Griffith v. Franklin Cnty.

• Citation: 975 F.3d 554
• Decision Date: 21 September 2020
• Docket Number: Nos. 19-5378/5438/5439/5440,s. 19-5378/5438/5439/5440
• Parties: Austin Christian GRIFFITH, Plaintiff-Appellant/Cross-Appellee, v. FRANKLIN COUNTY, KENTUCKY and Huston Wells, Michael Turner, Fred Goins, Don Sturgeon, Scotty Tracy, Marti Booth, Lambert Moore, and Rick Rogers, in their individual capacities (19-5378 & 19-5439); Southern Health Partners, Inc. and Ronald Waldridge, MD, Jane Bartram, APRN, Heather Sherrow, RN, and Sabina Trevette, LPN, in their individual capacities (19-5378 & 19-5440); Brittany Mundine, RN, in her individual capacity (19-5378 & 19-5438), Defendants-Appellees/Cross-Appellants.
• Court: United States Courts of Appeals. United States Court of Appeals (6th Circuit)

975 F.3d 554

Austin Christian GRIFFITH, Plaintiff-Appellant/Cross-Appellee,

v.FRANKLIN COUNTY, KENTUCKY and Huston Wells, Michael Turner, Fred Goins, Don Sturgeon, Scotty Tracy, Marti Booth, Lambert Moore, and Rick Rogers, in their individual capacities (19-5378 & 19-5439); Southern Health Partners, Inc. and Ronald Waldridge, MD, Jane Bartram, APRN, Heather Sherrow, RN, and Sabina Trevette, LPN, in their individual capacities (19-5378 & 19-5440); Brittany Mundine, RN, in her individual capacity (19-5378 & 19-5438), Defendants-Appellees/Cross-Appellants.

Nos. 19-5378/5438/5439/5440

United States Court of Appeals, Sixth Circuit.

Argued: January 28, 2020

Decided and Filed: September 21, 2020

JOHN K. BUSH, Circuit Judge.

This case involves a tragic turn of events during Austin Griffith's pretrial detention at Franklin County Regional Jail ("FCRJ"). Griffith was arrested on November 8, 2015 after a failed robbery attempt, and he suffered a series of seizures six days into his detention. He was sent to a local hospital, where he suffered a third seizure, and was then airlifted to University of Kentucky Hospital. He later recovered but continues to suffer headaches and other negative symptoms in the wake of this medical event.

Griffith brought suit under 42 U.S.C. § 1983 alleging that he received unconstitutionally inadequate medical care during his detention. His claims were against Franklin County, the county judge executive, the jailer and members of the Franklin County Fiscal Court (collectively, the "Franklin County Defendants"), as well as against Southern Health Partners, Inc. ("SHP"), a private medical company that provides medical services at the jail, and certain medical staff of SHP (collectively, the "SHP Defendants"). In addition to his constitutional claims, the complaint alleged state-law claims.

The district court granted summary judgment to Defendants on the constitutional claims, finding that Griffith failed to establish that Defendants acted with deliberate indifference to his serious medical needs. The district court then declined to exercise supplemental jurisdiction over the state-law claims. Griffith appeals the grant of summary judgment. For the reasons that follow, we AFFIRM the district court's judgment.

I. Background

A. Investigation and Arrest

Austin Griffith was arrested on November 8, 2015 for robbery and assault after he and two other individuals unsuccessfully attempted to rob a third party with a baseball bat. The intended victim was able to rebuff the attack, however. During the scuffle Griffith was struck in the back with the bat, and he began vomiting. Griffith and his friends fled the scene, but witnesses had identified the vehicle, which was registered to Griffith's mother. Law enforcement contacted Griffith's mother, and she in turn called Griffith and instructed him to return home to speak with the police. Griffith complied. Griffith was still vomiting when he returned home and remained unwell during a two-hour meeting with law enforcement. Griffith was arrested and brought to FCRJ, where, at 10:41 p.m., he was admitted and charged with assault and burglary.

Griffith remained nauseated during intake procedures. At his deposition, Griffith testified that he had been vomiting because of nerves, given that he had "never been in legal trouble." Austin Griffith Dep., R. 74-1 at PageID 1174–75. He was emotional when he arrived at the jail and began crying while on the phone with his mother. Griffith received a standard medical interview from Deputy Jailer Jessica Jenkins and filled out a medical questionnaire in which he indicated that he "smokes marijuana a few times everyday" and that he had taken four Xanax around 1 p.m. that day. Standard Medical Questions Form, R. 69-8 at PageID 773. Deputy Jenkins believed that Griffith demonstrated a potential for alcohol or drug withdrawal and accordingly recommended a referral for medical evaluation by the jail's nursing staff. Deputy Jenkins also identified Griffith as a moderate suicide risk. She classified him as a moderate risk for forty-eight hours to "monitor [his] stability and give [him] time to be clean from substances." KJMHCN Episode Report, R. 71-5 at PageID 940. Griffith acknowledged during this interview that he understood that he could request a health care provider at any time.

