UNITED STATES DISTRICT COURT FOR THE DISTRICT OF NEW HAMPSHIRE
Office of the Public Guardian
v. Civil No. 21-cv-705-LM Opinion No. 2022 DNH 110 P Elliot Hospital, et al.
ORDER
The Office of the Public Guardian, in its capacity as guardian of Seth
Brunelle, sues defendants Hillsborough County (the “County”), Elliot Hospital, and
Joey Scollan, Doctor of Osteopathic Medicine. Against the County, the Guardian
brings a claim under 42 U.S.C. § 1983, alleging that the County’s employees
violated Brunelle’s rights under the Fourteenth Amendment while he was detained
at the Hillsborough County House of Corrections—known as Valley Street Jail—in
the summer of 2018. See Monell v. Dep’t of Soc. Servs. of Cty. of N.Y., 436 U.S. 658
(1978).1 The County moved for judgment on the pleadings under Federal Rule of
Civil Procedure 12(c), arguing that the Guardian failed to allege that the County’s
employees acted pursuant to a custom or policy attributable to the County. Doc. no.
18. In response, the Guardian moves to amend its complaint to allege that the
employees’ violations of Brunelle’s rights were the result of the County’s policies
1 The Guardian originally alleged claims under the First and Eighth
Amendments against the County. The County moved for judgment on these claims, and the Guardian did not object to the motion as it applied to them. The Guardian’s amended complaint does not include claims under the First and Eighth Amendments against the County. and customs. Doc. no. 21. The County objects to the motion to amend, arguing both
that it is untimely and that the additional allegations would be futile.2 For the
following reasons, the court grants the motion to amend and denies the motion for
judgment on the pleadings as moot.
STANDARD OF REVIEW
This order deals with two pending motions, the County’s motion for judgment
on the pleadings under Rule 12(c) and the Guardian’s motion to amend, which the
County contests on the grounds it would be futile and untimely. The standard for
review on a motion for judgment on the pleadings is the same as for a motion to
dismiss under Rule 12(b)(6). See Aponte-Torres v. Univ. of P.R., 445 F.3d 50, 54-55
(1st Cir. 2006). Likewise, the standard for determining whether a motion to amend
is futile is the same as the Rule 12(b)(6) standard. See Glassman v. Computervision
Corp., 90 F.3d 617, 623 (1st Cir. 1996). In its motion for judgment on the pleadings,
the County asserts the same legal arguments it makes in its objection on grounds of
futility. Accordingly, the court analyzes the allegations in the proposed amended
complaint to determine whether they are sufficient to state a claim under Rule
12(b)(6). See id. (“There is no practical difference, in terms of review, between a
denial of a motion to amend based on futility and the grant of a motion to dismiss
for failure to state a claim.”).
2 The other defendants in this case, Elliot Hospital and Dr. Scollan, have not
objected to the motion to amend.
2 Under Rule 12(b)(6), the court must accept the factual allegations in the
complaint as true, construe reasonable inferences in the plaintiff’s favor, and
“determine whether the factual allegations in the plaintiff’s complaint set forth a
plausible claim upon which relief may be granted.” Foley v. Wells Fargo Bank,
N.A., 772 F.3d 63, 71 (1st Cir. 2014) (citation omitted). A claim is facially plausible
“when the plaintiff pleads factual content that allows the court to draw the
reasonable inference that the defendant is liable for the misconduct alleged.”
Ashcroft v. Iqbal, 556 U.S. 662, 678 (2009).
BACKGROUND
The allegations in the proposed amended complaint relate to Brunelle’s
treatment, or lack thereof, at Elliot Hospital and Valley Street Jail in July and
August 2018. Prior to this time, Brunelle had a long history of psychiatric and
substance use issues, including being hospitalized on numerous occasions for mania,
psychosis, catatonia, and physically aggressive behavior. His medical providers had
historically treated these conditions with medications including Lithium, Depakote,
Gabapentin, and Lorazepam. Brunelle had also consistently received
electroconvulsive therapy over the eight years before the summer of 2018. That
summer, he was receiving electroconvulsive therapy on a weekly basis.
