Jennifer Hall v. Terry Carl
Opinion
NOT RECOMMENDED FOR PUBLICATION File Name: 23a0137n.06
No. 22-5702
UNITED STATES COURT OF APPEALS FOR THE SIXTH CIRCUIT
JENNIFER HALL and DANIEL POWERS, ) FILED Administrators of the Estate of Serenity Renee ) Mar 17, 2023 Powers, ) DEBORAH S. HUNT, Clerk )
Plaintiffs-Appellees, )
)
v.
) ON APPEAL FROM THE ) UNITED STATES DISTRICT TERRY CARL, ) COURT FOR THE EASTERN Defendant, ) DISTRICT OF KENTUCKY )
MARK SCHAFFIELD, M.D., ) OPINION Defendant-Appellant. )
)
)
Before: MOORE, CLAY, and STRANCH, Circuit Judges.
KAREN NELSON MOORE, Circuit Judge. This appeal arises from the denial of a motion for summary judgment in a 42 U.S.C. § 1983 case alleging Eighth Amendment violations and state-law negligence claims. Although defendant Mark Schaffield did not assert a qualified immunity defense below, at issue is whether the district court was correct when it nevertheless noted in passing that binding Sixth Circuit precedent in McCullum v. Tepe, 693 F.3d 696 (6th Cir. 2012), prevented him from asserting such a defense.
Jennifer Hall was seven and a half months pregnant when she was admitted to the Kenton County Detention Center (“KCDC”) in April 2018. R. 77-2 (Hall Dep. at 160) (Page ID #524). She had been treated for her opioid-use disorder with Methadone since 2016. Id. at 41–42 (Page
ID #405–06). During the first month of her incarceration, she was transported daily to a Methadone clinic to receive treatment. Id. at 60–61 (Page ID #424–25). Healthcare services at KCDC were contracted to Southern Health Partners (“SHP”). R. 77-1 (Kenton Cnty. Mem. in Supp. of Mot. for Summ. J. at 3) (Page ID #342). Dr. Schaffield contracted with SHP to serve as Medical Director at KCDC. R. 77-4 (Schaffield Dep. at 160–61) (Page ID #729–30).
On May 25, 2018, when Jennifer Hall’s pregnancy was full-term, Dr. Schaffield gave an order to the nurses at KCDC to transition the pregnant women with opioid-use disorders at KCDC from Methadone to Buprenorphine. R. 77-5 (Thoman Dep. at 34–35; 62) (Page ID #851–52, 879); R. 77-6 (Setters Dep. at 61) (Page ID #990). Like Methadone, Buprenorphine is a prescription treatment for substance abuse disorders. R. 128 (Mem. Op. & Order at 2–3 (Page ID #4298–99). Buprenorphine, however, does not require daily trips to a clinic. R. 77-4 (Schaffield Dep. at 12) (Page ID #581). Kentucky regulations dictate professional standards for the prescription and dispensation of Buprenorphine, including a requirement that the prescribing doctor obtain a complete evaluation of the patient, explain treatment alternatives and risks, obtain written informed consent, and document the presence of opioid withdrawal prior to administering the first dose. 201 Ky. Admin. Reg. 9:270 Sec. 2(4). For pregnant patients, a doctor must also “obtain and document consultation with another independent physician that the potential benefit of [Buprenorphine] use outweighs the potential risk of use.” Id. Sec. 2(4)(b)(2)(a). Dr. Schaffield took none of these precautionary measures before ordering the change in the pregnant inmates’ medication. R. 77-4 (Schaffield Dep. at 30, 38–39, 42, 78, 89, 106–07, 129–30, 132–33, 134–35, 137, 215) (Page ID #599, 607–08, 611, 647, 658, 675–76, 698–99, 701–02, 703–04, 706, 784). SHP policy also prohibits detoxing pregnant inmates on Methadone and directs that they should
be continued on Methadone while incarcerated. R. 111-6 (SHP Policy at 2) (Page ID #3942). Dr. Schaffield did not recall if he consulted SHP’s policy on detoxing pregnant inmates before he switched them to Buprenorphine from Methadone. R. 77-4 (Schaffield Dep. at 34) (Page ID #603).
The pregnant inmates were told on Monday, May 28, 2018, that they would be given Buprenorphine instead of being taken to the Methadone clinic. R. 77-2 (Hall Dep. at 79–81) (Page ID #443–45). One pregnant woman who refused to take the Buprenorphine before speaking to her doctor was sent to an isolation unit until she agreed to take the medication three hours later. R. 102-4 (Incident Report at 1) (Page ID #1849); R. 77-8 (Ray Dep. at 27) (Page ID #1113). Shortly after Hall received her first dose of Buprenorphine, she began to suffer withdrawal symptoms. R. 77-2 (Hall Dep. at 86–87) (Page ID #450–51). She testified at her deposition that she vomited after taking the first dose. Id. The following day, she was given her second dose of Buprenorphine and vomited again. Id. at 109 (Page ID #473). Hall grew convinced that something was wrong with her pregnancy and reported to nurses that she was in labor so that they would transport her to the hospital. Id. at 92 (Page ID #456). After Hall arrived at the hospital, she suffered a stillbirth. Id. at 114–16 (Page ID #478–80).
Hall filed this suit alleging an Eighth Amendment deliberate-indifference claim and state-
law claims for negligence against Kenton County, SHP, and Dr. Schaffield, as well as other SHP and jail staff in their individual capacities. R. 1 (Compl. at 1–2, ¶¶ 27–31) (Page ID #1, 9–10). After discovery concluded, Dr. Schaffield moved for summary judgment. R. 105 (SHP Defs.’ Mot. for Summ. J. at 1) (Page ID #2336). Dr. Schaffield did not raise the affirmative defense of qualified immunity in his answer or in his motion for summary judgment. R. 9 (Schaffield Ans. at 1–8) (Page ID #68–75); R. 105 (SHP Defs.’ Mot. for Summ. J. at 1–16) (Page ID #2336–51).
Nevertheless, the district court noted that Schaffield was not entitled to assert the defense of qualified immunity based on the Sixth Circuit’s decision in McCullum. R. 128 (Mem. Op. & Order at 36) (Page ID #4332). The district court then denied Dr. Schaffield’s motion for summary judgment on the ground that a reasonable jury could find that Schaffield had been “deliberately indifferent to the serious risk posed by the medication change he ordered” and that his “actions were ‘so grossly incompetent, inadequate, or excessive as to shock the conscience or to be intolerable to fundamental fairness.’” R. 128 (Mem. Op. & Order at 48) (Page ID #4344) (quoting Terrance v. Northville Reg’l Psychiatric Hosp., 286 F.3d 834, 844 (6th Cir. 2002)). Dr. Schaffield appealed the district court’s purported determination that he was not entitled to qualified immunity and the district court’s denial of his motion for summary judgment.
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