Case: 18-14459 Date Filed: 03/26/2019 Page: 1 of 12
[DO NOT PUBLISH]
IN THE UNITED STATES COURT OF APPEALS
FOR THE ELEVENTH CIRCUIT ________________________
No. 18-14459 Non-Argument Calendar ________________________
D.C. Docket No. 5:17-cv-00077-LGW-BWC
SREDRICK JONES, as the surviving spouse of Brandi Nicole Griffin Jones,
Plaintiff–Appellant,
versus
DR. STEVE ANDERSON BEHAVIORAL MEDICINE, LLC, et al.,
Defendants,
D.O. WALLACE STEVE ANDERSON, in his individual and professional capacity, LPN TAMMY NICHOLE BASS, in her individual and professional capacity, SOUTH GEORGIA CORRECTIONAL MEDICINE, LLC, KIM PHILLIPS, in his individual capacity, DOYLE WOOTEN, in his individual and professional capacity,
Defendants–Appellees. Case: 18-14459 Date Filed: 03/26/2019 Page: 2 of 12
________________________
Appeal from the United States District Court for the Southern District of Georgia ________________________
(March 26, 2019)
Before WILSON, WILLIAM PRYOR and HULL, Circuit Judges.
PER CURIAM:
Sredrick Jones, surviving spouse of Brandi Jones, appeals the summary
judgment in favor of Doyle Wooten, the Sheriff of Coffee County; South Georgia
Correctional Medicine, LLC, the medical services provider for the Coffee County
Jail; and Nurse Tammy Bass. See 42 U.S.C. § 1983. Jones complained that the
officials’ deliberate indifference to the medical needs of his spouse during her
pretrial detention caused her death. Brandi Jones reported undergoing treatment for
mental illnesses and taking Subutex, a drug used to treat opioid addiction, to Nurse
Bass during an intake evaluation, but Jones received no medicine because she
denied abusing drugs and exhibited no signs of substance abuse. On her third day
in jail, Jones suddenly had convulsions and was transported to a hospital, where
she passed away four days later. The district court ruled that Nurse Bass and
Sheriff Wooten were entitled to qualified immunity and that South Georgia
Correctional Medicine was not liable because its employee, Nurse Bass, did not
violate Jones’s constitutional rights. We affirm.
2 Case: 18-14459 Date Filed: 03/26/2019 Page: 3 of 12
I. BACKGROUND
On July 8, 2015, Brandi Jones was arrested and booked into the Coffee
County Jail at 6:45 p.m. At 10:50 p.m., Nurse Bass interviewed Jones and obtained
her written consent to obtain “all medical records and/or information, . . . including
any hospital or medical doctor or another place where medical records may be
located.” Jones reported that she was receiving treatment for mental illnesses from
Dr. Mubbashir Khan, a local physician. Jones reported taking Subutex, but because
she denied abusing drugs, Nurse Bass thought Jones was “misus[ing]” Subutex.
Jones did not exhibit any signs of acute distress or other symptoms of substance
abuse, and Nurse Bass was unaware that discontinuing Subutex could cause drug
withdrawal syndrome. Nurse Bass classified Jones for routine supervision and
placed her in the general population of the jail.
Unbeknownst to Nurse Bass, when Jones entered the Coffee County Jail, she
had active prescriptions for Xanax, Subutex, Lexapro, Neurontin, and Seroquel.
During Jones’s detention, the jail had a policy that, “if alcohol and drug abuse
related problems are identified, the jail nurse will refer the inmate/patient to the
jail’s medical director.” The jail also had a kiosk where inmates could request an
appointment with medical staff.
On the morning of July 9, 2015, officers transported Jones to Atkinson
County on an outstanding arrest warrant. Wendy Funderburk, the assistant to the
3 Case: 18-14459 Date Filed: 03/26/2019 Page: 4 of 12
Sheriff of Atkinson County, talked to Jones and observed that she “was in a very
good mood and “did not appear ill and looked fine.” Jones returned to the Coffee
County Jail around 12:53 p.m.
