Calhoun v. Ramsey

• Decision Date: 17 May 2005
• Docket Number: No. 03-3036.,03-3036.
• Citation: 408 F.3d 375
• Parties: Norman CALHOUN, Plaintiff-Appellant, v. Kenneth RAMSEY, Sheriff of Kane County, and Correctional Medical Services, Inc., Defendants-Appellees.
• Court: U.S. Court of Appeals — Seventh Circuit

408 F.3d 375

Norman CALHOUN, Plaintiff-Appellant, v. Kenneth RAMSEY, Sheriff of Kane County, and Correctional Medical Services, Inc., Defendants-Appellees.

No. 03-3036.

United States Court of Appeals, Seventh Circuit.

Argued September 23, 2004.

Decided May 17, 2005.

Appeal from the United States District Court for the Northern District of Illinois, Ronald A. Guzman, J Kenneth N. Flaxman (argued), Chicago, IL, for Plaintiff-Appellant.

Robert P. Vogt (argued), Weldon-Linne & Vogt, Chicago, IL, Joseph F. Lulves, Office of the State's Attorney of Kane County, Geneva, IL, for Defendants-Appellees.

Before EASTERBROOK, WOOD, and EVANS, Circuit Judges.

WOOD, Circuit Judge.

Norman Calhoun brought this action under 42 U.S.C. § 1983 against Kenneth Ramsey, the Sheriff of Kane County, and Correctional Medical Services, Inc. (CMS), a private company that contracted with the County to provide medical care to inmates incarcerated in the county jail, complaining about injuries he sustained at the jail. He claimed that his injuries resulted from the fact that the jail's medical policy made no provision for advance verification of a detainee's medications. This omission, he argued, amounted to deliberate indifference to his medical needs in violation of the Eighth Amendment.

A jury found in favor of the defendants, and Calhoun now appeals. He complains about both the jury instructions on municipal liability and the introduction of certain evidence. We see no error with respect to either of these points, and we therefore affirm.

I

In 1999, Calhoun was sentenced to serve evenings and weekends at the Kane County Jail to satisfy a 120-day sentence for a motor vehicle violation. His sentence was to begin at 7:30 p.m. on June 1, 1999. In the days leading up to that time, Calhoun called the jail twice, in an effort to obtain pre-incarceration approval of his medication. He was doing so because he knew that detainees were not free simply to retain their own medications and take them as directed. Instead, consistent with the Illinois County Jail Standards, 20 Ill. Admin. Code § 701.40(j), the Kane County Jail's medical policy requires that medication prescribed to inmates prior to incarceration must be verified and approved by the jail's medical director before it can be administered to the inmate. CMS Policy 30.05. Moreover, "[a]ny medication in the possession of a detainee at admission shall be withheld until verification of its proper use is obtained and documented. This verification shall be made as soon as possible, but within the time interval specified for administration of the medication on the prescription container." 20 Ill. Admin. Code § 701.40(j). Calhoun was hoping to complete these administrative steps before he actually reported to the jail.

Each time, his efforts were rebuffed. The jail personnel told him that pre-approval was not important, and that he should just make arrangements at the time he checked in. On the evening of June 1, therefore, Calhoun arrived at the jail thirty minutes before the designated time. He reported to the booking area of the jail, where Officer Peter O'Connor took his intake information. Calhoun handed Officer O'Connor a bag containing eight prescription medications that he was taking and told the officer that he had to take some of the medication that night. The prescription labels on the bottles for two of the medications, Diazepam and Trazodone, stated that they had to be administered at "QHS," a medical term referring to "hour of sleep." The other medication did not have to be taken until the next morning. O'Connor placed Calhoun in a holding cell within the booking area. About fifteen minutes after his arrival at the jail, Lynn Kimmel, a nurse employed by CMS assigned to the jail, came to speak with him about his medications. As required by the jail's policy, Kimmel took Calhoun's prescription medicines with her when she left his cell, so that she could obtain authorization to administer them.

At around 8:30 p.m, Kimmel paged the jail physician and psychiatrist to obtain authorization to administer Calhoun's medications. Half an hour later, the psychiatrist authorized Trazodone, to be administered at "QHS," which at the jail meant between 10 p.m. and 10:30 p.m. At around 9:15 p.m., jail officials notified Kimmel that Calhoun needed medical attention. She promptly returned to his cell, arriving around 9:20 p.m., where she found him lying on the floor complaining of pain. Kimmel was not authorized to administer medication without a doctor's order, but she checked Calhoun's vital signs, which showed elevated blood pressure. She then directed the jail staff to call for an ambulance. The ambulance arrived at 9:45 p.m. and transported Calhoun to the hospital, where he was treated in the emergency room. The hospital discharged Calhoun in good condition at 11:30 p.m., a little more than one hour after his arrival at the hospital and four hours after his report time. He did not return to the jail that night or subsequently because he was released from the Sheriff's custody at that time and was not required to serve the rest of his sentence at the jail.

