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Ninth Circuit Modifies Deliberate Indifference Analysis for Pretrial Detainees’ Inadequate Medical Care Claims

by Matt Clarke

On April 30, 2018, the Ninth Circuit Court of Appeals held it was error to apply a subjective standard to a 42 U.S.C. § 1983 claim alleging inadequate medical care that resulted in the death of a pretrial detainee.

Matthew Shawn Gordon was arrested on drug charges and booked into jail in Orange County, California in September 2013. During the intake process, jail nurse Debra Finley used an assessment form designed for alcohol withdrawal (CIWA) instead of another form designed for opiate withdrawal (COWS). Gordon told her he had a 3 gram-per-day heroin habit. She consulted with a doctor, who directed that Gordon receive Tylenol, Zofran and Atarax for four days, but did not order him placed in the jail’s medical observation unit.

Gordon was instead housed in the general population. About 14 hours later, fellow prisoners discovered him unresponsive in his bunk; he was declared dead at a hospital. A jailer admitted that although he had performed three “wellness checks” on Gordon after he was placed in the general population unit, it was impossible to see whether he was alive or breathing from the distance and vantage point where the checks were done.

Gordon’s mother and estate filed a federal civil rights lawsuit pursuant to 42 U.S.C. § 1983 against Orange County, the sheriff, the jail, the jail’s health care provider, and security and medical personnel, alleging Gordon’s Fourteenth Amendment due process rights had been violated when he was denied adequate medical care.

The district court granted the defendants’ motion for summary judgment, finding there was inadequate evidence to show subjective deliberate indifference by the individual defendants, or that the county or jail had an unconstitutional custom or practice as required by Monell v. Department of Social Services, 436 U.S. 658 (1978). Aided by San Diego attorney David A. Schlesinger and Irvine attorney Cameron Sehat, the plaintiffs appealed.

The Ninth Circuit noted that Kingsley v. Hendrickson, 135 S.Ct. 2466 (2015) [PLN, July 2015, p.60] and Castro v. County of Los Angeles, 833 F.3d 1060 (9th Cir. 2016) had called into question whether subjective indifference was the proper standard of review in medical care cases brought by pretrial detainees. Kingsley held that pretrial detainees did not have to prove guards subjectively knew their use of force was unreasonable; instead, whether or not the force was excessive was subject to an objective determination.

In Castro, the Ninth Circuit extended the objective standard to failure-to-protect cases. Here, the appellate court saw no logical reason not to extend it to medical indifference cases as well, since § 1983 ‘“contains no state-of-mind requirement independent of that necessary to state a violation’ of the underlying federal right.” The Court of Appeals noted that the wording of Kingsley did not limit itself to “force,” but spoke more broadly of “the challenged government action.”

Therefore, the Court held that pretrial detainees’ claims related to inadequate medical care brought against individual defendants under the Fourteenth Amendment must be evaluated under an objective deliberate indifference standard. That is, plaintiffs need to “prove more than negligence but less than subjective intent – something akin to reckless disregard.”

Because the wrong standard was used to evaluate the claims brought by Gordon’s mother and his estate, the Ninth Circuit vacated the summary judgment order and remanded the case to the district court for further proceedings, including a decision on the defendants’ qualified immunity defense and the plaintiffs’ Monell claims. See: Gordon v. County of Orange, 888 F.3d 1118 (9th Cir. 2018), rehearing denied, rehearing en banc denied. 

Related legal case

Gordon v. County of Orange


 

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