Pena ex rel. Estate of Cornell v. Givens

637 F. App'x 775
Court of Appeals for the Fifth Circuit·Decided November 23, 2015·No. No. 14-11020·Published·Cited by 13 cases

Opinion

PER CURIAM: *

This case arises from George Cornell’s tragic death at a state-run psychiatric emergency room. His representative sued the doctors, nurses, and technicians who treated him and the hospital supervisors for violations of his Fourth and Fourteenth Amendment rights. The district court denied the defendants’ motions for summary judgment on the grounds of qualified immunity. The defendants bring this interlocutory appeal asserting that they are entitled to such immunity. We reverse.

I. FACTUAL AND PROCEDURAL BACKGROUND

In February 2011, Cornell arrived at a fire station and complained that he was being chased. A fireman called the police, who, upon arrival, handcuffed Cornell and took him to the Parkland psychiatric emergency room (the “Psych ER”). Cornell was considered “APOWW, i.e., apprehended by a police officer without a warrant.” 1 Parkland is a state hospital.

[777] A. Treatment at Parkland

Defendants-AppeUants Dr. Kevin Brown and Nurse Sherwin De Guzman were present at Cornell’s intake, during which Dr. Shawn Chambers took Cornell’s medical history. Cornell told Chambers that he had “tachycardia.” Cornell stated that “people had stolen his lottery' ticket and were chasing him.” Cornell was admitted to the Psych ER pursuant to Dr. Brown’s authorization.

Johnny Roberts, a technician in the Psych ER (a “psych tech”), took Cornell’s vital signs, which registered as abnormally high. Cornell’s pulse was 124 beats per minute, his blood pressure was 142/105 mm Hg, and his respirations were 17 breaths per minute. Because Cornell’s pulse and blood pressure readings were elevated, Roberts tried to take his vital signs again, but the machine malfunctioned. Though Cornell had been cooperative up to this point, he became agitated and refused to cooperate when Roberts attempted to take his vital signs a third time. Parkland staff provided no further cardiac treatment to Cornell.

Roberts asked Defendant-Appellant Robert Givens, another psych tech, for assistance calming Cornell, but Cornell continued to resist and tried to leave the Psych ER. Roberts informed Dr. Brown of Cornell’s behavior. Givens put Cornell in either a “basket hold” or “elbow-to-hip containment,” and pushed him into a seclusion room. The techs held Cornell on a mat on the floor. The techs’ testimony conflicts as to whether Cornell was held on his side or his stomach.

De Guzman arrived and injected Cornell with a mixture of Haldol, Ativan, and Be-nadryl to subdue him. Haldol and Bena-dryl can cause cardiac arrhythmia and death. The techs continued to hold Cornell down, though testimony varies as to how long the hold lasted: Givens stated it lasted “a minute or two,” Roberts said “several minutes,” and De Guzman said “maybe five minutes.”

After Givens and Roberts left the room, Cornell became agitated again. He began yelling, and he ripped up a vinyl tile from the floor and banged it against the door. A third psych tech, Defendant-Appellant Alexander Achebe, convinced Cornell to trade' the tile for a juice box. The techs began to move Cornell to a new room because he had ripped up the flooring. As they approached the second seclusion room, Cornell crushed the juice box and began physically resisting the techs. They again restrained Cornell and put him on a mat in the room. Cornell received a second injection of the same medications.

Again, there is conflicting testimony about how Cornell was held on the mat. Accepting Pena’s version of the facts, Cornell was held on his stomach for fifteen minutes after the injection. Psych techs were trained not to hold a patient in a prone position for more than a' minute, because longer holds can cause asphyxiation. The techs then left the room.

A nurse later found Cornell lying in a prone position in the room with his right arm beneath him and his hand pointed to the ceiling. His hand was cyanotic, and the nurse could not detect spontaneous respirations. The nurse called a code blue, and Cornell was transferred to the main emergency room, where he died. [778] The medical examiner found abrasions on the left side of Cornell’s forehead. After an investigation into Cornell’s death, the medical examiner found the cause of death to be undetermined, listing three potential causes: 1) mechanical compression; 2) underlying cardiac issues; or 3) effects of the medication he received in the Psych ER.

B. Supervision at Parkland

At the time of Cornell’s death, Defendant-Appellant Nancy Schierding was Parkland’s Director of Nursing for Psychiatric Services. Defendant-Appellant Nurse Vernell Brown was Unit Manager III for the Psych ER and was responsible for the Psych ER staff, including nurses and techs. At her deposition, Schierding recalled other complaints of improper treatment in the Psych ER. A Centers for Medicare and Medicaid Services (CMS) Report prepared after Cornell’s death noted that De Guzman’s restraint-and-seclusion training had lapsed at the time of the incident, as Nurse Brown and Schierding should have been aware. At the time, Defendant-Appellant Dr. Ronnie Anderson was the CEO of Parkland.

In 2008, prior to Cornell’s death, CMS sent a letter to Anderson stating that Parkland “fail[ed] to provide appropriate medical screening examination to determine whether an emergency medical condition existed” and that the “deficiencies [we]re so serious that they constitute an immediate threat to the health and safety of any individual that comes to [Parkland] with an emergency medical condition.” The CMS Report generated after Cornell’s death detailed ongoing problems, noting that, due to an unusually high number of complaints, injuries, and deaths, Parkland had been “under near constant surveillance and investigation” by the Texas Department of State Health Services and CMS.

C. Procedural History

Plaintiff-Appellee Onie Pena, as the representative of Cornell’s estate, filed a complaint in Texas district court against Parkland and the Defendants-Appellants, among others. Parkland removed the case to federal court. Relevant to this appeal, Pena alleges that Givens and Achebe used excessive force against Cornell in violation of the Fourth Amendment or, in the alternative, in violation of Cornell’s substantive due process rights. Pena alleges that De Guzman and Dr. Brown violated Cornell’s right to due process by denying him medical care for his heart condition. Finally, Pena avers that Schierding, Anderson, and Nurse Brown (collectively, “the Supervisory Defendants”) contributed to these constitutional violations by inadequately supervising the Psych ER.

The Appellants moved for summary judgment, arguing that they are entitled to qualified immunity. The district court denied their motions, and Appellants filed timely notices of interlocutory appeal.

II. JURISDICTION

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Pena ex rel. Estate of Cornell v. Givens, 637 F. App'x 775 (5th Cir. 2015).

637 F. App'x 775 (Pena ex rel. Estate of Cornell v. Givens) — published by Counsel Stack Legal Research, free access to 12M+ legal documents.

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