Ford v. County of Grand Traverse

• Decision Date: 05 August 2008
• Docket Number: No. 07-1062.,07-1062.
• Citation: 535 F.3d 483
• Parties: Amy Lynn FORD, Plaintiff-Appellee, v. COUNTY OF GRAND TRAVERSE, Defendant-Appellant.
• Court: U.S. Court of Appeals — Sixth Circuit

535 F.3d 483

Amy Lynn FORD, Plaintiff-Appellee, v. COUNTY OF GRAND TRAVERSE, Defendant-Appellant.

No. 07-1062.

United States Court of Appeals, Sixth Circuit.

Argued: April 25, 2008.

Decided and Filed: August 5, 2008.

ARGUED:

Joseph Nimako, Cummings, McClorey, Davis & Acho, Livonia, Michigan, for Appellant. Frederick E. Mackraz, Kuiper Orlebeke, Grand Rapids, Michigan, for Appellee.

ON BRIEF:

Joseph Nimako, Cummings, McClorey, Davis & ACHO, Livonia, Michigan, for Appellant. Frederick E. Mackraz, Kuiper Orlebeke, Grand Rapids, Michigan, for Appellee.

Before: DAUGHTREY, GILMAN, and ROGERS, Circuit Judges.

GILMAN, J., delivered the opinion of the court, in which DAUGHTREY, J., joined. ROGERS, J. (p. 499-500), delivered a separate dissenting opinion.

OPINION

RONALD LEE GILMAN, Circuit Judge.

On a Sunday morning in January of 2003, Amy Lynn Ford, a self-described recovering alcoholic who also suffers from epilepsy, was arrested on a probation violation and taken to the Grand Traverse County Jail in Traverse City, Michigan. That afternoon, Ford had a seizure, fell from the top bunk of a bed in her cell, and sustained significant injuries to her right hip and right clavicle. Ford subsequently brought suit against a number of jail officials and the County of Grand Traverse (collectively referred to as the defendants). She claimed that the officials had exhibited deliberate indifference to her serious medical needs in violation of her constitutional rights under the Eighth and Fourteenth Amendments to the U.S. Constitution. Ford also contended that the County's policy or custom regarding the provision of medical care at the jail on weekends reflected deliberate indifference to her serious medical needs and had caused her injuries.

Her case proceeded to trial. The jury found that none of the jail officials were deliberately indifferent to Ford's serious medical needs, but determined that the County's policy regarding weekend medical care exhibited deliberate indifference to and was the proximate cause of Ford's injuries. It awarded her $214,000 in damages. After the verdict was returned, the County brought two motions for judgment as a matter of law. The district court denied both motions. For the reasons set forth below, we AFFIRM the judgment of the district court.

I. BACKGROUND

A. Factual background

On the morning of Sunday, January 12, 2003, Ford was arrested for violating the terms of her probation for a prior offense and was transported to the Grand Traverse County Jail. Ford had been prescribed an anti-seizure medication, Dilantin, to control her epilepsy, and had been advised by her physician not to drink alcohol while taking the drug. Because she had been drinking on January 11 and January 12, Ford acknowledged that she had not taken her Dilantin on the morning of her arrest. The defendants, moreover, introduced proof (based on Ford's lack of memory, her physician's testimony, and pharmacy records) that she had not taken Dilantin since at least the preceding week.

Two nurses and a doctor are employed by the County to provide medical care for the inmates at the jail. One of the nurses is on duty full time during regular business hours on weekdays, and the part-time nurse is on duty 20 hours per week but makes her own schedule. The part-time nurse is not required to be present at the jail on weekends or to notify the jail officials whether or not she will be at the jail on any particular day. One of the nurses, however, is either on-site or on-call at all times.

The County's written policy states that if a new inmate "claim[s] a need for regular medications, a member of the medical staff must be contacted for approval." Jail officials are trained to contact medical personnel when a new inmate claims a need for medication, and the doctor and both nurses are authorized to consider and approve such a request.

During Ford's intake booking, Deputy Sheriff Luke Lansbach asked Ford about her medical needs and completed a Medical Screening Questionnaire. He noted on the form that Ford had epilepsy, that she took Dilantin, and that on that day she had not taken her medication. Lansbach testified that he placed the form in the nurse's inbox, but that he did not contact the nurse on-call or the doctor because Ford had not expressed an urgent need for the Dilantin and because he believed that one of the nurses was coming to the jail that day. Neither nurse, however, came to the jail on that Sunday.

