by Matt Clarke

On April 21, 2026, the United States Court of Appeals for the Tenth Circuit upheld an Oklahoma federal jury’s judgement and $33 million in compensatory damages against Ottawa County, Oklahoma in a lawsuit over a detainee’s horrific death due to untreated pneumonia that led to sepsis in the county’s jail. Surveillance and body camera video captured jail staff mocking the detainee as he suffered in extreme pain and begged for help.

Terral B. Ellis, II, 26, voluntarily surrendered to the Ottawa County Jail in Miami, Oklahoma on an outstanding DUI arrest warrant. During booking, he reported having asthma for which he required an Albuterol inhaler. A week later, he complained of back pain so severe he thought his back was broken. The jail’s nurse, licensed practical nurse (LPN) Theresa Horn, examined Ellis and told him he “had what appeared to be a dislocated rib” and the jail’s physician’s assistant would see him when he made rounds.

Two days later, Michael Harrington, another person on his pod, noticed that something was extremely wrong with Ellis. He “looked like he was going to drown in his own sweat,” had a racing heartbeat, and said he was in the worst pain of his life and felt like he was going to die. Harrington testified that jail security and medical staff ignored Ellis’s suffering, believing Harrington was trying to help Ellis get released on his own recognizance. Ellis responded, “I’m not lying” and “what are you going to tell my two-year-old son when I die?”

A week later, Ellis reported having suffered a seizure. Jail staff mocked him but nonetheless summoned emergency medical services (EMS). EMS responders documented that Ellis “was stable and nothing acute appeared to have happened.” One responder reported Ellis was “alert” and “oriented” but “sweating profusely” and “complaining about ‘[p]ain in his lower back from falling two days earlier.”

EMS responders were told that Ellis would be “put in a cell and checked on every 15 minutes,” would be seen by a physician in the morning, and EMS would be summoned “if anything changed.” Later, without examining Ellis or even coming to the jail, Horn recommended Ellis be placed in a solitary confinement cell without a bunk, toilet or sink. Staff did so.

This meant Ellis had to sleep on a thin mat on the floor and request permission from staff to leave his cell whenever he needed water or to use the toilet. Yet there was neither an intercom nor a camera in the cell to aid Ellis in getting the attention of the guards. Guards who moved Ellis to the solitary cell noticed that he could not even bend over to retrieve his shoes, walked with a limp, and struggled to move.

Later that day, Ellis asked for an inhaler but guards refused to help him, telling him that was “up to the nurse.” Meanwhile, guards mocked him, referring to Ellis as “the zombie.”

Two hours later, Ellis reported that his legs were numb. A guard laughed about his dilemma but nonetheless called Horn at home. Horn said she would see Ellis in the morning. Later that night, another guard told Ellis there was nothing wrong with him. Staff also ignored his “moaning in distress,” complaining of being unable to breathe and of having an asthma attack the next morning. Even the assistant jail administrator told Ellis to “shut up” when he said he thought he was dying and begged for Albuterol.

Horn also told Ellis to “shut up” and “ain’t a damn fucking thing wrong with you” when she finally checked on him. She dismissed his concerns that his legs were partially paralyzed and discolored black and purple, saying he was colorblind and that they were pink and red. She threatened to have him shackled to the “D-Ring” if he continued to complain, saying she was “tired of fucking dealing with your ass.” Horn never bothered to take his vitals such as temperature, heart rate and blood pressure.

Less than three hours later, a prisoner told staff Ellis appeared to be dying. Horn came and found him on the floor, with a “blank stare” and bluish “mottled” skin that caused pain when touched. EMS arrived and unsuccessfully attempted CPR. His cause of death was septic shock caused by acute bronchopneumonia.

Aided by Tulsa attorneys Robert M. Blakemore and Daniel Smolen, Ellis’s estate filed a federal civil rights lawsuit alleging denial of Ellis’s Fourteenth Amendment right to adequate medical care. During the trial, the only remaining defendant was the Sheriff of Ottawa County in his official capacity (Ottawa). Only compensatory damages were requested.

At trial, the evidence showed that, although the jail’s Medical Services Policy required medical care to be provided by trained personnel under the supervision of a physician and regularly-scheduled sick calls, none of this was the actual practice. Instead, the jail employed a single LPN, Horn, who answered to a physician’s assistant, Aleta Fox, with no physician supervision.

Fox did not regularly visit the jail and Horn screened medical requests for those she deemed important enough to warrant her attention. Horn also diagnosed illnesses, often over the phone, despite not being licensed to do so, and would call Fox when she needed Fox’s advice.

Guards testified they often saw Horn refuse to provide any kind of care to detainees and, contrary to policy, they were not permitted to call EMS services without Horn’s permission. Further, they receive little to no training on the actual medical policies.

Plaintiff’s attorney became emotional, tearing up while video showed staff mocking Ellis and again during closing arguments. He requested a large verdict to deter the county from treating anyone else like they did Ellis in the future or trying to continue a cheap medical system at the jail that saves them money by causing others to suffer.

The jury returned a verdict for the estate for $33 million plus post-judgment interest. The Court also awarded $970,402 in attorney fees and $19,480.54 in costs. The county filed motions for judgment as a matter of law (JMOL), remittitur, and a new trial, all of which were denied. The county appealed.

The Tenth Circuit upheld the denial of the county’s post-judgment motions. The Court also concluded that “‘substantial evidence’—both direct and circumstantial—shows Ottawa knew of a substantial risk of harm to Ellis and failed to take reasonable measures to abate that risk.” See: Stroup v. United Airlines, Inc., 26 F.4th 1147 (10th Cir. 2022). Instead, “staff mocked Mr. Ellis.”

Nurse Horn “threatened him for reporting his symptoms,” implied he was faking his illness, and told him she was tired of dealing with him. Other staff believed Ellis was in a medical crisis. Further, the risk was so obvious that it can be inferred that jail officials knew of it. See: Farmer v. Brennan, 511 U.S. 825 (1994).

The Court also upheld the inadequate training theory, noting that, regardless of what the medical policy said, guards testified to not having seen or received training on the policy and being ordered to adhere to practices, such as getting permission from Horn before summoning EMS, that contravened policy. Thus, Ottawa was not entitled to JMOL.

The Court also held that neither the jury instruction on deliberate indifference, the admission of national and state jail standards, nor the emotion showed by plaintiff’s attorney were sufficient to justify reversal. In doing so, the Court assumed without deciding that counsel’s tearing up amounted to misconduct. It held that any misconduct was cured by the trial court calling a sidebar and giving counsel a minute to collect himself.

Likewise, the Court held that asking for damages for deterrence was not impermissibly asking for punishment. Further, the award was not so excessive as to require remittitur. The verdict was upheld. See: Bond v. Sheriff of Ottawa County, 173 F.4th 1265 (10th Cir. 2026).  

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