Prior to July 19, 2018, Brunelle was being held at the New Hampshire State
Hospital. On July 19, the State Hospital conditionally discharged Brunelle to
3 Westbridge, a residential treatment facility in Manchester. At the time Brunelle
was at Westbridge, he was subject to certain bail conditions. On July 24, Brunelle’s
mental condition started to deteriorate, and he refused to take his medications.
Westbridge determined that it could no longer treat Brunelle. It discharged him
and arranged for his transportation to the Elliot Hospital emergency room. Later
that evening, the Manchester Police Department arrested Brunelle, claiming he
violated one of his bail conditions. The police transferred Brunelle to Valley Street
Jail that night.
Brunelle arrived at Valley Street Jail around 10:55 pm. At that time, staff
from the Manchester Police Department left a voicemail with Brunelle’s parents,
who were then his legal guardians, notifying them that Brunelle had just arrived at
the jail. After listening to the message, Brunelle’s parents called the jail and spoke
to the nurse on call. Brunelle’s parents informed the nurse that Brunelle had a
mental health condition and required medications and electroconvulsive therapy to
treat his illness. The nurse stated that she did not receive documentation that
Brunelle had a mental health diagnosis or information about his medications. The
nurse asked Brunelle’s parents to drop off his medication the next morning, which
they did.
At around 11:20 pm, the jail’s staff noted that Brunelle urinated on the floor
in the booking department, refused to speak to anyone, and stared straight forward.
The staff placed him on suicide watch.
4 Brunelle remained at the jail for about three weeks—until August 13, 2018—
when he was released to the State Hospital.3 While Brunelle remained at the jail,
the staff made no effort to move him to the State Hospital. Moreover, staff made no
attempt to facilitate his electroconvulsive therapy—even though they were aware
that electroconvulsive therapy was necessary to alleviate Brunelle’s symptoms.
Further, despite knowing that Brunelle required medication, staff took no action in
response to Brunelle’s refusal to take his medication. Throughout his stay, staff
kept Brunelle in isolation and on suicide watch. While he was detained, Brunelle
spent significant amounts of time naked or in a restraining jacket. In response to
his continuing mental deterioration, staff confined him to a restraining chair for
many hours.
DISCUSSION
Currently before the court are the County’s motion for judgment on the
pleadings and the Guardian’s motion to amend its complaint. Because allowing the
proposed amended complaint would moot the County’s motion for judgment on the
pleadings, the court first considers the motion to amend. See Fujifilm N. Am. Corp.
v. M&R Printing Equip., Inc., 565 F. Supp. 3d 222, 227 (D.N.H. 2021). The County
objects to the motion to amend on two grounds: (1) that it is untimely; and (2) that
even with the additional allegations, it fails to state a claim under § 1983. As it is a
3 It is not clear from the amended complaint who initiated Brunelle’s transfer
from Valley Street Jail to the State Hospital, or under what legal mechanism they did so.
5 preliminary issue, the court first considers whether the motion to amend is timely.
If it is, the court will consider whether the amended complaint states a § 1983 claim
under the Rule 12(b)(6) standard.
I. Timeliness of motion to amend
The County first argues that the motion to amend is untimely because it was
filed after the deadline for amending pleadings in the scheduling order. The
deadline for amendments was February 1, 2022, and the Guardian filed its motion
on March 2, 2022. Because the Guardian filed the motion to amend after the
scheduling deadline, the more stringent “good cause” standard under Federal Rule
of Civil Procedure 16(b)—rather than the liberal “freely given” standard under Rule
15—applies. O’Connell v. Hyatt Hotels of P.R., 357 F.3d 152, 154-55 (1st Cir. 2004).