County Sheriff Robert J. Hall, the jail administrator, testified at trial that although he was not the author of the County's written jail policy, he had the authority to develop and change the policy as necessary. Hall further stated that, in his opinion, Lansbach's decision to put Ford's Medical Screening Questionnaire into the nurse's inbox (as opposed to promptly calling the on-call nurse) did not constitute a violation of the County's written policy requiring that a member of the medical staff "be contacted" when an inmate claims a need for medication.

Deputy Sheriff Sophia DeLonghi helped Ford change from street clothes into jail attire and escorted Ford to her cell. Ford told DeLonghi that she was an epileptic and that she had not taken her medication. DeLonghi testified that on the way to Ford's cell, DeLonghi stopped and told the supervisor on duty, Sergeant Robert Smith, that Ford had not taken her medication that morning. When Ford and DeLonghi arrived at the cell, Ford again informed DeLonghi that she had not taken her seizure medication and also said that she needed a bottom bunk.

A bottom bunk was not available at that time. DeLonghi testified that she ordered another inmate to move and told Ford to take the newly available bottom bunk. Ford and one of her cellmates, however, did not recall DeLonghi making such an order. To the contrary, Ford testified that an inmate had offered her a bottom bunk, but that she said "[n]o, I'm fine," and proceeded to go to sleep in the top bunk.

Deputy DeLonghi also said that when she left Ford's cell, she told Sergeant Smith and Deputy Michael Johnson that Ford had "again asked for her meds" and that both men indicated that they were aware of Ford's medical situation. But Smith and Johnson both denied any recollection of such a conversation. None of the jail officials in fact called the on-call nurse or took other steps to procure Dilantin for Ford. Later that afternoon, Ford suffered a seizure and fell from the top bunk, severely injuring her right hip and right clavicle.

Dr. David Wilcox, the jail's physician, was the only expert to testify as to whether administering Dilantin to Ford on the morning of January 12, 2003, would have prevented her seizure that afternoon. The content and significance of his testimony have therefore been a source of much disagreement both at trial and now on appeal. Ford's attorney asked Dr. Wilcox on direct examination: "If someone came in with absolutely no Dilantin in their blood system and you gave them two caplets, would you not agree with me that in one to four hours they would have enough to inhibit seizures?" Dr. Wilcox responded by saying that "[t]hey would have enough to start inhibiting seizures...." (Emphasis added.)

At that point, Ford's attorney confronted Dr. Wilcox with his prior deposition testimony:

"[Question by Ford's attorney at Dr. Wilcox's deposition:] How long generally does it take for Dilantin to become effective to do its job and numb the brain?

Answer: If a patient doesn't have any Dilantin in their bloodstream it can take one to four hours to get it high enough.

....

Question: And after Dilantin circulates through the body one to four hours, I take it there's enough in the blood system to inhibit these seizures, correct?

Answer: There should be, yes.

....

Question: So it's safe for me to assume that two pills for Amy Ford is effective for 12 hours?

Answer: Yes.

Question: And assuming there's no Dilantin in her system, it would take one to four hours to actually become effective."

Rather than reading the answer that Dr. Wilcox had given to the last question, Ford's attorney asked Dr. Wilcox a follow-up question: "And your answer [to the last quoted question] was yes, is that right?" Dr. Wilcox responded by saying: "My answer was yes and that was an error."

On cross-examination by the County, Dr. Wilcox testified that if a person with epilepsy had not had Dilantin in their system for "several days," the one-to-four-hour window that he had discussed might not be sufficient to inhibit seizures. Dr. Wilcox also stated that, given the low level of Dilantin in Ford's blood at the hospital after the seizure, he could not say "to a reasonable degree of medical certainty" that giving Ford Dilantin in the morning would have prevented her seizure that afternoon.

B. Procedural background

Ford brought suit against DeLonghi, Johnson, Lansbach, Smith, and the County. She claimed, pursuant to 42 U.S.C. § 1983, that the jail officials had violated her Eighth and Fourteenth Amendment rights to medical treatment by failing to ensure that she was given Dilantin or to otherwise protect her from injuries due to her epilepsy. Ford further alleged that the County's policy and custom regarding the provision of weekend medical care at the jail had caused her injuries.

The case went to trial in May of 2006. At the close of the second day of trial, before Ford had rested her case but after all of her evidence had been proffered, the attorney for the defendants moved for a directed verdict pursuant to Rule 50(a) of the Federal Rules of Civil Procedure. (In 1991, Rule 50 was amended to substitute the uniform term "judgment as a matter of law" in place of "judgment notwithstanding the verdict" and "directed verdict." Both the district court and the parties, however, have consistently employed the outdated term "directed verdict." We will therefore do the same for the sake of convenience and clarity.)

The defendants'...