Goebert v. Lee County, 06-10606.

• Citation: 510 F.3d 1312
• Decision Date: 21 December 2007
• Docket Number: No. 06-10606.,06-10606.
• Parties: Michelle GOEBERT, Plaintiff-Appellant, v. LEE COUNTY, a political subdivision of the State of Florida, Lee County Sheriff's Office, Thomas P. Weaver, individually and as Captain of Lee County Sheriff's Office, Prison Health Services, Inc., a foreign corporation, EMSA Correctional Care, Inc., a Florida Corporation, et al., Defendants-Appellees, Rodney Shoap, individually and as Sheriff of Lee County, Defendant.
• Court: United States Courts of Appeals. United States Court of Appeals (11th Circuit)

510 F.3d 1312

Michelle GOEBERT, Plaintiff-Appellant, v. LEE COUNTY, a political subdivision of the State of Florida, Lee County Sheriff's Office, Thomas P. Weaver, individually and as Captain of Lee County Sheriff's Office, Prison Health Services, Inc., a foreign corporation, EMSA Correctional Care, Inc., a Florida Corporation, et al., Defendants-Appellees, Rodney Shoap, individually and as Sheriff of Lee County, Defendant.

No. 06-10606.

United States Court of Appeals, Eleventh Circuit.

December 21, 2007.

Michael Robert Cavendish (Court-Appointed), Gunster, Yoakley & Stewart, P.A., Jacksonville, FL, for Goebert.

Robert Marshall Rainey, Laurie L. Morris, Williams, Schifino, Mangione & Steady, P.A., Tampa, FL, Nancy Wood Gregoire, Bunnell, Woulfe, Kirschbaum, Keller, McIntyre & Gregoire, P.A., Ft. Lauderdale, FL, for Appellees.

Appeal from the United States District Court for the Middle District of Florida.

Before CARNES, WILSON and HILL, Circuit Judges.

CARNES, Circuit Judge:

On November 30, 2001, Michelle Goebert, a pregnant inmate in Lee County, Florida, was taken from jail to the hospital because she had been leaking amniotic fluid for eleven days. Two days later her fetus' heartbeat stopped, doctors induced labor, and the child was stillborn. Goebert filed a 42 U.S.C. § 1983 action against the county's sheriff, the jail facility commander, the jail doctor, and the jail's medical service provider, alleging deliberate indifference to her serious medical needs in violation of the Eighth and Fourteenth Amendments.

The district court granted summary judgment to all of the defendants based on Goebert's failure to exhaust her administrative remedies as required by the Prison Litigation Reform Act of 1995, 42 U.S.C. § 1997e(a). It also ruled alternatively that the sheriff and jail facility commander were entitled to summary judgment on the merits. This is Goebert's appeal from all aspects of the final judgment.

I.

The following are the facts viewed in the light most favorable to Goebert, which is how we are required to view them at this stage of the proceedings. See Tinker v. Beasley, 429 F.3d 1324, 1326 (11th Cir. 2005) (per curiam); Shotz v. City of Plantation, Fla., 344 F.3d 1161, 1164 (11th Cir.2003).

On April 27, 2001, Goebert killed someone in Florida while driving under the influence (of what, the record does not say). She fled to Canada where she was arrested on a Florida warrant. Canadian authorities detained Goebert for a month and a half before returning her to Florida.

While in Canadian custody, Goebert discovered that she was pregnant with her fiancé's child. She had been pregnant twice before, but both pregnancies ended in miscarriages — the first after her former husband threw her down a flight of stairs, and the second after she had been lifting heavy objects at work. While in the Canadian jail, Goebert received an ultrasound, was provided with access to a clinic that monitored her health and that of her child, and visited a doctor four or five times.

After waiving extradition, Goebert was returned to the United States and taken to jail in Lee County, Florida. When admitted to the jail on October 19, 2001, she met with the jail medical staff and told them that she was pregnant and had a high risk of miscarriage because of her age, Rhnegative blood, and history of miscarriages. Although Goebert asked the staff to get her medical records from the Canadian jail, they did not do so. Shortly after her arrival, Goebert herself attempted to get her medical records by writing to the Canadian jail where she had been held, but did not succeed.

The Lee County jail staff neither asked Goebert to sign any intake documents, nor explained to her the procedures for obtaining healthcare. Inmates are supposed to receive a copy of the Inmate Rules Orientation & Information Handbook, which includes the administrative procedures for requesting medical care and lodging grievances. During her deposition, Goebert testified that she did not believe that she had received a copy of the Inmate Handbook.

Healthcare at Lee County Jail is contracted out to EMSA Correctional Care, Inc., a subsidiary of Prison Health Services, Inc. EMSA employs a Health Services Administrator, who is responsible for the medical service staffs at the jail facilities in Lee County. It also employs a Regional Medical Director who, apparently, supervises the physician assigned to the Lee County Jail facilities.

