IN THE UNITED STATES COURT OF APPEALS

FOR THE FIFTH CIRCUIT

No. 12-40749

ESTATE OF LAURA ALLISON; WILLIAM ALLGOOD; KIMBERLY NOLET,

Plaintiffs-Appellees

v.

BILL WANSLEY; DAVID HAYES; CYNTHIA HYATT;

MICHAEL ALLISON; RYAN ZELLER; JOSHUA DEAN; BOBBYE LEFFEL,

Defendants-Appellants

Appeal from the United States District Court 

for the Eastern District of Texas

USDC No. 6:11-cv-00100

Before STEWART, Chief Judge, and BENAVIDES and HIGGINSON, Circuit

Judges.

PER CURIAM:*

Defendants-Appellants (“Appellants”)filed this interlocutory appeal of the

district court’s denial of summary judgment on the defense of qualified

immunity. Plaintiffs-Appellees (“Appellees”) had brought suit in the district

court, alleging that Appellants treated Laura Allison’s serious medical needs

with deliberate indifference while she was incarcerated in the Wood County Jail,

United States Court of Appeals

Fifth Circuit

F I L E D

May 15, 2013

Lyle W. Cayce

Clerk

* Pursuant to 5TH CIR. R. 47.5, the court has determined that this opinion should not

be published and is not precedent except under the limited circumstances set forth in 5TH CIR.

R. 47.5.4.

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therebyresultinginherdeath. WeREVERSEandREMANDfor furtherproceedings.

I. FACTUAL & PROCEDURAL HISTORY

In February 2007, Decedent Laura Allison (“Decedent Allison”) was

arrested in Wood County, Texas for driving under the influence of alcohol. As

a condition of her sentence, she was required to attend the Victim Impact Panel

(“VIP”) class, which the Wood County Probation Office conducted. On March 17,

2009, Decedent Allison arrived at a VIP class, which Adult Probation

Officer/Community Supervision Officer Colin Kovic (“Officer Kovic”) was

facilitating that day. When Officer Kovic first saw Decedent Allison as she

arrived at the class around 5:30 PM, he noticed that her eyes were glassy and

red, her speech was slow, and she smelled of alcohol. Decedent Allison explained

her condition to Officer Kovic by stating that she was suffering from allergies

and had taken a double dosage of her allergy medication. Officer Kovic

requested several times that Decedent Allison take a breathalzyer examination,

but she refused. Officer Kovic thus called the Wood County Sheriff’s

Department, which sent Quitman Police Officer David Barkley (“Officer

Barkley”) to the scene. Texas Department of Public Safety Trooper Brandon

Owens acted as backup for Officer Barkley. 

When Officer Barkley arrived, Officer Kovic told Officer Barkley that he

had requested that Decedent Allison take a breathalyzer test, but she had

refused. Officer Barkley also requested that she take a breathalyzer

examination, but she again refused. Officer Barkley told Decedent Allison that

he could smell alcohol about her person, but she denied that she had been

drinking. Officer Barkley then performed a simple sobriety test by requesting

that she stand on one leg, but she failed the test, as she was unable to keep her

leg raised. Officer Barkley therefore placed her under arrest at approximately

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6:37 PM and transported her to the Wood County Jail (“Jail”), where she arrived

at approximately 7 PM.1

Officer Barkley’s arrest report stated: “Suspect arrived at Probation Office

had been drinking and stated took prescription meds not in accordance with

direction.” (capitalization in original omitted). Officer Barkley’s Complaint/With

Probable Cause Affidavit states, in pertinent part:

I noticed the odor of an alcohol beverage emitting from

[Decedent] Allison’s breath. I further observed she was

confused in answering questions. Her speech was

slurred and she was staggered [sic]. [Decedent] Allison

stated she had misused her prescription medications. 

At this time I attempted to have [Decedent] Allison

complete a standard field sobriety test which she could

not. [Decedent] Allison did appear in a public place

while intoxicated and did present a threat [illegible]

danger to herself or others.

(capitalization in original omitted).

Officer Kovic later attested in his affidavit that, on the day of Decedent

Allison’s arrest, she appeared intoxicated, but not so intoxicated as to require

medical help. He averred that she was able to walk without assistance and

carry on a conversation with him. He further attested that, if she had appeared

to need medical help, he would have requested emergency assistance for her.