Around 6:00 p.m. on July 10, 2015, Jones attended a church service in the
jail led by Jan Boettcher. Boettcher noticed that Jones was “full of life, vibrant, and
energetic.” And Jones’s cellmate, Josie Lee Travis, witnessed her “g[et] saved”
and tell other attendees about her baby. When the two women returned to their cell,
Travis noticed that Jones was not eating, she was pale and sweaty, and she was
sleeping a lot. Travis asked Jones why she was “sleeping so much,” and she replied
that she was “coming off Suboxone and Xanax.” Travis advised Jones to request
medical treatment.
Around 12:37 a.m. the morning of July 11, 2015, Travis heard Jones having
convulsions and breathing deeply. Travis saw her “hit the wall” and noticed that
she could not move. Travis activated an alarm in their cell, but when officers
arrived, Jones had stopped breathing. Officers attempted to resuscitate her while
they waited for an ambulance to arrive.
Emergency technicians transported Jones to the Coffee County Regional
Medical Center, where she passed away on July 15, 2015. A coroner classified
Jones’s death as “undetermined.” The coroner reported that Jones’s “cause of death
[was] most likely due to drug withdrawal syndrome” based on her comment about
4 Case: 18-14459 Date Filed: 03/26/2019 Page: 5 of 12
“‘coming off’ of Xanax and Subutex,” Travis’s statements that Jones had been
“sleeping and not eating for the past two days” and had a “seizure-type activity,”
“the hospital clinical diagnosis of anoxic encephalopathy,” her “negative hospital
admission blood toxicology,” and “the lack of cause of death-specific autopsy
findings.”
Sredrick Jones filed in a Georgia court a 20-count complaint against Nurse
Bass, her employers, Dr. Wallace Anderson and South Georgia Correctional
Medicine, Sheriff Wooten, and the administrator of his jail, Captain Kim Phillips,
and they removed the action to the district court. Later, Sredrick Jones amended his
complaint to allege that Nurse Bass, Dr. Anderson, South Georgia Correctional
Medicine, Sheriff Wooten, and Captain Phillips were deliberately indifferent to
Brandi Jones’s serious medical needs, in violation of the Fourteenth Amendment.
Sredrick Jones also alleged that Sheriff Wooten had failed to train his officers how
to identify inmates with withdrawal syndrome; that South Georgia Correctional
Medicine had a custom or policy of deliberate indifference; and that Nurse Bass,
Dr. Anderson, and South Georgia Correctional Medicine had been negligent in
violation of state law.
All the defendants moved for summary judgment. The officials argued that
they were entitled to qualified immunity. South Georgia Correctional Medicine
5 Case: 18-14459 Date Filed: 03/26/2019 Page: 6 of 12
moved for summary judgment based on sovereign immunity under the Georgia
Constitution and under the Eleventh Amendment.
After Sredrick Jones dismissed his claims against Dr. Anderson, the district
court granted the remaining defendants’ motions for summary judgment and
declined to exercise supplemental jurisdiction over his claims under state law. The
district court ruled that Nurse Bass did not violate Brandi Jones’s constitutional
rights because she did not exhibit an obvious need for medical treatment.
Alternatively, the district court ruled that Sredrick Jones failed to establish that
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Case: 18-14459 Date Filed: 03/26/2019 Page: 1 of 12
[DO NOT PUBLISH]
IN THE UNITED STATES COURT OF APPEALS
FOR THE ELEVENTH CIRCUIT ________________________
No. 18-14459 Non-Argument Calendar ________________________
D.C. Docket No. 5:17-cv-00077-LGW-BWC
SREDRICK JONES, as the surviving spouse of Brandi Nicole Griffin Jones,
Plaintiff–Appellant,
versus
DR. STEVE ANDERSON BEHAVIORAL MEDICINE, LLC, et al.,
Defendants,
D.O. WALLACE STEVE ANDERSON, in his individual and professional capacity, LPN TAMMY NICHOLE BASS, in her individual and professional capacity, SOUTH GEORGIA CORRECTIONAL MEDICINE, LLC, KIM PHILLIPS, in his individual capacity, DOYLE WOOTEN, in his individual and professional capacity,
Defendants–Appellees. Case: 18-14459 Date Filed: 03/26/2019 Page: 2 of 12
________________________
Appeal from the United States District Court for the Southern District of Georgia ________________________
(March 26, 2019)
Before WILSON, WILLIAM PRYOR and HULL, Circuit Judges.
