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Wheeler explained that defendant had pursued voluntary substance abuse treatment at the Gateway Center in Belleville when he was 16, and that he had also received treatment from centers in St. Louis and the Chicago area. However, defendant received no treatment for substance abuse upon his release from prison in Wheeler had unsuccessfully urged defendant to get more treatment at that time.

Wheeler stated that, when defendant was on drugs, his personality changed and he became loud, rude and disrespectful. Wheeler also told the jury that defendant was the father of two boys, five and four years old, who now live with their mother. Defendant had lived with his sons for at least three years. After closing arguments, the jury concluded that there were no mitigating circumstances sufficient to preclude the imposition of the death penalty. Defendant was sentenced to death. The court subsequently sentenced defendant to two consecutive year prison terms for the attempted murder and armed robbery convictions.

This appeal followed. Prior to trial, defendant filed a motion to suppress the statements which he made to the Belleville police on October 24, In the motion, defendant alleged that the statements were given involuntarily and were obtained in violation of Miranda v. Arizona, and that he had been arrested without a warrant and without probable cause. On appeal, defendant does not contend that the statements which he gave to the Belleville police were involuntary or that his Miranda rights were violated. Instead, defendant repeats his assertion that the police lacked probable cause to arrest him on October At the hearing on defendant's motion to suppress, the State presented the testimony of Belleville police detectives David Ellis and Doug Jones.

Ellis testified that he was called to the Bollingers' trailer at about a. Once at the trailer, he familiarized himself with the background of the case by speaking to the officers who had first arrived at the murder scene. He then began interviewing people who were present in the trailer park. Ellis stated that one of the people he spoke to was Tony Graham, a resident of the trailer park. Graham gave Ellis a description of the person he had seen.

Shortly thereafter, Ellis related this description to another trailer park resident, Kathy Kunkle. According to Ellis, Belleville police officers spoke with Harvey and confirmed that defendant had, in fact, been at Harvey's trailer on the night of October Police officers also noted that Harvey's trailer was located across the street from the Bollingers' trailer. Ellis further testified that, at the time he and Jones were gathering information, he knew that defendant was frequently in the trailer park where the murder was committed. Ellis also stated that, because of previous arrests, he had some familiarity with defendant prior to October 24, Ellis told the court that after speaking with Kunkle, he and Detective Jones went to a convenience store to speak to a relative of defendant in an attempt to locate him.

The convenience store was located about four or five blocks from the Bollingers' trailer. At the time, Ellis and Jones had with them a picture of defendant and a personal history sheet which had been filled out during one of defendant's previous arrests. Ellis stated that, as he and Jones were leaving the store, they saw a man walking down the street who resembled the picture of defendant they had with them. The detectives got into their unmarked car and drove past the man once or twice, discussing between themselves if the man was, in fact, the person in the picture.

They decided that it was. The detectives stopped their car, got out, approached the man and asked him his name. The man told them that his name was Dennis Jones. On defendant's personal history sheet were listed identifying marks such as scars and tattoos. Ellis and Jones noticed that a scar and tattoo listed on the sheet were on the man they had approached.

The detectives then asked the man his birth date. The man gave defendant's date of birth, which was also listed on the personal history sheet. The detectives concluded that the person before them was indeed defendant. They advised defendant that he was under arrest and transported him to the Belleville police station.

Ellis stated that defendant was arrested at about a. Detective Jones also testified at the suppression hearing. Jones' testimony corroborated Ellis' description of defendant's arrest near the convenience store. Ertl, Ill. In addition, the special concurrence concludes that, even though the State introduced the testimony of Detectives Ellis and Jones concerning their investigation of the crimes and the events preceding defendant's arrest, probable cause was not litigated at the suppression hearing. We disagree. Defendant's motion to suppress plainly asserts that he was arrested without a warrant and without probable cause.

The State, on appeal, expressly acknowledges that defendant was arrested without a warrant. Further, in its brief before this court, the State argues only that defendant was arrested with probable cause. The State does not contend, in any way, that defendant failed to establish a prima facie case that his arrest was unlawful, or that defendant otherwise forfeited his right to challenge the legality of his arrest before this court.

Thus, the State has conceded that defendant met his prima facie burden and that probable cause was litigated at the suppression hearing. Indeed, the testimony of Ellis and Jones would have been unnecessary and irrelevant if the only contested issue was the voluntariness of defendant's statements given at the police station. We see no reason to disregard the State's concessions, particularly when those concessions coincide with defendant's characterization of the proceedings below.

Accordingly, we address the issue of the legality of defendant's arrest as framed by the parties to this appeal, i. To effect a valid, warrantless arrest, a police officer must have probable cause to arrest. Beck v. Ohio, U. Kidd, Ill. Probable cause to arrest exists where the facts and circumstances known to the police officer at the time of the arrest are sufficient to warrant a person of reasonable caution to believe that an offense had been committed and that the offense was committed by the person arrested.

People v. Lippert, 89 Ill. Mere suspicion is inadequate to establish probable cause to arrest, but the evidence relied upon by the arresting officers does not have to be sufficient to prove guilt beyond a reasonable doubt. The existence of probable cause is determined by the totality of the circumstances at the time of the arrest. Tisler, Ill. Gates, U. Williams, Ill. Further, a determination of probable cause is governed by commonsense, practical considerations, and not by technical legal rules. Buss, Ill. Because the present case involves the application of the law to undisputed facts, our standard of review is de novo.

Krueger, Ill. After examining the totality of the circumstances known to detectives Ellis and Jones at the time defendant was apprehended, we conclude that the officers had probable cause to effectuate an arrest. The record in the case at bar shows that the detectives, while investigating a brutal murder and attempted murder, canvassed the Bollingers' trailer park in an attempt to gather information about the crimes.

The only known witness to the murder, Jacob Bollinger, was hospitalized with head injuries and incoherent when Ellis and Jones began their interviews. The detectives were initially given a physical description of a suspect by a neighbor, Tony Graham, who reported seeing someone in the Bollingers' trailer. When the detectives gave this description to another neighbor, Kathy Kunkle, she provided them with defendant's name. Both Graham and Kunkle provided information in their capacity as ordinary citizens.

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Neither Graham nor Kunkle was an anonymous informant or a paid, criminal informant. See Kidd, Ill. Moreover, there is no indication in the record that Graham and Kunkle were biased against defendant in any way. At the time of defendant's arrest, Ellis and Jones also knew that defendant frequently visited the trailer park.

