Opinion ID: 4567449
Heading Depth: 3
Heading Rank: 1

Heading: SHP Defendants

Text: We consider Griffith’s claims against the SHP Defendants in the following order: (1) RN Sherrow; (2) LPN Trivette; (3) LPN Mundine; (4) Dr. Waldridge; and (5) SHP collectively.
Griffith argues that Sherrow was deliberately indifferent because she did not put Griffith on the list to be seen by an APRN before Wednesday, when she performed the urine dip test. He contends that at that time, Sherrow should have called Dr. Waldridge or an APRN rather than place him on the weekly list, and he further faults Sherrow for not initiating SHP’s drug withdrawal policy or nausea/vomiting protocol at some point during his detention. He also asserts that Sherrow was deliberately indifferent when she removed him from detox monitoring and allowed him to return to general population. Sherrow interacted with Griffith three times during his period of detention, each of which occurred while he was being held in the detox cell. She first interacted with him on Monday, November 9th at 7:42 a.m. to complete the Suicide Prevention Screening Guidelines Form when he was on his way to pretrial. She assessed his mental health and indicated that he was no longer showing signs of depression or anxiety. She recorded that he was experiencing nausea, but apparently did not take any action to follow up on his complaint. She indicated on the form that the deputy jailers had been conducting monitoring, but she did not herself review the observation log. To be sure, it may have been preferable for Sherrow to have taken a more aggressive course of action at this time in response to Griffith’s complaint of nausea and vomiting. Perhaps initiating the detox protocol would have given the medical staff a better opportunity to monitor Nos. 19-5378/5438/5439/5440 Griffith v. Franklin County, Ky., et al. Page 20 Griffith’s condition and allow them to intervene before he suffered a seizure several days later. But, when she conducted the screening, Sherrow made a decision that Griffith’s condition did not warrant elevation to medical observation. Sherrow testified that regardless of whether jail staff designates an inmate for observation, the medical staff makes an independent evaluation as to whether to place the inmate on medical observation. Based on the signs and symptoms that Griffith exhibited, Sherrow made the decision that further observation by medical was not necessary. Specifically, she indicated that observation would be appropriate for an inmate who was “hallucinat[ing], sweating, can’t [sic] get up.” Sherrow Dep., R. 75-5 at PageID 2013. She further testified that she would make the decision to place an inmate in medical observation based on their vital signs and other visible symptoms. There is no evidence that Sherrow “knew, or should have known,” that Griffith was suffering severe withdrawal symptoms that would lead to a series of seizures several days later or otherwise “posed an excessive risk to health or safety.” Bruno v. City of Schenectady, 727 F. App’x 717, 720 (2d Cir. 2018). To the contrary, Griffith has not introduced any evidence that his vomiting was caused by drug withdrawal, or that he was suffering drug withdrawal at all. Instead, he testified that he had been vomiting because of nerves. Even putting aside the issue of drug withdrawal, there is no evidence that Sherrow knew or should have known that Griffith’s vomiting evinced a substantial risk to his health. Griffith now contends that his vomiting caused him to experience dehydration, which in turn led to his seizures. But again, there is no medical evidence to support his theory. The UK Hospital discharge report said “his seizure was most likely due to PRES . . . . The cause of PRES was either due to his acute renal failure or possible intoxication.” UK Discharge Summary, R. 69-33. And the FRMC report, the document upon which Griffith relies, does not say that his renal failure was caused by dehydration. Instead, it says: “[Griffith’s] presentation is complex. Differential [diagnosis] is broad.” FRMC Physician Record, R. 101-18 at PageID 3892. It then discusses potential causes for his renal failure and seizures (including rhabdomyolysis, HUS, toxic ingestion, serotonin syndrome, encephalitis, or meningitis) without reaching any resolution. Moreover, Griffith’s expert testified that she did not think that dehydration was the primary source of his kidney failure, and she declined to testify definitively that he suffered dehydration Nos. 19-5378/5438/5439/5440 Griffith v. Franklin County, Ky., et al. Page 21 (rather than simply being dehydrated). Accordingly, there is no evidence that Sherrow should have known, based