Bruederle v. Louisville Metro Gov't

• Decision Date: 24 July 2012
• Docket Number: No. 11–5637.,11–5637.
• Citation: 687 F.3d 771
• Parties: David BRUEDERLE, Plaintiff–Appellant, v. LOUISVILLE METRO GOVERNMENT, et al., Defendants–Appellees.
• Court: U.S. Court of Appeals — Sixth Circuit

687 F.3d 771

David BRUEDERLE, Plaintiff–Appellant,

v.LOUISVILLE METRO GOVERNMENT, et al., Defendants–Appellees.

No. 11–5637.

United States Court of Appeals, Sixth Circuit.

July 24, 2012.

ON BRIEF:Andrew J. Horne, Anderson & Horne PLLC, Louisville, Kentucky, for Appellant. I. Joel Frockt, I.G. Spencer, Jr., Jefferson County Attorney's Office, Louisville, Kentucky, Sean Ragland, William P. Swain, Patricia C. Le Meur, Phillips Parker Orberson & Moore, P.L.C., Louisville, Kentucky, for Appellees.

Before: SILER and KETHLEDGE, Circuit Judges; MURPHY, District Judge.^*

OPINION

STEPHEN J. MURPHY, III, District Judge.

David Bruederle had a severe seizure two days after being booked into the Louisville Metro Corrections jail on assault charges. The seizure was likely caused by withdrawal from the many powerful prescription drugs Bruederle was taking at the time to control his back pain. Because police arrested him after business hours on Friday, and he did not manifest an imminent danger of suffering withdrawal symptoms, Bruederle's request for these drugs could not be reviewed until the Monday after his arrest. To obtain redress for the injuries caused by the seizure, Bruederle brought a “deliberate indifference” claim pursuant to 42 U.S.C. § 1983 against the Louisville Metro Government (“Louisville”); Correctional Medical Services (“CMS”); Tom Campbell, the director of the jail; Dr. Lawrence Mudd, a psychiatrist at the jail; and two jail nurses, Cindy Payne and Wyllis Smith.¹ Bruederle now appeals the district court's order granting summary judgment to the defendants on this claim, as well as its order denying a Civil Rule 59(e) motion to alter or amend that judgment. Because we agree with the district court that no reasonable juror could find the defendants violated the Due Process Clause of the Fourteenth Amendment, we AFFIRM.

I.

A.

Louisville police arrested Bruederle and his wife, Kelly Bruederle, on December 3, 2004, on suspicion of assault.² The police took the Bruederles to the jail for booking. Louisville owns and operates the jail, and CMS provides health care to inmates at the jail under a municipal contract. At approximately 8:15 PM, Smith conducted an intake interview with Bruederle. In the interview, Bruederle told Smith about his history of back surgery, and that he was taking hydrocodone, Xanax, Paxil, Flexeril, and Ambien to manage his back pain. Bruederle Med. Records at 18–19, R. 128–2. He had gone almost a full day without taking any medication at the time of the interview. Id.

CMS and Bruederle do not agree on the identity of the interviewer. CMS claims it was Smith, a white woman, while Bruederle and his wife insisted in their depositions that the woman who gave the interview was black. At the time of the interview, both Smith and Bruederle signed a form attesting that Smith gave Bruederle the screening interview, and the intake forms for Bruederle bear Smith's first initial and last name. Id. at 18. While Smith claims she has no specific memory of interviewing Bruederle, she testified in her deposition that she recognized her handwritten notes on the form and agreed that she had conducted the interview. Smith Dep. 9:21–25.

Bruederle did not express concerns about withdrawal, manifest withdrawal symptoms, or report a history of seizures to Smith. Id. According to CMS's diagnostic protocols, Bruederle presented a low risk for withdrawal that could be managed without medication. CMS Nursing Protocol at 56, R. 106–5. Medical authorities cited by Bruederle acknowledge that the precise trajectory of a particular individual's withdrawal symptoms is difficult to forecast. See Fed. Bureau of Prisons, Clinical Practice Guidelines: Detoxification of Chemically Dependent Inmates, at 4 (2000) (noting that while anxiolytics, like Xanax, and narcotics, like hydrocodone, can produce “dangerous withdrawal symptoms,” “[t]he intensity of withdrawal cannot always be predicted accurately” due to “many factors including the physiology, psychology and neurochemistry of the individual using the substance”). Nonetheless, Smith noted that Bruederle presented at least some risk of withdrawal because he had not taken any of his medications since Thursday. Smith Dep. 13:4–6, R. 131–8. Therefore, as a precautionary measure, she assigned Bruederle to the jail's medical dormitory for individuals with a potential for drug withdrawal symptoms, and the jail authorities transferred him there on the morning of December 5. Bruederle Dep. 34:13–14; Smith Dep. 18:7–23, 27:23–28:1; Classification Chronological Notes, R. 111–5.