They knew specifically that defendant had been across the street from the Bollingers' trailer hours before the murder occurred. The detectives located defendant, unexpectedly, four or five blocks from the murder scene hours after the murder had taken place. When the officers approached defendant on the street, he gave them a name which they knew to be false.

See People v. Williams, 79 Ill. Considering the totality of the circumstances set forth above, we believe that Ellis and Jones had probable cause to arrest defendant. Defendant argues, however, that certain facts known to the detectives at the time of the arrest must be discounted from our probable cause analysis. Citing to case law which held that a suspect's presence near a crime scene, by itself, is insufficient to establish probable cause see, e. Carnivale, 61 Ill. As the State points out, however, defendant was not arrested based solely on his presence near the crime scene.

In addition, we know of no reported decision which holds that a suspect's proximity to a crime scene is irrelevant to establishing probable cause to arrest. Accordingly, we determine that defendant's location both before and after the murder may properly be considered as factors in determining whether Ellis and Jones had probable cause to arrest defendant. Defendant also argues that Kathy Kunkle's identification of defendant must be discounted from our probable cause analysis because the State has failed to adequately explain how she arrived at defendant's name.

Defendant asserts that, at the suppression hearing, the State offered no evidence of the specific description given by Tony Graham to the police of the man he saw in the Bollingers' trailer. United States, U. The basis of knowledge inquiry is not a separate or independent test which must be satisfied in order to establish probable cause. Rather, an informant's basis of knowledge is simply a relevant factor to be considered as part of the totality of the circumstances known to police at the time of the arrest.

Adams, Ill. In the case at bar, the evidence shows that Kunkle's identification of defendant was not based on casual rumor. To the contrary, the evidence of record shows that Kunkle had personal knowledge of defendant, and that she provided Ellis and Jones with defendant's name only after the officers had relayed Graham's description to her. Wilson, Ill. Moreover, under the totality of the circumstances approach to establishing probable cause, an imperfect expression of the basis of knowledge may nevertheless suffice to establish probable cause when considered together with the other relevant facts known to the police at the time of the arrest.

As stated, Kunkle's identification of defendant was not the sole relevant factor under consideration by the police. The law requires us to consider Kunkle's identification of defendant as part of the totality of the circumstances known to the police at the time of the arrest, and to review all the known circumstances in a practical, nontechnical way.

After carefully considering the evidence of record, we have determined that Detectives Ellis and Jones had probable cause to arrest defendant. Accordingly, we hold that the circuit court properly denied defendant's motion to suppress. Defendant's trial took place in September In July , a fitness hearing was conducted before a separate jury.

During the hearing, the State presented the testimony of two witnesses, Dr. John Rabin and Delancey Moore.

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Rabin, a forensic psychiatrist, testified that he had tried to examine defendant in May At other times, defendant made comments of a religious nature. Rabin terminated this interview after about 20 minutes. Rabin attempted a second examination in June of , but defendant would not leave his cell to meet with Rabin. Because of defendant's refusal to cooperate, Rabin stated that he was unable to render an opinion as to whether defendant was fit to stand trial. Rabin also testified that it was possible that defendant was malingering, or faking a psychological disorder, during his examinations.

Moore, a classification specialist in the St. Clair County sheriff's department, testified that he was in charge of determining the housing and placement for all inmates in the county jail, and that he was the chair of the jail's disciplinary committee. Moore stated that, as a general matter, he would not hold a disciplinary hearing unless the inmate understood the nature of the charges and proceeding. Moore explained that he had dealt with defendant at disciplinary proceedings in the county jail in April , and in June During the April proceedings, defendant had requested that a witness be called on his behalf.

According to Moore, defendant was competent, aware of his surroundings, and cognizant of the nature of the proceedings in both April and June. Defendant's mother and grandmother testified on defendant's behalf during the fitness hearing. Both women stated that defendant's mental condition had deteriorated since his incarceration, that he was frequently unable to recognize them, and that he suffered memory lapses.

Defendant also presented the testimony of clinical psychologist Dr. Michael Gelbort. Gelbort stated that he examined defendant during two minute sessions in March During these sessions, defendant was largely uncommunicative and unresponsive, but he also engaged in consistent delusional behavior.

According to Gelbort, most of defendant's words and conduct appeared to be in response to his own internal thoughts. Defendant mumbled to himself, spit and stomped on the floor to get rid of imaginary bugs, and repeatedly asked for cigarettes despite Gelbort's statements that he had none. Defendant also indicated that he was hearing voices, and spoke of God and other matters in a jumbled manner. Based upon his examinations of defendant, as well as discussions with jail personnel, Gelbort determined that defendant was unfit to stand trial.

Gelbort was cross-examined at length regarding the basis of his conclusion that defendant was unfit, and about the possibility that defendant was malingering. During the State's cross-examination of Gelbort, the State sought to have Gelbort read the charging indictment. The objection was overruled. At the conclusion of the fitness hearing, the jury found defendant fit to stand trial. Defendant now argues that the circuit court erred when it permitted Gelbort to read the indictment before the jury, and that as a result of this error, a new fitness hearing and a new trial are required.

The State, in response, correctly observes that this argument is procedurally defaulted because defendant failed to include it in his post-trial motion. Enoch, Ill. Shaw, Ill. Wade, Ill. Initially, we note that the scope of defendant's argument regarding the indictment is somewhat unclear. In his opening brief, defendant appears to argue only that it was error to allow the jury to hear about the manner in which JoAna Bollinger was murdered, i.

In his reply brief, however, defendant states that the jury should not have been told that defendant was charged with murder at all. We do not believe that defendant may assert this latter argument. At several times during the fitness proceedings, the members of the jury were told that defendant had been charged with murder. Some of these occasions were initiated, or acquiesced in, by defense counsel. For example, during the questioning of the prospective jurors for the fitness hearing, a concern was raised about the publicity which defendant's case had received.

The following colloquy then occurred:. And I believe we'd have to probably, in conjunction with that, probably mention that the-names of the alleged victims here. And it would seem to me a little follow up question for any juror who is considering the question of whether they heard anything as to what it is we are talking about. Does that mean that we need describe anything other than the First Degree Murder charge?

In light of the foregoing, defendant cannot now contend that, because the indictment stated that defendant was charged with murder, the trial court erred when it permitted the indictment to be read before the jury. See, e. Abston, Ill. Defendant's remaining argument is that his fitness hearing was irreparably tainted by the fact that the jury heard that JoAna Bollinger had been murdered by strangulation.