on Griffith’s report of vomiting on Monday, November 9th, that he was at risk of dehydration leading to kidney failure and multiple seizures.7 There is also no evidence that Sherrow “recklessly failed to act with reasonable care to mitigate [that] risk.” Bruno, 727 F. App’x at 720. Based on her assessment, Sherrow did not consider Griffith to be at a high risk requiring medical observation. She testified that this was in part because of the signs and symptoms that she witnessed, and in part because Griffith or the deputy jailers could fill out a sick call slip if his conditioned worsened. “[C]ourts are generally reluctant to second guess the medical judgment of prison medical officials.” Rouster v. County of Saginaw, 749 F.3d 437, 448 (6th Cir. 2014) (alteration in original) (quoting Jones v. Muskegon County, 625 F.3d 935, 944 (6th Cir. 2010)). Even if Sherrow was negligent in failing to take more aggressive steps in monitoring Griffith, that would only constitute a claim of medical malpractice that lies beyond the Constitution’s reach. “When a prison doctor provides treatment, albeit carelessly or inefficaciously, to a prisoner, he has not displayed a deliberate indifference to the prisoner’s needs, but merely a degree of incompetence which does not rise to the level of a constitutional violation.” Winkler v. Madison County, 893 F.3d 877, 891 (6th Cir. 2018) (quoting Comstock v. McCrary, 273 F.3d 693, 703 (6th Cir. 2001)). For example, we have held that a prison doctor was not deliberately indifferent when he misdiagnosed the plaintiff’s cancer and attempted to treat the condition with over-the-counter medications. See Jones, 625 F.3d at 945–46. Similarly, we have twice held that prison medical officials were not deliberately indifferent when they misdiagnosed two severe ulcers—both of which were lethal—as symptoms of drug or alcohol withdrawal. See Winkler, 893 F.3d at 892–93; Rouster, 749 F.3d at 448–51. In Rouster, the prison nursing staff had misdiagnosed 7 For this reason, Griffith’s reliance on Clark-Murphy v. Foreback is unpersuasive. See 439 F.3d 280 (6th Cir. 2006). There, the inmate died of dehydration after being held in an observation cell for multiple days in 90degree heat without access to water. He also repeatedly asked for water and was seen drinking out of the toilet. The court held that collectively, this evidence was sufficient for a jury to infer that the jailers were subjectively aware that he was suffering dehydration. See id. at 289–90. By contrast, Griffith’s reports of vomiting to Trivette and Sherrow do not suggest that they knew, or should have known, that Griffith was at a risk of extreme dehydration that would cause acute renal failure which would, in turn, lead to a seizure. As discussed, there is no evidence that Griffith suffered dehydration. Moreover, the unrebutted evidence, discussed infra, demonstrates that Trivette took several measures to monitor for the possibility of dehydration in response to his complaints of vomiting and diarrhea. Nos. 19-5378/5438/5439/5440 Griffith v. Franklin County, Ky., et al. Page 22 ulcers as potential alcohol withdrawal, even though the plaintiff was seen eating food off the ground, drinking out of the toilet, and otherwise behaving erratically in ways not consistent with alcohol withdrawal. See 749 F.3d at 449. But, we explained, the medical staff did not know he had previously been treated for a perforated ulcer and therefore did not have the information necessary to make the appropriate diagnosis. See id. at 448.8 Accordingly, the nursing staff did not violate the Constitution by attempting to treat the plaintiff, even though the treatment ultimately was unsuccessful. See id.; see also Winkler, 893 F.3d at 892–93 (“Although [the defendant’s] assessment and treatment of [the detainee] might not represent the best of medical practices, her actions do not suggest deliberate indifference to a known risk to [the detainee’s] health.”). When Sherrow interacted with Griffith on the morning of Monday, November 9th, she completed the screening for potential suicide risk or mental health, which was the main reason Griffith was held by jail staff for observation. She recorded that he no longer presented such a risk based on her evaluation. She also noted his report of nausea, but she did not believe further action was needed based on his symptoms at that time and on her judgment and experience. She testified that Griffith would be able to submit a sick slip if he was experiencing further symptoms, and he in fact did submit such a slip and was treated by Trivette later that day during his full medical intake. The failure to take further steps based only on his statement that he was experiencing vomiting and nausea cannot rise to a level above negligence. 