Opinion ID: 2976945
Heading Depth: 3
Heading Rank: 3

Heading: Officers Ash, Harrell and Felsner

Text: Defendants Ash, Harrell and Felsner’s contact with Jones was even more limited than that of Oke, Abbott or Martin. At approximately 2:45 a.m., Defendant Ash was assigned to the “booking station.” (J.A. at 411) The only evidence on the record regarding Ash’s response to Jones’ asthma attack was that he left the booking station to go to the medical unit to see if he could assist the nursing staff in treating Jones. At that time, Ash “didn’t know what the problem was yet, [he] just knew that there was a problem.” (J.A. at 412) However, Defendants Kirk and Munro were administering oxygen to Jones when he arrived. Within a few minutes after Defendant Ash arrived at the medical unit, Defendants Harrell and Felsner escorted two emergency medical technicians to the unit where Jones was being treated. Clearly, Defendants Ash, Harrell and Felsner had minimal contact with Jones and were tangentially involved with his transportation to the hospital once an ambulance was called. Thus, it cannot be said that Defendants acted unreasonably or that Defendants were deliberately indifferent to Jones’ serious medical needs. In sum, we find that Harrison has not sufficiently demonstrated that any of the Defendant officers were deliberately indifferent to Jones’ serious medical needs.4 Even after taking the facts in a light most favorable to Harrison, the record does not demonstrate that any of the individual Defendant officers disregarded a serious risk to Jones’ health by failing to report Jones’ symptoms to the medical staff at the jail. While there may be occasions where deliberate indifference could be found where prison officials fail to obtain medical assistance when the local jail staff has provided inadequate treatment, this is not such an occasion. In the instant case, each of the named Defendant officers was present at the latter stage of Jones’ deterioration, when it was clear that emergency medical treatment was required and emergency medical care was already en route or on the scene. Despite Harrison’s assertions, there is no evidence in the record indicating that any of the named Defendants observed Jones’ deterioration, between 9:00 p.m. and 2:30 a.m., during the course of his treatment by medical staff. Thus, it cannot be said that any of the Defendant officers were deliberately indifferent to Jones’ serious medical needs and they are therefore entitled to qualified immunity. See Clark-Murphy v. Foreback, 439 F.3d 280, 287(6th Cir. 2006) (finding that two defendant prison guards were entitled to qualified immunity because each took “reasonable steps to ensure that [the other defendants] looked out for [decedent’s] care” and “had no reason to 4 Harrison asserts that Defendant officers are not entitled to qualified immunity because Macomb County had an inadequate policy regarding the treatment of inmates with asthma, thus evincing deliberate indifference to Jones’ serious medical needs. (Pl’s Br. at 33-36) To advance this argument, Harrison relies on a number of cases including City of Canton v. Harris, 489 U.S. 378 (1989), and Russo v. Cincinnati, 953 F.2d 1036 (6th Cir. 1992). Harris and Russo, however, set forth the standard for establishing deliberate indifference on the part of municipalities rather than individual defendants. Thus, Harrison’s argument is unavailing with respect to Defendant officers. Nos. 07-2077/2078 Harrison v. Ash, C.O., et al. Page 8 expect that [the other defendants] charged with [decedent’s] care would fail to secure [the necessary] help”). II. Denial of Summary Judgment to Defendant Nurses Defendant nurses also appeal the district court’s denial of their motion for summary judgment. As a general rule, however, 28 U.S.C. § 1291 grants appellate courts jurisdiction to hear only “final judgments” rendered by district courts. See 28 U.S.C. § 1291 (“The courts of appeals (other than the United States Court of Appeals for the Federal Circuit) shall have jurisdiction of appeals from all final decisions of the district courts of the United States . . . .”). Thus, a denial of summary judgment, which is not a final order by a district court, is not immediately appealable. Johnson v. Jones, 515 U.S. 304, 313 (1995) (holding the district court’s disposition, finding that the summary judgment record raised genuine issues of material fact regarding the merits of plaintiff’s claim, was not a “final order” within the meaning of § 1291). As noted above with respect to Defendant officers, however, under the “collateral order” doctrine, a district court’s order denying summary judgment is immediately appealable where “(1) the defendant was a public official asserting a defense of ‘qualified immunity;’ and (2) the issue appealed concerned, not which facts the parties might be able to prove, but, rather, whether or not certain given facts showed a violation of ‘clearly established’ law.” Id. at 311. In the instant case, the district court denied Defendant nurses’ motion for summary judgment on Harrison’s § 1983 claim. Thus, this Court lacks jurisdiction to consider the district court’s non-final order denying summary judgment under 28 U.S.C. § 1291 unless Defendant nurses are eligible to raise a qualified immunity defense. We find, however, that as employees of a private medical provider, rather than Macomb County itself, Defendant nurses may not assert a defense of qualified immunity and thus we lack jurisdiction to hear their appeal. As an initial matter, it is undisputed that Defendant