Ule v. Bexar County Hospital District

District Court, W.D. Texas·Decided September 22, 2020·No. 5:19-cv-01459·Unknown

Opinion

UNITED STATES DISTRICT COURT WESTERN DISTRICT OF TEXAS SAN ANTONIO DIVISION

JOE ULE, INDIVIDUALLY AND AS THE REPRESENTATIVE FOR THE ESTATE OF JACK ULE, DECEDENT,

Plaintiff,

v. No. 5:19-CV-01459-JKP-ESC

BEXAR COUNTY HOSPITAL DISTRICT, BEXAR COUNTY, SHERIFF JAVIER SALAZAR,

Defendants.

MEMORANDUM OPINION AND ORDER The Court has under consideration Defendants Bexar County and Sheriff Javier Salazar’s Motion to Dismiss. ECF No. 13. Plaintiff1 filed a response in opposition, see ECF No. 17, and Defendant filed a reply, see ECF No. 19. The motion is ripe for ruling. For the reasons that follow, the Court grants in part and denies in part the motion. BACKGROUND Accepted as true, Plaintiff’s complaint alleges the following factual allegations.2 Plaintiff Joe Ule is Jack Ule’s surviving brother. Jack Ule (“Jack”) died on April 18, 2019, while incarcerated as a pretrial detainee in the Bexar County Jail.3 At the time of his death, Jack was sixty-three years of age. He had previously been diagnosed with schizophrenia, atrial fibrillation,

1 Plaintiff Joe Ule brings this case in dual roles: individually and on behalf of his brother’s estate.

2 When conducting a Fed. R. Civ. P. 12(b)(6) analysis, a court must accept all of the factual allegations in the complaint as true. See Bell Atlantic Corp. v. Twombly, 550 U.S. 544, 555–56 (2007).

3 The parties use Bexar County Jail and Bexar County Adult Detention Center interchangeably. The Court uses the term “Bexar County Jail” or the “Jail.” hypertension, and an elevated “QTC.” Jack’s death was the result of “hypertrophic and dilated cardiomyopathy,” or an enlarged heart leading to heart failure. The events leading to Jack’s death, as relevant to Bexar County and Sheriff Salazar, are as follows. Jack’s history of mental illness began in his late twenties. In the year 2000, he was no longer able to work due to his mental illness. In 2015, after caring for his mother until her death,

Jack moved to Texas. Unable to work, Jack did not have health insurance and was homeless. In February 2019, Jack sought health care at Bexar County Hospital District d/b/a/ University Health Systems (“UHS”), where he was seen by health care providers at least eight times prior to his arrest on April 4, 2019. At his first visit to UHS on February 7, 2019, Jack was diagnosed with “Chronic Mental Illness.” Over the next two months, UHS police officers and Jack had multiple interactions when UHS officers were summoned for the following reasons: (1) Jack refused to “get up and out of the bed” after he had been discharged for refusing medical services (February 19, 2019); (2) a nurse complained that Jack was “touching/scratching” his genital area while in public view

(February 22, 2019); (3) Jack was lingering in the cafeteria (February 22, 2019); (4) Jack was sleeping in the cafeteria while waiting to be seen in the Emergency Department (February 23, 2019): (5) Jack was talking to himself and loitering in the cafeteria (March 13, 2019); (6) Jack received a written criminal trespass warning for “loitering and causing disturbance with staff” (March 19, 2019); (7) after he was discharged Jack would not allow medical staff to remove the IV from his arm and refused to leave because he did not have shoes (March 28, 2019). Each time, Jack was convinced to leave the hospital without incident. On April 4, 2019, Jack was arrested after he was found watching television in an unoccupied waiting area. It was shortly after midnight, so there was no one around and Jack was not bothering anyone. Jack told the officer that he had just been discharged from emergency but wanted to rest and watch television. The officer told Jack that watching television and loitering at the hospital were not permitted. The officer then detained Jack and escorted him to the “Behavioral Detainee” side of the UHS facility. After reviewing Jack’s history in the UHS database, the officer placed Jack in handcuffs and transported him to jail to be booked for

misdemeanor criminal trespassing. Jack was processed and jailed at the Bexar County Jail by an “unknown” jail administrator. Later that morning, Jack submitted to medical screening and a mental health assessment. During the mental health assessment, Jack admitted to being hospitalized multiple times for mental illness-related issues and also admitted to taking the antipsychotic Olanzapine at one point in his life. UHS provides medical services to Jail inmates including medical staff, on- site services, clinic, pharmacy, and in-patient care. On April 5, 2019, Jack was prescribed a daily dose of Olanzapine. Four days later Jack was observed as manic, irritable, and as having trouble getting to sleep. On April 9, 2019, a UHS employee permitted Jack to sign a refusal of medical

services. At that time, Jack had received two nonconsecutive doses of Olanzapine. On April 17, 2019, at 6:31 a.m., a “Code 1 (Medical Emergency)” was called because Jack was experiencing shortness of breath (“SOB”). Jack was seen by an LVN (licensed vocational nurse) who dismissed Jack’s complaint, noting Jack’s vital signs were “within normal limits” and that Jack had regularly complained of SOB “over the past 2 months.” The LVN put in a “plan for Mental Health” and had Jack returned to the pod. At 8:30 p.m., 9:00 p.m., and 11:30 p.m., Bexar County correctional officers sought medical attention for Jack. The officers relayed that Jack was requesting medical attention and was defecating and urinating on himself. The LVN deemed Jack’s request “not a medical emergency” and dismissed the incontinence as “behavioral.” At 12:30 a.m. on April 18, 2019, after an officer again expressed concern for Jack, the LVN decided to assess Jack’s status. The LVN determined that Jack was exhibiting “detention” issues, which were the purview of the officers. Jack died at 8:40 that morning. In December 2019, Plaintiff commenced this civil action asserting claims against Bexar County and Sheriff Salazar under 42 U.S.C. § 1983 and the Texas Constitution and against Bexar

County under the Americans with Disabilities and Rehabilitation Acts. See Pl.’s Orig. Compl. (ECF No. 4) at 26-49. Plaintiff’s complaint also names as defendant Bexar County Hospital District d/b/a/ University Health Systems (UHS), a political subdivision of the State of Texas. Id. at 1. Plaintiff’s claims arise from medical treatment Jack received from UHS between February 7, 2019 and April 18, 2019; from Jack’s arrest by a hospital district police officer on April 4, 2019; his two-week confinement at the Bexar County Jail between April 4, 2019 and April 18, 2019; and his death on April 18, 2019. ECF No. 13 at 1. Plaintiff specifically asserts Bexar County and Sheriff Salazar: (1) violated the Texas Constitution and Jack’s federal Fourteenth Amendment due process and equal protection rights

by confining him subject to a cash bail without making an adequate inquiry into his ability to pay, ECF No. 4, pars. 96-105; (2) violated the Texas Constitution, the Texas Code of Criminal Procedure, and Jack’s federal Fourteenth Amendment due process right to pretrial liberty by detaining him for an unconstitutionally prolonged period of time, id., pars. 106-114; and (3) subjected Jack to unconstitutional conditions of confinement when they provided constitutionally inadequate medical care, id., pars. 115-138.

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