Defendant Jail Sergeant David Hayes (“Sergeant Hayes”) was the

supervisor at the Jail the night of Decedent Allison’s arrest, and he booked her

into the Jail. Decedent Allison was crying and upset because she was arrested

and would be unable to see her grandchildren the next day as she had planned. 

Sergeant Hayes used a screening form to obtain information from her regarding

any “suicide and medical and mental impairments.” Sergeant Hayes noted her

1 While the arrest report indicates the arrest time was 6:37 PM and booking time was

7 PM, we note that the parties and the district court use slightly different times for these

events; these differences are immaterial to the issues presented on appeal, however.

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medications as “Paxil, Disapam [sic], [and] Clamara [sic],” and Decedent Allison

reported to him that she attempted suicide a year earlier by using pills because

she was depressed. In response to the screening form’s question, “Observed to

be under the influence of alcohol drugs or withdrawal?” Sergeant Hayes

answered, “No.” In response to the question, “Does arresting officer or any other

person believe that the inmate is at risk due to a medical condition, mental

illness, mental retardation, or suicide concern?” he also answered, “No.” In his

deposition, Sergeant Hayes testified that, while he did not recall whether he had

read the specific information in Officer Barkley’s arrest report that Decedent

Allison had taken prescription drugs not in accordance with directions, he

typically reads arrest reports when a new inmate is booked into the Jail. 

Several Jailers testified in deposition regarding Decedent Allison’s

condition when she arrived at the Jail. Defendant Jailer Joshua Dean (“Jailer

Dean”) testified that Decedent Allison did not appear to be in any medical

distress during the booking process: she was not falling down, vomiting, or

bleeding, and she was coherent, able to stand on her own, and capable of

answering all of Jailer Dean’s questions. Defendant Jailer Cynthia Hyatt

(“Jailer Hyatt”) likewise testified that Decedent Allison exhibited no signs of

medical distress. Additionally, Jailer Hyatt testified that she observed Decedent

Allison from 7 PM until 8:30 PM, that she was doing “okay,” and that by 8:30

PM, she was sleeping. Jailer Hyatt further testified that she asked Decedent

Allison if she needed anything at one point, but Decedent Allison said that she

did not. Defendant Jailer Bobbye Leffel (“Jailer Leffel”) also assisted with

Decedent Allison’s booking by conducting the pat-down search. Jailer Leffel

testified that Decedent Allison was “highly upset” about not getting to see her

grandchildren and “just appeared to be intoxicated.” Jailer Leffel further

testified that Decedent Allison was able to carry on a conversation and did not

stumble, fall, or trip on the way to her cell.

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On the other hand, Defendant Jailer Michael Allison (“Jailer Allison”)2

noticed Decedent Allison “passed out” on the bench in her cell around 8 PM. By

“passed out,” Jailer Allison meant “she was laid down asleep, and I know she

had got brought in for PI [public intoxication], for some sort of intoxication.” Due

to Jailer Allison’s knowledge that Decedent Allison was arrested for “some sort

of intoxication,” he asked Defendant Jailer Ryan Zeller (“Jailer Zeller”) if

Decedent Allison “was messed up with pills or alcohol.” However, Jailer Allison

also testified that he “didn’t know how messed up” she was but she “looked fine,”

despite the fact that she was passed out.

Various Jailers testified that they walked by Decedent Allison’s cell

approximately every thirty minutes at least to check on her, including to make

sure that she was still breathing. For example, Jailer Leffel testified that

Decedent Allison appeared to be fine at one point, by which she meant Decedent

Allison was breathing and snoring.

At approximately 9 PM, Decedent Allison’s husband went to the Jail and

asked to speak with his wife. The husband appeared concerned and had brought

Decedent Allison’s medication with him. He told Jailer Dean that he believed

that Decedent Allison “might have taken something,” but he was not sure what. 

When Jailer Dean asked for more information, the husband did not provide any. 

Some of the Jailers attempted to rouse Decedent Allison to speak with her

husband, but Allison merely moaned and mumbled; she did not fully wake up. 

Jailer Dean asked the husband to wait until another officer relieved him so that

he and the husband could speak more, but the husband left the Jail before Jailer

Dean returned.