The good cause standard emphasizes the diligence of the plaintiff in seeking
amendment. Id. at 155. Prejudice to the opposing party is relevant but secondary
to the moving party’s diligence. Id. Granting a motion to amend under this
standard is within the court’s discretion. Id.
The court finds good cause to grant the motion to amend in this case. As to
diligence, the County moved for judgment on the grounds the Guardian’s
allegations were deficient. The Guardian then promptly moved to amend its
complaint to cure this deficiency. The court finds the Guardian acted diligently.
See Frost v. Suffolk Constr. Co. Inc., No. 18-CV-11578-DJC, 2020 WL 7353403, at
*5 (D. Mass. Dec. 15, 2020) (“Given the sequence of events, particularly the timing
6 of the motion to amend on the heels of Vynorius's motion for judgment on
the pleadings, the Court does not conclude that Sunbelt failed to act diligently” in
moving to amend its complaint). As to prejudice, the Guardian filed the motion to
amend one month after the scheduling deadline. Moreover, the new allegations
clarify the Guardian’s claim rather than add a new cause of action or theory to the
case. In these circumstances, the amendment will not significantly prejudice the
County. Accordingly, the court finds good cause to allow the motion under Rule
16(b).
II. Sufficiency of § 1983 claim
The Guardian alleges that Brunelle’s treatment at Valley Street Jail violated
his due process rights under the Fourteenth Amendment to receive adequate
medical care while in pretrial confinement. See Burrell v. Hampshire Cnty., 307
F.3d 1, 7 (1st Cir. 2002). The Guardian further alleges that the County was
responsible for these violations because it maintained policies and customs related
to inmates with mental health issues that resulted in its employees violating
Brunelle’s constitutional rights. The County argues that the Guardian’s allegations
regarding the existence of policies and customs are conclusory and therefore
insufficient to state a claim for relief. In addition, the County argues that the
Guardian has failed to sufficiently plead that the alleged policies and customs
caused Brunelle’s alleged constitutional deprivations.
7 Under § 1983 individuals may bring lawsuits against “any person” who,
acting under the color of state law, deprived the individual of any right or privilege
guaranteed by federal law. 42 U.S.C. § 1983. Municipalities and local
governments, such as counties, are “persons” within the meaning of § 1983. See
Monell, 436 U.S. at 690; see also Glenn v. Hillsborough Cnty. Dep’t of Corrs., No.
06-cv-99-PB, 2006 WL 3308365 (D.N.H. Nov. 13, 2006) (noting that New Hampshire
counties are local governments under RSA 507-B:1).
Local governments’ liability, however, cannot be based on the torts of their
employees and agents under a respondeat superior theory. See Monell, 436 U.S. at
694-95. Rather, a local government is only liable when the plaintiff’s injury is the
result of the execution of the government’s policies or customs, whether made by its
lawmakers or those whose acts may fairly be said to represent official policy. Id.
Municipal liability may be based on either an official policy or an unofficial policy or
custom that municipal officials both knew of and tolerated to such an extent that
they essentially adopted it as official policy. Id. In either case, the plaintiff must
show that it was the cause of and the “moving force” behind the deprivation of
constitutional rights. Miller v. Kennebec Cnty., 219 F.3d 8, 12 (1st Cir. 2000).
Thus, there are three elements to a § 1983 claim against a municipality: (1) a
violation of the constitution or federal law; (2) a custom or policy of the
municipality; and (3) causation between the custom or policy and the constitutional
deprivation.
8 Here, the Guardian alleges that the County maintained the following “de
facto policies” and customs:
A. A custom, practice or policy of substituting restraints for proper medical treatment for inmates suffering from mental illness.
B. A custom, practice or policy of refusing or not administering psychiatric or psychotropic medication to inmates that had been legally prescribed such medication prior to their being incarcerated.