Believing that the events of June 1 demonstrated deliberate indifference to his medical needs in violation of the Eighth Amendment, Calhoun filed suit against Sheriff Ramsey, CMS, Officer O'Connor and Nurse Kimmel under 42 U.S.C. § 1983. Calhoun alleged that he had been injured as a result of the jail's failure to administer his medication in a timely fashion. The jail's failure, he asserted, was the result of a constitutionally inadequate policy: specifically, a policy that made no provision for advance verification of medication and indeed prohibited this approach, as illustrated by the refusal of the jail personnel to respond positively to Calhoun's efforts to obtain approval for his medications before he reported to serve his sentence. The district court granted summary judgment in favor of defendants O'Connor and Kimmel and partial summary judgment in favor of CMS and Ramsey on some claims. Calhoun does not appeal from these rulings.

The only claim presented to the jury was the one against the Sheriff and CMS in which Calhoun alleged that the absence of a pre-verification procedure in the jail's policy and the jail's refusal to verify his medication in advance amounted to deliberate indifference to his medical needs. After a trial, the jury found in favor of CMS and Ramsey.

Calhoun appeals the jury verdict on two grounds. First, he alleges that the jury instructions misstated the law by requiring "evidence that the circumstances he endured were not an isolated incident," but had been caused by a "widespread policy or practice that was so permanent and well settled as to constitute a custom or usage with the force of law." Second, he argues that the court improperly permitted the defendants to introduce extrinsic evidence to impeach him on a collateral matter.

II

Calhoun objects that the jury instructions misstated the law on municipal liability, at least for a claim like his that postulated liability under § 1983 through an express policy. He argues that evidence of only one violation is sufficient for finding liability under this theory. On that assumption, he continues, the following portions of the jury instructions were erroneous:

In order to prove that the defendants had a deliberately indifferent policy or practice, the plaintiff must establish that there existed a wide-spread policy or practice that was so permanent and well-settled as to constitute a custom or usage with the force of law.

For purposes of proving a widespread practice that is so permanent and well-settled as to constitute a custom or usage with the force of law, the plaintiff is required to present evidence that the circumstances that he endured was not an isolated incident. (Emphasis added.)

We review jury instructions de novo to determine whether they provide fair and accurate summaries of the law. United States v. Tingle, 183 F.3d 719, 729 (7th Cir.1999). We give the district court substantial discretion with respect to the precise wording of jury instructions so long as the final result, read as a whole, completely and correctly states the law. See id. Even if the instruction contains an error or misguides the jury, we reverse a jury verdict only if the error prejudiced a litigant. See Molnar v. Booth, 229 F.3d 593, 602 (7th Cir.2000).

We must first address the defendants' assertion that Calhoun waived this argument by objecting at trial only to the first paragraph reproduced above but not to the second. It is true that a litigant's failure to raise an objection before the trial court that would alert the court to the basis of a perceived defect precludes appellate review. See Haley v. Gross, 86 F.3d 630, 644 (7th Cir.1996). As the first instruction requires a showing of more than one incident, however, we think that Calhoun sufficiently alerted the court to the argument he now advances, namely, that he is not required to present evidence of other incidents of violations resulting from a municipality's express policy under § 1983. Therefore, we can reach the merits of this claim.

In Monell v. N.Y. City Dept. of Social Servs., 436 U.S. 658, 98 S.Ct. 2018, 56 L.Ed.2d 611 (1978), the Supreme Court established both the fact that "municipalities and other local government units [were] included among those persons to whom § 1983 applies," id. at 690, 98 S.Ct. 2018, and the limits of such actions. Most importantly, Monell held that "a municipality cannot be held liable under § 1983 on a respondeat superior theory." Id. at 691, 98 S.Ct. 2018. Instead, municipal liability exists only "when execution of a government's policy or custom, whether made by its lawmakers or by those whose edicts or acts may fairly be said to represent official policy, inflicts the injury." Id. at 694, 98 S.Ct. 2018. We have identified three different ways in which a...