In defendant's view, the circumstances of the victim's murder were irrelevant to the question of whether defendant understood the technical, legal charges against him. In addition, according to defendant, there is a strong possibility that, when the jury heard that JoAna Bollinger had been strangled, the jury lost its focus on whether defendant was fit to stand trial, and instead improperly focused on the nature of the crime.

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Thus, defendant argues that he is entitled to a new fitness hearing and new trial. Even if we assume that the circumstances of JoAna Bollinger's murder were irrelevant to determining the question of defendant's fitness, the admission of those circumstances was clearly harmless. Before Gelbort read the indictment, the jury knew that JoAna Bollinger had been murdered, and knew, obviously, that the murder had been committed in some manner.

No graphic or inflammatory details of the murder were included in the indictment. Under the facts of this case, we find that no reversible error occurred when the indictment was read before the jury. Consequently, we also find no plain error. Keene, Ill. In August, , the State filed a motion in limine to bar the defense from pursuing an area of impeachment during the cross-examination of the State's DNA expert witness, Phillip Sallee. According to the State's motion, the terms of the predisciplinary agreement required Sallee to perform a period of community service, to be suspended from work for a period of time without pay, and to forfeit vacation benefits.

Before this court, defendant contends that the circuit court erred when it barred the defense from impeaching Sallee with evidence of the predisciplinary agreement, and that this error requires reversal of his convictions and a new trial. The State initially maintains that this issue is procedurally defaulted because defendant failed to preserve the objection to the motion in limine in his post-trial motion. See Enoch, Ill. Defendant, in turn, responds that the circuit court's denial of his right to cross-examine Sallee rendered his trial fundamentally unfair and that this court may review the issue as plain error.

For the reasons set forth below, we find no error in the trial court's granting of the State's motion in limine. Accordingly, we also find no plain error and no basis to excuse defendant's procedural default. In criminal proceedings, a defendant has the right to cross-examine a witness regarding the witness' biases, interests or motives to provide false testimony. Triplett, Ill. Mason, 28 Ill. Phillips, 95 Ill. Therefore, the evidence used to establish bias, interest or motive should be timely, unequivocal and directly related.

In People v. Bull, Ill. In Bull, the State filed a motion in limine to bar the defense from cross-examining David Metzger, an employee of the Illinois State Police crime laboratory, regarding his administrative disciplinary record. Like Sallee, Metzger had been caught stealing a microscope and had been subject to various disciplinary measures by his employer. The circuit court granted the State's motion. This court rejected that argument, stating:. The catecholamine-mediated hypermetabolic response to severe burns causes increased energy expenditure and muscle-protein catabolism.

Twenty-five children with acute and severe burns more than 40 percent of total body-surface area were studied in a randomized trial. Thirteen received oral propranolol for at least two weeks, and 12 served as untreated controls. The dose of propranolol was adjusted to decrease the resting heart rate by 20 percent from each patient's base-line value. Resting energy expenditure and skeletal-muscle protein kinetics were measured before and after two weeks of beta-blockade or no therapy, in controls. Body composition was measured serially throughout hospitalization.

Patients in the control group and the propranolol group were similar with respect to age, weight, percentage of total body-surface area burned, percentage of body-surface area with third-degree burns, and length of time from injury to metabolic study. In children with burns, treatment with propranolol during hospitalization attenuates hypermetabolism and reverses muscle-protein catabolism. The hypermetabolic response to severe burns is associated with increased energy expenditure and the release of substrate from protein and fat stores.

After severe trauma, the rate of protein catabolism is increased, leading to the loss of lean body mass and muscle wasting. Endogenous catecholamines are primary mediators of the hypermetabolic response to trauma or burns. This study was approved by the institutional review board of the University of Texas Medical Branch, and written informed consent was obtained from each patient's parent or guardian. Children could be enrolled if they were less than 18 years of age, had burns on more than 40 percent of their total body-surface area, and had been transferred to our hospital within one week after injury.

Patients with a history of asthma were excluded. Within 48 hours after admission, each patient underwent burn-wound excision and grafting with skin autografts and allografts. The patients returned to the operating room in 6 to 10 days, when the autograft sites had healed. Sequential staged grafting procedures were performed until the wounds were closed. The patients were fed a commercial enteral formula Vivonex T.

The daily caloric intake was calculated to deliver kcal per square meter of body-surface area burned plus another kcal per square meter of total body-surface area. Enteral nutrition was started at admission and continued until the wounds healed. The patients remained in bed for five days after excision and grafting procedures, after which they were allowed to walk daily until the next excision-and-grafting procedure.

From January through December , 25 patients were enrolled in this prospective, randomized trial. Thirteen received propranolol, and 12 served as untreated controls. Randomization was performed with use of a random-number—generating scheme. On the fifth day after the first surgical procedure, all patients underwent metabolic examination. Resting energy expenditure and net protein balance across one of the patient's legs randomly determined were the main outcome variables.

In addition, all patients underwent whole-body potassium scanning at base line to determine the fat-free mass.


Immediately after the next operation, the patients in the propranolol group began to receive propranolol by nasogastric tube at a dose of 0. This dose was adjusted to achieve a 20 percent decrease in the heart rate of each patient, as compared with the hour average heart rate immediately before drug treatment. Heart rate and blood pressure were monitored continuously throughout the study. When the mean blood pressure fell below 65 mm Hg, the dose of propranolol was withheld or decreased.

The dose was then increased incrementally to meet the study goal of a decrease in heart rate by 20 percent from established base-line levels as tolerated. Propranolol was given as scheduled during surgical procedures. Two weeks after treatment was started, a second series of metabolic and protein-kinetics studies was performed. Patients who had received at least a four-week treatment course underwent a second measurement of whole-body potassium. At discharge, the patients underwent body-composition scanning with use of dual-image x-ray absorptiometry.

Temperature, heart rate, and systolic and diastolic blood pressure were measured hourly with use of a standard bladder-temperature monitor, electrocardiographic monitor, and arterial catheter, respectively. The average for each hour period was determined. The heart rate was compared between groups for the duration of the study. Other analyses of changes with treatment were made between groups with data gathered on the day of the stable-isotope study.