C. A custom, practice or policy of refusing or delaying prescribed and necessary treatment outside of the confines of the jail itself.
D. A custom, practice or policy of not providing processing of Involuntary Admission to the New Hampshire Hospital when plainly and urgently necessary.
E. A custom practice or policy of not employing or contracting a psychiatrist or other licensed physician who could examine inmates and prescribe proper medication.
F. A custom, practice or policy of not providing injectable medications for mentally ill inmates.
G. A failure to train and educate medical and correctional staff in the proper care and treatment of inmates suffering mental health issues.
Doc. no. 21-1. As explained further below, the court finds that allegations A-
D and F are sufficient to state a § 1983 claim based on unofficial policies or
customs. In addition, allegation E sufficiently states a § 1983 claim for
municipal liability based on official policy. Finally, allegation G sufficiently
states a § 1983 claim based on a failure to train. The court addresses each
category of allegations below.4
4 The County does not move for judgment on the pleadings on the grounds
that the injuries Brunelle allegedly suffered did not constitute violations of the
9 A. Allegations A-D and F
The court first considers whether allegations A-D and F, all of which concern
allegedly unofficial policies or customs, sufficiently state a claim for municipal
liability under § 1983. In other words, the court must consider whether the
Guardian has sufficiently alleged that the County maintained unofficial policies or
customs that were the “moving force” behind a deprivation of Brunelle’s Fourteenth
Amendment rights.
While establishing the existence of an official policy is straightforward
because the municipality either did or did not maintain the policy, proving an
unofficial policy or custom is more complicated. See Griego v. City of Albuquerque,
100 F. Supp. 3d 1192, 1215-16 (D.N.M. 2015). Although it concerns an unofficial
custom, the plaintiff must still show that the municipality’s tolerance of the custom
was a deliberate policy decision by its leadership. See Miller, 219 F.3d at 12. To do
so, the plaintiff must show that the custom was “so well settled and widespread that
the policymaking officials of the municipality had either actual or constructive
knowledge of it and yet did nothing to end the practice.” Id. (quotations omitted).
For this reason, establishing the existence of a municipal custom requires more
than proof that a particular course of action happened on one occasion. Id.
Fourteenth Amendment, focusing instead on the lack of causation and allegations of policies and customs. Nevertheless, the court addresses whether the Guardian has sufficiently alleged a Fourteenth Amendment violation because it informs the causation issue.
10 While the existence of a custom or unofficial policy is a question of fact, “it is
not a fact that can be baldly asserted at the pleading stage.” Griego, 100 F. Supp.
3d at 1212-13. To adequately plead a custom or policy under Rule 12(b)(6),
“[p]laintiffs cannot, through conclusory allegations, merely assert the existence of a
municipal policy or custom, but must allege facts tending to support, at least
circumstantially, an inference that such a municipal policy or custom exists.” Green
v. City of Mount Vernon, 96 F. Supp. 3d 263, 302 (S.D.N.Y. 2015) (quotations
omitted); see also Griego, 100 F. Supp. 3d at 1212-13. In other words, the plaintiff
must allege sufficient facts to support an inference that a particular practice
occurred enough times that municipal leaders should have reasonably been aware
of the practice and still failed to take actions to stop their employees. See Miller,
219 F.3d at 12.
There are several ways a plaintiff can sufficiently plead and prove an
unofficial policy or custom. For example, a plaintiff can allege that municipal
employees acknowledged the existence of the unofficial policy or custom. See
Griego, 100 F.Supp. at 1216. In the absence of such direct evidence, however, a
plaintiff ordinarily meets the pleading standard for an unofficial policy or custom by
alleging other instances of similar conduct that would give rise to an inference that
policy makers knew of and tolerated the conduct. Page v. Mancuso, 999 F. Supp. 2d
269, 284 (D.D.C. 2013). For this reason, it is not sufficient for the plaintiff to merely
allege that government officials harmed him, and then conclusorily allege that the
officials acted pursuant to an unofficial policy or custom. See id. (finding that
11 plaintiff did not sufficiently plead a custom or unofficial policy where he alleged he
was strip searched by D.C. police officers on two occasions without citing additional
instances in which the police strip searched inmates). Rather, the plaintiff “must
plead what he or she knows—whether it is a number of incidents or some other
evidence—that renders plausible the plaintiff’s conclusion that there is a policy,
custom, or practice in place.” Griego, 100 F.Supp. 3d at 1216.