nurses are subject to suit under § 1983 because they acted “under color of state law.” “It is well settled that private parties that perform fundamentally public functions, or who jointly participate with a state to engage in concerted activity, are regarded as acting ‘under the color of state law’ for purposes of § 1983.” Bartell v. Lohiser, 215 F.3d 550, 556 (6th Cir. 2000). In the instant case, Defendant nurses were acting under the color of state law when the alleged constitutional violation occurred because of the contractual relationship between Macomb County and CMS. Indeed, in West v. Atkins, 487 U.S. 42 (1988), the Supreme Court held that a private doctor under contract to provide medical care to inmates at a state prison acted under color of state law and was therefore subject to suit under § 1983. Id. at 56. The Supreme Court reached this conclusion after noting that “[c]ontracting out prison medical care does not relieve the State of its constitutional duty to provide adequate medical treatment to those in its custody, and it does not deprive the State’s prisoners of the means to vindicate their Eighth Amendment rights.” Id. Being subject to suit under § 1983, however, does not mean that a party has the right to assert qualified immunity. Although § 1983 “creates a species of tort liability that on its face admits of no immunities,” Wyatt v. Cole, 504 U.S. 158, 163 (1992), the Supreme Court has carved out areas of immunity from suit where the “tradition of immunity was so firmly rooted in the common law and was supported by such strong policy reasons that ‘Congress would have specifically so provided had it wished to abolish the doctrine.’” Id. at 164 (citations omitted). In Richardson v. McKnight, 521 U.S. 399 (1997), for example, the Supreme Court examined historical precedent and the policy considerations undergirding the doctrine of qualified immunity to find that qualified immunity was not available to prison guards who worked for a private, for profit corporation that was under contract with the state to manage a prison. Accord Duncan v. Peck, 844 F.2d 1261, 1264 (6th Cir. 1988) (finding that private parties are not eligible for immunity from suit based on common law practices and policy rationales). Thus, this Court must engage in a context specific analysis, Nos. 07-2077/2078 Harrison v. Ash, C.O., et al. Page 9 examining the common law tradition of immunity as well as the policy considerations supporting qualified immunity, to determine whether nurses employed by a private medical provider are eligible to assert qualified immunity in a § 1983 action. See Richardson, 521 U.S. at 408-09; Wyatt, 504 U.S. at 168-69. In Richardson, the Court examined the common law prior to the enactment of § 1983 to find that there was no “firmly rooted” history of providing immunity for private parties who operated prisons or other punitive establishments. While this finding might otherwise be dispositive of our inquiry into the historical record regarding immunity, the Court also observed that “the law did provide a kind of immunity for certain private defendants, such as doctors or lawyers who performed services at the behest of the sovereign.” Richardson, 521 U.S. at 407. As the Eleventh Circuit noted in Hinson v. Edmond, 192 F.3d 1342, 1345 (11th Cir. 1999), however, “[t]he sources cited by the Court suggest that, under certain circumstances, English doctors and lawyers were immune from liability for acts amounting to negligence. For acts amounting to recklessness or intentional wrongdoing, as are alleged here, immunity did not exist . . . . ” Indeed, it is well settled that claims of deliberate indifference must be supported by more than mere negligence.5 Johnson v. Karnes, 398 F.3d 868, 875 (6th Cir. 1995). Thus, to the extent that the deliberate indifference claim at issue turns on Harrison’s establishment of recklessness, like Richardson, we conclude that there is no “firmly rooted” common law practice of extending immunity to private actors under the circumstances present in this case. See Jensen v. Lane County, 222 F.3d 570, 579 (9th Cir. 2000) (denying qualified immunity to a private psychiatrist employed by a county to evaluate patients temporarily detained at the county mental health hospital). Nor do the policy rationales undergirding qualified immunity counsel in favor of extending immunity to Defendant nurses. As the Court noted in Wyatt v. Cole, the doctrine of qualified immunity “strikes a balance between compensating those who have been injured by official conduct and protecting government’s ability to perform traditional functions.” 504 U.S. at 167. Indeed, on the one hand, § 1983 is one of the most important vehicles for the vindication of constitutional and statutory rights and to insure that persons acting under of the color of state law comply with constitutional mandates. On the other hand, the threat of such suits can also dampen the vigorous exercise of official discretion and the discharge of essential governmental functions. Thus, qualified immunity allows suits which allege the violation of a clearly established constitutional right to go forward while insulating officers against suits that are frivolous or where a reasonable officer attempting to serve the public would not have known that his conduct violated a constitutional right. “In short, the qualified immunity [doctrine] . . . acts to safeguard government, and thereby to protect the public at large, not to benefit its agents.” Id. at 167-68. In Richardson, the Court stated that the policy rationales for extending qualified immunity include “protecting the public from unwarranted timidity on the part of public officials” and “encouraging the vigorous exercise of official authority.” 