8 The evidence suggests that, as in Rouster and Winkler, Griffith’s medical emergency arose from a latent issue that existed prior to his detention. He was already vomiting before he was admitted to the jail, beginning when he was struck with a baseball bat during the failed robbery. However, there is no evidence that Griffith informed the medical staff that he had been in a violent confrontation and had been vomiting ever since. Thus, Griffith would also not prevail on a theory that the medical staff failed to discover an underlying medical issue originating at the burglary because the medical staff did not have the “critical piece of information” that he had been in a violent incident. See Rouster, 749 F.3d at 448. The dissent suggests that we are overemphasizing the uncertainty about the cause of Griffith’s medical condition. See Dissent at 13 n.2. We disagree because, even accepting the dissent’s formulation, the test requires that we determine what a reasonable nurse “would have known, or should have known,” about Griffith’s condition. See id. at 10. That medical professionals were unable to identify what happened to Griffith, even with the benefit of hindsight, weighs strongly against a finding that a reasonable nurse “would have known, or should have known,” the extent of his condition at the time of treatment. Accord LeMarbe, 266 F.3d at 436 (“[A] factfinder may conclude that a prison official knew of a substantial risk from the fact that the risk was obvious.” (quoting Farmer, 511 U.S. at 842)). Nos. 19-5378/5438/5439/5440 Griffith v. Franklin County, Ky., et al. Page 23 Sherrow next saw Griffith the following day, Tuesday, November 10th, at 7:50 a.m. to administer medicine. Sherrow could not recall the length of this interaction, but indicated that based on her notes, Griffith did not make any other complaints at that time. There is no evidence from this interaction that she was or should have been aware that Griffith was suffering from a serious medical issue or that his condition had worsened. Finally, Sherrow saw Griffith on Wednesday, November 11th, and provided treatment along with Trivette. Sherrow performed the urine dip test while Trivette provided Imodium, Mylanta, and Gatorade. Consistent with the instructions on the urine dip test, Sherrow added Griffith to the list to be seen by an APRN on the next weekly visit to review the results of the urine test. Again, it would have been preferable if Sherrow had immediately elevated Griffith’s test results to an APRN rather than putting him on a list to be seen on the next weekly visit. Perhaps that was even what the standard of care dictated. But Griffith acknowledges that Sherrow did administer the urine test, review the results, and elevate those results to the APRN. Moreover, Sherrow witnessed Trivette provide over-the-counter treatment for his symptoms as well as Gatorade. Sherrow also witnessed that Griffith was able to drink the Gatorade without vomiting or other negative reaction, a fact that, in her experience, indicated that his medical status was stable. The decision to elevate Griffith’s results via the weekly list rather call an APRN directly may be evidence that Sherrow underestimated the severity of Griffith’s condition, but it does not demonstrate that she “recklessly failed to act with reasonable care to mitigate [the] risk,” Bruno, 727 F. App’x at 720, or that she should have known that his medical condition was declining.9 9 The dissent suggests that we are ignoring the “context” of Sherrow’s decision to elevate Griffith’s condition to an APRN by placing him on the weekly list rather than immediately placing a phone call or transferring him to the emergency room. See Dissent at 13. But it is the dissent that ignores the context of Griffith’s period of detention by focusing exclusively on this single interaction between Griffith and Nurse Sherrow. This meeting occurred only because Nurse Trivette was taking affirmative steps to monitor Griffith’s condition, not in response to a sick call slip. Indeed, Griffith only requested medical attention on two occasions—on September 9th and September 10th. The unrebutted evidence demonstrates that Nurse Sherrow and Nurse Trivette provided treatment to Griffith on September 11th, and Griffith never indicated that the treatment provided was insufficient or that his condition was not improving. Further, it is undisputed that Griffith’s condition was elevated to an APRN when he Nos. 19-5378/5438/5439/5440 Griffith v. Franklin County, Ky., et al. Page 24 There is also no evidence that by placing him on the weekly list rather