Here, the Guardian has not alleged that there were any other instances in
which Valley Street Jail staff acted pursuant to the customs or practices in
allegations A-D and F. Nevertheless, the court finds that these allegations, viewed
in the light most favorable to the Guardian, sufficiently plead unofficial customs or
policies. The Guardian has alleged that Brunelle was held at Valley Street Jail for
three weeks and that a number of jail employees kept him in restraints for most of
that time and failed to refer him to outside treatment or otherwise address his
refusal to take his medications for the entirety of his stay. This is not an instance
in which the plaintiff was harmed by a particular act once or twice and for which
there is no evidence of the government employees acting similarly in the past. Cf.
Page, 99 F. Supp. 2d at 284, supra. Rather, this is an allegation of a systemic
failure to provide treatment over an extended period. This systemic and prolonged
failure to provide adequate care is sufficient to show, at the pleading stage, that
these practices were widespread enough that County officials either were aware (or
should have been aware) of them. Accordingly, allegations A-D and F sufficiently
plead the existence of customs or policies at Valley Street Jail.
12 The court next considers whether the Guardian has adequately pleaded a
violation of the Fourteenth Amendment. The Guardian alleges that Brunelle’s
Fourteenth Amendment due process rights were violated because he did not receive
adequate medical care while he was confined at Valley Street Jail. The Fourteenth
Amendment’s Due Process Clause is at least as protective of pretrial detainees’
rights as the Eighth Amendment’s protections for individuals convicted of crimes.
Burrell, 307 F.3d at 7. The Supreme Court has held that “deliberate indifference to
serious medical needs of prisoners constitutes the unnecessary and wanton
infliction of pain proscribed by the Eighth Amendment.” Estelle v. Gamble, 429
U.S. 97, 104 (1976) (citation and quotations omitted). To prove a deliberate
indifference claim, the prisoner must satisfy two prongs: “(1) an objective prong that
requires proof of serious medical need, and (2) a subjective prong that mandates a
showing of prison administrators’ deliberate indifference to that need.” Kosilek v.
Spencer, 774 F.3d 63, 82 (1st Cir. 2014).
The objective prong contains two components. First, the prisoner must
demonstrate a “serious medical need.” Id. This requires that “the need be one that
has been diagnosed by a physician as mandating treatment, or one that is so
obvious that even a lay person would easily recognize the necessity for a doctor’s
attention.” Id. (quotations omitted). A serious medical need must create a
substantial risk of harm if left untreated. See Braggs v. Dunn, 257 F. Supp. 3d
1171, 1191 (M.D. Ala. 2017). “While mere discomfort is insufficient to support
13 liability, unnecessary pain or suffering qualifies as serious harm.” Id. (quotations
and citations omitted).
Here, the Guardian has alleged that Brunelle had a long history of mental
illness prior to incarceration. He was committed to the State Hospital until he was
discharged to Westbridge. Westbridge then discharged him because it was unable
to provide treatment given his deteriorating mental state. The Guardian further
alleges that Brunelle’s parents informed jail staff of his mental health history, and
the need for medication and electroconvulsive therapy to properly treat him. These
are sufficient allegations for the court to infer that medical professionals had
diagnosed Brunelle with a serious medical need, and that jail officials were at least
partially aware of his condition. Further, the Guardian alleges that Brunelle
appeared catatonic upon first arriving at the jail, that he urinated on the floor, and
that the jail staff kept him in isolation and in restraints throughout his stay. These
are sufficient allegations that Brunelle was displaying signs of mental illness so
severe that “even a lay person would easily recognize the necessity for a doctor’s
attention.” Kosilek, 774 F.3d at 82. In addition, the allegations that Brunelle had a
severe, untreated mental illness, and spent two weeks in restraints and isolation
that may have been unnecessary had he received proper care, are sufficient to
establish, at the pleading stage, that he suffered harm. See Braggs, 257 F. Supp. 3d
at 1191.
