Lara‑Grimaldi and the Objective Deliberate Indifference Standard: Holistic Suicide‑Risk Assessment and Limits on Summary Judgment in Pretrial Detainee Cases

Introduction

In Lara‑Grimaldi v. County of Putnam, the Second Circuit revisits the contours of a pretrial detainee’s Fourteenth Amendment right to protection from self‑harm, applying the objective deliberate indifference framework crystallized in Kingsley v. Hendrickson and Darnell v. Pineiro. The case arises from the tragic death of 23‑year‑old Alexandra Grimaldi, who attempted suicide during acute heroin withdrawal while detained at the Putnam County Correctional Facility (PCCF) and later died from complications.

Plaintiff Nancy Lara‑Grimaldi, individually and as administratrix of her daughter’s estate, sued the County and multiple officials under 42 U.S.C. § 1983 and New York law. The district court granted summary judgment to key individuals—Sergeant Karen Jackson, Correction Officer Steven Napolitano (the booking officer), and Correction Officer Michelle Nigro (the housing officer on the morning/afternoon of the attempt)—and granted summary judgment to the County on the Monell claim, then declined supplemental jurisdiction over state claims.

On appeal, plaintiff focused solely on the § 1983 dismissals as to Jackson, Napolitano, and Nigro. The panel (Kearse, Lynch, and Nardini, JJ.) affirmed in part and vacated in part, reinstating the § 1983 claim against Nigro and reviving all state‑law claims.

This opinion is significant for three reasons:

It underscores that pretrial detainee deliberate indifference is judged by an objective “knew or should have known” standard, not the officers’ subjective beliefs.
It insists on a holistic assessment of suicide risk factors (mental health, prior attempt, and imminent withdrawal), rather than piecemeal analysis of each factor “without more.”
It tightens summary judgment practice: courts must view the record as a whole in the light most favorable to the nonmovant, disregard favorable evidence that a jury need not believe, and recognize that surveillance footage and inaccurate log entries create triable issues.

Summary of the Opinion

The court affirmed summary judgment for Jackson and Napolitano on the Fourteenth Amendment deliberate indifference claims. Their intake‑day conduct—recommending routine supervision consistent with prior incarcerations and the nurse’s intake evaluation—could at most be negligent, not constitutionally reckless.
The court vacated summary judgment for Nigro. Video evidence, inconsistent log entries and statements, and medical documentation permitted a reasonable jury to find that Nigro knew or should have known of an excessive risk (including withdrawal symptoms) and recklessly failed to act with reasonable care by omitting timely checks.
Because a federal claim survives against Nigro, the court vacated the dismissal of state‑law claims (negligence, wrongful death, respondeat superior, state constitutional claim) against Nigro, Jackson, Napolitano, and the County and remanded for further proceedings.
The remainder of the judgment was affirmed. Notably, plaintiff did not ask the Second Circuit to reinstate the § 1983 Monell claim against the County; that dismissal therefore stands.

Analysis

Precedents Cited and Their Influence

Farmer v. Brennan, 511 U.S. 825 (1994): Establishes Eighth Amendment “deliberate indifference” for convicted prisoners, requiring subjective awareness. Lara‑Grimaldi clarifies that this subjective test does not govern pretrial detainees’ Fourteenth Amendment claims.
Kingsley v. Hendrickson, 576 U.S. 389 (2015): Sets an objective standard for pretrial detainees; a plaintiff need not prove officers’ subjective awareness. The Second Circuit faults the district court for relying on officers’ subjective beliefs (“we didn’t think she was a suicide risk”), which are irrelevant to the objective standard.
Darnell v. Pineiro, 849 F.3d 17 (2d Cir. 2017): Translates Kingsley’s objective lens to deliberate indifference claims under the Fourteenth Amendment. A detainee must show the official acted intentionally or recklessly failed to act with reasonable care, though the official knew or should have known the condition posed an excessive risk to health or safety. The court repeatedly invokes Darnell’s “knew or should have known” language to stress that officers’ lack of actual knowledge does not defeat liability.
Charles v. Orange County, 925 F.3d 73 (2d Cir. 2019): Applies Darnell’s objective standard to medical care claims and recognizes that whether officials knew or should have known is a factual question provable via circumstantial evidence. The court uses Charles to emphasize that circumstantial proof—like surveillance, logs, and contemporaneous medical records—can ground a jury finding of reckless disregard beyond negligence.
Reeves v. Sanderson Plumbing Products, Inc., 530 U.S. 133 (2000); Anderson v. Liberty Lobby, Inc., 477 U.S. 242 (1986); Porter v. Dartmouth‑Hitchcock, 92 F.4th 129 (2d Cir. 2024): Supply the summary judgment framework:
- View the record as a whole in the nonmovant’s favor; do not weigh credibility.
- Disregard favorable evidence to the moving party that a jury is not required to believe.
O’Bert v. Vargo, 331 F.3d 29 (2d Cir. 2003): Cautions against uncritical acceptance of self‑serving accounts where the decedent cannot testify, reinforcing skepticism at summary judgment of defendants’ unilateral narratives.
Other cited authorities: Revere, Weyant, Cuoco, Hathaway, Smith v. Carpenter are invoked to define serious medical needs and the constitutional baseline, particularly as psychiatric crises can present urgent needs that risk death.