Jailer Dean relayed his conversation with Decedent Allison’s husband to

Sergeant Hayes, to which Sergeant Hayes responded, “Keep a close eye on her.” 

2 There is no relation between Decedent Allison and Jailer Allison.

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Regarding these instructions, Jailer Dean later testified, “That’s all we were

doing to start with . . . . We already knew that information [regarding the

prescription medication] from the book-in report. [The husband] wasn’t telling

us anything we didn’t already know.” In response to a question, Jailer Dean

clarified that the Jail staff already had received information that Decedent

Allison “might have been taking prescription medication.” He stated, “We

received that in the book-in packet as well as her husband stated [sic], but we

did not know for a fact that she was. We’re not doctors.” The Jailers variably

testified that they closely monitored Decedent Allison for the rest of the night in

intervals of fifteen to thirty minutes.

At approximately 11:15 PM, Sergeant Hayes noticed that Decedent Allison

had not changed positions in a while, and he could not tell whether she was

breathing by looking into her cell. He banged on her door but received no

response. He thus asked Jailer Zeller to enter the cell with him, and they tried

to wake her, but were unable to do so. When Jailer Zeller noted that she had no

pulse, they presumed she had died. Sergeant Hayes called his captain, as well

as dispatch to call an ambulance. The ambulance arrived shortly after midnight. 

None of the Jailers attempted to resuscitate Decedent Allison after they

discovered she had no pulse. Appellants assert that no one on the Jail staff was

certified to perform cardiopulmonary resuscitation (“CPR”).

The Medical Examiner’s autopsy report states, “It is my opinion that

Laura Janette Allison, a 54 year old white woman, died from acute ethanol

intoxication. Although diazepan, in connection with ethanol can depress the

respiratory drive, the levels were low and had minimal, if any, contribution to

the death.” The toxicology report noted .39% ethanol, .07mg/l diazepam, and

.21mg/l demethyldiazpam. 

In addition to the foregoing facts surrounding Decedent Allison’s death at

the Jail, both parties presented evidence of the Jail’s policies and practices with

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respect to inmates requiring medical care. Appellees assert that they have

presented evidence demonstrating that: 1) there have been three deaths at the

Jail since 2006; 2) there is no policy requiring medical staff onsite at the Jail at

night; 3) the Jail’s policy is to leave decisions about whether to contact medical

personnel to the discretion of the Jailers on duty; 4) most Jailers are not trained

in CPR or “basic lifesaving measures”; and 5) none of the Jailers were disciplined

for failing to provide Decedent Allison with medical treatment, and the Jail has

made no changes to its policies since her death. Appellants assert that they

have presented evidence indicating that: 1) the Jail’s policy is not to accept

inmates who are so intoxicated that their health might be in danger; and 2) the

Jail’s policy is to obtain medical attention for any inmate who needs it.

Appellees–Decedent Allison’s Estate and her two children–filed their

complaint on March 2, 2011, alleging that Appellants treated Decedent Allison’s

serious medical needs with deliberate indifference while she was incarcerated

at the Jail on public intoxication charges. Appellees named as defendants all of

the Jailers who were on duty the night Decedent Allison died, as well as Sheriff

Bill Wansley (“Sheriff Wansley”) and Wood County, Texas (“County”).3 On April

3, 2012, Appellants moved for summary judgment, arguing that the individual

defendants were entitled to qualified immunity and that the County does not

have a policy, custom, or practice of treating inmates’ constitutional rights with

deliberate indifference. After holding a hearing, the district court denied

Appellants’ motion on July 3, 2012. Appellants timely filed a notice of

interlocutory appeal.

II. DISCUSSION

A. Jurisdiction

3 The County is not a party to this appeal.

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“Ordinarily, we do not have jurisdiction to review a denial of a summary

judgment motion because such a decision is not final within the meaning of 28

U.S.C. § 1291.” Gobert v. Caldwell, 463 F.3d 339, 344 (5th Cir. 2006) (quoting

Palmer v. Johnson, 193 F.3d 346, 350 (5th Cir. 1999)). However, “[t]he denial

of a motion for summary judgment based on qualified immunity is immediately

appealable under the collateral order doctrine to the extent that it turns on an

issue of law.” Manis v. Lawson, 585 F.3d 839, 842 (5th Cir. 2009) (citation and

internal quotation marks omitted). Our jurisdiction on appeal is limited. We

have jurisdiction to determine whether a factual dispute is material, but not

whether it is genuine. Id. at 842-43 (citation omitted). “A district court’s

decision to deny qualified immunity on a motion for summary judgment is ‘not

appealable if [it is] based on a claim regarding the sufficiency of the evidence.’” 