The second component of the objective prong is that jail officials failed to
provide adequate medical care. Kosilek, 774 F.3d at 82. This requirement “does not
14 impose on prison administrators a duty to provide care that is ideal, or of the
prisoner’s choosing.” Id. “Rather, the Constitution proscribes care that is so
inadequate as to shock the conscience.” Id. (quotations omitted). Accordingly,
allegations that reflect a mere disagreement over the course of treatment fall short
of a constitutional violation. Id. Here, the Guardian alleges that the jail staff
provided no medical care to Brunelle. They did not refer him to a psychiatrist.
And, despite knowing that he required electroconvulsive therapy and medications
that he refused to take, they took no actions to facilitate his medical treatment.
Rather, the Guardian alleges, they simply restrained and isolated him. These are
sufficient allegations that jail officials failed to provide care for a serious medical
need.
Next, the subjective prong of the test requires the prisoner to show that
prison officials were deliberately indifferent to the prisoner’s medical needs. Id. at
83. Deliberate indifference under the Eighth Amendment is equivalent to the
standard for criminal recklessness, i.e., prison officials must be aware that failing to
provide care will create a serious risk of harm to the prisoner and knowingly
disregard that risk. See Farmer v. Brennan, 511 U.S. 825, 837-38 (1994) (noting
that this requirement is because the Eighth Amendment prohibits cruel and
unusual punishments, not cruel and unusual conditions). Although the standard is
subjective, prisoners can show officials’ knowledge through evidence that the risk of
failing to provide care under the circumstances would be obvious to any reasonable
person. Id. at 842.
15 Here, the Guardian has sufficiently alleged that Brunelle had a serious
medical need that should have been obvious to a layperson. Similarly, it has
sufficiently alleged that the failure to treat this need resulted in Brunelle
experiencing deteriorating mental health and prolonged periods in isolation and
restraints. Based on these allegations, jail staff could witness the results of failing
to provide medical care to Brunelle. The jail staff, however, did not provide any
medical care to Brunelle. At this early stage of the case, these are sufficient
allegations that Brunelle had a serious medical need that created a risk of harm
and that jail staff were deliberately indifferent to that risk. Accordingly, the
Guardian has sufficiently alleged that jail staff violated Brunelle’s Fourteenth
Finally, the court considers whether the alleged customs and practices caused
the alleged constitutional deprivation. Without going through each allegation
separately, allegations A-D and F all relate to either the existence of a practice that
directly harmed Brunelle, such as placing him in restraints, or the absence of a
practice to provide him medical care, such as refusing to refer him to an outside
provider. These customs or practices are directly related to the alleged failure to
provide Brunelle medical care. While each custom or practice may not, on its own,
have been the moving force behind Brunelle’s injuries, they worked together to
deprive him of adequate medical care. Accordingly, the Guardian has sufficiently
alleged causation.
16 In sum, the County has failed to show that allegations A-D and F fail to state
a claim for municipal liability under § 1983. The court thus grants the motion to
amend as to these allegations.
B. Allegation E
In allegation E, the Guardian alleges that the County has a “custom[,]
practice[,] or policy of not employing or contracting a psychiatrist or other licensed
physician who could examine inmates and prescribe proper medication.” Doc. 21-1
¶ 44(E). Again, the court concludes that the Guardian has sufficiently pleaded all
three elements of a § 1983 claim against a municipality based on this allegation.
