qualified immunity unless 

their conduct clearly violates an established constitutional 

right that the officer reasonably would have known to exist. 

Harlow v. Fitzgerald, 457 U.S. 800 (1983) (granting qualified 

immunity in the Section 1983 context). Whether or not a police 

officer is entitled to qualified immunity is a question of law 

for the court, and when there are no relevant disputed material 

facts, a court should rule on the qualified immunity issue at 

the summary judgment stage. Willingham v. Crooke, 412 F.3d 553, 

558 (4th Cir. 2005) (“Ordinarily, the question of qualified 

 

58, 71 (1989) (“We hold that neither a state nor its officials 

acting in their official capacities are ‘persons’ under § 

1983.”); see also Gulledge v. Smart, 691 F. Supp. 947 (D.S.C. 

1988) aff’d 878 F.2d 379 (4th Cir. 1989) (holding that, in South 

Carolina, sheriffs and deputies are state officials). 

15 
16 

immunity should be decided at the summary judgment stage.”) 

(citing Wilson v. Kittoe, 337 F.3d 392, 397 (4th Cir. 2003)). 

In this case, as discussed above, none of the officers 

violated any of Bell’s constitutional rights. Without any 

evidence demonstrating the officers had knowledge that Bell was 

in urgent need of medical care, the officers cannot have 

violated a clearly established constitutional right and are 

entitled to qualified immunity. 

 IV. Conclusion 

 For the above reasons, we affirm the judgment of the 

District Court. 

AFFIRMED