Strain v. Regalado

• Decision Date: 09 October 2020
• Docket Number: No. 19-5071,19-5071
• Citation: 977 F.3d 984
• Parties: Faye STRAIN, as guardian of Thomas Benjamin Pratt, Plaintiff - Appellant, v. Vic REGALADO, in his official capacity; Armor Correctional Health Services, Inc.; Curtis McElroy, D.O.; Patricia Deane, LP N; Kathy Loehr, LPC, Defendants - Appellees and Board of County Commissioners of Tulsa County, Defendant.
• Court: U.S. Court of Appeals — Tenth Circuit

977 F.3d 984

Faye STRAIN, as guardian of Thomas Benjamin Pratt, Plaintiff - Appellant,

v.Vic REGALADO, in his official capacity; Armor Correctional Health Services, Inc.; Curtis McElroy, D.O.; Patricia Deane, LP N; Kathy Loehr, LPC, Defendants - AppelleesandBoard of County Commissioners of Tulsa County, Defendant.

No. 19-5071

United States Court of Appeals, Tenth Circuit.

FILED October 9, 2020

Robert Blakemore (Daniel Smolen with him on the brief), Smolen & Roytman, Cincinnati, Ohio, for Plaintiff-Appellant Faye Strain.

Sean Snider (Micah B. Cartwright with him on the brief), Johnson Hanan Vosler Hawthorne & Snider, Oklahoma City, Oklahoma, for Defendants-Appellees Armor Correctional Health Services, Inc., Curtis McElroy, D.O., Patricia Deane, LPN, and Kathy Loehr, LP C.

Guy Fortney (Katie Arnold with him on the brief), Brewster & De Angelis, Tulsa, Oklahoma, for Defendant-Appellee Vic Regalado.

Before HARTZ, MATHESON, and CARSON, Circuit Judges.

CARSON, Circuit Judge.

The Fourteenth Amendment prohibits deliberate indifference to a pretrial detainee's serious medical needs. Disagreement about course of treatment or mere negligence in administering treatment do not amount to a constitutional violation. Rather, to state a claim for deliberate indifference, a plaintiff must allege that an official acted (or failed to act) in an objectively unreasonable manner and with subjective awareness of the risk. Indeed, the word deliberate makes a subjective component inherent in the claim.

Pretrial detainee Thomas Pratt exhibited alcohol withdrawal symptoms while in a county jail. Healthcare providers diagnosed and treated Mr. Pratt's symptoms, but their course of treatment proved ineffective. Plaintiff Faye Strain, as Mr. Pratt's guardian, sued. Although Plaintiff's alleged facts suggest that Defendants may have underestimated the extent of Mr. Pratt's symptoms, Plaintiff's allegations do not rise to the high level of deliberate indifference. Exercising jurisdiction under 28 U.S.C. § 1291, we affirm the district court's dismissal of Plaintiff's federal claims, as well as its decision not to exercise supplemental jurisdiction over Plaintiff's remaining state law claims.

I.

Officials at the Tulsa County Jail (the Jail) booked Mr. Pratt into the Jail on December 11, 2015.¹ The next morning, Mr. Pratt expressed that he was experiencing alcohol withdrawal and submitted a request for detox medication. An Armor nurse conducted a drug and alcohol withdrawal assessment of Mr. Pratt that afternoon. During the assessment, Mr. Pratt stated that he had habitually drank fifteen-to-twenty beers per day for the past decade. Staff admitted Mr. Pratt to the Jail's medical unit, conducted a mental health assessment, and documented his withdrawal symptoms.

On December 13, Armor staff placed Mr. Pratt on seizure precautions, which dictated that staff check his vital signs every eight hours. Armor staff also placed Mr. Pratt on Librium

medication to treat his alcohol withdrawal symptoms at an undetermined time. Around 2 a.m. on December 14, Nurse Patricia Deane conducted a withdrawal assessment, which revealed worsening symptoms. Nurse Deane observed vomiting, severe tremors, acute panic states, and disorientation. Plaintiff alleged that Mr. Pratt's symptoms showed he was suffering from delirium tremens

.² Despite the severity of Mr. Pratt's symptoms, and against an assessment tool's direction, Nurse Deane did not contact a physician. Nurse Deane also failed to check Mr. Pratt's vitals or perform any additional assessments.³ But someone, presumably a nurse practitioner at the request of Nurse Deane, switched Mr. Pratt from Librium to Valium shortly after Nurse Deane's assessment.

About eight hours later, at 10:30 a.m. on December 14, Dr. Curtis McElroy examined Mr. Pratt. Dr. McElroy noticed a two-centimeter cut on Mr. Pratt's forehead and a pool of blood in his cell. Dr. McElroy, aware of Mr. Pratt's earlier symptoms from his medical records, observed Mr. Pratt's disoriented state, but did not send Mr. Pratt to the hospital or provide more care. Dr. McElroy recorded that Mr. Pratt received his first dose of Valium that morning. Another Armor nurse encountered Mr. Pratt later that afternoon and noted that he needed assistance with daily living activities. Again, Armor staff did not escalate Mr. Pratt's level or place of care.

The next morning, Kathy Loehr, a licensed professional counselor (LPC), conducted a mental health evaluation of Mr. Pratt. Mr. Pratt reported that he was detoxing from alcohol and appeared shaky. LPC Loehr observed that Mr. Pratt struggled to answer questions and determined the cut on his forehead

appeared unintentional. LPC Loehr declined to seek more care for Mr. Pratt.

