Opinion ID: 790266
Heading Depth: 3
Heading Rank: 2

Heading: Merits of Hollins's Qualified Immunity Claim

Text: 17 Hollins knew that Carter was exhibiting the classic symptoms of an impending heart attack, knew she had cried for help, and believed that she was three days behind in taking her heart medication. His failure to order transportation to take Carter to the hospital violated Carter's clearly established right to adequate medical treatment while in pretrial custody. 18 Qualified immunity is an affirmative defense that shields government officials from liability for civil damages insofar as their conduct does not violate clearly established statutory or constitutional rights of which a reasonable person would have known. Harlow v. Fitzgerald, 457 U.S. 800, 818, 102 S.Ct. 2727, 73 L.Ed.2d 396 (1982). There are two steps in the analysis: (1) whether, considering the allegations in a light most favorable to the party injured, a constitutional right has been violated, and (2) whether that right was clearly established. 2 Saucier v. Katz, 533 U.S. 194, 201, 121 S.Ct. 2151, 150 L.Ed.2d 272 (2001). The initial inquiry is whether a constitutional right was violated, if the allegations are established. Id. 19 Pre-trial detainees have a right under the Fourteenth Amendment to adequate medical treatment, a right that is analogous to the right of prisoners under the Eighth Amendment. 3 Watkins v. City of Battle Creek, 273 F.3d 682, 685-86 (6th Cir.2001). A cause of action under § 1983 for failure to provide adequate medical treatment requires a showing that the defendants acted with `deliberate indifference to the serious medical needs' of the pre-trial detainee. Watkins, 273 F.3d at 686 (quoting Estelle v. Gamble, 429 U.S. 97, 97 S.Ct. 285, 50 L.Ed.2d 251 (1976)). There are two parts to the claim, one objective, one subjective. For the objective component, the detainee must demonstrate the existence of a `sufficiently serious' medical need. Blackmore v. Kalamazoo County, 390 F.3d 890, 895 (6th Cir.2004) (quoting Farmer v. Brennan, 511 U.S. 825, 834, 114 S.Ct. 1970, 128 L.Ed.2d 811 (1994)). For the subjective component, the detainee must demonstrate that the defendant possessed a sufficiently culpable state of mind in denying medical care. Id. (quoting Brown v. Bargery, 207 F.3d 863, 867 (6th Cir.2000)). 20 First, Carter's medical need was sufficiently serious because—taking the facts in a light most favorable to the Estate—Carter was demonstrating the classic signs of an impending heart attack. As we recently explained: 21 [W]here a plaintiff's claims arise from an injury or illness so obvious that even a layperson would easily recognize the necessity for a doctor's attention, the plaintiff need not present verifying medical evidence to show that, even after receiving the delayed necessary treatment, his medical condition worsened or deteriorated. Instead, it is sufficient to show that he actually experienced the need for medical treatment, and that the need was not addressed within a reasonable time frame. 22 Blackmore, 390 F.3d at 899-900 (internal citation and quotation omitted); see also Johnson v. Karnes, 398 F.3d 868, 874 (6th Cir.2005). The court in Blackmore held that Blackmore's appendicitis was an obvious illness because, while in police custody, he complained of sharp and severe stomach pains, made these complaints over two days, and vomited. 390 F.3d at 899. These symptoms were the classic signs of appendicitis. Id. at 900. 23 Hollins argues that under an earlier Sixth Circuit case, Napier v. Madison County, 238 F.3d 739 (6th Cir.2001), the Estate was required to provide verifying medical evidence to satisfy the objective requirement. The decision in Blackmore, however, expressly limited Napier 's requirement of verifying medical evidence to cases involving only minor maladies or non-obvious complaints of a serious need for medical care. Blackmore, 390 F.3d at 898. Carter, like Blackmore, displayed the classic signs of a serious illness, not a minor malady, but an impending heart attack. She was complaining of chest pain and complaining that she had trouble breathing. She said that she was three days behind in taking her heart medication. She was lying on the floor while Hollins was still in the precinct. Although her complaints were made over a much shorter period of time than the two days of Blackmore, that fact is not dispositive because even laypersons can be expected to know that a person showing the warning signs of a heart attack needs treatment immediately in order to avoid death. Therefore, the Estate was not required to provide medical documentation in order to satisfy the objective component of the test. The obviousness of Carter's condition satisfies the objective requirement of the failure to provide adequate medical treatment test. 24 The next question is whether the Estate has demonstrated that Hollins possessed a sufficiently culpable state of mind in denying medical care so that the subjective component is satisfied. There is sufficient evidence in this case that Hollins actually understood that Carter was subject to a substantial risk of serious harm, and the Estate has therefore met its burden. A defendant possess a sufficiently culpable state of mind when he acts with deliberate indifference. Johnson, 398 F.3d at 875. 