Gobert, 463 F.3d at 344 (alteration in original) (citations omitted). Thus, “if the

district court concludes that the summary judgment record raises a genuine

issue of material fact with respect to whether . . . qualified immunity is

applicable, then that decision is not immediately appealable[.]” Id. (citations

omitted). “The scope of clearly established law and the objective reasonableness

of those acts of the defendant that the district court found the plaintiff could

prove at trial are legal issues we review de novo.” Thompson v. Upshur Cnty.,

Tex., 245 F.3d 447, 456 (5th Cir. 2001) (citations omitted).

We conclude, as a threshold matter, that we have jurisdiction to determine

the materiality of the factual disputes here, and we address those factual

disputes in our section entitled, “Qualified Immunity Applied Here,” infra.

B. Standard of Review

The standard of review for “an interlocutory appeal asserting qualified

immunity differs from the standard employed in most appeals of summary

judgment rulings.” Kinney v. Weaver, 367 F.3d 337, 347 (5th Cir. 2004) (en

banc). We accept the plaintiffs’ version of events as true and examine “only

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whether the district court erred in assessing the legal significance of the conduct

that the district court deemed sufficiently supported for purposes of summary

judgment.” Id. at 348 (citations omitted). We review this question de novo. Id.

at 349.

C. Qualified Immunity

Generally, government officials performing discretionary functions have

qualified immunity, which shields against civil damages liability, so long as their

actions reasonably could have been thought consistent with the rights they are

alleged to have violated. Anderson v. Creighton, 483 U.S. 635, 638 (1987);

Gobert, 463 F.3d at 345 (citation omitted). To determine whether defendants are

entitled to qualified immunity, we ask: (1) whether the facts, taken in the light

most favorable to the party asserting the injury, show that the defendants’

conduct violated a constitutional right, and (2) whether the right violated was

clearly established at the time of the defendants’ alleged conduct. See Pearson

v. Callahan, 555 U.S. 223, 232 (2009) (citing Saucier v. Katz, 533 U.S. 194, 201

(2001), overruled in part by Pearson, 555 U.S. at 236) (other citations omitted).

While it is often appropriate to answer these two questions sequentially, courts

are allowed to exercise their “sound discretion in deciding which of the two

prongs of the qualified immunity analysis should be addressed first in light of

the circumstances in the particular case at hand.” Id. at 236.

“‘Clearly established’ means that the ‘contours of the right must be

sufficiently clear that a reasonable official would understand that what he is

doing violates that right.’” Thompson, 245 F.3d at 457 (quoting Anderson, 483

U.S. at 640). “The defendant’s acts are held to be objectively reasonable unless

all reasonable officials in the defendant’s circumstances would have then known

that the defendant’s conduct violated the United States Constitution or the

federal statute as alleged by the plaintiff.” Id. (citations omitted). The

“defendant’s circumstances” includes facts that the defendant knows. Id. 

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“However, because qualified immunity turns only upon the objective

reasonableness of the defendant’s acts, a particular defendant’s subjective state

of mind has no bearing on whether that defendant is entitled to qualified

immunity.” Id. (citations omitted). “An official is eligible for qualified immunity

even if the official violated another’s constitutional rights.” Id. (citations

omitted). “The Supreme Court has characterized the doctrine [of qualified

immunity] as protecting ‘all but the plainly incompetent or those who knowingly

violate the law.’” Cozzo v. Tangipahoa Parish Council-President Gov’t, 279 F.3d

273, 284 (5th Cir. 2002) (quoting Malley v. Briggs, 475 U.S. 335, 341 (1986)).

“Whether an official’s conduct was objectively reasonable is a question of

law for the court, not a matter of fact for the jury.” Brown v. Callahan, 623 F.3d

249, 253 (5th Cir. 2010) (citation omitted). 

