900 F.3d 335 (7th Cir. 2018), 17-1603, Miranda v. County of Lake

Docket Nº:17-1603
Citation:900 F.3d 335
Opinion Judge:Wood, Chief Judge.
Party Name:Alfredo MIRANDA, Administrator of Estate of Lyvita Gomes, Plaintiff-Appellant, v. COUNTY OF LAKE, et al., Defendants-Appellees.
Attorney:Janine L. Hoft, Attorney, Shubra Ohri, Attorney, Janis M. Susler, Attorney, People’s Law Office, Chicago, for Plaintiffs-Appellants. Jeffrey N. Given, Attorney, Caroline P. Golden, Attorney, James G. Sotos, Attorney, Sotos Law Firm, P.C., for Defendants-Appellees. David A. Brueggen, Attorney, Sot...
Judge Panel:Before Wood, Chief Judge, and Easterbrook and Hamilton, Circuit Judges.
Case Date:August 10, 2018
Court:United States Courts of Appeals, Court of Appeals for the Seventh Circuit

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900 F.3d 335 (7th Cir. 2018)

Alfredo MIRANDA, Administrator of Estate of Lyvita Gomes, Plaintiff-Appellant,


COUNTY OF LAKE, et al., Defendants-Appellees.

No. 17-1603

United States Court of Appeals, Seventh Circuit

August 10, 2018

Argued December 6, 2017

Rehearing and Rehearing En Banc Denied September 17, 2018 [*]

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Appeal from the United States District Court for the Northern District of Illinois, Eastern Division, No. 12 C 4439— Sharon Johnson Coleman, Judge .

Janine L. Hoft, Attorney, Shubra Ohri, Attorney, Janis M. Susler, Attorney, People’s Law Office, Chicago, for Plaintiffs-Appellants.

Jeffrey N. Given, Attorney, Caroline P. Golden, Attorney, James G. Sotos, Attorney, Sotos Law Firm, P.C., for Defendants-Appellees.

David A. Brueggen, Attorney, Sotos Law Firm, P.C., Itasca, Scott L. Howie, Attorney, Pretzel & Stouffer, Chartered, Chicago, Robert P. Vogt, Attorney, Vogt & O’Kane, Chicago, for Defendants-Appellees Rozel Elazegui, Hargurmukh Singh.

David Michael Shapiro, Attorney, Macarthur Justice Center, Chicago, Amy Fettig, Attorney, ACLU National Prison Project, Washington, Benjamin S. Wolf, Attorney, Roger Baldwin Foundation of ACLU, INC., Chicago, for Amicus Curiae.

Before Wood, Chief Judge, and Easterbrook and Hamilton, Circuit Judges.


Wood, Chief Judge.

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In the fall of 2011, Lyvita Gomes failed to show up for jury duty. This minor infraction triggered a series of events that led to her untimely death in the early days of 2012. She wound up in the county jail, where she refused to eat and drink. The medical providers who worked at the Jail did little other than monitoring as she wasted away in her cell. By the time she was sent to the hospital, it was too late to save her.

Alfredo Miranda, the administrator of Gomes’s estate, brought an action under 42 U.S.C. § 1983 and assorted state-law theories against Lake County, the Jail officials (the "County defendants"), and Correct Care Solutions (CCS, the Jail’s contract medical provider) and its employees (the "medical defendants"). The district court dismissed the County defendants at summary judgment. The medical defendants proceeded to trial, but halfway through the proceeding the court granted judgment as a matter of law under Federal Rule of Civil Procedure 50(a) for them on some claims. The Estate prevailed to a modest degree on another claim, and part of the case resulted in a mistrial. Our principal ruling in response to the Estate’s appeal is that the Rule 50(a) judgment was premature, and so further proceedings are necessary.



On October 12, 2011, an officer arrested Gomes, a 52-year-old Indian national, for failing to appear for jury duty. (In hindsight, this was the County’s first misstep: as a non-citizen, Gomes was categorically ineligible to serve as a juror. 705 ILCS 305/2(a)(4).) Gomes pulled away from the officer as he attempted to arrest her. That action earned her a second charge of resisting arrest. The officers took Gomes to Lake County Jail, where she made statements that landed her on suicide watch the next day. But she did not stay at the Jail long. On October 14, Gomes was transferred to the custody of the federal Immigration and Customs Enforcement (ICE) service, which released her within a few days.

Roughly two months later, on December 14, after failing to appear in court on the resisting-arrest charge, Gomes found herself back in the Lake County Jail. Though officials initially placed her in the general population, it quickly became apparent that her physical and mental health were deteriorating, and so she was moved.

