Shadrick v. Hopkins Cnty.

• Citation: 805 F.3d 724
• Decision Date: 06 November 2015
• Docket Number: No. 14–5603.,14–5603.
• Parties: Cindy SHADRICK, Administratrix of the Estate of Tyler Butler, deceased, Plaintiff–Appellant, v. HOPKINS COUNTY, KENTUCKY, et al., Defendants, Southern Health Partners, Inc., Defendant–Appellee.
• Court: United States Courts of Appeals. United States Court of Appeals (6th Circuit)

805 F.3d 724

Cindy SHADRICK, Administratrix of the Estate of Tyler Butler, deceased, Plaintiff–Appellant

v.HOPKINS COUNTY, KENTUCKY, et al., Defendants

Southern Health Partners, Inc., Defendant–Appellee.

No. 14–5603.

United States Court of Appeals, Sixth Circuit.

Argued: March 5, 2015.

Decided and Filed: Nov. 6, 2015.

Rehearing En Banc Denied Dec. 21, 2015.^*

ARGUED:Gregory A. Belzley, Belzleybathurst Attorneys, Prospect, Kentucky, for Appellant. Robert F. Duncan, Jackson & Kelly, PLLC, Lexington, Kentucky, for Appellee. ON BRIEF:Gregory A. Belzley, Belzleybathurst Attorneys, Prospect, Kentucky, for Appellant. Robert F. Duncan, Margaret Allison Moreman, Jackson & Kelly, PLLC, Lexington, Kentucky, for Appellee.

Before: GRIFFIN and STRANCH, Circuit Judges; STEEH, District Judge.^**

STRANCH, J., delivered the opinion of the court in which STEEH, D.J., joined.

GRIFFIN, J. (pp. 751–60), delivered a separate dissenting opinion.

OPINION

STRANCH, Circuit Judge.

Hopkins County contracted with Southern Health Partners, Inc. (SHP), a private, for-profit corporation, to provide medical services to inmates housed at the Hopkins County Detention Center (HCDC) in Madisonville, Kentucky. On April 8, 2010, twenty-five year old Tyler Butler entered the jail to serve a short sentence for a misdemeanor offense. He died three days later from complications of an untreated methicillin-resistant staphylococcus aureas (MRSA) infection.

Butler's mother, Cindy (Jimenez) Shadrick, filed suit under 42 U.S.C. § 1983, alleging that SHP's failure to train and supervise its LPN nurses employed at HCDC violated Butler's constitutional right to adequate medical care. She also alleged that SHP was negligent under state law. The district court granted summary judgment for SHP on both claims. Jimenez v. Hopkins Cnty., No. 4:11–CV–00033, 2014 WL 176478, at *19–20, 22–23 (W.D.Ky. Jan. 13, 2014). Because the record demonstrates that there are genuine issues of material fact on the § 1983 claim and SHP is not entitled to share the county's governmental immunity on the state-law claim, we REVERSE the grant of summary judgment in favor of SHP and REMAND the case to the district court for further proceedings.

I. FACTS

Butler arrived at HCDC close to five o'clock on the afternoon of Thursday, April 8, 2010. He was late for his scheduled intake appointment, having walked from his residence. While Butler stood outside the door, Sherri McDowell, control tower operator, saw Butler put something in his mouth and swallow it. McDowell relayed her observation to Deputy Angela Peterson who, along with Deputy Rodney Knox, started Butler's booking procedures.

As Deputy Knox helped Butler change into a prison uniform, Butler vomited twice. Deputy Peterson noticed that Butler appeared to be under the influence and was sweating profusely. As she asked him questions to complete intake paperwork, his demeanor deteriorated and he had difficulty standing up.

Butler told Deputy Peterson that he had an MRSA infection

and he was under a doctor's care for high blood pressure, rheumatoid arthritis, gout, and osteoporosis. He listed several prescribed medications he was taking, including Prednisone, Seroquel, Allopurinol, and Colchicine.¹ Butler denied drug or alcohol addiction.

Deputies Peterson and Knox did not want to admit Butler to HCDC due to his condition. Deputy Peterson asked Sgt. Carl Coy if she could refuse admission to an inmate who reported to HCDC pursuant to a court order. Sgt. Coy replied, in alignment with HCDC's written policy, that only the medical staff possessed authority to refuse admission of an inmate for health reasons.

Deputy Peterson asked Candace Moss, SHP's licensed practical nurse (LPN) and the only medical staff member on duty at the jail, to come to the booking area. It was 5:25 p.m., shortly before shift change at 6:00 p.m. Moss knew she had to decide whether to admit Butler to HCDC. He told her that he had frequent staph infections, that he was suffering from a staph infection in his groin area that his doctor had not examined, and that he had been vomiting, which he attributed to the staph infection. He also reported having a different rash that his doctor had not diagnosed.