First, as to policy or custom, the allegation sufficiently pleads that the
County maintained a policy of failing to maintain staff to examine and prescribe
medications to inmates with mental health conditions. Unlike allegations A-D and
F, which concerned unofficial policies and customs, the decision whether to
maintain this staff was essentially a policy decision of the County. The County, or
an individual with decision-making authority for the County, either did or did not
employ a medical professional to provide psychiatric evaluations and prescribe
medications at Valley Street Jail. In contrast to customs, alleging an official policy
is much simpler because the plaintiff only has to allege that the policy did or did not
exist. Here, the Guardian has sufficiently alleged that the County failed to
maintain a medical professional to provide care to detainees at Valley Street Jail.
17 Second, as to a constitutional deprivation, the court has already concluded
that the Guardian has sufficiently alleged a violation of the Fourteenth Amendment
based on the failure to provide him adequate medical care while he was in pretrial
confinement.
Third, the Guardian has sufficiently alleged causation with respect to this
policy. The Guardian has alleged that the failure to provide medical care resulted,
in part, from the County’s failure to refer Brunelle to medical providers and
adequately train its employees on how to treat inmates suffering from mental
illness. At the pleadings stage, it is a reasonable inference that had the County
maintained a medical professional at Valley Street Jail, he or she would have
provided appropriate care to Brunelle. Of course, the failure to retain a medical
professional might not have been the only cause of Brunelle’s injuries and the
County might have been able to avoid injuring Brunelle in other ways. But,
together with the other alleged policies and customs, it contributed to the overall
pattern of practices that caused Brunelle’s lack of medical care. Accordingly, the
Guardian has adequately pleaded causation with respect to this allegation.
In sum, the County has not shown that allegation E is insufficient to state a
claim for municipal liability under § 1983. The court grants the motion to amend as
to this allegation.
18 C. Allegation G
Finally, the Guardian alleges that the County failed to “train and educate
medical and correctional staff in the proper care and treatment of inmates suffering
from mental health issues.” Doc. 21-1 ¶ 44(G). A municipality may be liable under
§ 1983 if its employee’s violation of an individual’s rights is connected to the
municipality’s failure to adequately train its employees. City of Canton, Ohio v.
Harris, 489 U.S. 378, 388 (1989). As with other forms of municipal liability under
§ 1983, the municipality’s failure to train must stem from its deliberate adoption or
acceptance of policies or customs. Id. at 389.
For a city to deliberately adopt a policy of failing to train its employees, it
must have been aware of the need for training and nevertheless decided against
providing it. Id. In other words, the municipality must have been deliberately
indifferent to the potential harms the lack of training could cause. Id. In addition,
the municipality’s failure to train must have been the “moving force” behind the
deprivation of constitutional rights. Id. Thus, to succeed on a failure to train claim
under this standard, a plaintiff must show: (1) that the municipality failed to
provide training to its employees; (2) that the municipality’s employee violated the
constitutional rights of the plaintiff; (3) that the failure to train was the “moving
force” behind the plaintiff’s injury; and (4) that the municipality should have been
aware of the potential consequences of failing to train the employee such that the
failure to do so constituted “deliberate indifference.” See id. at 388-89. The court
considers each in turn.
19 The first issue is whether the Guardian has sufficiently alleged that the
County failed to train its employees. The Guardian alleges that the County failed to
provide any training to Valley Street Jail employees about treating detainees with
mental illnesses. It further alleges that Valley Street Jail employees failed to take
any steps to manage Brunelle’s medical care and instead restrained and isolated
him. Considered together, these allegations support a reasonable inference that the
County should have either trained its employees to seek outside assistance for
Brunelle’s treatment or on the appropriate procedures for providing treatment
themselves rather than ignoring his need for treatment. These are sufficient
allegations as to what the County failed to train its employees to do.