Deputy Jenkins discussed Griffith's mental health status with clinician Kelley Ford at the Kentucky Jail Mental Health Crisis Network to determine Griffith's pertinent risk level. Ford conducted a telephonic observation and recommended that FCRJ place Griffith on moderate observation for forty-eight hours. The Incident Report indicated that he was designated for observation because of the "seriousness of his charges and his emotional behavior while making his phone call [with his mother]." Incident Report, R. 69-10, PageID 776. The order from the Kentucky Jail Mental Health Crisis Network to conduct this monitoring did not indicate that he was being held for observation because of potential drug withdrawal.

B. Detox Cell

Griffith was placed in a "detox" cell at 11:10 p.m. so he could be monitored for the first forty-eight hours of his detention. During this time, FCRJ deputy jailers checked on his condition approximately every twenty minutes, and observed Griffith vomiting seven times between the time he was placed in the detox cell and 9 a.m. the next morning, when he was first seen by medical staff. The deputy jailers testified that this amount of vomiting was not uncommon for an inmate in detox. The deputy jailers recorded these observations in Griffith's observation log.

As indicated, Griffith had also been referred to the jail medical staff to be screened for potential medical observation. FCRJ provides medical care by contracting with SHP. The SHP medical staff at FCRJ falls into three general categories: a Medical Director, Dr. Robert Waldridge; two Advanced Practice Registered Nurses ("APRNs"); and three nurses, two of whom were Licensed Practical Nurses ("LPNs") and one of whom was a Registered Nurse ("RN").

As Medical Director, Dr. Waldridge oversaw healthcare services at the jail during the operative time period. SHP's original contract required Dr. Waldridge to conduct weekly visits to the jail, but he ultimately delegated this duty to APRNs Jane Bartram and Stacy Jensen. Dr. Waldridge remained available for telephone consultation. APRNs Bartram and Jensen therefore visited the facility once per week on a rotating basis, during which time they signed off on medical charts and visited specific inmates who were identified by the daily nursing staff as requiring additional care. Inmates who needed further attention from an APRN would be designated on a weekly list by the daily nursing staff.

The nursing staff in turn provided daily care. During the work week, LPN Sabina Trivette and RN Heather Sherrow¹ provided a combined sixteen hours of medical coverage per day. Weekend care was provided by RN Brittany Mundine, who worked six hours on both Saturdays and Sundays. Because RNs and LPNs cannot make diagnostic or treatment decisions, SHP employs policies and protocols to guide the nurses’ daily operations. Many of these policies and protocols require approval of an APRN or physician before an RN or LPN can take a specific course of action; for example, the FCRJ's protocol for "intoxication and withdrawal" requires that a nurse call a physician or an APRN before the protocol is initiated. RNs and LPNs thus have various options to respond to medical situations. They can provide treatment that is within their standard of care (such as providing over-the-counter medication in certain circumstances), place the patient on the weekly list (so the patient will be seen by an APRN on the next visit), call an APRN to receive immediate guidance or initiate a certain protocol, or directly send the patient to the hospital for emergency care. RN Sherrow and LPN Trivette testified that they took the latter three steps with some regularity.

Griffith first interacted with SHP medical staff at 7:42 a.m. on Monday, November 9th—after being in the facility for approximately eight hours—when Sherrow conducted a medical screening. Sherrow testified that she checked on him at this time because of his Kentucky Jail Mental Health Crisis Network designation as a moderate suicide risk.² Sherrow met with Griffith while he was on his way to "pre-trial" and completed a Suicide Prevention Screening Guidelines Form. Sherrow indicated that Griffith was no longer showing signs of depression, did not appear overly anxious, and was otherwise behaving normally. She also indicated that he was experiencing nausea and vomiting. There is no indication that Sherrow did anything at this time to address his nausea or take his vital signs. The form cross-referenced the observation log recorded by the deputy officers indicating that Griffith had been vomiting regularly throughout the night, but RN Sherrow testified that she never reviewed the observation log herself.

After returning from pre-trial, Griffith completed a medical request form, referred to as a "sick call slip," wherein he complained of stomach issues and vomiting. Trivette met with Griffith at approximately 10:00 a.m. to conduct his medical intake screening and to respond to his sick call slip. Trivette took Griffith's vital signs and conducted a medical observation. Trivette stated that Griffith had reported vomiting and diarrhea, that she reviewed his hydration, and that his skin was warm, dry, "race appropriate & [that it had] good turgor," Medical Staff Receiving Screening Form, R. 69-21 at PageID 815. To address Griffith's reports of vomiting and diarrhea, Trivette provided Imodium

and Mylanta. Griffith also indicated that he was not able to urinate, so Trivette put him on a list to provide a urine sample the following day. Trivette also indicated that Griffith reported some drug use—marijuana daily and Xanax on weekends—but further...