As Moss talked with Butler, Deputy Jennifer Chambers noticed that Butler's skin was clammy, he was almost gray in color, and he was bloated. She saw Butler lift his shirt and pants legs to show Moss open wounds

on his skin. He pulled his pants down slightly to show Moss part of his groin area. Deputy Chambers heard Butler say, “I have staph infection all over me ... it's in my groin.... I don't need to be here.”

Moss instructed the deputies to admit Butler to the jail. As an LPN, she knew she lacked the credentials to diagnose any illness, but she was aware that MRSA infection

could lead to sepsis and death if not treated. She asked the chief deputy to accompany her as she physically examined Butler, but he declined and told her not to worry about it. Moss returned to the medical office where she wrote a short incident report at 5:40 p.m., placing Butler on 72–hour detoxification for suspected drug use and on medical watch due to his reported staph infection.² Moss admitted that she did not contact SHP's Medical Director for HCDC, Dr. Henry Davis, to request medical orders for Butler's care during the detoxification period.

SHP's “Intoxication and Withdrawal Policy” provided that “[d]etoxification will be carried out only under medical supervision and initiated by the medical staff with physician overview on an individual care basis. ” R. 101–5 PageID 2037 (emphasis added); R. 84 PageID 1407–08, 1418. The policy further required consistent monitoring, documentation of all findings in the inmate's medical chart, and documentation of vital signs twice daily on an Alcohol and Drug Detox Flow Sheet. Anticipating the end of her shift, Moss expected that Andy Johnson, LPN, the nurse coming on duty, would take Butler's vital signs, start the Alcohol and Drug Detox Flow Sheet, and monitor Butler's condition. Moss told Johnson that she had not examined Butler. When Johnson started his shift, he did not examine Butler or record his vital signs on an Alcohol and Drug Detox Flow Sheet. He did not call Dr. Davis for orders to manage Butler's medical conditions or to insure continuity of prescription medications.

HCDC staff assigned Butler to cell 203, located across from the booking area. His bed consisted of a mat placed on a concrete slab three to four inches off the floor. Although HCDC staff placed Butler on suicide watch, there is no evidence that Butler was evaluated for suicidal ideation

.

During Butler's short stay at HCDC, his blood pressure was taken once each day on April 9, 10, and 11 at unknown times, as shown on a “Blood Pressure Record Form” bearing the nurse initials “AJ.” Nurse Andy Johnson did not recall ever touching Butler. Each reading showed a decrease in blood pressure, but there is no evidence that Butler received blood pressure medication during his confinement or that the nurses took steps to assess why his blood pressure was falling in the absence of medication. A “Medication Administration Record” indicates Butler received Allopurinol

twice on April 9, Prednisone twice on April 9, and Quetiapine (Seroquel ) once on April 9; however, SHP stated under oath in response to a discovery interrogatory that “Butler's medical record does not reflect that he was given any medications during his incarceration beginning on April 8, 2010.” R. 101–12 PageID 2051–52. Even if Butler received medication at HCDC, there is no evidence it was prescribed by Dr. Davis.³

None of the nurses who worked shifts during Butler's confinement at HCDC followed SHP's written policy guidelines for the treatment of staph and MRSA infections

. Because these infections can progress rapidly, the policy instructs medical staff to: examine inmate skin infections carefully; monitor the patient and document all medical findings; report the infection to the HCDC Medical Director and obtain orders for proper antibiotic treatment; seek emergency hospital care if the inmate's condition worsens; notify jail staff to institute universal precautions to prevent spread of the infection; and report the infection to SHP's corporate headquarters. These steps were not taken after Butler reported his staph infection.

As medications were passed out to inmates late on Friday afternoon, April 9, Deputy Knox heard Butler tell Candace Moss through the food flap of his cell that he had a staph infection. Although Butler was still on detoxification and suicide watch, Moss did not medically assess Butler's condition. Moss later admitted that her failure to monitor Butler and chart his vital signs in the medical record violated written SHP policies.

At mid-afternoon on Saturday, April 10, Butler told Deputy Knox that he was too sick to be in jail. He asked for a sick-call slip, which Deputy Knox provided. Knox and Deputy Chambers discussed Butler's bloated appearance and gray pallor, and Knox tried to persuade the SHP nurse on duty to see Butler. The record contains no evidence that a nurse examined Butler at that time.

Later on Saturday afternoon, Sgt. Coy accompanied an unknown nurse as she handed out medications to inmates. When Butler stated that he was unable to get up from the floor and walk to the cell door to receive his medication, Sgt. Coy and the nurse entered the cell to give Butler medication. The nurse did not converse with Butler or medically assess his condition. There is no written documentation that Butler actually received medication on Saturday.

Early Sunday morning, April 11, Deputy Brandon Lampton saw Butler sitting on the floor of his cell, leaning against the wall. His elbows were red and swollen, and he was in obvious pain. Lampton asked Butler if he was okay; Butler replied, “I'm fine.” A few minutes later, at 6:18 a.m., LPN nurse Renee Keller, SHP's only medical staff member on duty, cleared Butler from detoxification...