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Florida: No Qualified Immunity for Jail Medical Staff in Prisoner’s Death

by David M. Reutter

Florida federal district court has held that a doctor and nurse at the Orange County Jail (OCJ) were not entitled to qualified immunity in a lawsuit filed by the estate of a pretrial detainee who died at that facility.

Max Gracia, Jr., 22, was treated at a local hospital for severe dog bites to his legs and hands that were incurred during his arrest on August 6, 2015. After being booked into OCJ, Gracia was assigned to a call in the infirmary. In addition to the multiple dog bites, medical staff were aware that Gracia was HIV positive; while he was given other medications, he did not receive the drugs needed to treat his HIV infection.

Dr. Robert J. Buck III was OCJ’s medical director and its sole doctor. He saw Gracia around the time of his admission, but never saw or inquired about him afterward. 

Medical records indicated that Gracia’s wound dressing was changed daily but his vital signs were not taken until August 9. At that time he had an abnormal heart rate of 130 and a respiratory rate of 22, and complained of “weakness and dizziness.” Other than ordering increased fluid intake, no action was taken by jail medical staff. Gracia allegedly refused his medication later that evening.

Just before midnight, he was moved to a cell with video monitoring because staff had incorrectly determined he was “faking or exaggerating his medical condition and inability to get up.” Jail guard Connie Wambush wrote a disciplinary report on that basis. 

Less than six hours later, Gracia was found unresponsive and not breathing in his cell. He was pronounced dead upon arrival at a hospital, and an autopsy listed the cause of death as “septic shock complicating infected dog bite wounds,” with HIV as a contributing factor. His August 10, 2015 death was ruled a homicide. [See: PLN, Dec. 2018, p.15].

“He was treated in a way that we wouldn’t treat the worst among us or a rabid animal,” said Mark NeJame, the attorney representing Gracia’s estate. “For four days, he languished in pain as infection and fever raged through his body, and ultimately he died without any care, concern or compassion apparently, shown by those who were charged with caring for him.”

The defendants moved for summary judgment, and Gracia’s estate agreed to the dismissal of all defendants except Dr. Buck and nurse Karen Clairmont. For his part, Buck argued he had only acted in a supervisory role because he was the medical director, and his “single, brief evaluation” of Gracia did not indicate indifference because his “treatment was overseen and provided by various other medical providers.”

The district court wrote it would “not disregard Buck’s indifference as a medical provider simply because he was also a medical director.” The fact remained that Dr. Buck was Gracia’s treating physician, and his incarceration prevented him from seeing any other doctor. Buck also was aware when he examined Gracia that he had “examined an HIV positive patient with a severe dog bite wound and deliberately declined to play any active role in his subsequent treatment.” Gracia’s HIV status made him especially susceptible to infection and septic shock. The court found Dr. Buck could be found to be deliberately indifferent as both a medical director and a doctor, precluding qualified immunity.

Likewise, Nurse Clairmont could be found to be deliberately indifferent. Her progress notes said Gracia was refusing care, and the district court found the only basis for her refusal to provide care was because she felt that Gracia was malingering. Yet in the motion for summary judgment, Clairmont claimed she believed Gracia was suffering from a serious medical need. The court noted her refusal to intervene medically could be viewed by a jury as “classic indifference.”

Clairmont resigned following Gracia’s death while another jail nurse, Maryanne Evans, was reprimanded.

The defendants’ motion for summary judgment was denied on April 24, 2019 as to Dr. Buck and Clairmont, and granted as to the other defendants. The case remains pending. See: Bryant v. Orange County, U.S.D.C. (M.D. Fla.), Case No. 6:17-cv-01423-GAP-KRS; 2019 U.S. Dist. LEXIS 69121. 


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Related legal case

Bryant v. Orange County, Florida