Serum levels of glucose and potassium were determined Stat-5 analyzer, Novel Biomedical, Waltham, Mass. On the same morning, serum levels of insulin-like growth factor I were determined by ethanol extraction, and serum levels of growth hormone, cortisol, and insulin were determined by enzyme-linked immunosorbent assay or enzyme immunoassay Diagnostic Systems Laboratories, Webster, Tex. Infection was defined throughout hospitalization by the presence of burn sepsis, which we have previously described. On the fifth day after the first and third operations, all patients underwent a five-hour protein-kinetics study, as previously described, 18 while receiving a continuous feeding.

Biopsy of the vastus lateralis muscle of the study leg was performed two and five hours after the commencement of the infusion. To determine blood flow in the leg, indocyanine green was infused into the femoral artery. Cross-leg amino-acid kinetics were calculated according to a three-compartment model described by Biolo et al.

The blood levels of unlabeled phenylalanine and its isotopic counterpart were simultaneously determined by gas chromatography—mass spectrometry with the use of the internal-standard approach and N -methyl- N - tert-butyldimethylsilyl trifluoroacetamide, as previously described. Each sample was weighed, and protein was precipitated out with 5 percent perchloric acid solution. An internal standard containing 5. The level of bound-protein precipitate was determined by comparison with a set of isotopically labeled phenylalanine dilution-calibration standards, with correction for the various weights of the labeled compounds.

We calculated the fractional rate of synthesis of skeletal-muscle protein by determining the rate of incorporation of labeled phenylalanine into protein and then measuring the level of bound protein in the intracellular pool, as previously described. The fat-free mass was determined by whole-body potassium scintillation counting in a heavily shielded counting room with a low level of background noise, a 32 NaI detector array, and a computed data-analysis method that has been validated for use in children.

Feeding and intravenous fluids were discontinued during the studies to minimize exogenous potassium contamination. The total-body lean mass and fat mass were measured with use of a dual-image x-ray absorptiometer model QDRW, Hologic, Waltham, Mass. This system has a minimal mean error rate with respect to the measurement of fat-free mass in children.

The distribution of the data was normal, and the degree of variation within individual subjects was similar. We did not control for differences between the groups in sex, age, or weight. Two-sided paired t-tests were used to compare data within groups. Comparisons between groups were made by unpaired t-tests. Fisher's exact test was used for frequency data. P values of less than 0. The characteristics of the patients are shown in Table 1. One of the 25 patients chose not to participate in the stable-isotope studies. Three patients two in the control group and one in the propranolol group were fully healed and discharged before receiving four weeks of treatment.

These subjects did not undergo a second whole-body potassium-counting study. Heart rate and blood pressure were measured hourly. No clearly established law guaranteed a prisoner's right to treatment for infertility, erectile dysfunction, or retrograde ejaculation. Michtavi v. Scism, , U. Lexis 3rd Cir. A transsexual prisoner claimed that defendant prison officials acted with deliberate indifference to her serious medical needs by refusing to provide hormone replacement therapy for her Gender Identity Disorder GID.

The plaintiff's claims against the defendants in their official capacities were barred by sovereign immunity. The defendants in their individual capacities were entitled to qualified immunity because the evidence, even viewed in the light most favorable to the plaintiff, did not show an Eighth Amendment violation. The appeals court noted that "numerous" mental health professionals had evaluated the plaintiff, but that none of them reached a diagnosis of GID or stated that GID treatment was appropriate.

The fact that the plaintiff disagreed with their medical judgment was no basis for a federal civil rights claim.

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Reid v. Griffin, , U. An Illinois state inmate claimed that a prison's medical staff were deliberately indifferent to the results of 11 blood tests it administered over a period of five years, during which he progressed from pre-diabetic to diabetic, even failing to tell him, until the last test, that his blood glucose levels were dangerously high.

A federal appeals court held that the allegations, if true, did constitute deliberate indifference to a serious medical need. The two-year statute of limitations would have tolled between the time he discovered that he was diabetic and when he filed suit, since he was then engaged in exhausting available administrative remedies as required by the Prison Litigation Reform Act. Nally v. Ghosh, , F. An insurer had no duty under a Commercial Umbrella Liability policy to defend or indemnify a private corporation operating a prison against claims that an inmate's death was caused by the failure to provide needed medications, as this fell under a professional liability exclusion in the policy.

It did, however, have a duty to defend and indemnify the defendant on this claim under a Commercial General Liability policy, and was not required to do so under a Commercial General Liability policy because of an exclusion for providing medical services.

Lexington Ins. A female prisoner who was pregnant when she arrived at a county jail claimed that the jail employees were deliberately indifferent in failing to take a proper medical history, failing to respond to several requests for medical assistance, and failing to react quickly enough when she went into labor. As a result, she further claimed, her child suffered serious birth defects. She was taken to a hospital where she gave birth and then returned to the jail where she was transferred to another facility after four days.

The trial court erred in dismissing the lawsuit for failure to exhaust available administrative remedies at the jail. Even had she been informed upon her return to the jail from the hospital that he had only four days to file a grievance, that time period would have been an unreasonable deadline to impose on a woman right after she gave birth to a severely impaired child.

White v. Bukowski, , F. A pretrial detainee who saw medical staff members 26 times during 18 months of detention failed to show deliberate indifference to his serious medical needs or that he was deprived of essential medical care despite his allegations that he did not receive the medications that he had been prescribed before confinement, as the medications he brought with him were confiscated. He did receive the medications prescribed for him by a physician's assistant at the detention center, including an opioid pain medication similar to Vicodin. A two-day delay in the distribution of his pain medication may have been negligent, but did not constitute deliberate indifference.

Burton v. Downey, , U. A county detention center employee saw a newly arrived prisoner put something in his mouth and swallow, and conveyed her observation to deputies who had started the booking procedure. The prisoner was sweating profusely, and appeared to be under the influence of something. While being questioned, he had trouble standing and his demeanor deteriorated. He stated that he had high blood pressure, rheumatoid arthritis, gout, osteoporosis, and an MRSA infection.

He denied alcohol or drug addiction and listed several prescription medications. A licensed practical nurse examined him and instructed the deputies to admit him to the facility despite his condition. While he was placed on suicide watch, there was no evidence that he was evaluated for suicidal ideation, that he received blood pressure medication, or that facility nurses questioned why his blood pressure dropped even in the absence of medication.

Three days after arriving, he died from MRSA complications. A federal appeals court reinstated a claim for inadequate medical care, finding that the variety of medical conditions found that required treatment and care easily met the objective component of the deliberate indifference standard. The court also found that a reasonable jury could conclude that the medical contractor's failure to provide adequate training and supervision to the nurses could constitute deliberate indifference to the risk of the potential unconstitutional behavior by licensed practical nurses who lacked the essential knowledge and preparation to respond to prisoners' recurring medical needs in a jail setting.

