Opinion ID: 3157371
Heading Depth: 2
Heading Rank: 1

Heading: Treatment at Parkland

Text: Defendants–Appellants Dr. Kevin Brown and Nurse Sherwin De Guzman were present at Cornell’s intake, during which Dr. Shawn Chambers took Cornell’s medical history. Cornell told Chambers that he had “tachycardia.” Cornell stated that “people had stolen his lottery ticket and were chasing him.” Cornell was admitted to the Psych ER pursuant to Dr. Brown’s authorization. Johnny Roberts, a technician in the Psych ER (a “psych tech”), took Cornell’s vital signs, which registered as abnormally high. Cornell’s pulse was 124 beats per minute, his blood pressure was 142/105 mm Hg, and his respirations were 17 breaths per minute. Because Cornell’s pulse and blood pressure readings were elevated, Roberts tried to take his vital signs again, 1 Texas law allows a police officer to take a person into custody without a warrant if “the officer . . . has reason to believe that (A) the person is a person with mental illness; and (B) because of that mental illness there is a substantial risk of serious harm to the person or to others unless the person is immediately restrained.” Tex. Health & Safety Code § 573.001(a). The officer must “immediately transport” that person to the nearest appropriate mental-health facility. Id. § 573.001(d). The mental-health facility may detain that person “in custody for not longer than 48 hours after the time the person is presented to the facility unless a written order for protective custody is obtained.” Id. § 573.021(b). Appellees do not challenge the officers’ grounds for bringing Cornell to Parkland. 2 Case: 14-11020 Document: 00513282187 Page: 3 Date Filed: 11/23/2015 No. 14-11020 but the machine malfunctioned. Though Cornell had been cooperative up to this point, he became agitated and refused to cooperate when Roberts attempted to take his vital signs a third time. Parkland staff provided no further cardiac treatment to Cornell. Roberts asked Defendant–Appellant Robert Givens, another psych tech, for assistance calming Cornell, but Cornell continued to resist and tried to leave the Psych ER. Roberts informed Dr. Brown of Cornell’s behavior. Givens put Cornell in either a “basket hold” or “elbow-to-hip containment,” and pushed him into a seclusion room. The techs held Cornell on a mat on the floor. The techs’ testimony conflicts as to whether Cornell was held on his side or his stomach. De Guzman arrived and injected Cornell with a mixture of Haldol, Ativan, and Benadryl to subdue him. Haldol and Benadryl can cause cardiac arrhythmia and death. The techs continued to hold Cornell down, though testimony varies as to how long the hold lasted: Givens stated it lasted “a minute or two,” Roberts said “several minutes,” and De Guzman said “maybe five minutes.” After Givens and Roberts left the room, Cornell became agitated again. He began yelling, and he ripped up a vinyl tile from the floor and banged it against the door. A third psych tech, Defendant–Appellant Alexander Achebe, convinced Cornell to trade the tile for a juice box. The techs began to move Cornell to a new room because he had ripped up the flooring. As they approached the second seclusion room, Cornell crushed the juice box and began physically resisting the techs. They again restrained Cornell and put him on a mat in the room. Cornell received a second injection of the same medications. Again, there is conflicting testimony about how Cornell was held on the mat. Accepting Pena’s version of the facts, Cornell was held on his stomach for fifteen minutes after the injection. Psych techs were trained not to hold a 3 Case: 14-11020 Document: 00513282187 Page: 4 Date Filed: 11/23/2015 No. 14-11020 patient in a prone position for more than a minute, because longer holds can cause asphyxiation. The techs then left the room. A nurse later found Cornell lying in a prone position in the room with his right arm beneath him and his hand pointed to the ceiling. His hand was cyanotic, and the nurse could not detect spontaneous respirations. The nurse called a code blue, and Cornell was transferred to the main emergency room, where he died. The medical examiner found abrasions on the left side of Cornell’s forehead. After an investigation into Cornell’s death, the medical examiner found the cause of death to be undetermined, listing three potential causes: 1) mechanical compression; 2) underlying cardiac issues; or 3) effects of the medication he received in the Psych ER.