521 U.S. at 408. Additionally, the Court noted that qualified immunity is intended to prevent lawsuits from distracting officials from 5 However, even if, as a general matter, private medical providers could raise immunity from suit in the context of negligence actions, there is no such history of immunity in the state of Michigan. See Rambus v. Wayne County General Hospital, 483 N.W.2d 455, 457-58 (Mich. Ct. App. 1992) (finding that private medical provider was not entitled to governmental immunity despite the fact that the provider and its employees contracted with a governmental agency to provide such medical services); Roberts v. City of Potomac, 440 N.W.2d 55, 57 (Mich Ct. App. 1989) (denying governmental immunity to private health provider that contracted with a county hospital after finding “no reason to extend the protection of governmental immunity to a private entity merely because it contracts with the government”). Nos. 07-2077/2078 Harrison v. Ash, C.O., et al. Page 10 adequately carrying out their6duties and “ensur[ing] that talented candidates [are] not deterred from entering public service.” Id. In considering the first of the policy rationales supporting qualified immunity in the context of private prisons, the Court noted that “the most important special government immunity-producing concern–unwarranted timidity–is less likely present, or at least not special, when a private company subject to competitive market pressures operates a prison.” Id. at 409. “Competitive pressures mean not only that a firm whose guards are too aggressive will face damages that raise costs, thereby threatening its replacement, but also that a firm whose guards are too timid will face threats of replacement by other firms with records that demonstrate their ability to do both a safer and more effective job.” Id. The Court observed that the corporation was required to buy insurance to compensate victims of civil rights torts, and that its performance was regularly reviewed by government authorities, thus creating “pressure from potentially competing firms who can try to take its place.” Id. at 410. Thus, the Court concluded that because the private firm possessed the “freedom to respond to those market pressures through rewards and penalties that operate directly upon its employees,” the private guard defendants “resemble those of other private firms and differ from government employees.” Id. Additionally, the Court found that the private prison would be able to insure that talented candidates are not deterred by the threat of damages even in the absence of qualified immunity. Indeed, private firms may obtain comprehensive insurance and do not operate under “civil service law restraints” and were therefore better able to “offset increased employee liability risk with higher pay or extra benefits.” Id. at 411. Moreover, the Court held that although the possibility of being brought into court for an alleged civil rights violation could distract the employees of the private prison, “the risk of distraction alone cannot be sufficient grounds for an immunity. Our qualified immunity cases do not contemplate the complete elimination of lawsuit-based distractions.” Id. Thus, the Court held that the private prison was not entitled to qualified immunity. In reaching this conclusion, however, the Court limited its denial of qualified immunity to the context of “a private firm, systematically organized to assume a major lengthy administrative task (managing an institution) with limited direct supervision by the government, [which] undertakes that task for profit and potentially in competition with other firms.”7 Id. at 413. Applying the wisdom of Richardson to the instant case, we find that the purposes of qualified immunity do not support the extension of the doctrine to nurses employed by a private medical 6 In reaching this conclusion, the Supreme Court rejected a “functional approach” to determining whether private defendants may assert qualified immunity. Richardson, 521 U.S. at 408. Rather, the Court concluded that whether the private guards were performing the same work as public guards was irrelevant to the question of whether the private guard defendants could invoke qualified immunity. Id. (noting that the Court never “held that the mere performance of a governmental function could make the difference between unlimited § 1983 liability and qualified immunity, especially for a private person who performs a job without government supervision or direction”). Noting the logical absurdity of such an approach, the Court observed that “a purely functional approach bristles with difficulty, particularly since, in many areas, government and private industry may engage in fundamentally similar activities, ranging from electricity production, to waste disposal, to even mail delivery.” Id. at 408-09. 