In McCann v. Ogle County, No. 17-3139 (7th Cir. Nov. 30, 2018), the estate of an Ogle County inmate sued a county sheriff, jail superintendent and nurse and doctor, claiming that the inmate died while detained at the jail due to the over-prescription of methadone. The inmate was being detained in the jail after his arrest for arson and aggravated battery. He arrived at the jail after a month-long treatment in a hospital for burn injuries sustained in trying to burn down his mother’s house. His care was supervised by the jail doctor who was not a county employee and provided contract medical services. After the jail doctor settled with the estate, the district court granted summary judgment for the county officials. While the appeal was pending, the Seventh Circuit decided Miranda v. County of Lake, 900 F.3d 335 (7th Cir. 2018), replacing deliberate indifference with a standard requiring a showing of objective reasonableness. Even under this new and seemingly less demanding evidentiary standard, the Seventh Circuit affirmed summary judgment.
The court began by explaining the new standard under Miranda. This is a two-step process. The first step focuses on the intentionality of the individual defendant’s conduct and asks whether the defendant acted purposefully, knowingly, or perhaps even recklessly when they considered the consequences of their handling of the inmate’s case. Thus, a showing of negligence or even gross negligence will not suffice. The second step asks whether the challenged conduct was objectively reasonable and focuses on the totality of facts and circumstances faced by the defendant and gauges objectively—without regard to any subjective belief held by the individual—whether the response was reasonable.
In affirming summary judgment for the jail nurse, the court found that the nurse administered methadone in strict compliance with the jail doctor’s orders. She did not act intentionally in the sense that she could not foresee nor ignore the potential consequences of her actions. The court also found that the nurse’s actions were objectively reasonable. As a licensed practical nurse, she was able to rely on the doctor to determine the proper dosage of methadone to treat the ongoing pain the inmate was experiencing from his burn wounds. She was not responsible to second-guess the doctor’s medical judgment. The nurse also attended diligently and conscientiously to the inmate’s medical needs in that she checked and documented his condition every 5 to 15 minutes, regularly changed his bandages, bathed him, and served him meals. She was available off duty if necessary and even voluntarily came in on a weekend to assist the inmate with taking a shower. While the estate argued that the nurse failed to take the inmate’s vital signs during the hours preceding his death, this allegation sounded in negligence which was insufficient to support a claim for inadequate medical care under the Fourteenth Amendment.
The court applied the same analysis to the claims against the sheriff and jail superintendent. Neither was responsible for providing medical care to the inmate and reasonably relied on the jail doctor to determine the proper course of care. The court also rejected the municipal liability against Ogle County and the official capacity claims against the sheriff and jail superintendent. The estate had argued that the decision to house the inmate instead of transferring him to a hospital reflected a policy that elevated cost savings over necessary medical care. This theory lacked support in the evidence. The evidence showed that the jail doctor assessed the inmate’s condition and determined that the Ogle County facility had the capacity to attend to his ongoing medical needs. Thus, the decision to house the inmate following his discharge from the local hospital reflected the jail doctor’s medical judgment on which the county officials reasonably deferred. The Court also concluded that the inmate’s tragic death resulted from the jail doctor’s over-prescription of methadone, not the decision to house him within the Ogle County facility or, for that matter, the care he received from the nurse or jail staff. Mike Bersani and David Mathues represented the County, Sheriff’s Office and jail superintendent.