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Ivey v. Audrain County

United States District Court, E.D. Missouri, Northern Division

July 16, 2019

DAVID IVEY, Plaintiff,
AUDRAIN COUNTY, et. al., Defendants.



         Mark Ivey died a day and a half after being confined to the Audrain County jail. His father, David Ivey, brings this suit under 42 U.S.C. § 1983 alleging that the defendants - jail officials and jail medical providers - were deliberately indifferent to Mark Ivey's serious medical needs. He also brings claims against Audrain County, and he brings state-law medical negligence claims against the medical providers.

         Mark Ivey (“Ivey”) suffered from asthma and mental health issues and was withdrawing from several controlled substances when he was admitted to the jail. He had initially been taken to the hospital by the arresting officers; he was only admitted to the jail after hospital personnel issued a “fit for confinement” letter indicating, among other things, that he needed an albuterol inhaler every four hours as needed for shortness of breath or wheezing. He died during his second night at the jail, and the coroner ruled that he died of acute asthma exacerbation.

         The government defendants are Audrain County and jail guards Nathanael Atkinson, Richard White and Nicholas Jensen. The three guards were on duty both nights that Ivey was in the jail. The medical defendants are Advanced Correctional Healthcare, Inc., which provides medical services at the jail, and its employees Dr. Shawndra Brown-Foote and nurse Stephanie Hildebrand.

         Numerous factual disputes remain regarding what each defendant knew and what each defendant did about Ivey's medical condition before his death. Disputes also exist about Ivey's cause of death. I will grant summary judgment to Audrain County and Advanced Correctional Healthcare on only the claims that the jail medical policies were deficient, but the claims against both defendants regarding their failure to adequately train the jail guards on medical issues remain. I will deny the pending motions for summary judgment in all other respects, both on the merits and on the correctional officers' arguments for qualified immunity. I will deny without prejudice plaintiff's motion to preclude one of defendant's expert witnesses from testifying to a different cause of death, as at least one part of her proposed testimony appears to be admissible. The case remains set for jury trial on August 12, 2019 in Hannibal.

         Legal Standards

         Summary judgment must be granted when the pleadings and proffer of evidence demonstrate that no genuine issue of material fact exists and that the moving party is entitled to judgment as a matter of law. Fed.R.Civ.P. 56(a); Celotex Corp. v. Catrett, 477 U.S. 317, 322-23 (1986). I must view the evidence in the light most favorable to plaintiff (the nonmoving party) and accord him the benefit of all reasonable inferences. Scott v. Harris, 550 U.S. 372, 379 (2007). Where sufficient evidence exists to support a factual dispute, a jury must resolve the differing versions of truth at trial. Anderson v. Liberty Lobby, Inc., 477 U.S. 242, 248-49 (1986).

         To establish a claim under 42 U.S.C. § 1983 based on deliberate indifference to serious medical needs a plaintiff must demonstrate an objectively serious medical need and that each defendant had actual knowledge of that need but deliberately disregarded it. Barton v. Taber, 908 F.3d 1119, 1124 (8th Cir. 2018). A medical need is objectively serious if it has been diagnosed by a physician or “if it is so obvious that even a layperson would easily recognize the necessity for a doctor's attention.” Id. (quoting Jackson v. Buckman, 756 F.3d 1060, 1065 (8th Cir. 2014)). “To demonstrate that a defendant actually knew of, but deliberately disregarded, a serious medical need, the plaintiff must establish a mental state akin to criminal recklessness: disregarding a known risk to the inmate's health.” Vaughn v. Gray, 557 F.3d 904, 908 (8th Cir. 2009). Whether a serious medical need exists and whether an official was deliberately indifferent to it are questions of fact. Schaub v. VonWald, 638 F.3d 905, 915 (8th Cir. 2011).

         A county such as Audrain County may be liable under § 1983 where an unconstitutional policy has led to the deprivation of a plaintiff's civil rights as well as where its failure to train or supervise its employees leads to the deprivation of rights. City of Canton v. Harris, 489 U.S. 378, 380 (1989). Where a private actor, such as Advanced Correctional Healthcare, is a willing participant in a “joint action with public servants acting under color of state law, ” it can be liable along with the county or municipality. Johnson v. Outboard Marine Corp., 172 F.3d 531, 536 (8th Cir. 1999).

         Contracting out prison medical care does not discharge government of its constitutional obligation to provide suitable medical care to those in its custody. West v. Atkins, 487 U.S. 42, 56 (1988). Private doctors who provide medical services to detainees, even on a part-time basis, act under color of law for § 1983 purposes. Estate of Schwartz v. Assisted Recovery Centers of Am., LLC, No. 4:16 CV 673 JMB, 2017 WL 840542, at *6 (E.D. Mo. Mar. 3, 2017).


         It is undisputed that when Mark Ivey was arrested at a convenience store he was acting strangely, had defecated on himself, and was under the influence of heroin, methamphetamine, fentanyl and methadone. At the emergency room a doctor concluded that he had normal vital signs and normal respiratory effort but had wheezes. He was diagnosed with asthma and drug intoxication and was given a nebulized treatment of albuterol to clear his lungs. The fit for confinement letter issued by the hospital stated that Ivey needed albuterol (two puffs every four hours as needed for shortness of breath or wheezing), Atarax and Xanax (as needed for anxiety), and Zoloft and Seroquel (the letter also said that these two medications had not been refilled for a year, based on pharmacy records).

         The first night at the jail Ivey vomited twice and defecated on himself once. One of the guard defendants monitoring the cell video also saw what he described as seizure-like movements and stated that Ivey appeared stiff and started to slide off the bench. When asked, Ivey told the guards he did not need medical attention; his cell was cleaned and he was given a shower. No. medical personnel were notified of these events that night.

         The next morning nurse Hildebrand saw Ivey; she noted the fit for confinement letter and his heroin use within the last two days. The medical intake questionnaire noted that he had anxiety, asthma and breathing problems and had been hospitalized in the last year. She noted in her records that Ivey complained of cramping, nausea, vomiting two times, decreased appetite, and one loose stool. She and the guard defendants disagree about whether she was told of the seizure- like movements and that Ivey had defecated on himself. She concluded that his symptoms were the early stages of drug withdrawal. She testified that Ivey did not have wheezing or shortness of breath, but what happened with regard to checking his lungs is disputed. Nurse Hildebrand contacted Dr. Brown-Foote, told her of the fit for confinement letter and reported on her exam. The ...

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