Opinion ID: 3036756
Heading Depth: 4
Heading Rank: 2

Heading: Adequacy of training

Text: Appellant claims that the County failed adequately to train jail medical staff to document patients’ conditions and to monitor and assess the need for patients to be transferred to a facility with a higher level of medical care. A county’s failure adequately to train its employees to implement a facially valid policy can amount to deliberate indifference. See Berry v. Baca, 379 F.3d 764, 768 (9th Cir. 2004) (even where county’s policy for releasing inmates was theoretically reasonable, as a matter of law the county could not be immune from allegations that, in practice, its implementation of the policy amounted to deliberate indifference); Munger v. City of Glasgow Police Dep’t, 227 F.3d 1082, 1088 (9th Cir. 2000) (policy of helping intoxicated individuals would not insulate county from liability for individual’s death if plaintiff could show that the deprivation was caused by the police department’s deliberate indifference in failing adequately to train officers). [8] It is undisputed that the County knew of Mr. Idlet’s medical condition and that the MSB unit was not equipped to care for acutely ill patients. Appellant argues that given the known limitations of the MSB unit it was obvious that MSB medical staff would need special training in order to care adequately for medically unstable patients and to assess whether such patients should be transferred to the hospital. Appellant has presented declarations of experts who, based on their review of Mr. Idlet’s medical records for the eighteen days he was in the MSB and the depositions of MSB medical staff, opine that the MSB nurses had not been trained adequately in monitoring, documenting and assessing patients’ acute medical conditions within the confines of a limited-care facility such as the MSB, and that this failure to train led to a fatal 3360 LONG v. COUNTY OF LOS ANGELES delay in Mr. Idlet’s care, resulting in his death. Appellant’s experts further opine that, despite the County Jail’s general policy requiring that medically unstable inmates be seen by a doctor and transferred to a hospital for acute care, the County had failed to train the MSB doctors adequately as to the urgency with which medically unstable patients must be seen and assessed in light of the MSB’s limited medical facilities. In rebuttal, the County provides testimony of its expert doctors and the MSB nurses, as well as relevant portions of the medical record, to show that Mr. Idlet was seen by nurses fifty times while he was in the MSB and that the staff cared for him diligently. The County asserts that the alleged instances of the MSB medical staff’s neglect were isolated occurrences that do not reflect deliberate indifference and cannot be the basis for municipal liability. [9] The evidence creates a triable issue of fact regarding whether the County’s policy of relying on medical professionals without training them how to implement proper procedures for documenting, monitoring and assessing patients for medical instability within the confines of the MSB amounted to deliberate indifference.