2011 Decisions

Opinions of the United

States Court of Appeals

for the Third Circuit

1-19-2011

Brenda Navolio v. Lawrence County

Precedential or Non-Precedential: Non-Precedential

Docket No. 10-1820

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NOT PRECEDENTIAL

UNITED STATES COURT OF APPEALS

FOR THE THIRD CIRCUIT

___________

No. 10-1820

___________

BRENDA S. NAVOLIO, Individually

and as the Administratrix of the Estate

of MATTHEW A. HAMILTON, Deceased,

Appellant,

v.

LAWRENCE COUNTY;

PRIMECARE MEDICAL, INC.,

individually and officially

___________

On Appeal from the United States District Court

for the Western District of Pennsylvania

(D.C. No. 2:08-cv-01286)

District Judge: Honorable Terrence F. McVerry

___________

Submitted Under Third Circuit LAR 34.1(a)

January 6, 2011

Before: AMBRO and FISHER, Circuit Judges, and SÁNCHEZ, District Judge.

(Filed: January 19, 2011 )

___________

OPINION OF THE COURT

___________

SÁNCHEZ, District Judge.

 

The Honorable Juan R. Sánchez, District Judge of the United States District Court for the 

Eastern District of Pennsylvania, sitting by designation.
2

This case arises out of the tragic death of Matthew Hamilton from head injuries he 

sustained while in the custody of the Lawrence County Jail (the Jail) as a pretrial detainee. 

Hamilton was injured when he hit his head after either jumping or falling over a stairway railing 

on the Jail‟s second floor and landing on the first floor eleven feet below. Following Hamilton‟s 

death, his mother, Brenda Navolio, filed suit against Lawrence County and PrimeCare Medical, 

Inc. (PrimeCare), the Jail‟s medical services provider, pursuant to 42 U.S.C. § 1983 and 

Pennsylvania law. The District Court granted summary judgment in favor of both Defendants as 

to Navolio‟s § 1983 claims and declined to exercise supplemental jurisdiction over Navolio‟s 

state law claim, and Navolio appealed. For the reasons set forth below, we affirm

I.

On September 13, 2006, Hamilton was arrested on a bench warrant and taken to the Jail. 

During the intake process, Hamilton told a nurse he was under the influence of various drugs and 

alcohol. As a result, he was placed on a detoxification regimen, which included prescriptions for 

Vistaril and Bentyl, medications used to treat symptoms of drug and alcohol withdrawal.

1

 The 

prescribing physician also restricted Hamilton to the bottom bunk of his cell for ten days, in 

accordance with PrimeCare‟s standard practice, because a small percentage of inmates would 

experience seizures or dizziness during detoxification. Because Hamilton was placed in a cell on 

the second level of the Jail, he was required to walk down a flight of stairs in order to receive his 

medications and be evaluated by a nurse.

On September 15, 2006, at approximately 8:20 p.m., Hamilton walked from his cell to 

the medical station where nurse Lynn Sharp checked his blood pressure and gave him his 

medications. Hamilton told Sharp he had vomited twice since dinner but had not vomited for 

 

1

These medications have a number of possible side effects, including drowsiness and dizziness. 

(App. 272a-274a.)
3

over an hour since his last dose of medications was administered. He also stated he felt the 

medications were helping. Sharp reported Hamilton was ambulating without difficulty and 

showed no signs of depression, pain, or discomfort, other than vomiting. She also completed an 

alcohol/drug withdrawal flow chart, indicating Hamilton displayed or reported signs of 

weakness, restlessness, sweating, shakiness, muscle twitching, vomiting, and nausea, but 

displayed no signs of drowsiness, confusion, slurred speech, unsteady gait, or involuntary eye 

movements. (App. 241a, 256a.)

After receiving his medication, Hamilton walked back up the stairs and toward his cell. 

Before reaching his cell, Hamilton turned and walked back toward the stairway. When he 

reached the top of the stairwell, he either jumped or fell over the railing to the ground 

approximately eleven feet below.2 Although Hamilton initially landed on his feet, he fell back 

and hit his head on the concrete floor. Nurse Sharp immediately attended to Hamilton and 

directed Captain Shawn Carna, a correctional officer at the Jail who observed the incident, to call 

an ambulance. Paramedics arrived within ten minutes, and Hamilton was transported first to

Jameson Memorial Hospital and then to St. Elizabeth Health Center. On September 25, 2006, 

Hamilton died of the head injuries he sustained at the Jail.