Legal Reasoning and Application

1) Error in relying on subjective beliefs and piecemeal risk analysis

The panel underscores that the “deliberate indifference” inquiry for pretrial detainees is objective. District courts may not credit officers’ assertions that they did not “believe” a detainee was suicidal or lacked “knowledge” of risk; the question is whether they knew or should have known of an excessive risk and acted (or failed to act) reasonably in light of it.

Equally important, the court rejects a piecemeal approach that examines mental illness, a prior attempt, and imminent withdrawal “without more.” The risk must be assessed holistically. The district court’s statements that bipolar disorder plus a prior attempt four years earlier do not, “without more,” indicate a significant risk, and that expected withdrawal, “without more,” does not either, improperly siloed factors that together could materially elevate risk.

2) What the record required the court to accept (and to disregard) at summary judgment

Applying Reeves and Porter, the Second Circuit criticizes three aspects of the district court’s summary judgment analysis:

Overcrediting defense‑favorable testimony: The district court accepted, as indisputable, Diaz’s testimony that Grimaldi asked for Clonidine “for later that night,” partly because Diaz was not a defendant. That is not a valid summary judgment rationale; a court must disregard even neutral witness testimony if a jury need not believe it, especially where other record evidence (including Diaz’s own contemporaneous statement) cuts the other way.
Ignoring favorable nonmovant evidence and context: The court emphasized Nurse Stewart’s note “no symptoms now,” but omitted its context: “may need to be revisited if symptoms reemerge,” which implies earlier symptoms and heightened vigilance going forward. It also overlooked that the COWS assessments registered “mild” withdrawal both at intake and the next morning—contradicting a finding of “no symptoms.”
Failing to analyze the record as a whole: The district court stated that “all available circumstantial evidence” suggested no symptoms before 2:30 p.m. But the record included Diaz’s contemporaneous written statement that at about 10:00 a.m. “inmate complained about mild withdrawal symptoms,” as well as the COWS scores and the Stewart caveat—all pointing to the presence of symptoms well before 2:30 p.m.

3) Distinguishing the defendants’ roles: Intake (Jackson and Napolitano) vs. Supervision (Nigro)

The Second Circuit carefully separates the intake defendants from the housing officer:

Napolitano (booking officer) and Jackson (sergeant):
- On October 27, they recommended routine supervision after intake screening. Their decision aligned with prior incarcerations (no constant watch had ever been imposed; at times 15‑minute checks were recommended), and a nurse independently found no suicidal ideation and only mild withdrawal at intake.
- Although Nurse Stewart warned that supervision might need to be “revisited” if symptoms reemerged, and although cross‑shift communication was less than ideal, the court concluded any failure to brief successors was, on this record, at most negligent and not constitutional recklessness. Plaintiff lacked counter‑evidence to create a triable issue that these intake decisions or communications reflected a reckless disregard of an excessive suicide risk.
Nigro (housing officer on October 28):
- Nigro was responsible for care and 30‑minute checks from 7:30 a.m. to 3:30 p.m. She personally escorted Grimaldi to the 10:00 a.m. COWS evaluation and again to medical around 1:00 p.m., when Grimaldi asked for Clonidine—a medication commonly used for opiate withdrawal symptoms.
- Critical evidence: The Sheriff’s review of PCCF surveillance video established about a 40‑minute gap between Nigro’s last appearance on the unit and the discovery of Grimaldi hanging at 3:18 p.m. The Sheriff concluded Nigro’s log and memorandum entries claiming a 3:00 p.m. check were “inaccurate” and “false.” Nigro’s deposition nevertheless insisted checks were timely.
- Combined with Diaz’s contemporaneous note that Grimaldi complained of “mild withdrawal symptoms” at 10:00 a.m., the COWS scores, and Stewart’s “revisit” warning, a jury could reasonably find that Nigro knew or should have known of an elevated risk and recklessly failed to act with reasonable care by omitting a timely check. The inconsistencies in Nigro’s account and the video record preclude summary judgment.

