Opinion ID: 4567449
Heading Depth: 5
Heading Rank: 1

Heading: Detox Policy

Text: Griffith contends that the deputy jailers should have reported Griffith’s vomiting to the SHP nurses in addition to monitoring his condition every twenty minutes. He asserts that the deputy jailers’ practice in attending to detoxing detainees—in particular, monitoring only for “living, breathing flesh”—was “in complete derogation of the language of and duties imposed by the Jail’s written EMS policy.” But, as we have already explained, the violation of an internal policy does not establish a constitutional violation. See, e.g., Winkler, 893 F.3d at 891–92; Smith v. Freland, 954 F.2d 343, 347–48 (6th Cir. 1992). Moreover, although the deputy jailer’s testimony that they were monitoring for “living, breathing flesh” is troubling, the deputy jailers actually monitored Griffith’s condition every twenty minutes throughout his forty-eight hours in detox and took detailed notes of his condition each time—including whether he had eaten and how much, whether he was experiencing physical symptoms such as vomiting, and whether he had spoken to the deputy jailer. The deputy jailers testified that they would alert medical staff if a detainee was vomiting excessively or if their condition was deteriorating. Furthermore, Griffith was seen by the medical staff at least two times a day during his stay in detox, and the deputy jailers were entitled to rely on the assessments made by medical professionals. See, e.g., Winkler, 893 F.3d at 901 (“[I]t is not unconstitutional for municipalities and their employees to rely on medical judgments made by private medical professionals responsible for prisoner care[.]” (cleaned up)); Spears v. Ruth, 589 F.3d 249, 255 (6th Cir. 2009) (explaining that officer was entitled to rely on assessments of medical professionals). Griffith does not contest that the deputy jailers promptly alerted the medical staff every time he submitted a sick call slip. To be sure, there does appear to have been a miscommunication with regard to Griffith’s status—medical staff indicated that he did not seem to be at risk for drug withdrawal while the deputy jailers and prison staff seemed to believe he was being held in a segregated cell because he was detoxing. But there is no evidence that this Nos. 19-5378/5438/5439/5440 Griffith v. Franklin County, Ky., et al. Page 35 was anything other than a single miscommunication in an otherwise functioning system. See North, 754 F. App’x at 392 (“While imperfect, the apparent problems . . . seem to consist of ‘one or two missteps’ rather than the kind of widespread, gross deficiencies that would support a finding of deliberate indifference.” (quoting Daniel v. Cook County, 833 F.3d 728, 734–35 (7th Cir. 2016)). Griffith also could not prevail on a theory that the constitutional violation arose out of the deputy jailers’ inaction. For such a claim, he would need to prove (1) “a clear and persistent” pattern of unconstitutional conduct by [County] employees; (2) the municipality’s “notice or constructive notice” of the unconstitutional conduct; (3) the municipality’s “tacit approval of the unconstitutional conduct, such that [its] deliberate indifference in [its] failure to act can be said to amount to an official policy of inaction”; and (4) that the policy of inaction was the “moving force” of the constitutional deprivation . . . . Winkler, 893 F.3d at 902 (second and third alterations in original) (citing D’Ambrosio, 747 F.3d at 387–88). Griffith “discusses only [his own] treatment, and therefore cannot establish that the County had a custom of deliberate indifference to the serious healthcare needs of all the inmates [detained at FCRJ].” Id.; see also Thomas, 398 F.3d at 433 (“[A plaintiff] cannot rely solely on a single instance to infer a policy of deliberate indifference.”).