D. Constitutional Right to Reasonable Medical Care

Pretrial detainees have a constitutional right notto have confining officials

treat their serious medical needs with deliberate indifference, under the Due

Process Clause of the Fourteenth Amendment. See Jacobs v. W. Feliciana

Sheriff’s Dep’t, 228 F.3d 388, 393 (5th Cir. 2000) (“Unlike convicted prisoners,

whose rights to constitutional essentials like medical care and safety are

guaranteed by the Eight[h] Amendment, pretrial detainees look to the

procedural and substantive due process guarantees of the Fourteenth

Amendment to ensure provision of these same basic needs.” (citing Bell v.

Wolfish, 441 U.S. 520 (1979)). This right was clearly established law at the time

of the incident in question.

1. Standards for Section 1983 Individual Liability

Appellees have alleged that the individual officers were deliberately

indifferent to Decedent Allison’s serious medical need, given her cause of death–

acute ethanol poisoning. “It is well-settled in the law that ‘a state official’s

episodic act or omission, violates a pretrial detainee’s due process rights to

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medical care . . . if the official acts with subjective deliberate indifference to the

detainee’s rights.’”4Id. at 393 (citation omitted). In order to demonstrate

subjective deliberate indifference, a plaintiff must present evidence: “(1) that

each defendant had subjective knowledge of facts from which an inference of

substantial risk of serious harm could be drawn, (2) that each defendant actually

drew that inference; and (3) that each defendant’s response to the risk indicates

that the [defendant] subjectively intended that harm occur.” Tamez v. Manthey,

589 F.3d 764, 770 (5th Cir. 2009) (citation and internal quotation marks

omitted). Deliberate indifference cannot be inferred merely from a negligent or

even a grossly negligent response to a substantial risk of serious harm. See Hare

v. City of Corinth, 74 F.3d 633, 645, 649-50 (5th Cir. 1996) (en banc) (citations

omitted). “Deliberate indifference is an extremely high standard to meet.”

Domino v. Tex. Dep’t of Criminal Justice, 239 F.3d 752, 756 (5th Cir. 2001). 

2. Standards for Section 1983 Supervisory Liability

“Under [42 U.S.C. § 1983 (“Section 1983”)], supervisory officials are not

liable for the actions of subordinates on any theory of vicarious liability.”

Thompkins v. Belt, 828 F.2d 298, 303 (5th Cir. 1987) (citations omitted); see also

Roberts v. City of Shreveport, 397 F.3d 287, 292 (5th Cir. 2005) (citation omitted). 

Where, as here, a sheriff is not personally involved in the acts that allegedly

deprived the plaintiff of her constitutional rights, that sheriff is liable under

Section 1983 if: “1) the sheriff failed to train or supervise the officers involved;

2) there is a causal connection between the alleged failure to supervise or train

4 Appellees’ claim against the individual defendants is properly analyzed as an “episodic

act or omission” case, rather than a “condition of confinement” case. See Scott v. Moore, 114

F.3d 51, 53 (5th Cir. 1997) (en banc) (“In an ‘episodic act or omission’ case, an actor usually is

interposed between the detainee and the municipality, such that the detainee complains first

of a particular act of, or omission by, the actor and then points derivatively to a policy, custom,

or rule (or lack thereof) of the municipality that permitted or caused the act or omission.”).

If a case falls under the “episodic act or omission” category, we apply the deliberate

indifference standard. Id. at 54 (citation omitted).

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and the alleged violation of the plaintiff’s rights; and 3) the failure to train or

supervise constituted deliberate indifference to the plaintiff’s constitutional

rights.” Thompson, 245 F.3d at 459 (citations omitted).

“Proof of more than a single instance of the lack of training or supervision

causing a violation of constitutional rights is normally required before such lack

of training or supervision constitutes deliberate indifference.” Id. (citations

omitted). Generally, the plaintiff must demonstrate at least a pattern of similar

violations. Id. (citation omitted). Moreover, “the inadequacy of training must

be obvious and obviously likely to result in a constitutional violation.” Id.

(citations omitted).

E. Qualified Immunity Applied Here

1. Individual Jailers

The Jailers argue that they have presented uncontroverted evidence that

they did not treat Decedent Allison’s serious medical needs with deliberate

indifference. They further argue that, even if they did treat her medical needs

with deliberate indifference, their actions were objectively reasonable. 