Dr. David Brown was the only physician at the facility where Goebert was jailed during the relevant period. He was not employed by EMSA but instead worked for another company that contracted his services as a physician to EMSA. Brown lacked the authority to send an inmate to the hospital immediately.

Because Goebert was pregnant, the jail medical staff prescribed her prenatal vitamins, extra milk at meals, and, about a month after her arrival, a lower bunk. Progress reports from this period indicate no problems with her pregnancy. EMSA approved an outside office visit to an OB/GYN for Goebert, during which she had a pap smear and was tested for venereal diseases.

Goebert's pregnancy was normal until November 19, 2001. On that morning she awoke to find that she was leaking a noticeable amount of fluid from her vagina, which she thought was amniotic fluid. Goebert waited for the jail nurses to arrive, which was usually around seven or eight in the morning, at which time she alerted them to her problem. The nurses took her to see Dr. Brown.

Dr. Brown took Goebert's blood pressure and told her that she was fine, although he did order an ultrasound for later that afternoon. Brown's notes from that visit read: "S[ubjective] — I think my water is broke and leaking `I had a miscarriage before!' O[bjective] — noted 6 in[ch] square wettness [sic] in pants when getting up this A.M. [complains of] mild back discomfort[.] [N]o bleeding or cramping noted."

Following the ultrasound, which did not show any loss of amniotic fluid, Dr. Brown noted that there was "no drainage noted on pad [at that] time," but Goebert should "remain on bedrest." Despite what Brown's notes said, Goebert had never been on bedrest. Lee County Jail forbids a prisoner from lying down during daylight hours unless she receives a "lie-in pass" from a medical staff member. Goebert never did receive a lie-in pass.

The following day, November 20, Goebert again went to see Dr. Brown. His notes indicate that she reported tenderness in the upper right quadrant of her abdomen and was suffering pain there after she ate. The notes also report his impression as: "? leakage of amniotic fluid" with "no treatment" but "cont[inued] observation." In responding to Goebert's concerns, Brown asked her how they could "be certain it was an amniotic leak? The baby could be tap dancing on [her] bladder." Goebert requested that an amniotic pH strip test be done, which would determine whether the fluid was in fact amniotic fluid. She was told, however, that one could not be done because it would require transporting her to the infirmary at the main jail facility. Brown also told Goebert that it was not an amniotic leak and they should just wait.

The next morning, November 21, Goebert again awoke to find that she had leaked fluid from her vagina. When the nurses came in, she told them that she was continuing to leak and that it was getting worse. At this point, Goebert was soaking through a sanitary pad every few hours, but the nurses refused to take her to the doctor. The same thing happened every day for the next eight days. Some days the nurses would simply refuse to take her medical request forms. On November 24, a nurse just looked at her soaked sanitary pad and did nothing. Another time during this period one of the nurses wadded up Goebert's written request to see the doctor and threw it back at her. The nurses would also refuse to give her more medical request forms, telling her that she was "wasting [their] time," that they were already "aware of [her] problem," and that "there was `nothing' wrong with [her]."

Goebert began seeking help from everyone with whom she had contact. In addition to the nurses, she spoke with three corrections officers between November 20 and 28. Sometimes the officers would give her medical request forms, but they did not allow her to lie down because of the jail's policy requiring lie-in passes to be signed by a member of the medical staff. Goebert also told her criminal attorney, other inmates, her fiancé, and her mother about the problems she was having. Although she leaked fluid every day during this eight day span, she was not taken to see a doctor.

On November 28, 2001, Goebert managed to submit another medical request form. It read: "I am 5 months pregnant & have been leaking a yellowish fluid since Sat. Nov 24/01. Since then I have been soaking a sanitary pad overnight. I have been informing Medical Staff of this since then & no one seems concerned. I would like to see a Doctor ASAP!" On that same day Goebert also sent a message to Thomas Weaver, the facility commander for the jail. The message was written on a form that had "request" and "complaint" at the top. There was an "X" marked next to "complaint." In the space provided for complaint, Goebert had written:

I am 5 months pregnant & began leaking fluids on Nov. 19th. I was given an ultrasound that day & seen by the jail Doctor the following day, who told me I would be seen by an outside Dr., which I have NOT. I have continued leaking fluids, soaked a maxi-pad a day since Sat. Nov. 24th when it became worse. I have notified medical staff on a daily basis since then, but they seem unconcerned. I NEED to be seen by an obstetrician, not the jail Doctor. I lost a child at 5 months last year when my water broke early & NEED a doctor to let me know if everything is OK. I have not felt the baby move in a few days.

Goebert was told on November 28 that the next day she would finally be...