On November 13, 2024, the U.S. Court of Appeals for the Tenth Circuit upheld a jury award of more than $8.7 million to the Estate of detainee who died in Utah’s Davis County Jail. In its ruling, the Court agreed that jail Nurse Marvin Anderson and other County officials were deliberately indifferent to detainee Heather Miller’s serious medical needs, resulting in her death.

Miller, 28, was booked into the Jail on December 20, 2016, and assigned a top bunk in a cell on the second floor. The following day around 6:00 p.m., Miller fell from her bed and landed on the concrete floor. Miller’s cellmate summoned help by pounding on the cell window. Nurse Anderson then arrived at the cell and was informed that Miller—who was still lying on the floor—had fallen from her bed. Miller complained of pain in her side and reported feeling dizzy and nauseous. She also stated that she was “coming off” methamphetamine. Incredibly, Anderson did not take Miller’s vital signs, did not call for a physician, and did not transport her to the medical unit for monitoring.

Miller, unable to walk, had to scoot down the stairs on her butt—one step at a time— to a wheelchair, where she was placed. It was observed that “[h]er body went limp, her head lolled backward and remained there, and her eyes rolled skyward,” according to the complaint later filed on her behalf. Anderson wheeled Miller across the Jail to a one-person cell where he left her—failing again to take Miller’s vital signs, call for a doctor or medical assistance, or even request that she be medically monitored while in the one-person cell. The only “treatment” that the nurse provided to Miller was some Ibuprofen. He then returned to the medical unit to schedule Miller for an appointment with a doctor the following day.

Anderson never checked on Miller, but about an hour later a guard observed Miller in her cell. He saw that she was lying on the floor, naked from the waist down, and had one foot on the toilet. The guard also observed blood on Miller’s chin. The guard phoned the medical unit and reported his observations. Nurse Daniel Layton told the guard that medical intervention was not necessary and Anderson believed that blood on Miller’s chin was not serious.

Despite the nurses’ dismissal of his reported observations, the guard enlisted the assistance of two other guards and wheeled Miller to the medical unit. Miller was cold to the touch, her skin clammy and gray. Her hair was soaked with sweat, and she was in pain. Upon seeing Miller, Anderson “thought she was dead.” The nurse finally called for an ambulance, but while being transported, Miller stopped breathing and entered cardiac arrest. Upon arrival at the emergency room, she lacked a pulse. She was pronounced dead at 10:06 p.m.

Trial and Jury Award

On behalf of herself and Miller’s Estate, her mother, Cynthia Stella Miller, sued Davis County, Sheriff Todd Richardson, Anderson and Nursing Supervisor James Ondricek in federal court for the District of Utah. The case ultimately went to trial on three claims: two claims brought under 42 U.S.C. § 1983 alleging (1) that Anderson acted with deliberate indifference to Miller’s serious medical needs, in violation of her Fourteenth Amendment right to due process before being punished, and (2) that the County was also liable by reason of its deficient policies and training, as provided under Monell v. Dep’t of Soc. Servs., 436 U.S. 658 (1978); additionally, (3) a state-law claim alleged that the County, Anderson, Richardson, and Ondricek had subjected Miller to “unnecessary rigor” in her confinement, in violation of Article 1 § 9 of the Utah Constitution.

At trial, a doctor testified that Miller’s fall resulted in blunt-force trauma that ruptured her spleen, causing her death from internal bleeding. The injury was “very highly treatable,” though, and with “proper assessment and monitoring,” she had a “very high probability of survival.” According to the testimony of a nursing expert, Anderson’s failure to take Miller’s vitals and order routine medical monitoring was a “dereliction of duty.”

Perhaps most shocking was Sheriff Richardson’s testimony that the Jail had no policies, procedures, or protocols for its nurses. In 2012, the state Department of Professional Licensing (DPL) had instructed the Jail to “get rid of” its nursing protocols because they were in conflict with state licensing requirements, and the Jail complied—but never replaced the abandoned protocols with new written policies. The County contended that it had “unwritten nursing protocols for how to treat and monitor detainees in situations like Miller’s.” Yet there was no evidence that the Jail’s nursing staff had ever received any training in those unwritten protocols.

The Jury then awarded Miller’s estate $300,000 against Anderson and $3,850,000 against the County on the Fourteenth Amendment deliberate indifference claims, plus another $3,850,000 against the County on the state law claim. An additional award for Miller’s mother was struck by the district court. Defendants appealed to the Tenth Circuit, which affirmed the verdict and judgment. 

Tenth Circuit Affirms $8,797,376 Judgment

Defendants objected to the exclusion at trial of “impeachment evidence” about Miller’s “drug-use history, prostitution-solicitation history, and mental-health diagnoses,” the Court recalled, as well as “the effects of mental-health diagnoses and drugs on Miller’s life expectancy and earning potential.” In addition to this victim-blaming, the Defendants also objected to evidence that was admitted “about non-constitutional medical standards of care, like nursing standards.” But the Court found no error in any of these evidentiary rulings.

Nor did it sustain an objection that the evidence was insufficient for jurors to find that Miller’s medical need was “sufficiently serious” and that Defendants should have known she faced a “substantial risk of serious harm” which they then “disregarded”—satisfying the objective and subjective prongs of the test for deliberate indifference laid out in Farmer v. Brennan, 511 U.S. 825 (1994).

Monell liability for the County was also supported by sufficient evidence, the Court ruled, to show “a municipal policy or custom involving deficient training” along with “an injury caused by the policy that is ‘obvious’ and ‘closely related,’” so that the County’s adoption of the policy—or lack of policy—demonstrated deliberate indifference, too, as laid out in Valdez v. Macdonald, 66 F.4th 796 (10th Cir. 2023).

The district court had instructed jurors that a violation of internal policy does not necessarily create a federal claim, though it may serve as circumstantial evidence of such. But the Defendants wanted additional instruction that spelled out a warning not to conflate policy violations with deliberate indifference. The district court didn’t think it was necessary, and the Tenth Circuit found no error in that. Nor did it find error in the refusal to instruct jurors that Anderson would be protected by qualified immunity (QI) if he reasonably believed that Miller was suffering withdrawal symptoms. 

“[T]hat reasoning is wrong,” the Court declared. “As we have explained, Anderson could have held a reasonable belief that Miller was withdrawing from methamphetamine while also being deliberately … indifferent to Miller’s serious medical needs related to the fall.” The County also said the state-law verdicts were inconsistent in finding it guilty of violations that were not also imputed to individual Defendants. But the Court said that it “agree[d] with the district court. Utah law has no such requirement.”

The Court also affirmed awards to Plaintiff of $728,256 in fees and $69,120 in supplementary fees for her attorneys, Daniel M. Baczynski of Baczynski Law PLLC, and the Law Offices of Tad D. Draper, both in the town of Draper. See: Stella v. Davis Cty., 2024 U.S. App. LEXIS 28720 (10th Cir.).  

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