Shadrick v. Hopkins Cnty. A prisoner who claimed that a prison doctor was negligent in treating his hepatitis was not entitled to summary judgment when he did not even attempt to establish the amount of damages that he claimed he was entitled to. Establishing damages was an essential element of his state law claim. The court committed no error in failing to have the trial proceedings recorded by a court reporter when it informed the plaintiff that one was not then available. The plaintiff also failed to show that the trial judge exhibited bias or prejudice towards him.

Jameson v. Desta, D, Cal. Lexis A prisoner failed to show that prison officials were aware of a substantial risk of harm to him in the time leading up to his injuries in a prison riot to impose liability. But he did adequately show a basis for moving forward on an Eighth Amendment claim relating to his alleged conditions of confinement in the hospital for his injuries for a three day period. A deputy warden was not entitled to qualified immunity, as it was clearly established that forcing a prisoner to soil himself over several days while chained in a hospital bed could create an "obvious health risk," and constituted "an affront to human dignity.

Brooks v. Warden, , U. A doctor at a prison infirmary prescribed Vicodin, crutches, and a week of "meals lay-in" after a prisoner felt a "pop" and extreme pain in his left ankle while climbing stairs. The medical director noted in the prisoner's medical file that he had suffered an "Achilles tendon rupture" and directed that he "urgently" be scheduled for an MRI and an examination by an orthopedist.

Three appointments were cancelled, however, as a result of prison lockdowns, and eight weeks passed before the prisoner received an orthopedic boot. Over a year later, the prisoner claimed that he still suffered serious pain, soreness, and stiffness in his ankle, and that the medical director was deliberately indifferent by failing to immediately after the injury immobilize the ankle with a cast or orthopedic boot.

He also claimed that a doctor he saw later was deliberately indifferent by failing to order physical therapy for him. The trial court had found that waiting before immobilizing the ankle was not deliberate indifference, since several doctors held different opinions about the appropriate treatment and that a jury could not reasonably find the rejection of a recommendation for physical therapy to constitute deliberate indifference, since it was based on medical judgment.

The appeals court agreed that a jury could not reasonably find the treatment of the ankle injury to be a constitutional violation. An inmate suffered from gastroesophageal reflux disease GERD , which can cause severe heartburn. When he arrived at the prison, he stated that he took prescription medication for the condition. He asked a nurse to get his prescription renewed, but an appointment to see the doctor the next day for that purpose was cancelled because of a prison lockdown. He filed an emergency grievance, but the warden decided that it was not an emergency, so that he could not see the doctor until the lockdown ended.

He complained about his condition for two months to no avail until he saw a doctor, and once pressed an emergency button upon vomiting stomach acid. A federal appeals court reversed a grant of summary judgment to the defendants on the prisoner's deliberate indifference lawsuit, finding that the trial judge had engaged in "medical speculation" rather than evidence in concluding that there was no deliberate indifference. Miller v. Campanella, , F. An Illinois prisoner who completed his rape sentence continued to be confined civilly as a sexually violent offender.

He suffers from a number of medical conditions—carpal-tunnel syndrome, pain in his hips and back lingering from past injuries, flat feet, and ligament damage in one foot—that, he says, prevent him from climbing to the top bunk in his cell. During a previous incarceration, he had a low-bunk permit but a doctor at his present facility refused his request to authorize a similar permit, which he claimed forced him to sleep on the floor of his cell. He sued the doctor for deliberate indifference to his serious medical needs and the jury returned a verdict for the defendant. On appeal, the court rejected an argument that the trial judge should have declared a mistrial when the doctor violated a pretrial order by mentioning to the jury that the plaintiff had been incarcerated for 26 years, noting that the jury could already infer from the plaintiff's testimony and his medical issues going back at least 13 years that he had been in prison a long time.

Lochard, , U. Upholding a judgment for prison medical staff in a lawsuit the plaintiff brought concerning their cutting off of his methadone treatment while incarcerated, a federal appeals court held that it wss an error to instruct the jurors in a prison medical care case to defer to the adoption and implementation of security-based prison policies absent a plausible connection between the prison's narcotics policy and the challenged decision to cut off the treatment.

The error was harmless, however, as the policy did not categorically prevent the plaintiff from receiving methadone. Chess v. Dovey, , U. A prisoner serving a day sentence for marijuana was moved to a padded cell in a manic state after he beat on the walls of his cell. That night, the staff merely viewed him through a monitor camera, despite a supposed obligation to conduct in-person checks for an affirmative response four times an hour. He fell and hit his head first against a wall and then on a door jamb. Staff members allegedly did not open the cell door despite him complaining that he had injured his head and required medical attention.

In the morning, attempts to wake him were unavailing, and he died in a hospital three days later, as a result of a subdural hematoma caused by his falls. A sergeant and a lieutenant were denied qualified immunity on claims for deliberate indifference as a jury could infer that they were aware of a substantial risk of serious harm but failed to respond appropriately.

A third defendant employee, a case manager, was entitled to qualified immunity as her actions constituted, at most, negligence, rather than deliberate indifference. Farnsworth, , F. An inmate injured his hand during a prison basketball game. While a nurse quickly wrapped his hand, she was not able to either give him medicine or do stitches. A day later, the inmate saw a doctor who also did not stitch his wound, but prescribed antibiotics and recommended a specialist.

Approval for seeing a specialist took a number of days, during which the wound remained open and bleeding. The prisoner filed a grievance, which was rejected, arguing that the delay was retaliatory for him having filed a previous grievance over the withholding of prescription medication. He was then taken to a clinic where he saw a physician's assistant, who stated that he could not suture the wound because of its age. The inmate claimed that prison officials did not follow care instructions after that and did not return him to the clinic for follow-up care.

Seven months later, he still had continuing pain, and then had surgery. He claims that due to an overall ten-month delay in getting required treatment, he suffered irreparable damage. The trial court dismissed his lawsuit after screening it, and a federal appeals court reversed, finding that the alleged facts stated both valid Eighth Amendment and First Amendment retaliation claims. Perez v. Fenoglio, , U. Death row inmates at a new prison that has no air conditioning claimed that the heat they were exposed to during the summer violated their Eighth Amendment rights because of their pre-existing medical conditions and disabilities, including hypertension, obesity, diabetes, depression, and high cholesterol.