than calling an APRN, Sherrow “consciously expos[ed] [Griffith] to an excessive risk of serious harm,” Richmond v. Huq, 885 F.3d 928, 940 (6th Cir. 2018) (quoting LeMarbe v. Wisneski, 266 F.3d 429, 439 (6th Cir. 2001)), or provided care “so woefully inadequate as to amount to no treatment at all,” id. (quoting Asplaugh v. McConnell, 643 F.3d 162, 169 (6th Cir. 2011)). Griffith and the dissent rely on LeMarbe, but that reliance is misplaced. There, a surgeon conducting exploratory surgery visually observed five liters of bile that had leaked into the plaintiff’s abdomen. See 266 F.3d at 433. But the surgeon was unable to determine the source of the leak and simply drained the fluid and closed the surgical incision. Id. Even though he knew that bile was leaking into the plaintiff’s abdomen, knew that he had not identified or remedied the leak, and knew the continuing bile leakage required immediate medical attention, the surgeon discharged the plaintiff several days later without taking any further action. Id. We held that this was evidence of deliberate indifference. See id. at 439. That case is distinguishable in two important respects. The first involves what the defendant knew or should have known. There, the surgeon personally saw five liters of bile that had leaked into the plaintiff’s abdomen, which exposed a risk of harm that was “extreme and obvious to anyone with a medical education and to most lay people.” Id. at 437. In contrast, Nurse Sherrow saw the results of a urine test that indicated a potential abnormality. Even Griffith’s expert report does not speak in the unequivocal language used in LeMarbe: Griffith’s expert stated only that the urinalysis shows “a potentially serious medical condition which required immediate medical evaluation and treatment.” Report of Madeline LaMarre, R. 101-26 at PageID 4065. Second, and more importantly, LeMarbe differs from this case because of the evidence there indicating the surgeon “disregarded” the risk. LeMarbe, 266 F.3d at 438. The surgeon in LeMarbe took no further steps to address the leaking bile; he simply ended surgery and discharged the patient. Id. at 433. In contrast, Nurse Sherrow elevated Griffith’s condition to an APRN by placing him on the weekly list. It is therefore undisputed that Griffith’s medical condition was still under review and that he would have received further treatment. Even if was placed on the weekly list. The dissent also ignores the three full days Griffith spent in general population, during which time Nurse Sherrow had no information about his condition. Nos. 19-5378/5438/5439/5440 Griffith v. Franklin County, Ky., et al. Page 25 Sherrow’s chosen approach was negligent, that is not enough to satisfy Griffith’s evidentiary burdens, either under Farmer or Kingsley: “Whatever Kingsley requires, it is more than negligence.” Martin v. Warren County, 799 F. App’x 329, 338 n.4 (6th Cir. 2020). Finally, for two reasons there is no merit to Griffith’s contention that Sherrow’s deliberate indifference is demonstrated because Griffith was released into the general population or because she did not follow up with Griffith after that time. First, Griffith had been held for observation by jail staff and the Kentucky Jail Mental Health Crisis Network, not medical staff. Accordingly, the recommendation to release him into general population came not from the nurses but from Clinician Thompson with the Kentucky Jail Mental Health Crisis Network. There is no evidence to suggest that the nursing staff was responsible for releasing Griffith into general population. Second, there is no evidence that the nursing staff should have affirmatively followed up with Griffith for continued monitoring. To the contrary, the expectation was that either Griffith or a deputy jailer would submit a sick slip if he needed further attention. There is no evidence that the nurses should have expected that Griffith’s condition was deteriorating or that they could have known that their attempts to treat his condition had been unsuccessful. In sum, Sherrow had three brief interactions with Griffith over the course of his time in detox. During that period, she conducted a urine sample that contained information about his condition and elevated the test results to an APRN. Griffith made no effort to obtain further care other than the two sick call slips he filled out in detox, and there is no evidence that Sherrow would have expected that he had not responded to the treatment provided by herself and Trivette. Sherrow’s treatment may have been suboptimal, but it does not rise to the level of a constitutional violation. We therefore affirm the grant of summary judgment in favor of Sherrow.