Accordingly, they argue that they are entitled to immunity from suit on this

basis.

Appellees contend that the evidence illustrates that the Jailers both had

“subjective knowledge of facts from which an inference of substantial risk of

serious harm could be drawn” and “that each defendant actually drew that

inference.” See Tamez, 589 F.3d at 770 (citation and internal quotation marks

omitted). Specifically, Appellees allege that the Jailers knew that Decedent

Allison was extremely intoxicated and had taken prescription medication in

greater dosages than necessary, a combination which could be deadly. Further,

Appellees argue that the Jailers’ actions prove that they actually drew this

inference, in light of their frequent monitoring of Decedent Allison to ensure that

she was still breathing. Appellees further argue that the genuine disputes of

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fact as to both the Jailers’ knowledge regarding Decedent Allison’s ingestion of

prescription drugs and her apparent physical condition upon arriving at the Jail

preclude summary judgment in the Jailers’ favor on their qualified immunity

defense. The district court agreed with Appellees, concluding that the Jailers

were not entitled to qualified immunity because there was “conflicting summary

judgment evidence on the issue ofthe Defendants’ knowledge regarding Allison’s

medical condition.” 

We conclude, however, that Appellees’ deliberate indifference claim fails,

as they present no evidence that the Jailers “subjectively intended that harm

occur.” See Tamez, 589 F.3d at 770 (citation omitted). To the contrary, the

Jailers’ constant monitoring of Decedent Allison and their attempts to rouse her

to speak to her husband and take her medication suggest that they did not

subjectively intend harm to befall her. “Even if those steps were ‘ineffectual,’

they do not demonstrate deliberate indifference.” Southard v. Tex. Bd. of

Criminal Justice, 114 F.3d 539, 554 (5th Cir. 1997); see also Farmer v. Brennan,

511 U.S. 825, 835 (1994) (noting that deliberate indifference “entails something

more than mere negligence”). Appellees have presented no evidence to suggest

that the Jailers had this subjective intent to harm, nor evidence to suggest that

they “responded with deliberate indifference” to a risk of serious harm. See

Hare, 74 F.3d at 650 (emphasis added).

Further, even if Appellants treated Decedent Allison’s medical needs with

deliberate indifference in violation of her constitutional rights,their actions were

objectively reasonable. See Brown, 623 F.3d at 253 (“If the defendant’s actions

violated a clearly established constitutional right, the court then asks whether

qualified immunity is still appropriate because the defendant’s actions were

‘objectively reasonable’ in light of ‘law which was clearly established at the time

of the disputed action.’” (citation omitted)); id. (“Whether an official’s conduct

was objectively reasonable is a question of law for the court, not a matter of fact

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for the jury.”). Viewing the facts in the light most favorable to Appellees, the

Jailers had knowledge that: Decedent Allison was very intoxicated, had taken

prescription drugs not in accordance with directions, and had attempted to

commit suicide using pills a year earlier. Specifically, with respect to the

medication, the evidence demonstrates that she either took twice her normal

dosage of allergy medicine, as she stated to Officer Kovic, or more vaguely, that

she took the medicine “not in accordance with directions” or “not like she was

supposed to.” This evidence is a far cry from a suggestion that she overdosed on

pills or took an unusually large amount. Moreover, Appellees have presented no

evidence to indicate that Decedent Allison’s physical condition exceeded

anything beyond perhaps significant intoxication. Officer Barkley’s probable

cause affidavit states that: 1) he noticed the odor of an alcoholic beverage

emitting from her breath; 2) she was confused in answering questions; 3) her

speech was slurred; 4) she was unsteady on her feet; 5) she stated she had

misused her prescription medications; 6) she failed a field sobriety test; and 7)

she presented a danger to herself or others. On these facts, we cannot say that,

by frequently monitoring Decedent Allison and allowing her to sleep, “all

reasonable officials in the defendant[s’] circumstances would have then known

that the defendant[s’] conduct violated the United States Constitution or the

federal statute.” See Thompson, 245 F.3d at 457 (citations omitted).