A federal appeals court upheld a trial court finding of deliberate indifference constituting an Eighth Amendment violation, as the heat put the plaintiffs at substantial risk of serious harm, but found that an injunction issued requiring the installation of air conditioning throughout death row was overbroad under prior precedent and the Prison Litigation Reform Act, 18 U. The appeals court upheld the rejection of the disability discrimination claims, however, as the prisoners failed to present evidence to prove that they were disabled.

Ball v. LeBlanc, , U. He further asserted a claim for deliberate indifference to his medical needs. A federal appeals court found that the plaintiff successfully alleged facts sufficient to go forward on his Sabbath and cell assignment claims, and the fact that he received some medical treatment for some of his various symptoms did not defeat his deliberate indifference claim when he alleged that some symptoms were not treated at all.

The appeals court reversed the summary dismissal of the wine communion claim, as the plaintiff did not have the opportunity to submit a brief on whether the wine ban substantially burdened the exercise of his religion and the record did not show that the total ban on wine consumption during communion was the least restrictive means of furthering the prison's asserted security interest. Jehovah v. Clarke, , U. A prisoner suffered symptoms of acute appendicitis, and was sent to a hospital emergency room the following day based on the recommendation of the prison doctor. The officer who accompanied the prisoner initially refused to remove his restraints, allegedly causing a 45 minute delay in treatment.

The prisoner allegedly suffered nerve damage to his leg during the surgery, and the prison doctor allegedly subsequently decline to prescribe Neurontin for pain from the nerve damage, a medication that other doctors indicated was necessary. A federal appeals court found that the defendants the prison doctor and correctional officer had waived possible qualified immunity defense by failing to assert them in an answer to the complaint.

Allowing them to assert that defense at this point in the proceeding, after discovery issues had been litigated for a number of years would unduly prejudice the plaintiff. Henricks v. Gonzalez, , U. A prisoner who was allegedly injured during a violent scuffle with correctional officers sued two prison staff nurses for deliberate indifference to his serious medical problems.

The nurses were improperly granted summary judgment, as the prisoner claimed that he told them that he was in pain and that his jaw was broken. If that were true, it would be obvious even to a lay person that they should have at least examined his jaw. There were disputed factual issues as to whether he had, at the time, been barely able to speak or open his mouth. Perry v. Roy, , U. A prisoner reported symptoms of constipation and gas and received treatment for those problems for about two weeks, after which he suffered a bowel obstruction and perforation, requiring emergency surgery to repair his bowel and install a colostomy bag.

Rejecting a federal civil rights claim for inadequate medical care, a federal appeals court agreed that the prisoner had shown that the medical staff had failed to properly diagnose his bowel obstruction and that the failure to treat it led to the bowel perforation, but he failed to show that they acted with deliberate indifference to a known serious medical problem. Allard v. Baldwin, , U. Corizon Health, a private medical firm which services more than , inmates in 27 states, along with a California county, reached a settlement in a lawsuit based on the death of a man detained in the county jail for failing to appear in court on a warrant for drunken driving after being arrested for jaywalking.

The decedent's family claimed that the firm's employees failed to properly diagnose the detainee, who was suffering from alcohol withdrawal delirium tremens with hallucinations and had allegedly been beaten by 10 deputies at the jail, as well as shocked with a Taser in the dart mode, first for two cycles or ten seconds, and then for at least 27 more seconds in five separate sessions. The lawsuit further claims that the detainee should have been hospitalized for the alcohol withdrawal. An unsupervised licensed vocational nurse, instead of an RN, did the medical screening of the decedent when he was placed in custody at the jail.

The county sheriff stated that the decedent had, before his death, attacked jail officers, after acting erratically, making a mess of his cell, breaking food trays, screaming, and blocking a toilet. Harrison v. February 27, Prior decisions in the case are M. County of Alameda, cv, U. Lexis N. An inmate stated a plausible claim of deliberate indifference against a doctor when he alleged that the doctor had failed to enter the orders needed to provide him with the promised medical care including prescribed tests and treatment for a serious heart condition.

It could fairly be inferred, since that doctor had prescribed those tests and treatments, that he subjectively believed that they were necessary and therefore must have known that failure to follow through and provide them could pose an excessive risk to the inmate's health. Claims against a second doctor boiled down to a mere disagreement over the proper medical care to provide. Lightsey, , U. He suffered from bipolar schizoaffective disorder. The cause of death was severe hyponatremia low sodium-blood levels , which is treatable if medical assistance is quickly provided. When the prisoner was found lying face down on the floor, officers believed that he was intentionally refusing to respond, and they dragged him out, took off his clothes, chained him to a chair, and placed a mask over his head.

They watched the seizures, apparently thinking that he was faking. He ultimately died lying on the concrete floor in his underwear. Three prison employees were fired and five others disciplined after the death. Lopez v. Wasko, cv, U. Click here to see the complaint. Click here to see an edited video of the death.

An Illinois prisoner slipped on some wet stairs and injured his back. He had previously used those steps while showering and had, one month before, alerted the warden to the fact that the stairway could be "treacherous" as a result of the water tracked onto the stairs from nearby showers. He sued the warden for alleged deliberate indifference to the hazard and a private company and one of its doctors, under contract to provide medical care at the facility, for alleged inadequate care for his back injury, neglecting to investigate his ongoing, significant pain.

A federal appeals court found that the stairway hazard was insufficiently dangerous to support an Eighth Amendment claim. The medial deliberate indifference claim was also rejected, as a reasonable finder of fact could not, from the evidence submitted, find anything more than a mere disagreement about the appropriate course of treatment for the back injury.

Pyles v. Fahim, , F. UPDATE: An anatomically male prisoner in their mid-sixties suffering from gender identity disorder and self-identifying as a female sued the Massachusetts Department of Corrections for not providing her with sex reassignment surgery. It was providing her with hormonal and other medical treatments. A prior federal appeals court panel decision held that the plaintiff was entitled to taxpayer-funded sex change operation, and that refusing to provide the procedure would violate the Eighth Amendment.

The request for sex reassignment surgery, the panel stated, was based on a serious medical need, and the defendant correctional department refused to meet that need for reasons amounting to a pretext that were not supported by any legitimate penological interests. Kosilek v. The full federal appeals court, ruling en banc, reversed, finding that, in light of the community standard of medical care, the adequacy of the already provided treatment, and various concerns related to safety and prison security at the medium-security facility where the prisoner was incarcerated, the care currently provided did not violate the Eighth Amendment.