Griffith argues that Trivette was deliberately indifferent because she did not call Dr. Waldridge or an APRN when she saw Griffith on Monday and Tuesday and because she did not implement SHP’s drug withdrawal policy or the nausea/vomiting protocol. Griffith further contends that Trivette failed to make other arrangements after trying to place Griffith in a dry Nos. 19-5378/5438/5439/5440 Griffith v. Franklin County, Ky., et al. Page 26 cell and finding that none was available. He also asserts that Trivette demonstrated a culpable mental state because she provided Immodium, Mylanta, and Cipro without first calling Dr. Waldridge or an APRN. Finally, Griffith claims that Trivette was deliberately indifferent when she allowed Griffith to be released into the general population and took no further efforts to check on his status. Griffith submitted his first sick call slip on Monday morning after Sherrow conducted his initial screening. Trivette then met with Griffith at 10:00 a.m. both to conduct his medical intake screening and to respond to the sick call slip. Trivette took Griffith’s vital signs, conducted the medical observation, and noted that Griffith had reported nausea, diarrhea, and vomiting. Because of this complaint, Trivette assessed Griffith’s hydration by performing a skin turgor test, and she reported that his skin was “race appropriate & [had] good turgor,” and further noted that she had reviewed Griffith’s hydration. Griffith indicated that he was unable to urinate, so Trivette scheduled him to provide a urine sample the following day. Further, Trivette assessed Griffith to determine whether he was at risk to suffer withdrawal from drugs or alcohol and, based on his reported drug use, indicated that he did not appear to be under the influence of or withdrawing from drugs or alcohol. She testified that she made this determination because he was not experiencing more extreme symptoms, such as “sweating, shaking delusions,” or extreme emotions such as anger. Trivette Dep., R. 75-7 at PageID 2278. Based on that assessment, Trivette did not initiate a detox protocol. Although in hindsight we can say that it may have been preferable for Trivette to have taken a more aggressive approach to monitoring, there is no evidence that she was aware, or should have been aware, that Griffith was in need of immediate emergency medical care. See Bruno, 727 F. App’x at 720. There is no evidence that Trivette should have recognized, based only on Griffith’s complaint of “stomach/vomiting,” inability to urinate, and reported daily use of marijuana and weekend use of Xanax, that he would suffer significant withdrawal symptoms, leading to dehydration and multiple seizures. As indicated, the medical evidence submitted by Griffith still does not support the theory that he was suffering dehydration or that such dehydration caused his seizures. Nos. 19-5378/5438/5439/5440 Griffith v. Franklin County, Ky., et al. Page 27 Further, there is no dispute that Trivette provided treatment by administering over-thecounter medications to ease Griffith’s symptoms in response to his complaints. See Rouster, 749 F.3d at 448–49 (emphasizing that the defendants “took appropriate steps” in response to plaintiff’s condition, including provision of over-the-counter medications). “To be sure, medical providers may ‘not escape liability if the evidence showed that [they] merely refused to verify underlying facts that [they] strongly suspected to be true, or declined to confirm inferences of a risk that [they] strongly suspected to exist.” Id. at 451 (quoting Farmer v. Brennan, 511 U.S. 825, 843 n.8 (1994)). However, the unrebutted evidence demonstrates that Trivette took steps to identify the source of Griffith’s condition and attempted to treat it each time he complained of continuing symptoms. Trivette was aware that Griffith was experiencing nausea and gastrointestinal distress, and she took steps to alleviate his symptoms. She provided over-thecounter treatment and scheduled a urine test to gather more information. She also checked his vital signs, tested for dehydration, and assessed whether he presented a risk of drug withdrawal. After providing over-the-counter medication and conducting his medical screen on Monday, Trivette next saw Griffith later in the day to provide medication, seemingly without incident. Griffith filled out his second sick call slip the following day. Nurse Trivette responded to his complaint and evaluated the condition of his skin, abdomen, gait, and skin turgor. Further, Trivette again checked him for dehydration. Because he was still unable to urinate, Trivette attempted to place him in a dry cell for observation but was unable to do so because no such cells were available. Griffith never filled out another sick slip, but Trivette saw Griffith once more the following day to perform the urinalysis. This time, Griffith was able to urinate, so he provided a sample for the dip test. He also complained of vomiting, and Trivette provided more over-thecounter medications and Gatorade. She witnessed him drink the Gatorade without incident while Sherrow administered the urine test. Trivette reviewed the sample and determined that, in her experience, the sample indicated that there was a risk that Griffith was experiencing an infection, so she prescribed Cipro to treat the infection. Further, Sherrow added Griffith to the list to be Nos. 19-5378/5438/5439/5440 Griffith v. Franklin County, Ky., et al. Page 28 seen by the APRN at the next visit. Trivette testified that the nurses took this approach because they wanted the samples reviewed but were not alarmed by the test results.10 Trivette therefore responded to all of Griffith’s complaints, attempted to treat his condition, and performed tests to identify its cause. Because of these steps, Griffith received a urinalysis and his condition was elevated to an APRN by designating him on the weekly list. Even if Sherrow’s “assessment and treatment of [Griffith] might not represent the best of medical practices, her actions do not suggest deliberate indifference to a known risk to [Griffith’s] health.” Winkler, 893 F.3d at 892. Griffith also contends that Trivette’s mental culpability is demonstrated because she failed to follow SHP’s internal policies by providing over-the-counter medication and Cipro without contacting Dr. Waldridge and by failing to initiate the detox protocol. But we have held that “the failure follow internal policies, without more, [does not] constitute deliberate indifference.” Id. at 891–92 (citing Meier v. County of Presque Isle, 376 F. App’x 524, 529 (6th Cir. 2010)). We therefore affirm the grant of summary judgment in favor of Trivette.