PER CURIAM:
Sredrick Jones, surviving spouse of Brandi Jones, appeals the summary
judgment in favor of Doyle Wooten, the Sheriff of Coffee County; South Georgia
Correctional Medicine, LLC, the medical services provider for the Coffee County
Jail; and Nurse Tammy Bass. See 42 U.S.C. § 1983. Jones complained that the
officials’ deliberate indifference to the medical needs of his spouse during her
pretrial detention caused her death. Brandi Jones reported undergoing treatment for
mental illnesses and taking Subutex, a drug used to treat opioid addiction, to Nurse
Bass during an intake evaluation, but Jones received no medicine because she
denied abusing drugs and exhibited no signs of substance abuse. On her third day
in jail, Jones suddenly had convulsions and was transported to a hospital, where
she passed away four days later. The district court ruled that Nurse Bass and
Sheriff Wooten were entitled to qualified immunity and that South Georgia
Correctional Medicine was not liable because its employee, Nurse Bass, did not
violate Jones’s constitutional rights. We affirm.
2 Case: 18-14459 Date Filed: 03/26/2019 Page: 3 of 12
I. BACKGROUND
On July 8, 2015, Brandi Jones was arrested and booked into the Coffee
County Jail at 6:45 p.m. At 10:50 p.m., Nurse Bass interviewed Jones and obtained
her written consent to obtain “all medical records and/or information, . . . including
any hospital or medical doctor or another place where medical records may be
located.” Jones reported that she was receiving treatment for mental illnesses from
Dr. Mubbashir Khan, a local physician. Jones reported taking Subutex, but because
she denied abusing drugs, Nurse Bass thought Jones was “misus[ing]” Subutex.
Jones did not exhibit any signs of acute distress or other symptoms of substance
abuse, and Nurse Bass was unaware that discontinuing Subutex could cause drug
withdrawal syndrome. Nurse Bass classified Jones for routine supervision and
placed her in the general population of the jail.
Unbeknownst to Nurse Bass, when Jones entered the Coffee County Jail, she
had active prescriptions for Xanax, Subutex, Lexapro, Neurontin, and Seroquel.
During Jones’s detention, the jail had a policy that, “if alcohol and drug abuse
related problems are identified, the jail nurse will refer the inmate/patient to the
jail’s medical director.” The jail also had a kiosk where inmates could request an
appointment with medical staff.
On the morning of July 9, 2015, officers transported Jones to Atkinson
County on an outstanding arrest warrant. Wendy Funderburk, the assistant to the
3 Case: 18-14459 Date Filed: 03/26/2019 Page: 4 of 12
Sheriff of Atkinson County, talked to Jones and observed that she “was in a very
good mood and “did not appear ill and looked fine.” Jones returned to the Coffee
County Jail around 12:53 p.m.
Around 6:00 p.m. on July 10, 2015, Jones attended a church service in the
jail led by Jan Boettcher. Boettcher noticed that Jones was “full of life, vibrant, and
energetic.” And Jones’s cellmate, Josie Lee Travis, witnessed her “g[et] saved”
and tell other attendees about her baby. When the two women returned to their cell,
Travis noticed that Jones was not eating, she was pale and sweaty, and she was
sleeping a lot. Travis asked Jones why she was “sleeping so much,” and she replied
that she was “coming off Suboxone and Xanax.” Travis advised Jones to request
medical treatment.
