Opinion ID: 2821159
Heading Depth: 2
Heading Rank: 3

Heading: Dr. Bolin

Text: Plaintiffs’ allegations against Dr. Bolin are properly characterized, and have been treated by both parties below, as attacking episodic acts or omissions rather than conditions of Henson’s confinement. In Plaintiffs’ First Amended Complaint, they asserted that Dr. Bolin acted with “deliberate indifference to Mr. Henson’s constitutional rights” through a series of omissions, such as his “failure to provide appropriate medical evaluation” and his “failure to transport Mr. Henson to an appropriate medical facility.” Plaintiffs also asserted that Dr. Bolin failed to provide adequate training and supervision for the nurses, who, as a result, failed to “exercise that degree of care that a nurse of ordinary prudence would have exercised under the same or similar circumstances on the occasion in question.” These allegations fault “specific jail officials for their acts or omissions,” id. at 452, rather than “conditions, practices, rules, or restrictions,” Hare, 74 F.3d at 644. Indeed, throughout Plaintiffs’ pleadings in the district court, they consistently asserted that the deliberate indifference standard should apply to their claims against Dr. Bolin. In response to Dr. Bolin’s motion for a more definite statement, Plaintiffs set forth detailed factual allegations regarding their claims against Dr. Bolin. In that response, Plaintiffs explicitly urged the court to apply the deliberate indifference standard, acknowledging that it is the appropriate standard for analyzing the constitutionality of “an episodic act or omission by a governmental employee.” Plaintiffs made no mention of an alternative conditions-of-confinement theory or standard. Similarly, in response to Dr. Bolin’s subsequent motion to dismiss and for summary judgment, which focused solely and extensively on the deliberate indifference standard, Plaintiffs still did not express disagreement with this legal standard but, 10 Case: 14-10126 Document: 00513132667 Page: 11 Date Filed: 07/28/2015 No. 14-10126 instead, asserted that Dr. Bolin was “deliberately indifferent” to the medical needs of Henson and other inmates. Given the Plaintiffs’ allegations before the district court, we decline their invitation now to construe their claims against Dr. Bolin as attacking conditions of Henson’s confinement. To do so would effectively allow Plaintiffs to amend their complaint at the appellate stage. See Shepherd, 591 F.3d at 452 n.1 (describing a challenge to conditions of confinement as a “claim” that can be pled and evaluated separately from, and in addition to, an episodic-actsor-omissions claim). Accordingly, we find that as to Dr. Bolin, Plaintiffs challenged only episodic acts and omissions by him and the nurses that he supervised, rather than conditions of Henson’s confinement. Because Plaintiffs on appeal have abandoned a theory of liability against Dr. Bolin based on episodic acts or omissions, no viable claims are left against him. Even if we were to construe Plaintiffs’ allegations against Dr. Bolin as challenging a condition of Henson’s confinement—despite Plaintiffs’ consistent representation to the district court that the deliberate indifference standard, applicable to episodic-acts-or-omissions claims, should apply—Plaintiffs’ claims against Dr. Bolin would fail. Plaintiffs generalized in their complaint that Dr. Bolin “condoned and enforced with fear and intimidation a well-known policy and custom among the nurses of the Wichita County Sheriff’s Department not to send inmates with serious medical conditions to the hospital.” And on appeal, Plaintiffs allege that “Dr. Bolin fostered an environment of intimidation at the Jail, such that the LVNs (and other Jail staff) were so discouraged from contacting him regarding severely ill inmates . . . that the LVNs ultimately decided on a treatment plan for inmates.” As there was no explicit policy of nurse intimidation, Plaintiffs would have to show that an unstated or de facto policy existed. See Shepherd, 591 F.3d at 452 (“In some cases, a condition may reflect an unstated or de facto policy . . . 11 Case: 14-10126 Document: 00513132667 Page: 12 Date Filed: 07/28/2015 No. 14-10126 .”). However, in order to base a constitutional claim on Dr. Bolin’s implementation of an unstated rule or policy, Plaintiffs must show that Dr. Bolin’s “acts or omissions were sufficiently extended or pervasive, or otherwise typical of extended or pervasive misconduct by other officials, to prove an intended condition or practice.” Hare, 74 F.3d at 645. Plaintiffs have not done so. Plaintiffs’ evidence of a de facto “policy” of nurse intimidation comes mostly from a previous case involving the death of Jason Brown, a pretrial detainee who died in the Wichita County jail four months before Henson. Plaintiffs presented: (1) deposition testimony of Sheriff Callahan, taken in the Brown case, stating that Dr. Bolin is “grumpy” and “[d]oesn’t like to be bothered”; (2) an affidavit of Pathena Dawn Tweed, a former nurse at the Wichita County jail, who stated that she was “personally chastised by Dr. Bolin when [she] would contact him to obtain medical instruction” and that on one occasion she defied Dr. Bolin’s orders by sending a diabetic inmate to the hospital and Dr. Bolin “became very irate [and] yelled at [her]”; (3) an affidavit of Dawn Marie Wilkinson, a former nurse at the Wichita County jail, who similarly stated that she “feared calling Dr. Bolin for fear of unwarranted criticism” and that on one occasion she sent a female inmate to the hospital despite Dr. Bolin’s explicit instruction not to do so; and (4) a memorandum written by a Wichita County detention officer pertaining to Brown’s death, which quoted Nurse Krajca as saying: “Do you know what kind of ass chewing I would get from Dr. Bolin, if I sent [Jason Brown] to the hospital in the good health that he is in.” While this evidence indicates brusque and critical mannerisms, it falls short of proving conduct so pervasive and typical as to constitute an intended condition or practice of nurse intimidation that discouraged nurses from sending inmates to the hospital. In fact, the two affidavits from former nurses support the opposite view, as they both state that 12 Case: 14-10126 Document: 00513132667 Page: 13 Date Filed: 07/28/2015 No. 14-10126 they sent inmates to the hospital despite Dr. Bolin’s harsh attitude. See Brown v. Callahan, 623 F.3d at 256 (reviewing the same affidavits and explaining “[t]hat two nurses decided to send inmates to the ER over Dr. Bolin’s objections proves the opposite of intimidation”). At most, Plaintiffs’ evidence shows that, on one occasion, one nurse was cognizant of Dr. Bolin’s temper as she assessed an inmate, which is insufficient to prove an unconstitutional policy. See Shepherd, 591 F.3d at 454 (“[I]solated examples of illness, injury, or even death, standing alone, cannot prove that conditions of confinement are constitutionally inadequate.”). More problematic, Plaintiffs put forth no evidence that Dr. Bolin’s alleged intimidation of nurses played any role in the present case. See Duvall v. Dallas Cnty, 631 F.3d 203, 207 (5th Cir. 2011) (explaining that to prevail on a challenge to an unconstitutional condition of confinement, the plaintiff must show that the condition “caused the violation of [the inmate’s] constitutional rights”). Unlike in the Brown case, which included Nurse Krajca’s rhetorical statement about Dr. Bolin’s temper, there is no evidence in the present case that any of the nurses who encountered Henson acted, or failed to act, out of fear for Dr. Bolin. See Callahan, 440 F. App’x at 358 (“[N]o evidence supports that an alleged reluctance to send seriously ill inmates to the hospital contributed to Henson’s death.”). Because Plaintiffs did not assert a conditions-of-confinement claim against Dr. Bolin, and because, even if they had, such claim would fail, we find that Dr. Bolin is entitled to summary judgment and the district court’s order is affirmed with respect to Plaintiffs’ claims against him.