25 Deliberate indifference is not mere negligence. Deliberate indifference requires that the defendants knew of and disregarded a substantial risk of serious harm to [the detainee's] health and safety. This standard is subjective. It is not enough that there was a danger of which an officer should objectively have been aware. [T]he official must both be aware of facts from which the inference could be drawn that a substantial risk of serious harm exists, and he must also draw the inference. If 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. 26 Watkins, 273 F.3d at 686 (internal citations omitted) (quoting Farmer, 511 U.S. at 837, 114 S.Ct. 1970). 27 There was substantial evidence before the district court that Hollins was fully aware of all the symptoms Carter displayed and believed that she had not taken her heart medication for three days. He was informed of Tori Carter's complaints by Officer Carter, and, taking the facts in a light most favorable to the plaintiff, spoke with Tori Carter in person. There is also evidence that Hollins did in fact draw the inference that Carter was suffering from a serious medical problem, as he repeatedly claims that he ordered Crouch to transport Carter to the hospital. Although Hollins claims that he only elected to act, and did not actually believe that Carter was ill, a jury would be entitled to discount that explanation. See Johnson, 398 F.3d at 876. Nor was it necessary for the Estate to offer explicit evidence that Hollins in fact drew the inference. In most cases in which the defendant is alleged to have failed to provide treatment, there is no testimony about what inferences the defendant in fact drew. Nonetheless, in those cases, a genuine issue of material fact as to deliberate indifference can be based on a strong showing on the objective component. For example, in a recent case, Garretson v. City of Madison Heights, a panel of this court held that where one named and one unnamed officer were told by the plaintiff pre-trial detainee that she was a diabetic in need of insulin, and was past due for her next dose, a genuine issue of material fact existed as to whether the two acted with deliberate indifference to her medical needs in failing to have her transported to the hospital. 407 F.3d 789, 796, 2005 WL 1076560, at  (6th Cir.2005). Carter's situation was similar, because, taking the facts as the Estate alleged, Hollins was both directly informed by Tori Carter that she was in distress and was informed by Officer Carter that she was experiencing chest pains, had not taken her heart medication, and needed to go to the hospital. 28 There is also evidence that Hollins disregarded the substantial risk of serious harm to Carter's health. For purposes of avoiding summary judgment, the Estate has sufficiently demonstrated deliberate indifference. Again, taking the facts in a light most favorable to the plaintiff, Hollins did not in fact implement the decision to order a car, did not inform his replacement of Carter's illness, and made no record in the police blotter that might have alerted other officers to the problem or the fact that transportation should have arrived. 4 Furthermore, when he left the precinct at approximately 1:00 p.m., he knew that Carter still had not been transported to the hospital. 29 In sum, based on the alleged facts taken in the light most favorable to Carter, Carter's medical need was sufficiently serious, Hollins was aware that the need was serious, and yet disregarded it. Hollins therefore violated Carter's right to be free from deliberate indifference to her serious medical need. 30 Finally, to complete the qualified immunity analysis, this right was clearly established at the time of Hollins's violation. As early as 1972, this court stated that where the circumstances are clearly sufficient to indicate the need of medical attention for injury or illness, the denial of such aid constitutes the deprivation of constitutional due process. Fitzke v. Shappell, 468 F.2d 1072, 1076 (6th Cir.1972). Furthermore, in 1992, this court explicitly held that a pretrial detainee's right to medical treatment for a serious medical need has been established since at least 1987. Heflin v. Stewart County, 958 F.2d 709, 717 (6th Cir.1992). The right that Hollins violated was therefore clearly established. Under the facts alleged by the Estate, Hollins is not entitled to qualified immunity. The district court's denial of summary judgment was proper.