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Single Incident of Deliberate Indifference Insufficient to Establish Policy or Custom

The Eleventh Circuit Court of Appeals has affirmed a district court’s grant of summary judgment on the grounds that the plaintiff’s evidence, which indicated a single case of a constitutional violation, did not prove a private medical provider had a policy, practice or custom of deliberate indifference.

The appellate ruling was entered in a civil rights action that alleged an Eighth Amendment violation for deliberate indifference to the serious medical needs of Henry Craig, who was approached by a police officer in Rome, Georgia on July 4, 2006. Craig had consumed methamphetamine hours earlier, was acting erratically and told the officer to shoot him.

Two other police officers arrived and one used a Taser on Craig. When he fell, a puddle of blood formed on the ground beside his head. He was transported to a hospital and examined. A doctor cleared him to be taken to the Floyd County Jail (FCJ), where he was placed under the care of the jail’s medical provider, Georgia Correctional Health, LLC.

The next day, nurse practitioner Susan Hatfield determined that the dried blood around Craig’s right ear was from a ruptured eardrum. He was coherent and expressed no other complaints about his health. Over the following nine days, Craig received sixteen evaluations by nine different Georgia Correctional Health employees, including nurses, nurse practitioners, a psychologist and a physician.

During some of those evaluations Craig did not complain about his medical condition, but during others he complained about not eating for five days, having urinated only once while in jail, and experiencing severe headaches, neck pain and a lack of hearing in his right ear. He received “acetaminophen, ibuprofen, other pain relievers and muscle relaxants” for the headaches.

Hatfield ordered a tomography scan of Craig’s head on July 13, 2006, which indicated he had air and bleeding in his skull along with several fractures. He was taken to a hospital where he received neurological surgery.

Craig filed a federal civil rights complaint that alleged three “persistent and widespread practices” to support his deliberate indifference to serious medical needs claim against Georgia Correctional Health. He argued the company had a practice of not referring detainees to physicians, of erroneously relying on hospital clearance forms rather than doing its own diagnostic tests, and of using the least costly means to treat detainees. The district court granted summary judgment to the defendants and Craig appealed.

The Eleventh Circuit held that even if it assumed the practices cited by Craig represented constitutional violations, the evidence he had presented was insufficient to prove a widespread policy or custom by Georgia Correctional Health (the applicable legal standard under Monell v. Dept. of Social Services, 436 U.S. 658 (1978)). Craig had only addressed issues related to his own medical care and presented the testimony of Dr. Jimmy Graham, who stated he did not have any knowledge of the FCJ or Georgia Correctional Health. His testimony relied solely on his experiences with other jails.

Since a single incident of an alleged constitutional violation was insufficient to prove a custom, policy or practice, the district court’s grant of summary judgment to the defendants was affirmed. See: Craig v. Floyd County, Georgia, 643 F.3d 1306 (11th Cir. 2011).

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Related legal case

Craig v. Floyd County, Georgia