Griffith argues that Mundine was deliberately indifferent because she failed to take earlier action to elevate Griffith’s status to a doctor or an APRN. He argues that her deliberate indifference is demonstrated because she failed to affirmatively look for him when he failed to come and receive his medicine on Saturday morning. Further, he contends that she did not act quickly enough in response to his first seizure, and that she acted improperly by calling RN Sherrow for treatment advice rather than calling Dr. Waldridge or an APRN. 10 In reaching the contrary conclusion, the dissent fails to recognize that “[w]e address the subjective component individually for each defendant.” Rinehart, 894 F.3d at 738 (citing Garretson, 407 F.3d at 797). The dissent would hold Trivette to have acted with deliberate indifference simply “for the reasons applicable to Sherrow,” Dissent at 14, even though both nurses testified that it was Sherrow, not Trivette, that performed the urine test. The dissent fails to explain why Trivette demonstrated deliberate indifference by declining to override the judgment of Sherrow (Trivette’s superior) and call an APRN directly to report the results of a test that she did not herself perform. Trivette’s attempt to provide immediate treatment to Griffith by prescribing an antibiotic to treat a perceived infection further weighs against a finding of deliberate indifference. By focusing only on the fact that this treatment was incorrect, the dissent fails to accord the appropriate deference to the “medical judgment of prison medical officials,” Rouster, 749 F.3d at 448 (quoting Jones, 625 F.3d at 944), and ignores our frequent admonition against constitutionalizing claims for medical negligence, see Burgess, 735 F.3d at 478. Nos. 19-5378/5438/5439/5440 Griffith v. Franklin County, Ky., et al. Page 29 Griffith’s arguments are without merit. As an initial matter, Griffith relies exclusively on Blackmore v. Kalamazoo County, 390 F.3d 890 (6th Cir. 2004) for the proposition that Mundine violated the Constitution by delaying Griffith’s treatment. However, that case only involved whether a plaintiff could demonstrate a sufficiently serious medical need to satisfy the objective component by introducing evidence of a delay in treatment of an obvious medical need even without medical proof of harm caused by the delay. See Blackmore, 390 F.3d at 899–900. As discussed, the objective component is not at issue here, so the case is wholly inapposite. Moreover, we find no evidence that Mundine disregarded any risk to Griffith’s safety. Mundine responded to Griffith’s first seizure and immediately conducted an examination of his condition. She had him escorted to booking where she continued to examine him, tested him for drugs, and listened to Griffith’s complaint that he had been vomiting. She responded to this complaint by prescribing an anti-nausea drug and providing him Gatorade. After Griffith stabilized and requested to go back to his cell, Mundine permitted him to go to his cell— provided that he move to a lower bunk—while she continued reviewing his file. Mundine testified that she was still reviewing his file at the time of Griffith’s second seizure, at which time she immediately sent Griffith to the emergency room. Griffith contends that Mundine did not follow SHP protocol with regard to seizures. That, he maintains, amounts to deliberate indifference. But, because “the failure to follow internal policies, without more, [does not] constitute deliberate indifference,” Winkler, 893 F.3d at 891, Griffith’s arguments fail.11 Griffith points to no additional steps that Mundine should have taken and, because he suffered a second seizure before she had the opportunity to finish reviewing his file, it is hard to imagine what else she could have done. There is certainly nothing to suggest that she “acted intentionally to impose the alleged condition, or recklessly failed to act with reasonable care to mitigate the risk that the condition posed to the pretrial detainee even though the defendant11 The dissent acknowledges that the failure to follow internal procedures cannot alone establish deliberate indifference, but points to little else in reaching its conclusion. See Dissent at 15–16. The undisputed facts demonstrate that Mundine responded immediately to Griffith’s seizure, provided appropriate care, contacted Sherrow to get further guidance, and had not even completed review of Griffith’s file at the time he suffered his second seizure. Nos. 19-5378/5438/5439/5440 Griffith v. Franklin County, Ky., et al. Page 30 official knew, or should have known, that the condition posed an excessive risk to health or safety.” Bruno, 727 F. App’x at 720 (emphasis in original) (quoting Darnell 849 F.3d at 35). We therefore affirm the grant of summary judgment in favor of Nurse Mundine.