7 The Court, however, reserved the question of whether “a private individual briefly associated with a government body, serving as an adjunct to government in an essential governmental activity, or acting under close official supervision” may assert qualified immunity in a § 1983 suit. Id. at 413. Based on this reservation, this Court has permitted defendants acting under close official supervision to assert qualified immunity in the face of a § 1983 suit. See Bartell, 215 F.3d at 557. In Bartell, for example, we held that a non-profit firm that contracted with a state social services agency for the provision of foster care services was eligible to assert qualified immunity. We reached this conclusion because the defendant was “closely supervised” by the state and because the particular function filled by the defendant, non-profit foster care services, “require[d] the deliberate and careful exercise of official discretion in ways that few public positions can match.” Id. at 557. Nos. 07-2077/2078 Harrison v. Ash, C.O., et al. Page 11 provider. With respect to unwarranted timidity, the most important rationale underlying qualified immunity, it is clear that market forces will operate to insure that CMS and its employees will effectively execute their contractual duties. Like the private prison in Richardson, CMS must compete with other firms to obtain contracts to provide medical services in prisons and jails. At the time of the alleged constitutional violation, CMS was under a two-year agreement with Macomb County to “provide for the delivery of reasonable and necessary medical, dental, mental health and limited psychiatric care to individuals under the custody and control of the County.” (J.A. at 249) Moreover, under the terms of the agreement, CMS was required to maintain liability insurance to cover claims arising out of the performance of its contractual duties. To the extent that CMS performs its contractual duties in a manner that is overly cautious or unduly concerned with its bottom line at the expense of inmate care, its performance will be subject to review at the end of the contractual term and it will likely face “pressure from potentially competing firms who can try to take its place.” Richardson, 521 U.S. at 410. Thus, CMS and its employees have an incentive to perform in a manner that comports with constitutional standards and with the expectations of the contracting governmental entity. Additionally, a finding that CMS nurses are ineligible for qualified immunity will not deter talented candidates from serving in such a capacity. Even in the absence of qualified immunity, CMS may attract candidates for nursing and other positions by increasing pay, benefits packages and obtaining adequate insurance coverage. Although such measures will not entirely eliminate the distraction caused by the threat of damages from a § 1983 suit, any distraction caused by the threat of suit is certainly no greater than the threat of malpractice suits faced by other medical professionals. In short, we find that, like Richardson, public policy considerations do not militate in favor of qualified immunity for Defendant nurses. Here, as in Richardson, there are no special concerns to distinguish CMS from other private firms and thus, there is no need to extend qualified immunity to Defendant nurses. Importantly, like the company in Richardson, CMS is a for-profit entity that has undertaken the major administrative task of providing health care to Macomb County inmates, operates with little supervision from Jail authorities, and is subject to the pressures of the marketplace. Under these circumstances, extending qualified immunity to Defendant nurses would do little to quell the “concern that threatened liability would, in Judge Hand’s words, ‘dampen the ardour of all but the most resolute, or the most irresponsible,’ public officials” and thus qualified immunity must be denied in this circumstance. Richardson, 521 U.S. at 408 (citation omitted); see also Cook v. Martin, 148 F. App’x 327, 342 (6th Cir. 2005); Manis v. Corrections Corporation of America, 859 F. Supp. 302, 306 (M.D. Tenn. 1994). We are not alone in reaching this conclusion. In Cook v. Martin, 148 F. App’x 327 (6th Cir. 2005), a panel of this Court held that a physician’s assistant employed by a subcontractor of CMS was not entitled to qualified immunity. The Cook court found that the extension of qualified immunity was inappropriate inasmuch as an examination of “the history and purposes of qualified immunity does not reveal anything sufficiently special about the work of private prison medical providers that would warrant providing such providers with governmental immunity.” Id. at 342. Moreover, other circuits have denied qualified immunity to private medical providers under similar circumstances. See Jensen, 222 F.3d at 580 (finding that the policy justifications for qualified immunity did not support the availability of the defense to private psychiatrist that contracted with a county-run hospital); Halvorsen v. Baird, 146 F.3d 680, 685-86 (9th Cir. 1998) (private non-profit organization that contracted with municipality to provide involuntary detoxification services could not assert qualified immunity); Rosewood Services, Inc. v. Sunflower Diversified Services, 413 F.3d 1163, 1169 (10th Cir. 2005) (finding that policy considerations did not justify extending qualified immunity protection to non-profit firm that was under contract with the government to provide services to developmentally disabled individuals); Hinson v. Edmond, 192 F.3d 1342, 1347 (11th Cir. 1999) (privately employed jail physician ineligible for qualified immunity). In sum, the history Nos. 07-2077/2078 Harrison v. Ash, C.O., et al. Page 12 and purpose of qualified immunity, as well as the case law interpreting the scope of the doctrine, are clear that Defendant nurses, as employees of CMS, are not eligible for qualified immunity in a § 1983 suit. Richardson, 521 U.S. at 413. Thus, we lack jurisdiction to hear Defendant nurses’ appeal of the district court’s denial of summary judgment.