Opinion ID: 4387846
Heading Depth: 2
Heading Rank: 3

Heading: Deliberate Indifference Against Corizon

Text: Blaine appears to allege that Cross suffered harm as the result of Corizon’s policies or practices of (1) allowing LPNs to conduct initial assessments, (2) relying upon LPNs to determine whether to call a physician, and (3) providing medical staff with the option to wait hours before checking on impaired inmates ultimately caused harm to Cross. Though Blaine asks us to engage in an inquiry of whether Corizon’s policies or practices were a “moving force behind” Cross’s death, id. at 453 (quotation omitted), neither Blaine nor Corizon has provided Corizon’s official written polices or procedures for the record. Instead, both parties rely upon deposition testimony from Alicia Pennington, the Senior Correctional Nurse Specialist at Corizon, in which she stated that an inmate who has been admitted to the jail in an intoxicated state is to be awakened once every eight hours. This is in accordance with the procedure Kohl and Sloan followed for Cross, and, as discussed, neither Kohl nor Sloan violated Cross’s constitutional rights in so doing. Pennington’s deposition testimony appears to refer to various written policies and procedures, but these documents are not before us. Other than Pennington’s deposition, there is no mention of Corizon’s policies in the record.5 We cannot evaluate Blaine’s claim based on this insufficient evidence. See North, 2018 WL 5794472, at  (“[A] plaintiff pursuing an affirmative policy or custom claim against a municipal entity must (1) show the existence of a policy, 5 It is unclear why the written policies and procedures are not in the record. At oral argument, Plaintiff’s counsel initially seemed surprised to learn that they were not in the record, before confirming in rebuttal that this was the case. (Dec. 5, 2018, Oral Arg. 7:38-8:51; 25:03-25:48.) It was error not to include the policies and procedures in the record, as they are central to the case. Plaintiff’s counsel should have obtained these documents during the course of discovery, or otherwise sought to compel their production. It is unfortunate that we are unable to consider a claim due to counsel’s failure to submit documents. 22 Case No. 18-5224, Blaine v. Louisville Metro. Gov’t (2) connect that policy to the municipality, and (3) demonstrate that his injury was caused by the execution of that policy.” (citation omitted)). For instance, Blaine claims that “Corizon did not require an assessing LPN like Kohl to contact a physician or ARPN about an intoxicated inmate like Cross until the end of her shift,” (Appellant Br. at 13), and cites Pennington’s deposition as support; however, it is unclear if this is actually Corizon’s policy. (See Pennington Dep., R. 109- 6, Page ID # 1048–49 (stating that an LPN was able contact a physician “sometime on her shift. It’s different [depending on the medical severity].” “So at some point in the shift, she would have called the doctor if he was on a withdrawal protocol . . . .”) (emphasis added)). The only evidence of a written Corizon policy available to this court is included in Cross’s medical intake records. The Withdrawal Initial Screening & Treatment Plan states that an LPN conducting the initial assessment had the ability to call a physician or qualified healthcare professional for immediate assistance if the LPN perceived that such necessity was present; for instance, it says, in all capital letters, “notify physician immediately if severity score increases any time during withdrawal,” and “Severe Withdrawal – Immediate provider notification required.” See Withdrawal Initial Screening & Treatment Plan, R. 103-2, Page ID # 660. However, if the LPN determined that a serious risk of harm was not present, the LPN was not required to call a physician. In other words, nothing in Corizon’s policies prevented an LPN from calling a physician, and in fact, if an assessment or the intake itself yielded such severity, an LPN was required to call a physician. Accordingly, even from the policies and protocols that are available from the record, we are unable to find evidence of a constitutional violation stemming from Kohl and Sloan’s failure to call a physician or advanced practicing registered nurse. It is true that “[a]n official’s failure to follow applicable policies and protocols can be persuasive evidence of deliberate indifference in 23 Case No. 18-5224, Blaine v. Louisville Metro. Gov’t the Eighth Amendment context,” North, 2018 WL 5794472, at , though “the failure to follow internal policies, without more, [does not] constitute deliberate indifference,” Winkler, 893 F.3d at 891. Blaine must show that Kohl and Sloan were “subjectively aware of information from which [they] could have inferred a substantial risk to [Cross’s] health, and that [they] acted with reckless disregard to that risk.” Id. at 892. Based upon Cross’s normal vital signs, the results of his assessment at the intake, and his concession that he had consumed alcohol that day, Kohl determined that Cross was suffering from alcohol intoxication and that observation and reorientation were needed, not immediate physician assistance. It is not that Kohl or Sloan determined Cross’s medical condition was severe and required physician assistance, and then they both deliberately disregarded that risk, in contravention of Corizon policy. Rather, neither Kohl nor Sloan determined that Cross’s medical condition was of a such severity so as to warrant immediately calling a physician. This does not constitute deliberate indifference, but rather, is a professional medical assessment in accordance with what Blaine has presented to this court as Corizon’s policies and protocols. To the extent that Blaine argues that Corizon failed to adequately train its medical staff, again, Blaine “provides no supporting evidence or explanation . . . that the training was inadequate . . . .” Winkler, 893 F.3d at 904. “Because [Blaine] has not . . . otherwise explained how [Corizon’s] training . . . was inadequate, the record would not support a jury finding that [Corizon] exhibited deliberate indifference toward inmates at the [facility] by failing to adequately train its medical staff.” Id. at 905 (citing Miller v. Calhoun Cty., 408 F.3d 803, 816 (6th Cir. 2005) (“Mere allegations that an officer was improperly trained or that an injury could have been avoided with better training are insufficient to prove liability.”)). 24 Case No. 18-5224, Blaine v. Louisville Metro. Gov’t Blaine does not “identify a specific policy that reflects deliberate indifference to [Cross’s] right to adequate medical care.” Id. Accordingly, we affirm the district court’s grant of summary judgment regarding the claim of Corizon’s deliberate indifference of medical care.