The second issue is whether the Guardian has adequately pleaded a
deprivation of Brunelle’s constitutional rights. The court has already concluded
that the Guardian has done so based on the County’s failure to provide Brunelle
adequate medical care.
The third issue is whether the failure to train was connected to the alleged
deprivation of constitutional rights. The Guardian alleges that the County failed to
train its employees on how to manage the care of mentally ill detainees and that, as
a result, the employees did not know the appropriate procedure to administer
psychiatric medications to inmates with mental health issues, when to refer
inmates to outside providers, and when to properly use restraints in the care of
mentally ill patients. The County’s alleged failure to train its employees on these
issues is directly related to Brunelle’s alleged injuries in this case. At this early
20 stage of the litigation, the allegations support an inference that, had corrections
staff been properly trained on these issues, they would not have violated Brunelle’s
constitutional rights by failing to provide him adequate medical care.
The fourth, and final, issue is whether the County’s alleged failure to train
amounted to “deliberate indifference” to Brunelle’s constitutional rights. See Young
v. City of Providence ex rel. Napolitano, 404 F.3d 4, 26 (1st Cir. 2005). “A finding of
deliberate indifference requires that the [municipality] have disregarded a known or
obvious risk of serious harm from its failure to develop a training program” related
to the practice at issue. Id. at 28. Most often, “[s]uch knowledge can be imputed to
a municipality through a pattern of prior constitutional violations.” Id. However,
“in a narrow range of circumstances,” a failure-to-train claim can succeed without
showing a pattern of previous constitutional violations. Id. Specifically, liability
without a pattern is appropriate where a violation of a federal right is a highly
predictable consequence of a failure to train municipal employees with specific tools
to handle recurring situations. Id. (citing Bd. of Cnty. Comm'rs of Bryan Cnty., Okl.
v. Brown, 520 U.S. 397, 409 (1997)). Unlike the standard under the Eighth
Amendment, deliberate indifference in the failure to train context is objective.
Farmer, 511 U.S. at 840-41.
Here, the Guardian has not alleged a pattern of corrections staff failing to
provide proper care to inmates with mental health issues. However, at this early
stage of the litigation, the Guardian’s allegations are sufficient to establish
deliberate indifference through the second route. It is a more than fair inference
21 that individuals with mental health issues will be detained at Valley Street Jail and
that jail officials would reasonably be aware of this possibility. As the Guardian’s
allegations demonstrate, the treatment of detainees with severe mental health
conditions is complex. It is reasonably foreseeable that the failure to train staff on
how to respond to patients might result in a lack of adequate treatment that would
violate the Fourteenth Amendment. Because there is a reasonable inference that
the County should have known that individuals with mental health issues would be
incarcerated at Valley Street Jail and that corrections staff would likely require
training on how to treat them to avoid violating their Fourteenth Amendment
rights, the failure to provide such training may amount to deliberate indifference.
In sum, the Guardian has adequately alleged a § 1983 claim premised on the
County’s failure to adequately train Valley Street Jail staff on the proper care for
inmates suffering from mental health issues. The court grants the motion to amend
as to this allegation.
Finally, because the court concludes the proposed amended complaint states
a claim for relief and grants the Guardian’s motion to amend, the County’s motion
for judgment on the pleadings on the grounds the original complaint failed to state
a claim under the Rule 12(b)(6) standard is moot. Fujifilm N. Am. Corp., 565 F.
Supp. 3d at 227.
22 CONCLUSION
For the foregoing reasons, the court grants the motion to amend (doc.
no. 21) and denies the motion for judgment on the pleadings (doc. no. 18) as
moot. On or before September 15, 2022, the Guardian shall electronically
refile the pleading attached to the motion to amend (doc. no. 21-1) using the
appropriate event in the court’s electronic filing system.
SO ORDERED.
__________________________ Landya McCafferty United States District Judge
September 8, 2022
cc: Counsel of Record.