A man claimed that he had been denied needed medical care for a pre-incarceration abdominal bullet wound during his nine months as a pretrial detainee in a county jail. The trial court dismissed the lawsuit for failure to properly exhaust available administrative remedies as there was no record of his having filed a grievance. He testified that he had never received or been allowed access to a copy of the jail's grievance procedure, while acknowledging that he knew of the existence of the procedure from other prisoners. He also stated that he had asked a guard for a grievance form, but never received one.

There was testimony from another prisoner who overheard the plaintiff ask for a grievance form. There was also evidence that the plaintiff met with the warden, who promised to "take care" of the problem and speak to the medical staff, but allegedly did not suggest filing a grievance. The federal appeals court reinstated the lawsuit. When a jail official invites noncompliance with a grievance procedure, the detainee is not required to follow the procedure.

Swisher v. Porter Cnty. Sheriff's Dep't. In a prisoner's lawsuit claiming that correctional officers used excessive force in restraining him, a federal appeals court reversed a grant of summary judgment on claims against one officer, as he had exhausted available administrative remedies against that defendant. The law did not require the jury instruction given that it was established that he had resisted the officers because he was found guilty of resisting in a disciplinary hearing , and the plaintiff was prejudiced on his claims that were tried by the instruction given, so the judgment based on a jury verdict for the remaining defendants was vacated.

Wilkerson v. Wheeler, , U. A prisoner claimed that he experienced excruciating pain from large and protruding keloids scar tissue growths on his hips, chest, and legs. He further claimed that he tested positive for a stomach infection from the bacterium helicobacter pylori, and that a prison's medical director ignored both his conditions, acting with deliberate indifference to his serious medical needs.

The trial court ruled that the claim concerning the keloids could continue while dismissing the infection claim in light of the fact that blood tests that the plaintiff attached to his complaint revealed that he actually tested negative for the infection. The trial court also denied a motion that the medical director be immediately ordered to refer the plaintiff to a "suitable doctor.

The limited evidence in the case so far did not show that the prisoner would experience any irreparable harm without the issuance of a preliminary injunction, and also did not establish that his deliberate indifference claim against the defendant had a reasonable likelihood of success. Wheeler v. Talbot, , U. A man claimed that he was beaten by police officers and sustained a fractured collarbone, a SLAP-type labral tear, and facial injuries leaving permanent scarring and requiring two nose surgeries. He also became legally deaf in one ear and has reduced hearing in the other.

A federal appeals court reversed the dismissal of a deliberate indifference denial of medical care claim against the doctor at a hospital emergency room, finding that if the complaint were amended to allege two things claimed in the plaintiff's opposition to the doctor's motion to dismiss, it would show a sufficiently culpable state of mind for a constitutional violation.

Those two things were that the officers falsely told the female doctor that one of the officers he allegedly attacked was a woman, and that he should therefore be "ignored and left alone.

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  4. Rabin, , F. A hospital sued federal agencies and officials, asking the court to issue a declaratory judgment that 18 U. Rejecting the argument, a federal appeals court ruled that the hospital had voluntarily opted into the Medicare program, that as a condition of participation it was required to provide emergency services to federal detainees, and that it was therefore barred from challenging the compensation provided as an "unconstitutional taking" under the Fifth Amendment.

    Baker County Medical Services v. Attorney General, , F. Massachusetts state prisoner suffering from HIV challenged a change in medication practices. While previously, they had been provided with a monthly or bimonthly supply of their prescribed HIV medications, the state Department of Corrections decided to only dispense such medication in single doses. The prisoners claimed that this violated their Eighth and Fourteenth Amendment rights, as well as constituting disability discrimination under the Americans with Disabilities Act ADA. Upholding summary judgment for the Department, the federal appeals court ruled that the change did not violate these constitutional or statutory rights.

    Nunes v. A pretrial detainee was in jail waiting for a probable cause determination. He was rapidly tapered off of psychotropic medication by the jail's medical staff, and complained of seizure-like symptoms, but was placed in an isolated cell for seven hours, after which he was found dead. A lawsuit was filed against the county and a jail nurse. During summary judgment proceedings in the case, an appeal, and post-remand pretrial preparations, both sides used a deliberate indifference legal standard, but six weeks before trial, the plaintiff's counsel argued for the first time that the correct legal standard for the jury instructions was objective reasonableness rather than deliberate indifference.

    The trial court abused its discretion in granting the nurse's motion to bar the plaintiff arguing this legal standard and in trying the case under the deliberate indifference standard. While the plaintiff's long, unexplained delay in asserting the correct standard was "puzzling," there was not a sufficient explanation in the trial court's ruling as to how the defendant nurse would suffer prejudice as a result of the delay. The judgment in favor of the county was upheld, however, as the shift in the legal standard would not have any impact on the ruling as to it liability.

    King v. Kramer, , F. A prisoner who ultimately was diagnosed with kidney stones defeated qualified immunity defenses by a prison nurse who allegedly acted with deliberate indifference to his several hours of severe abdominal pain by failing to provide him then with any kind of medical treatment or evaluation.

    His pain was a sufficiently serious medical need to meet the objective part of the deliberate indifference test. A number of other defendants who were not medical professionals, however, were entitled to qualified immunity. Al-Turki v. Robinson, , U. Lexis 10th Cir. A state law wrongful death claim against both government officials and private medical contractors rising out of the death of a pretrial detainee from diabetic ketoacidosis was properly dismissed for failure to comply with affidavit and report requirements of a state statute.

    But the failure to allow the plaintiffs to amend their complaint to attempt to comply with those requirements was an abuse of discretion, particularly when the trial court did not make any factual determinations to base that refusal on. Claims against the sheriff were properly dismissed as the plaintiffs failed to present any evidence that the sheriff had any knowledge about a problem with diabetic detainees refusing to participation in their medical treatment, causing serious adverse effects. Hahn v. Walsh, , U.

    A domestic violence probation violator with a lengthy history of substance abuse and mental health problems killed himself while awaiting transportation to another facility. A federal appeals court ruled that prison administrators in the case were not entitled to qualified immunity on a claim that inadequate provision of medical care by a private third party contractor cause the prisoner's suicide. Barkes v. First Corr. A prisoner submitted a number of requests for healthcare for his bloodshot left eye, but was allegedly released on parole without receiving treatment.