Indeed, it seems objectively reasonable for the Jailers to allow an

intoxicated inmate to “sleep it off,” with periodic monitoring to safeguard her

well-being. As the Fourth Circuit aptly has stated: 

[The deceased inmate’s] symptoms hardly distinguish

him from the multitude of drug and alcohol abusers the

police deal with everyday. [The deceased inmate] was

found in possession of drugs while acting irrationally

and slurring his speech. However, an officer could

hardly be faulted under [Estelle v. Gamble, 429 U.S. 97

(1976)] for believing that [the deceased inmate] needed

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nothing so much as to sleep it off. To accept appellant’s

claim would be to mandate as a matter of constitutional

law that officers take all criminal suspects under the

influence of drugs or alcohol to hospital emergency

rooms rather than detention centers. That would be a

startling step to take.

Grayson v. Peed, 195 F.3d 692, 696 (4th Cir. 1999). While the result here was

tragic, we cannot say that all, or even most, reasonable officers would not have

done the same, absent an inmate’s additional external manifestations of medical

distress.

We note that the district court here ruled that the existence of factual

disputes precluded a finding that the Jailers were entitled to qualified

immunity. Accordingly, we emphasize our conclusion, on the basis of the

materiality of those disputed facts in the light most favorable to Appellees, that

the Jailers here are entitled to qualified immunity. See Manis, 585 F.3d at 842

(citation omitted) (“Where . . . the district court finds that genuinely disputed,

material fact issues preclude a qualified immunity determination, this court can

review only their materiality, not their genuineness.”). We therefore reverse the

district court’s denial of qualified immunity for the individual Jailers.

2. Sheriff Wansley

Appellees assert that they have presented evidence demonstrating that: 

1) there have been three deaths at the Jail since 2006; 2) there is no policy

requiring medical staff onsite at the Jail at night; 3) the Jail’s policy is to leave

decisions about whether to contact medical personnel to the discretion of the

Jailers on duty (who are ill-equipped to make this determination); 4) most

Jailers are not trained in CPR or “basic lifesaving measures”; and 5) none of the

Jailers were disciplined for failing to provide Decedent Allison with medical

treatment, and the Jail has made no changes to its policies since her death. 

Appellants argue that they have presented evidence indicating that: 1) the Jail’s

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policy is not to accept inmates who are so intoxicated that their health might be

in danger; and 2) the Jail’s policy is to obtain medical attention for any inmate

who needs it.

The district court concluded that if the Jailers were adequately trained

and yet they were deliberately indifferent to Decedent Allison’s serious medical

needs, then the Jailers “are at fault” for ignoring their training. The court

further stated:

However, if defendants did not know of Allison’s

condition or need for medical care, then fact issues

remain as to: (1) the adequacy of Wansley’s training

regarding recognizing a serious medical need; (2) his

implementation of Wood County’s policies of not

providing medical personnel on site at night who are

able to recognize that need; and (3) whether an

inadequacy amounted to deliberate indifference.

We conclude, however, that Appellees have failed to demonstrate that

Sheriff Wansley was deliberately indifferent to his responsibility to train his

staff. To the contrary, the uncontroverted evidence in the record illustrates that

the Jailers receive training on obtaining medical assistance for any inmate when

needed, and that the Sheriff has promulgated this policy. Further, “[p]roof of

more than a single instance of the lack of training or supervision causing a

violation of constitutional rights is normally required before such lack oftraining

or supervision constitutes deliberate indifference.” Thompson, 245 F.3d at 459

(citations omitted). The three jail deaths in the record–for unrelated or

unknown reasons–do not evidence such a pattern. Moreover, Appellees fail to

demonstrate how the Sheriff’s policies were inadequate. See id. at 459 (citations

omitted) (noting that “the inadequacy of training must be obvious and obviously

likely to result in a constitutional violation”). As Appellees fail to carry their

burden, we conclude that Sheriff Wansley is entitled to qualified immunity.

III. CONCLUSION

16

 Case: 12-40749 Document: 00512242220 Page: 16 Date Filed: 05/15/2013
No. 12-40749

Based on the foregoing, we REVERSE the district court’s denial of

summary judgment to Appellants on their qualified immunity defense, and we

REMAND for further proceedings not inconsistent with this opinion.

17

 Case: 12-40749 Document: 00512242220 Page: 17 Date Filed: 05/15/2013