Around 12:37 a.m. the morning of July 11, 2015, Travis heard Jones having
convulsions and breathing deeply. Travis saw her “hit the wall” and noticed that
she could not move. Travis activated an alarm in their cell, but when officers
arrived, Jones had stopped breathing. Officers attempted to resuscitate her while
they waited for an ambulance to arrive.
Emergency technicians transported Jones to the Coffee County Regional
Medical Center, where she passed away on July 15, 2015. A coroner classified
Jones’s death as “undetermined.” The coroner reported that Jones’s “cause of death
[was] most likely due to drug withdrawal syndrome” based on her comment about
4 Case: 18-14459 Date Filed: 03/26/2019 Page: 5 of 12
“‘coming off’ of Xanax and Subutex,” Travis’s statements that Jones had been
“sleeping and not eating for the past two days” and had a “seizure-type activity,”
“the hospital clinical diagnosis of anoxic encephalopathy,” her “negative hospital
admission blood toxicology,” and “the lack of cause of death-specific autopsy
findings.”
Sredrick Jones filed in a Georgia court a 20-count complaint against Nurse
Bass, her employers, Dr. Wallace Anderson and South Georgia Correctional
Medicine, Sheriff Wooten, and the administrator of his jail, Captain Kim Phillips,
and they removed the action to the district court. Later, Sredrick Jones amended his
complaint to allege that Nurse Bass, Dr. Anderson, South Georgia Correctional
Medicine, Sheriff Wooten, and Captain Phillips were deliberately indifferent to
Brandi Jones’s serious medical needs, in violation of the Fourteenth Amendment.
Sredrick Jones also alleged that Sheriff Wooten had failed to train his officers how
to identify inmates with withdrawal syndrome; that South Georgia Correctional
Medicine had a custom or policy of deliberate indifference; and that Nurse Bass,
Dr. Anderson, and South Georgia Correctional Medicine had been negligent in
violation of state law.
All the defendants moved for summary judgment. The officials argued that
they were entitled to qualified immunity. South Georgia Correctional Medicine
5 Case: 18-14459 Date Filed: 03/26/2019 Page: 6 of 12
moved for summary judgment based on sovereign immunity under the Georgia
Constitution and under the Eleventh Amendment.
After Sredrick Jones dismissed his claims against Dr. Anderson, the district
court granted the remaining defendants’ motions for summary judgment and
declined to exercise supplemental jurisdiction over his claims under state law. The
district court ruled that Nurse Bass did not violate Brandi Jones’s constitutional
rights because she did not exhibit an obvious need for medical treatment.
Alternatively, the district court ruled that Sredrick Jones failed to establish that
Nurse Bass knew his spouse faced a substantial risk of serious harm if she
discontinued using Subutex or that the nurse deliberately disregarded any risk of
serious harm or acted with gross negligence by failing to order Brandi Jones’s
medical and prescription records. Next, the district court ruled that Sheriff Wooten
did not participate in Brandi Jones’s treatment and that he was not liable as a
supervisor because no clearly established law required him to train his officers
about drug withdrawal syndrome. And, in the alternative, the district court ruled
that Sheriff Wooten had not acted with deliberate indifference to the need to train
because he had contracted with a medical services company for inmates’ treatment
and he had instituted a system for inmates to report their health issues. Finally, the
district court ruled that it did not have “to address [Sredrick Jones’s] municipal
liability claim against [South Georgia Correctional Medicine]” because he had
6 Case: 18-14459 Date Filed: 03/26/2019 Page: 7 of 12
been unable to prove that Nurse Bass violated Brandi Jones’s constitutional rights
and he had voluntarily dismissed his claims against Dr. Anderson.
II. STANDARD OF REVIEW
We review de novo a summary judgment based on qualified immunity. Nam
Dang by & through Vina Dang v. Sheriff, Seminole Cty. Fla., 871 F.3d 1272, 1278
(11th Cir. 2017). Summary judgment is appropriate when there exists no genuine
dispute as to any material fact and the movant is entitled to judgment as a matter of
law. Fed. R. Civ. P. 56(a). We “resolve all issues of material fact in favor of the
plaintiff” and “then answer the legal question of whether the defendant is entitled
to qualified immunity under that version of the facts.” Lee v. Ferraro, 284 F.3d
1188, 1190 (11th Cir. 2002) (internal quotation marks and citation omitted).
