by Douglas Ankney

A United States District Court for the Southern District of Ohio denied motions for summary judgment filed by private healthcare provider NaphCare Inc. (NaphCare) and its employee Emergency Medical Technician (EMT) Jack Saunders in a suit alleging they failed to treat a jail prisoner’s fractured pelvis.
Jeffrey Day was a passenger in a car November 26, 2015, which was involved in a collision in Trotwood, Ohio. As a result of the collision, Day suffered a fractured right acetabulum — the part of the pelvis that forms the socket of his hip. Day, who was intoxicated, was arrested on a charge of Obstructing Official Business because he provided false information about the accident.
At the scene of the accident, Day signed a waiver, refusing medical treatment. But upon his arrival at the Montgomery County Jail (MCJ), he was unable to walk into the booking area without assistance. Video showed Day could not stand on his right leg, and he was in pain. He was placed in a wheelchair.
According to a deposition from Saunders, during Day’s medical intake assessment Day told Saunders about the vehicle accident. Day told Saunders he felt like he had broken something in his leg. He told Saunders he had pain in his right hip. Day said on a scale of 1 to 10, the pain was a 10. Saunders told Day that a nurse would examine him. Because NaphCare had a policy of not sending anyone to the hospital unless it was a life-threatening emergency, Saunders placed Day on the sick call list as a “priority.” He anticipated Day would be seen in a day or two by a nurse practitioner.
The day after his booking, Day stood in line to see medical staff as they handed out medication. When his turn came, he explained that he was not receiving medication but that he needed medical care. He was told that he could be held in jail for up to 72 hours without jail personnel having to provide him with any medical treatment. Day tried again on the next day, telling medical staff he needed medical care, and that he was in horrible pain. The staff member replied that he could not give Day anything for his pain. Day then submitted a written request, but he received no response.
After five days without receiving so much as an aspirin to dull the pain, Day was released from MCJ. He went to Miami Valley Hospital where he underwent surgery to correctly position the broken bone so that it would heal properly. Day obtained a deposition from Dr. Jonathan Paley, wherein Paley testified that it is the standard of care for an EMT to order a CT scan, or at the very least an X-ray for anyone in an automobile accident. And if they are limping and needing a wheelchair, it is necessary to send the patient to the emergency room for an evaluation. He further testified that the standard of care for Day’s injury was immediate surgery. Any delays would cause further complications and result in permanent injury.
Day subsequently filed a 42 USC § 1983 lawsuit naming several defendants, including NaphCare, Saunders, and Sheriff Phil Plummer in his official capacity. He asserted, inter alia, a claim of deliberate indifference to his medical needs under the Fourth and Fourteenth Amendments and state law medical malpractice claims. All parties filed motions for summary judgment.
The Court observed that Federal Rules of Civil Procedure, Rule 56 provides that summary judgment “shall be rendered forthwith if the pleadings, depositions, answers to interrogatories, and admissions on file, together with the affidavits, if any, show that there is no genuine issue as to any material fact and that the moving party is entitled to a judgment as a matter of law.” Conversely, a motion for summary judgment must be denied “[i]f there are any genuine factual issues that properly can be resolved only by a finder of fact because they may reasonably be resolved in favor of either party.” Anderson v. Liberty Lobby, Inc., 477 U.S. 242 (1986).
Under Ohio law, to prove a claim of medical negligence requires a plaintiff to show: (1) the standard of care recognized by the medical community; (2) the failure on the part of the medical care provider to meet that standard of care; (3) that the negligent act on the part of the Defendants proximately caused the plaintiff’s injury, and (4) damages.
While NaphCare and Saunders disputed Paley’s testimony, the Court determined that Paley’s testimony was evidence that a factfinder could consider in deciding if NaphCare and Saunders were negligent in their treatment of Day. Thus, the Court denied NaphCare’s, Saunder’s, and Day’s motions for summary judgment on the malpractice claim.
However, a suit against Plummer in his official capacity is the same as a suit against Montgomery County. Chesher v. Neyer, 477 F.3d 784 (6th Cir. 2007). The County is entitled to immunity under state law. Ohio Rev. Code § 2744.02. Accordingly, Plummer’s motion as to the malpractice claim was granted.
The Court then determined that it is unclear if Day’s constitutional claims for deliberate indifference to his medical needs should be analyzed under the Fourth or Fourteenth Amendment. So the Court provided analysis under both.
To prevail on his § 1983 claim, Day must prove (1) he was deprived of a right secured by the Constitution or laws of the United States and (2) the deprivation was caused by a person acting under the color of state law. Shadrick v. Madison County, 805 F.3d 724 (6th Cir. 2015). Private medical professionals who provide healthcare services to prisoners are government officials acting under the color of state law for § 1983 purposes. Id. A pretrial detainee’s right to medical treatment for a serious medical need has been established for at least 32 years. Estate of Carter v. City of Detroit, 408 F.3d 305 (6th Cir. 2005). But the Sixth Circuit has yet to decide whether the Fourth or the Fourteenth Amendment should be applied to a pretrial detainee’s medical-based claim. Esch v. County of Kent, 699 F. App’x 509 (6th Cir. 2017).
To prove a claim under the Fourth Amendment, a plaintiff must prove: (1) the officer had notice of the detainee’s medical needs; (2) the seriousness of the need; (3) the scope of the requested treatment; and (4) the police interests, including administrative, penological, or other investigative concerns. Esch. A plaintiff must also show the defendant caused the complained of harm. Gayton v. McCoy, 593 F.3d 610 (7th Cir. 2010). Generally, a recent traumatic injury is sufficient to demonstrate a serious medical need. Brown v. Hughes, 894 F.2d 1533 (11th Cir. 1990). The Court determined that a reasonable juror could conclude Saunders had notice of Day’s medical needs; the seriousness of those needs, and the scope of the requested treatment. And since Day was confined in jail, a juror could conclude there were no overriding police interests. Thus, Day could prevail under the Fourth Amendment.
A pretrial detainee’s claim of deliberate indifference to a serious medical need brought under the Fourteenth Amendment has an objective component and a subjective component. The detainee must demonstrate a sufficiently serious medical need to satisfy the objective component. Farmer v. Brennan, 511U.S. 825 (1994). The subjective component requires demonstrating the defendant had a sufficiently culpable state of mind, such as knowing of and disregarding an excessive risk to a prisoner’s health or safety. Id. The Court concluded that given the knowledge Saunders had, a reasonable juror could find that he disregarded a substantial risk of harm to Day.
NaphCare argued it could not be held liable under § 1983 for the actions of one of its employees because the statute does not permit suits under the doctrine of respondeat superior. But the Court ruled that an employer can be held liable if the employee acted according to an official policy of the employer. Thomas v. Coble, 55 F. App’x 748 (6th Cir. 2003). Since Saunders testified that he did not provide further treatment for Day because NaphCare had a policy that prohibited sending prisoners to the hospital unless it was a life-threating emergency, a juror could conclude that the policy caused the harm suffered by Day. Therefore, the Court denied NaphCare’s and Saunder’s motions for summary judgment on these claims.
Finally, a county is liable for the constitutional deprivations caused by the policies or customs of a contracted medical provider. Ancata v. Prison Health Services, Inc., 769 F.2d 700 (11th Cir. 1985). Thus, the Court concluded that this claim against Plummer in his official capacity was really a suit against the County, so it also survived summary judgment.
The case remains pending. See: Day v. Delong, No. 3:16-cv-437 (S.D. Ohio 2019).

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