In September 2008, Navolio, individually and as administratrix of Hamilton‟s estate, sued 

Lawrence County and PrimeCare, asserting claims pursuant to § 1983 for violations of 

Hamilton‟s Fourth, Eighth, and Fourteenth Amendment rights and a state law negligence claim. 

Both Defendants filed motions for summary judgment as to Navolio‟s federal claims, and the 

Magistrate Judge to whom the motions were referred issued a Report and Recommendation 

recommending the motions be granted. Analyzing Navolio‟s inadequate medical care claim 

 

2

The parties dispute whether Hamilton jumped or fell over the railing; however, this dispute is 

not material to our disposition.
4

under the Eighth Amendment, the Magistrate Judge concluded Navolio had failed to show 

Hamilton had a serious medical need or that any state actor had been deliberately indifferent to 

any such need. The Magistrate Judge concluded Navolio‟s remaining federal claims were also 

insufficient, finding Navolio had not attempted to establish a Fourth Amendment violation and 

finding the Fourteenth Amendment claim was superseded by Navolio‟s Eighth Amendment 

allegations. Having determined Navolio failed to establish a violation of Hamilton‟s 

constitutional rights, the Magistrate Judge concluded Lawrence County and PrimeCare could not 

be liable under Monell v. Department of Social Services, 436 U.S. 658 (1978). After reviewing 

Navolio‟s objections, the District Court adopted the Report and Recommendation as the opinion 

of the Court, granted the Defendants‟ motions for summary judgment as to Navolio‟s federal 

claims, and declined to exercise supplemental jurisdiction over Navolio‟s state law claim. 

Navolio timely appealed.

II.

The District Court had jurisdiction under 28 U.S.C. § 1331. We have jurisdiction 

pursuant to 28 U.S.C. § 1291. We review the grant of summary judgment de novo, applying the 

same standard as the District Court, and we may affirm “for any reason supported by the record, 

even if not relied on by the District Court.” Natale v. Camden Cnty. Corr. Facility, 318 F.3d 

575, 580 (3d Cir. 2003). Summary judgment is proper when, viewing the facts in the light most 

favorable to the nonmoving party and drawing all reasonable inferences in that party‟s favor, 

“the movant shows that there is no genuine dispute as to any material fact and the movant is 

entitled to judgment as a matter of law.” Fed. R. Civ. P. 56(a); Hugh v. Butler Cnty. Family 

YMCA, 418 F.3d 265, 267 (3d Cir. 2005). Material facts are those facts which “might affect the

outcome of the suit under the governing law.” Anderson v. Liberty Lobby, Inc., 477 U.S. 242, 
5

248 (1986). A factual issue is genuine “if the evidence is such that a reasonable jury could return 

a verdict for the nonmoving party.” Id.

III.

Navolio presses two claims on appeal: a claim for denial of adequate medical care and a 

substantive due process claim based on the state-created danger theory. Navolio argues the 

District Court erred in granting summary judgment because she presented evidence from which a 

reasonable jury could conclude Hamilton‟s Eighth and Fourteenth Amendment rights were 

violated and the policies of Lawrence County and PrimeCare caused these violations. We 

address each claim in turn.3

A.

Because Hamilton was a pretrial detainee, Navolio‟s inadequate medical care claim arises 

under the Due Process Clause of the Fourteenth Amendment, rather than the Eighth Amendment, 

as Navolio alleges. Natale, 318 F.3d at 581. We have previously recognized the Fourteenth 

Amendment “affords pretrial detainees protections „at least as great as the Eighth Amendment 

protections available to a convicted prisoner.‟” Id. (quoting City of Revere v. Mass. Gen. Hosp., 

463 U.S. 239, 244 (1983)). We have also distinguished between pretrial detainees‟ Fourteenth 

Amendment right to protection from “punishment” prior to an adjudication of guilt and 

convicted prisoners‟ Eighth Amendment right to “protection from punishment that is „cruel and 

unusual.‟” Hubbard v. Taylor, 399 F.3d 150, 166 (3d Cir. 2005). Navolio does not argue the 