III. DISCUSSION
Qualified immunity shields government officials who are acting within their
discretionary authority from liability when “their conduct does not violate clearly
established statutory or constitutional rights of which a reasonable person would
have known.” Nam Dang, 871 F.3d at 1278 (quoting Harlow v. Fitzgerald, 457
U.S. 800, 818 (1982)). If an official is acting within the scope of his discretionary
authority when he or she committed the allegedly unlawful actions, the plaintiff
must prove “that qualified immunity is not appropriate.” Lee, 284 F.3d at 1194.
“We are required to grant qualified immunity to a defendant official unless the
7 Case: 18-14459 Date Filed: 03/26/2019 Page: 8 of 12
plaintiff can demonstrate two things: (1) that the facts, when construed in the
plaintiff’s favor, show that the official committed a constitutional violation and, if
so, (2) that the law, at the time of the official’s act, clearly established the
unconstitutionality of that conduct.” Singletary v. Vargas, 804 F.3d 1174, 1180
(11th Cir. 2015).
Sredrick Jones argues that Nurse Bass, South Georgia Correctional
Medicine, and Sheriff Wooten violated the constitutional rights of his spouse
during her pretrial detention. Because the parties agree that the officials were
acting within their discretionary authority, they were not liable unless they “acted
with deliberate indifference to” Brandi Jones’s “objectively serious medical need.”
Harper v. Lawrence Cty., Ala., 592 F.3d 1227, 1234 (11th Cir. 2010) (quoting
Burnette v. Taylor, 533 F.3d 1325, 1330 (11th Cir. 2008)). “[A] ‘serious medical
need’ [is] one that is diagnosed by a physician as requiring treatment or one that is
so obvious that a lay person would recognize the need for medical treatment.”
Burnette, 533 F.3d at 1330. To exhibit deliberate indifference, the officials had to
have subjective knowledge of a risk of serious harm to Jones and had to have
disregarded that risk by acting with more than gross negligence. Id.
Nurse Bass did not violate Brandi Jones’s constitutional rights. Even if we
assume that Jones had an objectively serious medical need, Nurse Bass was not
subjectively aware that she was at substantial risk of developing drug withdrawal
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syndrome. See id. Sredrick Jones argues that his spouse had active prescriptions for
several medications, but she told Nurse Bass that she was taking only Subutex.
And Nurse Bass thought she was “misus[ing]” Subutex because she denied abusing
drugs and she did not appear to be in acute distress or exhibit any other symptom
of substance abuse. Nurse Bass testified that she was “unaware” that discontinuing
Subutex could cause drug withdrawal syndrome. Although Nurse Bass knew “a
sudden stoppage of Xanax [could] cause withdrawal syndrome,” Jones’s use of
that medicine was never communicated to Nurse Bass or to any other jail official.
Jones and her cellmate, Travis, also never reported that Jones was sleeping
excessively and fasting, which might have alerted officials that Jones required
medical attention. Nurse Bass never was “aware of facts from which the inference
could [have] be[en] drawn that a substantial risk of serious harm exist[ed]” for
Jones. See id. (quoting Farmer v. Brennan, 511 U.S. 825, 837 (1994)).
