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New Trial on Causation Required in Illinois Jail Detainee’s Suicide

by David M. Reutter

The Seventh Circuit Court of Appeals held on August 10, 2018 that an Illinois federal district court erred in granting judgment as a matter of law on the issue of causation in the death of Lyvita Gomes while she was incarcerated at the Lake County jail. In doing so, the appellate court set a new standard in the circuit for medical claims involving pretrial detainees.

Gomes, 52, was arrested improperly in the fall of 2011 for failing to report for jury duty; as an Indian national, she was ineligible to serve as a juror. While being arrested, Gomes pulled away from the officer and was charged with resisting arrest. She made statements that landed her on suicide watch, but a few days later was released to Immigration and Customs Enforcement (ICE). She was then freed. 

After failing to appear on the resisting arrest charge, Gomes was arrested on December 14, 2011. By the 18th, she was on suicide watch and hunger strike protocol due to her refusal to eat or drink. Her weight dropped from 146 pounds to 128 pounds on December 28. During that time period, “Drs. [Rozel] Elazegui and [Hargurmukh] Singh deliberately chose a ‘wait and see’ monitoring plan, knowing that Gomes was neither eating nor drinking nor competent to care for herself,” the Seventh Circuit found.

By the time Gomes was sent to a hospital on December 29, it was “too late” because she was experiencing acute liver and renal failure. Gomes died on January 3, 2012 due to “complications of starvation and dehydration.” The manner of death was classified as suicide in the autopsy report. [See: PLN, Oct. 2013, p.32].

Her estate sued Lake County, sheriff’s officials, the jail’s medical contractor (Correct Care Solutions), the company’s Director of Mental Health Jennifer Bibbiano, Drs. Elazegui and Singh, and two social workers. The complaint raised due process claims under 42 U.S.C. § 1983, state law and common law claims, violations of international treaty obligations and claims under the Americans with Disabilities Act. 

The jury, however, was not given the opportunity to resolve some of those claims; eventually, only the claims against the medical defendants went to trial. In entering judgment for those defendants at the close of the estate’s case, the district court concluded the estate failed to present enough evidence to reach the jury on the question of whether the defendants had caused Gomes’ death.

Further, the court declared a mistrial on a due process claim alleging that Drs. Elazegui and Singh rendered inadequate medical care, which caused Gomes pain and suffering, as the jury could not reach a unanimous verdict but did find Bibbiano liable on that claim. The district court awarded the estate $119,000.

On appeal, the Seventh Circuit noted that to prevail on the causation issue, it “would have been enough for the estate to show that the resulting harm was a diminished chance of survival,” and that the record included “ample evidence from which a jury could infer Drs. Elazegui and Singh’s inaction diminished Gomes’ chance of survival.” Finding a new trial was required as to the causation claim, the Court of Appeals turned to the jury instructions as to intent.

The Court joined the Ninth and Second Circuits in concluding that medical care claims brought by pretrial detainees under the Fourteenth Amendment are only subject to the objective unreasonableness inquiry set forth in Kingsley v. Hendrickson, 135 S.Ct. 2466 (2015) [PLN, July 2015, p.60]. That test includes a “state-of-mind requirement for constitutional cases that remains higher” than the negligence requirement for medical malpractice claims, but does not include the subjective component that applies to Eighth Amendment claims brought by prisoners who have been convicted.

“Any death is a great loss, but one as preventable as Gomes’s is especially disturbing,” the Seventh Circuit wrote. “On this record, a jury could have found that the intentional and knowing inaction of Drs. Elazegui and Singh caused Gomes’s death.”

The district court’s judgment was affirmed in part and reversed in part for a new trial on the estate’s claims against the two doctors. The case remains pending on remand. See: Miranda v. County of Lake, 900 F.3d 335 (7th Cir. 2018), rehearing, rehearing en banc denied. 


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Related legal case

Miranda v. County of Lake