On December 16, CCS’s Director of Mental Health, Jennifer Bibbiano (a social worker), performed a mental health evaluation on Gomes. Bibbiano documented that Gomes had ingested no food or water since arriving at the Jail two days earlier. As a result, Gomes was transferred the next day to the Jail’s medical pod for closer monitoring. On December 18, staff placed Gomes on suicide watch and the hunger strike protocol. At that point, after she had gone four days without food or water, staff weighed her for the first time and recorded a weight of 146 pounds. Over the next ten days, this number plummeted; by December 28, Gomes weighed only 128 pounds.

During this period, social workers and physicians continued to assess Gomes daily. Defendant Dr. Rozel Elazegui, an internist,

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saw Gomes on December 22 and 27. In several progress notes, the CCS staff reported various symptoms of dehydration, such as skin tenting. Gomes’s refusal to eat or drink and her unresponsiveness often prevented the medical staff from recording her vital signs and collecting any blood or urine samples. For most of this time, Gomes lay in bed and refused to speak.

As Gomes’s physical condition worsened, concerns about her mental state grew. When Gomes appeared in court on December 20, the judge ordered a mental fitness examination. On December 22, Gomes was identified as needing an urgent psychiatric visit. That prompted a visit two days later from psychiatrist Hargurmukh Singh, who first met Gomes then and diagnosed her with a "psychotic disorder not otherwise specified." He prescribed no medication. After seeing Gomes again on December 27, Dr. Singh concluded that her psychosis rendered her unable to understand the risks of not eating and unable to participate in her treatment plan. But his only advice to Dr. Elazegui, who wanted to perform an involuntary blood draw for monitoring purposes, was that Elazegui could do so if push came to shove.

Around this time the officials in charge of Lake County Jail entered the picture. On December 26, Wayne Hunter, the Jail’s acting chief, was first notified by email that Gomes was in the Jail and was refusing medical treatment and tests. Hunter received assurances that CCS staff were monitoring Gomes’s condition and that they would provide him with any updates. Two days later, Hunter personally went down to Gomes’s cell in a futile attempt to persuade her to eat. On December 27, Scott Fitch, the liaison between the correctional and medical staff, learned about Gomes. He too asked for updates. Fitch called Gomes’s public defender, entreating her to visit and encourage her client to eat. Sheriff Mark Curran did not hear about Gomes until December 29, the day she left the Jail. That same day, Jail officials went to court to get Gomes formally released from custody.

Also on December 29, Dr. Young Kim, another CCS internist, returned to work from a vacation. Dr. Kim was surprised to learn that Gomes had remained in the Jail while continuing to refuse all food and drink. (A few stray comments in Gomes’s medical records suggest that she may have rubbed water on her body and perhaps taken a few sips of water from her sink. But the record as a whole implies little to no water intake.) Dr. Kim immediately called an ambulance to take Gomes to the hospital for evaluation and treatment of her dehydration and psychosis. Unfortunately, this intervention came too late. On January 3, 2012, five days after arriving at the hospital, Gomes died. The autopsy opined that she died of "Complications of Starvation and Dehydration." The manner of death was suicide.


The Estate filed this action against Lake County, Sheriff Curran, Hunter, Fitch, CCS, Dr. Elazegui, Dr. Singh, Bibbiano, and two more social workers, Ruth Muuru and Edith Jones. It raised due process claims under 42 U.S.C. § 1983, state statutory and common law tort claims, violations of international treaty obligations, and claims under the Americans with Disabilities Act, 42 U.S.C. § 12101 et seq. Only the claims against the medical defendants went to trial.

But the jury never had the opportunity to resolve some of those claims. At the close of the Estate’s presentation of evidence, the court entered judgment as a matter of law under Rule 50(a) for social workers Muuru and Jones on all claims

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against them. The court also concluded that the Estate had failed to present enough evidence to reach the jury on the question whether the medical defendants caused Gomes’s death; it therefore granted them judgment as a matter of law on that part of the case. The only question remaining for the jury was the Estate’s due process claim for inadequate medical care, limited to the pain and suffering Gomes experienced while in the Jail. The jury failed to reach a unanimous verdict regarding the conduct of Dr. Elazegui and Dr. Singh but it held social worker Bibbiano liable. It awarded the Estate $119,000 in compensatory damages, which Bibbiano has paid in full.

The Estate does not challenge the jury verdict, but it takes issue with four aspects of the proceedings below: first, the district court’s dismissal of the County defendants; second, the judgment as a matter of law on causation of death; third, the court’s ruling barring the Estate from pursuing one of its theories of recovery under the Due Process Clause; and fourth, the court’s instruction on the applicable legal standard. While we find no merit in its first point, we conclude on the latter three that the Estate is entitled to the opportunity to try its full case against the medical defendants before a jury.



We start with the Estate’s attempt to revive some of the claims against the County defendants. It first challenges the district court’s conclusion that the Jail’s chief, Hunter, and liaison, Fitch, were not deliberately indifferent to Gomes’s inadequate medical care in violation of her due process rights. We need not delve into the nuances of...

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