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Seventh Circuit: New Trial for Wrong Legal Standard in Jail Death Case

Seventh Circuit: New Trial for Wrong Legal Standard in Jail Death Case

by Mark Wilson

In an amended decision on August 14, 2014, the Seventh Circuit Court of Appeals held a district court had abused its discretion when it required an inadequate medical care claim involving the death of a pretrial detainee to be tried under an incorrect legal standard.

As previously reported in PLN, John King suffered from asthma, diabetes, a heart condition, high blood pressure, seizures, and severe anxiety and other mental health issues when he was booked into Wisconsin’s La Crosse County Jail on April 7, 2007. [See: PLN, July 2013, p.24].

King entered the jail with “two grocery bags full of his medications, including a bottle with 115 one-milligram tablets of alprazolam, a benzodiazepine.” He was taking “five milligrams of alprazolam” a day. Without examining King, a jail doctor instructed nurses by phone to wean him off the alprazolam over a three-day period.

That was “a dangerously rapid reduction” given the dosage King was taking. “Abrupt withdrawal from alprazolam can be life-threatening; associated symptoms include agitation, elevated blood pressure, elevated pulse, tremors, delusions, hallucinations and seizures. The severity of such symptoms requires medical providers to monitor the patient closely, preferably in a hospital.” Nobody at the jail monitored King’s withdrawal.

King filed a medical request on April 11 that went unanswered for six days. The doctor who finally examined him noted that he “had pressured speech and flights of ideas with manic insomnia.”

At about 10:30 a.m. on April 18, 2007, King was found “convulsing on the floor, screaming and foaming at the mouth.” He was shaking so badly that Nurse Sue Kramer, employed by the jail’s private medical contractor, Health Professionals Ltd., could not get a blood pressure reading. Consistent with seizures, he did not respond to smelling salts and his face turned blue. Nevertheless, Kramer told three nursing students that prisoners were known to fake seizures.

Nurse Kramer and jail guards left King lying on the floor of his cell because they thought he was faking. They did not contact the doctor or call an ambulance.

“Kramer was aware that King was being tapered off alprazolam and understood that alprazolam withdrawal can cause seizures, hallucinations, and death.” Yet when King had another seizure an hour later, Kramer again did not call the doctor or an ambulance.

Later that evening, Kramer told Nurse Karen Mondry-Anderson that King had faked a seizure and responded to smelling salts. Neither was true.

At about 5:30 p.m., King called on his cell intercom but was incoherent. When Mondry-Anderson brought medication to his cell two hours later, she found him unresponsive. He was pronounced dead shortly afterwards.

John’s widow, Lisa King, filed suit in federal court, alleging that jail officials were deliberately indifferent to her husband’s serious medical needs. The district court granted summary judgment to the defendants but the Seventh Circuit reversed. See: King v. Kramer, 680 F.3d 1013 (7th Cir. 2012).

Following remand, settlement negotiations failed. Approximately six weeks before a scheduled trial, King’s attorney sent an email to the defendants’ counsel arguing that “the Fourth Amendment objective reasonableness standard, not the deliberate indifference standard, should apply in evaluating the medical care provided to a pretrial detainee.” Both parties had previously assumed that the deliberate indifference standard controlled.

The district court granted the defendants’ motion in limine, barring King from arguing the applicability of the objective reasonableness standard. Finding that King had waived argument on that issue, the court required her “to prove deliberate indifference under the more exacting Eighth and Fourteenth Amendment standards.”

The case went to trial in January 2013 and the jury returned a verdict for the defendants, finding they were not deliberately indifferent to King’s serious medical needs. The Seventh Circuit again reversed, concluding the district court had abused its discretion in ordering that the case be tried under an incorrect legal standard.

The district court improperly failed to identify any harm that “would result from the shift in the legal standard,” and the Court of Appeals noted it was “an extraordinary sanction indeed to require that a case be tried under the incorrect legal standard.” Accordingly, the case was remanded for another trial. See: King v. Kramer, 763 F.3d 635 (7th Cir. 2014).

A second trial was scheduled following remand, but Kramer settled in April 2015 under confidential terms. Separately, Lisa King was ordered to pay $30,397.17 in costs to La Crosse County, as the county had prevailed at the first trial and that verdict did not turn on the correct legal standard.


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King v. Kramer

King v. Kramer