Griffith argues that Dr. Waldridge is liable under a theory of supervisory liability. Section 1983 liability of supervisory personnel “must be based on more than the right to control employees. Section 1983 liability will not be imposed solely upon the basis of respondeat superior. There must be a showing that the supervisor encouraged the specific incident of misconduct or in some other way directly participated in it.” Doe v. Claiborne County, 103 F.3d 495, 511 (6th Cir. 1996) (quoting Bellamy v. Bradley, 729 F.2d 416, 421 (6th Cir. 1984)). Accordingly, “a supervisory official’s failure to supervise, control or train the offending individual is not actionable unless the supervisor ‘either encouraged the specific incident of misconduct or in some other way directly participated in it. At a minimum a plaintiff must show that the official at least implicitly authorized, approved, or knowingly acquiesced in the unconstitutional conduct of the offending officers.’” Shehee v. Luttrell, 199 F.3d 295, 300 (6th Cir. 1999) (quoting Hays v. Jefferson County, 668 F.2d 869, 874 (6th Cir. 1999)); see Ashcroft v. Iqbal, 556 U.S. 662, 677 (2009) (“[E]ach Government official . . . is only liable for his or her own misconduct.”). Moreover, a plaintiff cannot establish a claim for supervisory liability without establishing an underlying constitutional violation by a supervised employee. See, e.g., McQueen v. Beecher Cmty. Schools, 433 F.3d 460, 470 (6th Cir. 2006) (“Because [the plaintiff] also has not pointed to unconstitutional conduct by any other employee supervised by [the individual defendant], it necessarily follows that the supervisory liability claim . . . must fail.”). Because Griffith has failed to establish that his constitutional rights were violated by Sherrow, Trivette, or Mundine, his claim against Dr. Waldridge fails as well. See id. We therefore affirm the grant of summary judgment in favor of Dr. Waldridge. Nos. 19-5378/5438/5439/5440 Griffith v. Franklin County, Ky., et al. Page 31
Griffith also argues that SHP collectively can be held liable on a theory of Monell liability. He argues that this court has already held that SHP’s training procedures were inadequate in Shadrick v. Hopkins County, 805 F.3d 724 (6th Cir. 2015). Griffith’s argument is unconvincing because he has made no effort to develop any facts about the training that the SHP nurses in this case received. Indeed, Griffith’s expert disclaimed any opinion on the adequacy of SHP’s training. In Shadrick, the plaintiff was sentenced to a short term of imprisonment and informed medical staff that he had a severe staph infection. The medical staff failed to provide meaningful treatment, put him in a segregation cell but failed to rigorously monitor him, and he died within four days. Id. at 732–33. The court held that SHP had failed to train its nurses because “[t]here [was] no indication in the record . . . that S[H]P designed and implemented any type of ongoing training program for its LPN nurses.” Id. at 740. The plaintiff had provided expert testimony who “opined that SHP failed to provide adequate training and supervision to the LPN nurses.” Id. at 741. This court has explained that “[e]specially in the context of a failure to train claim, expert testimony may prove the sole available avenue to plaintiffs to call into question the adequacy of . . . training procedures.” Russo v. City of Cincinnati, 953 F.2d 1036, 1047 (6th Cir. 1992) (quoted in Shadrick, 805 F.3d at 741). Griffith points to no expert testimony or any other evidence to support his failure-to-train claim against SHP.12 We therefore affirm the grant of summary judgment in favor of SHP.