Morris v. Dall. Cnty.

• Decision Date: 18 June 2013
• Docket Number: Civil Action No. 3:11–CV–0527–K.
• Citation: 960 F.Supp.2d 665
• Parties: Arthur MORRIS, et al., Plaintiffs, v. DALLAS COUNTY, et al., Defendants.
• Court: U.S. District Court — Northern District of Texas

960 F.Supp.2d 665

Arthur MORRIS, et al., Plaintiffs,

v.DALLAS COUNTY, et al., Defendants.

Civil Action No. 3:11–CV–0527–K.

United States District Court,

N.D. Texas,

Dallas Division.

June 18, 2013.

Susan E. Hutchison, Hutchison, Lewis & Dauphinot, P.C., Kern Allen Lewis, Foreman Lewis & Hutchison, Grapevine, TX, for Plaintiffs.

Dolena T. Westergard, Dallas, TX, Winston L. Borum, Borum & Hancock, Fort Worth, TX, for Defendants.

MEMORANDUM OPINION AND ORDER

ED KINKEADE, District Judge.

Before the court are Defendants' Frye, Joseph and Warden's Motion for Summary Judgment, filed December 13, 2012, and Defendant Dallas County's Motion for Summary Judgment, filed December 21, 2012. The court has reviewed and considered the motions, combined response, replies, the summary judgment evidence, and the applicable law. For the reasons that follow, Defendant Joseph's motion for summary judgment is granted, and Defendants Frye, Warden and Dallas County's motions for summary judgment are granted in part, and denied in part.

I. Factual and Procedural Background

The majority of the facts presented herein are undisputed. Any material factual disputes are noted by the court, and will be viewed in the light most favorable to Plaintiffs.

A. Morris's Arrival at the Jail and Time in Central Intake

Plaintiffs' son Craig Morris (“Morris”) was arrested on the evening of August 1, 2009 and brought to Central Intake at the Dallas County Jail. He was given a health screening by a nurse in Central Intake at approximately 7:30 p.m. During this screening, Morris reported that he had been experiencing nausea and vomiting, with an elevated temperature, and also stated that he had broken ribs but he said he had not had an x-ray. At the time of this health screening, Morris's vital signs were stable. Nothing in the records related to the health screening Morris had at Central Intake shows any documented complaint of chest pain or other pain. The nurse there noted on the screening record that Morris was drinking alcohol daily, and the only entry on the “problem list” was that he needed to detox.

Because he appeared to be suffering from alcohol withdrawal, the Central Intake nurse referred Morris to the jail's Medical Assessment Program (“MAP”) and to the infirmary following the MAP provider evaluation. She also requested that Morris be given “Expedite” status for medical reasons, and explained that the specific concern was alcohol detoxification. An inmate with an “Expedite” is supposed to go straight to MAP, but even inmates on “Expedite” status still must go through the booking process before coming to MAP. None of the parties have produced any evidence regarding how quickly a medical “Expedite” request due to apparent alcohol withdrawal is required to be completed. Morris was then booked into the jail at 8:37 p.m.

B. Morris's Initial Appearance

Jail records show that Morris's appearance before the Magistrate was expedited at 11:05 p.m. He appeared before the Magistrate at 11:20, and was finished at the Magistrate by 12:02 a.m. on August 2, 2009.

C. Morris is Taken to the Medical Assessment Program (“MAP”)

After he was finished at the Magistrate, Morris went to MAP, where he was seen by Defendant Wendy Joseph, P.A. (“Joseph”) at 1:20 a.m. Joseph examined Morris and found that his lungs were clear, without wheezes or abnormal crackling or rattling sounds (also known as “rales”), and noted that Morris had nausea, vomiting, and delirium tremors (“DT's”). During the exam, Morris removed his shirt and Joseph palpated (or examined by touch) his chest and abdomen. She found no bruising or injury in those areas. Morris also did not complain upon palpation of those areas, and Joseph did not order an x-ray. She also evaluated Morris's vital signs and found them stable, although his blood pressure was slightly elevated. She concluded that the high blood pressure was consistent with alcohol withdrawal. Morris told Joseph he had “the shakes” in his hands and legs, but he did not tell her he had been in an altercation or that he thought he might have broken ribs. He was verbal and not hallucinating.

The MAP assessment form completed by Joseph states that Morris disclosed a history of daily alcohol abuse, but does not mention broken ribs. The record does not show that Joseph had the Central Intake form referencing broken ribs. Sometimes these forms came to MAP with the patient, and sometimes they did not. Joseph does not recall whether she had the form during her encounter with Morris; however, the MAP assessment form she prepared indicates that she did not. Morris also was assessed for tuberculosis while in MAP, and told the nurse “no” when asked if he had experienced a cough longer than 3 weeks, coughing up blood, night sweats, or unexplained weight loss.