That afternoon, Dr. McElroy again assessed Mr. Pratt and noted that he was underneath the sink in his cell with a cut on his forehead

. Another Armor nurse observed Mr. Pratt around midnight on the morning of December 16, but he would not get up, so she did not check his vitals. Just before 1 a.m., a detention officer found Mr. Pratt lying motionless on his bed and called for a nurse. An Armor nurse responded immediately, initiated cardiopulmonary resuscitation, and called a medical emergency. First responders soon resuscitated Mr. Pratt and rushed him to a hospital. Mr. Pratt had suffered a cardiac arrest. The hospital later discharged Mr. Pratt with a seizure disorder and other ailments that left him permanently disabled.

Plaintiff Faye Strain, as guardian of Mr. Pratt, sued Armor, Nurse Deane, LPC Loehr, Dr. McElroy, and Tulsa County Sheriff Vic Regalado in his official capacity (collectively, Defendants) for Mr. Pratt's treatment at the Jail.

Plaintiff asserted claims for deliberate indifference to Mr. Pratt's serious medical needs under 42 U.S.C. § 1983 against all Defendants, as well as related state law claims. The district court dismissed all of Plaintiff's federal claims and declined to exercise supplemental jurisdiction over her state law claims. Plaintiff now appeals.

II.

We review de novo the district court's dismissal of a complaint under Federal Rule of Civil Procedure 12(b)(6) for failure to state a claim. Strauss v. Angie's List, Inc., 951 F.3d 1263, 1266 (10th Cir. 2020). To survive a Rule 12(b)(6) motion, Plaintiff's complaint must allege sufficient facts to state a claim for relief plausible on its face. Ashcroft v. Iqbal, 556 U.S. 662, 678, 129 S.Ct. 1937, 173 L.Ed.2d 868 (2009) (explaining that a claim is facially plausible "when the plaintiff pleads factual content that allows the court to draw the reasonable inference that the defendant is liable for the misconduct alleged").

We review the district court's decision declining to exercise supplemental jurisdiction for an abuse of discretion. Robey v. Shapiro, Marianos & Cejda, L.L.C., 434 F.3d 1208, 1213 (10th Cir. 2006).

III.

We consider whether the district court erred by dismissing Plaintiff's federal claims under a standard for deliberate indifference that included both an objective and a subjective component. Plaintiff contends we should analyze her claims under a purely objective standard given the Supreme Court's decision in Kingsley v. Hendrickson, 576 U.S. 389, 135 S.Ct. 2466, 192 L.Ed.2d 416 (2015). She also argues that the district court abused its discretion by declining to exercise supplemental jurisdiction over her related state law claims. We reject Plaintiff's arguments and hold that deliberate indifference to a pretrial detainee's serious medical needs includes both an objective and a subjective component, even after Kingsley. We also conclude that Plaintiff failed to allege sufficient facts to support her deliberate indifference claims and that the district court did not err by declining to exercise supplemental jurisdiction over her remaining state law claims.

A.

The Supreme Court first recognized a § 1983 claim for deliberate indifference under the Eighth Amendment, which protects the rights of convicted prisoners. Estelle v. Gamble, 429 U.S. 97, 104, 97 S.Ct. 285, 50 L.Ed.2d 251 (1976) (holding that deliberate indifference to a convicted prisoner's serious medical needs constitutes cruel and unusual punishment in violation of Eighth Amendment). We later granted pretrial detainees access to the claim under the Fourteenth Amendment. Garcia v. Salt Lake Cty., 768 F.2d 303, 307 (10th Cir. 1985) (holding that, although the Eighth Amendment protects the rights of convicted prisoners and the Fourteenth Amendment protects the rights of pretrial detainees, pretrial detainees are "entitled to the degree of protection against denial of medical attention which applies to convicted inmates"). And we apply the same deliberate indifference standard no matter which amendment provides the constitutional basis for the claim. Estate of Hocker by Hocker v. Walsh, 22 F.3d 995, 998 (10th Cir. 1994) (holding that a pretrial detainee's Fourteenth Amendment "claim for inadequate medical attention must be judged against the deliberate indifference to serious medical needs test of Estelle" (internal quotation marks and citation omitted)).

To state a cognizable claim, Plaintiff "must allege acts or omissions sufficiently harmful to evidence deliberate indifference to serious medical needs." McBride v. Deer, 240 F.3d 1287, 1289 (10th Cir. 2001) (quoting Estelle, 429 U.S. at 106, 97 S.Ct. 285 )). This standard includes both an objective component and a subjective component. Clark v. Colbert, 895 F.3d 1258, 1267 (10th Cir. 2018). To establish the objective component, "the alleged deprivation must be ‘sufficiently serious’ to constitute a deprivation of constitutional dimension." Self v. Crum, 439 F.3d 1227, 1230 (10th Cir. 2006) (quoting Farmer v. Brennan, 511 U.S. 825, 834, 114 S.Ct. 1970, 128 L.Ed.2d 811 (1994) ). "A medical need is [objectively] serious if it is one that has been diagnosed by a physician as mandating treatment or one that is so obvious that even a lay person would easily recognize the...