4) What did not change: The threshold above negligence remains

Consistent with Darnell, the panel reiterates that mere negligence does not violate due process; the Constitution requires intentional acts or reckless failures to act with reasonable care despite a known (or knowable) excessive risk. The court’s split result reflects that standard: intake judgments here—viewed against prior history and the nurse’s findings—did not rise above negligence; the supervision omissions and contradicted accounts during the critical window did.

Impact and Implications

Holistic risk assessment is mandatory: Courts and corrections officials must consider the cumulative risk from mental illness, prior attempts, and imminent physiological stressors like opioid withdrawal. Evaluating any factor “without more” is legally insufficient.
Objective standard polices the use of “we didn’t know” defenses: Officers’ subjective beliefs or professed ignorance cannot defeat a Fourteenth Amendment claim where the facts show they knew or should have known of an excessive risk.
Surveillance video and recordkeeping matter: When video contradicts log entries or post‑incident memoranda, summary judgment is disfavored. Falsified or inaccurate checks can be powerful circumstantial evidence of reckless disregard.
Summary judgment rigor sharpened: District courts must:
- Disregard movant‑favorable evidence that a jury is not required to credit, even from non‑defendant witnesses.
- Avoid piecemeal appraisal; assess the full record in the nonmovant’s favor.
Operational guidance for facilities:
- Ensure faithful adherence to supervision intervals and accurate logging, particularly when nurses flag evolving risks (“revisit if symptoms reemerge”).
- Institutionalize shift‑to‑shift handoffs that highlight evolving risks (e.g., expected withdrawal escalation) even if intake did not warrant constant watch.
- Train staff that detainee requests for withdrawal‑related medications (e.g., Clonidine) are risk cues requiring heightened observation and prompt reevaluation of supervision levels.
Litigation posture: Plaintiffs should marshal contemporaneous medical notes (e.g., COWS scores, nurse statements), surveillance video, and log discrepancies to survive summary judgment. Defendants should not expect subjective disclaimers to carry the day under Kingsley/Darnell.
Municipal liability landscape: The Monell dismissal remains intact in this appeal because plaintiff did not pursue it; however, revival of state‑law claims (including respondeat superior) against the County may carry substantial exposure on remand, independent of § 1983.

Complex Concepts Simplified

Pretrial detainee vs. prisoner: Detainees (not yet convicted) invoke the Fourteenth Amendment’s Due Process Clause; prisoners invoke the Eighth Amendment. Detainees get at least as much protection, but the standard is objective for them.
Deliberate indifference (Fourteenth Amendment): Liability attaches if an official intentionally creates a risky condition or recklessly fails to act with reasonable care even though the official knew or should have known the condition posed an excessive risk. Negligence is not enough.
“Knew or should have known”: The test is not what the officer says she believed; it is what a reasonable officer would have understood given the facts (including medical notes, observable symptoms, and known history).
COWS (Clinical Opiate Withdrawal Scale): A scoring tool assessing opioid withdrawal severity. “Mild” scores still evidence withdrawal symptoms and can escalate, especially within 24–48 hours of last use.
Supervision levels: Routine checks (approximately every 30 minutes), 15‑minute checks, and constant supervision. Policies generally require upward adjustment if risk escalates.
Monell liability: A municipality is liable under § 1983 only if a constitutional violation was caused by a policy, practice, or failure to train—not via respondeat superior. Here, the Monell claim was not pursued on appeal; only state‑law claims against the County were revived.
Summary judgment basics: No weighing evidence or judging credibility; view the record favorably to the nonmovant; disregard movant‑favorable evidence the jury need not believe; deny summary judgment if a reasonable jury could find for the nonmovant.

Conclusion

Lara‑Grimaldi reinforces and operationalizes the Second Circuit’s objective deliberate indifference framework for pretrial detainees. It directs courts to assess suicide risk holistically and restricts reliance on officers’ subjective assertions of ignorance or benign intent. Surveillance footage and inconsistencies in supervision logs are recognized as potent circumstantial evidence that can defeat summary judgment.

On the merits, the court distinguishes intake decisions (Jackson and Napolitano), which aligned with prior history and contemporaneous medical findings and were, at most, negligent, from supervision failures (Nigro), where video‑corroborated omissions and contradictory records create a triable issue of reckless disregard in the face of known or knowable risks, including documented withdrawal symptoms earlier that day.

Practically, this decision will tighten summary judgment practice in detainee suicide cases, incentivize rigorous adherence to observation protocols and accurate recordkeeping, and ensure that correctional staff treat combined mental health vulnerabilities and impending withdrawal as a dynamic, escalating risk requiring vigilant checks and, when indicated, enhanced supervision.