Like the Central Intake nurse, Joseph determined that Morris was experiencing alcohol withdrawal, and needed to detox. Joseph prescribed several drugs to Morris that were administered by a nurse before he left MAP, and placed Morris on the jail's detox protocol. This protocol called for various medications to be given and vital signs taken at least every 12 hours for several days. Overall, based upon her own examination and what Morris told her, Joseph found him to be a medically stable alcoholic inmate with an acuity level of 2 or “non-urgent,” and recommended that he be assigned to the infirmary. In Joseph's judgment, nothing about Morris's condition indicated that he should be taken to the emergency room.

The Medical Assessment Program provider and nurse on duty are not permitted to leave the MAP area. Once an inmate is transferred from MAP into the infirmary, all follow up care is done by jail health staff, unless someone from the infirmary asks a MAP provider to see an inmate on an emergency basis. After Morris left the MAP area, Joseph was not asked to see, nor did she, see Morris again (Joseph's shift ended at 7:00 a.m.). After Joseph finished her assessment and orders for Morris, sheriff's department personnel took him to a waiting area pending his reassignment to the infirmary.

D. Morris is Assigned and Transferred to the Infirmary

The parties agree that Morris was sent to the infirmary of the Dallas County Jail in the early hours of August 2, 2009, and spent the remaining hours of his life there.

1. Description of the Infirmary

The infirmary has 14 tanks, and each tank houses 8–16 inmates. There are no guards in the tanks, but the tanks are watched from a guard station using video surveillance. On each shift, four field officers made regular rounds of the tanks to check for fire hazards. They also would distribute and pick up meal trays, and give inmates the supplies needed to keep their tanks clean (e.g. mops and buckets). If inmates needed the guards' attention, they communicated using an intercom system between the tank and the guard station.

When an inmate's vital signs were being checked, neither the guard nor the nurse would go into the tanks. The guard would call an inmate's name, and he would come out individually to have his vitals taken outside the tank. The nurses and officers also did not go inside the tanks during medication pass. The officers went into the tanks only to check for hygiene and cleanliness. Defendant Dallas County stipulated that the jail security officers did not monitor the medical condition of the inmates, and that there were no policies for such monitoring. Frye also testified that there was no formal procedure for guards to pass medical information or observations regarding inmates to the nursing staff, and that there was no training for doing so, although she believed that the guards should relay that kind of information since the nursing staff did not go into the tanks.

Inmates in the tanks were unable to directly contact any of the jail's nursing or other medical personnel. Some of the tanks were visible from where the medical personnel were, and some were not. Morris was in a tank that was down the hall, where inmates could not wave through the window to get the attention of the medical staff. If an inmate had an emergent medical issue, they had to contact the guards at the guard station via intercom. The officers in the guard station then were responsible for relaying the information to the medical staff. There was no way for inmates to contact the medical staff directly.

2. Morris's Stay in the Infirmary

Morris arrived to the infirmary floor at 2:41 a.m., and was examined in the infirmary at 3:34 a.m. There, nurse Debra Smith (“Smith”) reviewed the MAP transfer documents and noted Morris's history of alcohol abuse. She found Morris to be alert and oriented. Morris told her of his 30 year history of alcohol abuse, that he had delirium tremors in the past, and that he had been assaulted two weeks prior and broken his ribs, but had not sought medical attention for this injury. Upon examination, Smith found no bruising to Morris's rib area, that his lungs were clear, and that he was not experiencing respiratory distress. Smith's notes show that both Morris's vital signs and overall condition were stable. Smith's follow-up plan for Morris was to continue with the medications ordered by Joseph and the monitoring of his vital signs. Smith also ordered that Morris be placed for a follow-up provider visit and a rib x-ray. She then had Morris returned to his tank.

At 6:00 a.m. on August 2, L.V.N. Teresa Frye (“Frye”) began her shift, and took report from Smith. Frye was responsible for five tanks in the infirmary, with a total of approximately 100–110 inmates. Smith and Frye talked for a little over 20 minutes, and Frye was told that she had a “new detoxer” in Tank 1. Frye understood that someone going through detox would need nursing care, but when she checked the computer no order for the detox protocol had been scanned in for Morris. Therefore, she could not give him the medications provided for by the protocol. During their meeting, Smith did not...