Due Process Clause of the Fourteenth Amendment provides additional protections, but instead 

argues her inadequate medical care claim should have been sustained under the standard 

 

3 Although Navolio also makes passing reference to her Fourth Amendment seizure claim in her 

statement of issues (Appellant‟s Br. 3), she presents no argument as to how Hamilton‟s Fourth 

Amendment rights were violated. We agree with the District Court that Navolio has failed to 

establish a Fourth Amendment violation.
6

applicable to such claims under the Eighth Amendment. (See Appellant‟s Br. 28-31.) In similar 

circumstances, we have analyzed inadequate medical care claims by pretrial detainees under the 

Eighth Amendment standard, evaluating whether the evidence shows “(i) a serious medical need, 

and (ii) acts or omissions by prison officials that indicate deliberate indifference to that need.” 

Natale, 318 F.3d at 582. We will do the same here.

We assume, for purposes of this appeal, the chemical withdrawal Hamilton experienced 

during his detention was a serious medical need. See Atkinson v. Taylor, 316 F.3d 257, 266 (3d 

Cir. 2003) (recognizing a serious medical need includes one that “has been diagnosed by a 

physician as requiring treatment”); United States ex rel. Walker v. Fayette Cnty., 599 F.2d 573, 

576 (3d Cir. 1979) (prisoner‟s severe drug withdrawal symptoms constituted a serious medical 

need).4 The remaining question, therefore, is whether Navolio produced sufficient evidence to 

create a genuine issue of material fact regarding prison officials‟ deliberate indifference. We 

conclude she did not.

Deliberate indifference requires more than negligence or medical malpractice. Rouse v. 

Plantier, 182 F.3d 192, 197 (3d Cir. 1999). Rather, a prison official acts with deliberate 

indifference when “the official „knows of and disregards an excessive risk to inmate health or 

safety.‟” Natale, 318 F.3d at 852 (quoting Farmer v. Brennan, 511 U.S. 825, 837 (1994)). Thus, 

to survive summary judgment on this issue, Navolio was required to point to some evidence 

suggesting Jail or PrimeCare employees knew of a substantial risk of harm to Hamilton and 

failed to act despite that knowledge. Id.

 

4 Navolio also appears to argue Hamilton had a serious medical condition because he had a 

“particular vulnerability” as a result of his detoxification medications. (Appellant‟s Br. 19-20.) 

We disagree. Although we have recognized in pretrial detainee suicide cases that “[a] particular 

vulnerability to suicide represents a serious medical need,” Woloszyn v. Cnty. of Lawrence, 396 

F.3d 314, 320 (3d Cir. 2005), this “particular vulnerability” standard has no application here.
7

Navolio argues Lawrence County and PrimeCare acted with deliberate indifference by 

requiring Hamilton to walk up and down a flight of stairs unassisted to obtain his medications 

while he was undergoing chemical withdrawal and taking detoxification medications. However, 

there is no evidence anyone at the Jail knew Hamilton was experiencing any symptoms of 

withdrawal or side effects of his detoxification medications that would have made it unsafe for 

him to walk up and down the stairs. To the contrary, Sharp evaluated Hamilton moments before 

the incident and determined he was walking without difficulty, “[d]id not appear to be in any 

distress,” showed no signs of unsteady gait, drowsiness, or confusion, and had no complaints 

other than vomiting. (App. 149a-150a, 153a-154a.) In these circumstances, we cannot conclude 

Sharp was deliberately indifferent in permitting Hamilton to walk back to his cell unescorted. 

See Inmates of Allegheny Cnty. Jail v. Pierce, 612 F.2d 754, 762 (3d Cir. 1979) (noting the 

deliberate indifference standard “affords considerable latitude to prison medical authorities in the 

diagnosis and treatment of the medical problems of inmate patients”).

Navolio also argues PrimeCare‟s policy of restricting detoxifying inmates to bottom 

bunks shows awareness of the risks associated with the detoxification process. However, Sharp 

testified the reason for this practice was “a small percentage of people” undergoing 

detoxification would experience seizures or dizziness due to dehydration. (App. 147a-148a.) As 

noted, the record refutes any suggestion Sharp (or anyone else at the Jail) had reason to believe 

Hamilton was experiencing such symptoms. The record also refutes any suggestion Sharp 

disregarded any risk to Hamilton as a result of the detoxification process because Sharp 

evaluated Hamilton‟s withdrawal symptoms moments before the incident. 