    Upon release, he underwent laser surgery for glaucoma in his right eye, but continued to have problems with his left eye. When he was reincarcerated, he made several more attempts to receive treatment, and finally underwent surgery to remove part of his left eye's ciliary body three years later. In his lawsuit claiming deliberate indifference to his glaucoma condition, the trial court denied repeated requests for an appointed lawyer, finding that his claims were not meritorious or overly complex.

    A federal appeals court found that this denial of appointed counsel was an abuse of discretion and that this abuse impacted on the prisoner's ability to develop and litigate his claim. DeWitt v. Corizon, Inc. The widow of a detainee at a county jail claimed that officers used excessive force while extracting him from his cell, which resulted in his asphyxiation and death, and that some defendants acted with deliberate indifference to his medical needs during the incident.

    The appeals court, overturning summary judgment for the defendants, found that there were genuine issues of material fact from which a jury could conclude that excessive force was used. Further proceedings were needed to consider whether individual defendants should face trial on either direct liability for use of force or on a bystander liability theory.

    The appeals court upheld summary judgment for the individual defendants on the claim concerning deliberate indifference to serious medical needs and for the municipality on an inadequate training claim. Kitchen v. Dallas County Texas, U. Lexis 5h Cir. A pre-trial detainee failed to show that a prison doctor acted with deliberate indifference to a surgical thread that was protruding from a wound on his abdomen from bowel obstruction surgery he had almost a year before, prior to his incarceration.

    The appeals court also upheld a ruling that a prison nurse's alleged act of hitting the plaintiff's nose was a de minimus minimal use of force that was not a violation of his due process rights. Buckman, , U. A prisoner broke his hand in a fight. He claimed that he filed an emergency grievance over an alleged inadequate medical treatment for his injury, but never received any response.

    He then was transferred to another facility, where he allegedly told an officer that he had been authorized, at the first facility, to be assigned to a bottom bunk, but was told to merely work things out with his cellmate. He claimed to have filed a grievance over this too, but prison officials said that he had not.

    His lawsuit was dismissed for failure to exhaust available administrative remedies as required by the Prison Litigation Reform Act. A federal appeals court upheld the dismissal of the claim against the receiving officer at the second facility, as the grievance allegedly filed had not mentioned that officer's name nor contained information from which he could be identified. If the defendants wanted to contest whether the emergency grievance at the first facility was filed, an evidentiary hearing would be required. Neal, , F. A prisoner claimed that he was denied adequate medical treatment and that, further, he was punished for seeking it.

    The trial court did not abuse its discretion in dismissing the lawsuit after the prisoner engaged in slurs, insults, and abusive attacks on the magistrate judge to whom the case was referred. The trial court properly found that the plaintiff was acting in bad faith and that no lesser sanction would be sufficient. Koehl v. Bernstein, , F. A prisoner claimed that prison officials and medical personnel acted with deliberate indifference to his need for medical treatment for his epilepsy.

    He claimed to have had no money or income when the fee was due, and also asserted that any money received in his account was automatically deducted by the prison to pay for the costs of printing copies of his complaint. Thomas v. Butts, , F. A private company served as an independent contractor providing healthcare service to those detained in a county jail. After a pretrial detainee there died from self-inflicted injuries, a federal civil rights lawsuit claimed that three jail employees were deliberately indifferent to his serious medical needs.

    A federal appeals court found that it lacked jurisdiction to review a denial of qualified immunity to the defendants when the basis for the denial was based on the presence of disputed issues of material fact. Cady v. Cumberland County Jail, , U. A prisoner claimed that his Eighth Amendment rights were violated when a sergeant pepper-sprayed him because he refused to return to his cell after showering. He further claimed that another officer then turned off the water, which prevented him from rinsing off the pepper spray for ten to fifteen minutes. A federal appeals court upheld summary judgment for the defendant on the excessive force claim, noting that the prisoner had been warned that he would be pepper sprayed if he did not comply with orders, and that he either threw an object at or spit at the sergeant three times, with a small quantity of pepper spray used after each act of defiance.

    There was no indication of a malicious intent to harm or that the force used was excessive. The other officer was entitled to qualified immunity on the delayed decontamination claim, as the prisoner failed to establish that he acted with deliberate indifference to a serious medical need.

    Burns v. Eaton, , U. A man arrested on a warrant for failing to appear in court on a drug charge died in custody during booking.

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    A number of officers restrained him when he allegedly acted in an insubordinate manner, pinning him face-down to the ground while one put him in a carotid restraint and another used a Taser on him in the stun mode on his leg for eight seconds after he was handcuffed. The appeals court upheld the trial court's denial of the defendants' motion for summary judgment on the basis of qualified immunity on both excessive force and denial of medical care claims.

    There was evidence that, viewed in the light most favorable to the plaintiff, showed that the officers used various types of force on the arrestee while he was handcuffed, not resisting, and on his stomach. Estate of Booker v. Gomez, , F. Prisons in California have operated under a receivership since to comply with consent decrees concerning prison health care. The trial court ordered the state to disclose its expert witnesses and their reports days before moving to terminate the decrees under the Prison Litigation Reform Act.

    The state appealed the order, and the appeal was denied. The trial court's order was a sensible scheduling order designed to allow the plaintiffs and the court adequate notice of the evidence the state would rely on in support of its motion. Plata v. Brown, , U. A detainee at a county jail died as a result of a perforated duodenal ulcer, succumbing to sepsis. He had allegedly complained about stomach pain prior to his death, displayed signs of agitation, and acted in a bizarre manner indicating mental health problems. His estate claimed that medical staff members were deliberately indifferent to his medical needs, and could have saved his life if they had given him prompt medical attention in the 36 hours before his death.

    Expert witnesses stated that he received substandard care. Summary judgment for the defendants was upheld as it could not be concluded that the medical staff deliberately failed to provide appropriate treatment after becoming aware of his serious medical needs. They had mistakenly interpreted his symptoms as indicating a different medical condition, for which they provided appropriate care. Claims against the private corporation providing medical care for inadequate training and supervision were properly rejected, and the trial court appropriately decided not to exercise jurisdiction over state law claims.

    Rouster v. Saginaw Cnty. Lexis , Fed App. A jail detainee claimed that he became partially blind because of a delay in treatment for his high blood pressure. A doctor and a nurse were entitled to qualified immunity on a claim that they failed to carry out a medical screening of the plaintiff when he was booked into the jail, as there was no clearly established right to a general medical screening upon admission to a detention center.