After his transfer, Bruederle claims that he asked jail nurses about receiving his medication because he was experiencing serious back pain and could neither sleep nor eat. The nurses denied his request, and Bruederle asserts he was told that there was “no way” he would get those sorts of medications in the jail and that he would have to “sleep [his] time off.” Bruederle Dep. 65:9–66:4. But Bruederle did not testify to experiencing any withdrawal symptoms at that time.

During the evening hours of December 5, after spending most of the day lying around his cell, Bruederle suffered a sudden seizure when he attempted to stand up. Payne and several other jail officers responded by immediately placing Bruederle in a restraint chair and relocating him to a medical observation room. They contacted Mudd, who prescribed a standard detox regimen for Bruederle over the phone; Payne and other jail employees implemented the regimen. Bruederle Med. Records at 2. The intervention succeeded in stabilizing Bruederle's condition, and he returned to the medical dormitory around midnight. Nonetheless, he suffered compression fractures of three thoracic vertebrae, along with other injuries, as a result of the seizure. On Monday, prison nurses again refused to administer Bruederle's prescriptions, and dispensed Tylenol to alleviate the back pain. Bruederle Dep. 97:1–19. There were no further issues until Bruederle's release from jail on late Tuesday night or early Wednesday morning.

B.

Bruederle's claim centers on the jail's failure to provide him with his various prescription medications. Jail personnel would not have provided his medication before his seizure for at least two reasons. First, Bruederle's pharmacy had to verify the claimed prescriptions. Payne Dep. 27:13–16, R. 131–7. Smith claimed she sent the verification request to the pharmacy before leaving her shift the night of Bruederle's arrest, in keeping with her standard practice, but there is no explicit record of this transmission. Smith Dep. 39:20–40:3. The request was re-transmitted to Bruederle's pharmacy on December 7, and returned the same day. Bruederle Med. Records at 16. By that point, Bruederle had already endured his seizure and undergone the detoxification protocol prescribed by Mudd.

Second, even if the pharmacy verified the prescriptions in a timely manner, jail procedures required that a CMS physician screen and approve all prescription drug requests. Payne Dep. 29:11–16. CMS does not staff a physician to review these requests over the weekend. Therefore, since Bruederle was brought into the jail on a Friday evening, his prescriptions could not be reviewed and approved until the Monday following his arrest, at the earliest. Bruederle Med. Records at 17; Smith Dep. 39:12–40:1. The only exception to this rule, according to the nurses who gave deposition testimony in this case, would have been in an emergency situation in which the medicine could be deemed “life-sustaining.” Payne Dep. 28:2–18.

Even if a physician had been available to review his request and the pharmacy verified his prescriptions promptly, the defendants concede that it was highly unlikely that Bruederle would have received Xanax and hydrocodone. According to CMS, its doctors have the discretion to prescribe and approve whatever medicines they deem appropriate for patients. But according to Mudd, inmates use certain drugs, such as Xanax and hydrocodone, as a form of jailhouse currency, which can lead to violence against fellow inmates and staff. Mudd Dep. 50:2–15, R. 131–6. Therefore, whenever it is feasible, physicians avoid prescribing these drugs, or provide an alternative medication. While defendants agreed that it would be an exceedingly rare case in which narcotics would be approved, they also insist there was no per se rule against prescribing them.

C.

Bruederle brought his lawsuit against a number of known and unknown jail employees, CMS, Louisville, and Tom Campbell, the Director of the Louisville Metro Department of Corrections, in state court in Kentucky, alleging violations of state tort law and federal civil rights law. Defendants removed the matter to federal district court. On December 18, 2009, the district court granted motions for summary judgment filed by the defendants on Bruederle's § 1983 claims. The district court agreed with Bruederle that his need for medication was objectively serious, but found that the defendants had not been deliberately indifferent to Bruederle's medical needs. The defendants also won summary judgment on the alleged “no narcotics” policy at the jail. The district court ruled that it was not unconstitutional to place decisions regarding what drugs to prescribe to inmates in the hands of jail physicians, even assuming that physicians occasionally exhibit deliberate indifference in prescribing medication. In doing so, the district judge rejected Bruederle's contentions about the existence of a “no narcotics” policy as lacking support in the record.

After the district court made its ruling, Bruederle moved to alter, amend, or vacate the order under Civil Rule 59(e). He presented new evidence from two witnesses he had not called upon in opposing the motion for summary judgment—Laura McKune, the former Deputy Director of the Metro Department of Corrections; and Donald L. Leach, a nationally recognized jail consultant. McKune submitted...