Sredrick Jones argues that Nurse Bass acted with deliberate indifference by
failing to order Brandi Jones’s medical and pharmaceutical records, but no
evidence established that Nurse Bass’s failure to order records manifested a
conscious disregard for Jones’s health. “No liability arises under the Constitution
for ‘an official’s failure to alleviate a significant risk that he should have perceived
but did not,’” id. at 1331 (quoting Farmer, 511 U.S. at 838), and we must judge
Nurse Bass’s conduct in the light of the information available to her. Nurse Bass
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might “not escape liability if the evidence showed that [she] merely refused to
verify underlying facts that [she] strongly suspected to be true, or declined to
confirm inferences of risk that [she] strongly suspected to exist,” Farmer, 511 U.S.
at 843 n.8, but Nurse Bass never suspected that Jones was at risk of any harm. Had
Nurse Bass known that discontinuing Subutex could cause drug withdrawal
syndrome or that Jones had been taking Xanax, the failure to administer
medication to her might have been so cursory as to amount to a conscious
disregard of her medical needs. See Burnette, 533 F.3d at 1330. But Sredrick Jones
never established that Nurse Bass was aware that Brandi Jones had a serious
medical need that warranted further investigation and declined to pursue the matter
further.
Sredrick Jones’s claim against South Georgia Correctional Medicine fails as
a matter of law. “[W]hen a private entity contracts with a county to provide
medical services to inmates, it performs a function traditionally within the
exclusive prerogative of the state and becomes the functional equivalent of the
municipality under section 1983.” Craig v. Floyd Cty., Ga., 643 F.3d 1306, 1310
(11th Cir. 2011) (internal quotation marks and citation omitted). Sredrick Jones
had to prove that the agents of South Georgia Correctional Medicine violated his
spouse’s constitutional rights and its policy or custom was the “moving force
behind” the deprivation of her rights. See id. Because Brandi Jones did not suffer a
10 Case: 18-14459 Date Filed: 03/26/2019 Page: 11 of 12
constitutional violation, South Georgia Correctional Medicine was not subject to
municipal liability. See Los Angeles v. Heller, 475 U.S. 796, 799 (1986).
The failure of Sheriff Wooten to train his officers regarding drug withdrawal
syndrome did not exhibit deliberate indifference to Brandi Jones’s constitutional
rights. Sredrick Jones argues that Sheriff Wooten refrained from training his
officers although he knew training was needed based on “a widespread pattern of
prior abuse” of “inmates suffering withdrawal”; caselaw that makes it unlawful to
delay or to withhold from inmates treatment for alcohol withdrawal syndrome; and
“obvious” guidance provided in our precedents. See Keith v. DeKalb Cty., Ga., 749
F.3d 1034, 1053 (11th Cir. 2014); Willingham v. Loughnan, 321 F.3d 1299, 1302
(11th Cir. 2003). But Sredrick Jones’s evidence fails to establish that inmates were
neglected or denied treatment by untrained employees. See Keith, 749 F.3d at
1053. Nurse Bass’s testimony that she saw more than 50 inmates suffering from
withdrawal syndrome at the jail established only that inmates experienced
withdrawal syndrome. And Travis, who witnessed inmates suffering from
withdrawal syndrome, said the jail “most of the time. . . put them on Vistaril and
something for nausea . . . .” Sredrick Jones also cites no precedent that clearly
established the need for Sheriff Wooten to train his officers to identify drug
withdrawal syndrome. See id. Our caselaw may “put supervisors on notice that
policies or customs of delayed investigation into and the treatment of alcohol
11 Case: 18-14459 Date Filed: 03/26/2019 Page: 12 of 12
withdrawal would be unlawful,” Harper, 592 F.3d at 1237, but it does not address
training officers to identify signs of drug withdrawal, see Hoyt v. Cooks, 672 F.3d
972, 977 (11th Cir. 2012) (“[P]recedent . . . [must] stake[] out a bright line.”). And
our precedents that hold that the “knowledge of the need for medical care and an
intentional refusal to provide that care constitutes deliberate indifference,” Adams
v. Paog, 61 F.3d 1537, 1543 (11th Cir. 1995), do not make it “obvious” that
officers at the Coffee County Jail required better training. See Willingham, 321
F.3d at 1302. The record contains no evidence that a jail official subjectively knew
that Brandi Jones needed medical care.
IV. CONCLUSION
We AFFIRM the summary judgment in favor of Nurse Bass, South Georgia
Correctional Medicine, and Sheriff Wooten.