Navolio also points to the report of her experts, Dr. Pogos Voskanian and Dr. Cyril 

Wecht. Dr. Voskanian found PrimeCare‟s assessment, treatment, and monitoring of Hamilton
8

was “inadequate and inappropriate” and concluded PrimeCare‟s treatment of Hamilton “fell 

below [the] acceptable standard of care and constituted a breach of duty owed by the health care 

provider.” (App. 344a-345a.) Dr. Wecht opined “the failure to employ strict observance for 

possible adverse drug reactions contributed to the occurrence of the accident.” (App. 326a.) 

These conclusions amount to allegations of medical malpractice or disagreements as to the 

proper medical treatment for patients undergoing detoxification. As such they are insufficient to 

show deliberate indifference. Spruill v. Gillis, 372 F.3d 218, 235 (3d Cir. 2004).

Finally, although Navolio notes an inmate had either jumped or fallen from the second 

level to the first level of the Jail on three separate occasions prior to the incident involving 

Hamilton, she points to no evidence suggesting any of these inmates fell over the stairway railing 

because of withdrawal symptoms or the side effects of detoxification medications.

Because Navolio failed to produce evidence from which a reasonable jury could conclude 

Jail or PrimeCare employees were deliberately indifferent to Hamilton‟s serious medical needs, 

the District Court properly granted the Defendants‟ motions for summary judgment. See 

Startzell v. City of Phila., 533 F.3d 183, 204 (3d Cir. 2008) (finding Monell claim against a 

municipality was properly dismissed where the court had found “no violation of Appellants‟ 

constitutional rights”).

B.

Navolio also argues the District Court erred in granting summary judgment as to her 

Fourteenth Amendment claim pursuant to the state-created danger theory. The state-created 

danger theory is an exception to the general rule that “[t]here is no affirmative right to 

governmental aid or protection under the Due Process Clause of the Fourteenth Amendment.” 

Ye v. United States, 484 F.3d 634, 636 (3d Cir. 2007). The theory recognizes a substantive due 
9

process violation may occur “when state authority is affirmatively employed in a manner that 

injures a citizen or renders him „more vulnerable to injury from another source than he or she 

would have been in the absence of state intervention.‟” Bright v. Westmoreland Cnty., 443 F.3d 

276, 281 (3d Cir. 2006) (quoting Schieber v. City of Phila., 320 F.3d 409, 416 (3d Cir. 2003)). 

To prevail on a Fourteenth Amendment claim pursuant to the state-created danger theory, a 

plaintiff must show, inter alia, conduct by a state actor which “shocks the conscience.” Id. 

Navolio argues the Defendants created a danger to Hamilton or rendered him more 

vulnerable to danger by (1) inadequately treating him for chemical withdrawal, leaving him 

vulnerable to impaired judgment, confusion, and disorientation, and (2) housing him on the Jail‟s 

second floor, thus requiring him to walk up and down the stairs to obtain his medications. Like 

Navolio‟s inadequate medical care claim, however, this claim fails for lack of evidence any state 

actor acted with the requisite mental state.

In a case where state actors have the time to make unhurried judgments, the level of 

culpability required to shock the conscience is deliberate indifference. Sanford v. Stiles, 456 

F.3d 298, 309 (3d Cir. 2006). We have previously acknowledged that, in the state-created 

danger context, deliberate indifference may not require a state actor‟s actual knowledge of a risk 

of harm “when the risk is so obvious that it should be known.” Id. at 309-310. Even under this

lower standard of culpability, however, Navolio is unable to meet her burden. As explained in 

our discussion of Navolio‟s inadequate medical care claim, there is simply no basis on which to 

conclude Jail or PrimeCare employees disregarded any risks associated with Hamilton‟s 

chemical withdrawal or detoxification medications by permitting him to walk back to his cell 

unescorted. Accordingly, summary judgment was appropriate as to Navolio‟s state-created

danger claim.
10

IV.

Although we acknowledge the tragic loss of life that occurred in this case, we cannot 

conclude Hamilton‟s death was the result of a violation of his constitutional rights. Accordingly, 

we will affirm the order of the District Court.