Qualified Immunity for Nonmedical Jail Officers Who Defer to Medical Staff Absent Clear Notice of Inadequate Care (and Waiver of Unpreserved Monell Theories)

Introduction

In Nicholas Zemlick v. Brad Burkhart, et al., No. 24-2799 (7th Cir. Jan. 22, 2026), the Seventh Circuit affirmed summary judgment for a county sheriff and two jail officers on a pretrial detainee’s Fourteenth Amendment medical-care claims under 42 U.S.C. § 1983, as well as on an official-capacity Monell claim.

Nicholas Zemlick, a pretrial detainee at the Hancock County Jail, underwent an elective off-site abdominal procedure (colostomy reversal). While recovering at the jail, his surgical wound worsened and ultimately required emergency hospital surgery for infection. Zemlick recovered fully but sued: (1) Sheriff Brian Burkhart (policy-maker for the jail), (2) Lieutenant Matthew Boots (assistant jail commander), and (3) Corporal Luke Schmidt (overnight shift commander). He claimed they were deliberately indifferent to his serious medical needs, and he asserted a Monell theory that the Sheriff’s policies (variously framed as resource/staffing deficiencies and later training failures) caused the constitutional deprivation.

The appeal centered on two themes: (i) the extent to which nonmedical jail officers may rely on medical staff without incurring constitutional liability, especially under the objective Fourteenth Amendment framework for detainees; and (ii) whether qualified immunity and procedural waiver doctrines foreclose liability even when the detainee’s outcome was serious.

Summary of the Opinion

The Seventh Circuit (Kolar, J.) affirmed across the board, holding:

  • Sheriff Burkhart (individual capacity): No evidence of personal involvement in any constitutional deprivation; approving payment for elective surgery did not connect him to subsequent care decisions. Supervisory liability requires more than negligence and cannot be vicarious.
  • Lieutenant Boots (individual capacity): Qualified immunity applied because it was not clearly established in December 2020 that Boots had to do more than defer to ongoing medical care where Zemlick was housed near medical staff and receiving treatment. At most, any failure to relay complaints sounded in negligence, which is insufficient for a due process claim.
  • Corporal Schmidt (individual capacity): Qualified immunity applied to Schmidt’s decision to wait roughly two hours for a shift change before transporting Zemlick (by officer transport rather than ambulance), where a nurse advised that an ambulance was unnecessary and Zemlick was already under medical supervision. Existing precedent did not place the unlawfulness of the two-hour delay “beyond debate.”
  • Monell (official capacity): The district court properly found waiver where Zemlick advanced a new Monell theory at summary judgment that was not preserved in the court-ordered “statement of claims.” In any event, the Monell claim failed on the merits for lack of evidence of a policy/custom, deliberate municipal action, or causation as the “moving force” behind a constitutional violation.

Analysis

Precedents Cited

1) Summary judgment and appellate review standards

  • Anderson v. Liberty Lobby, Inc., 477 U.S. 242 (1986): The court applied the familiar rule of viewing evidence and reasonable inferences in the nonmovant’s favor.
  • James v. Hale, 959 F.3d 307 (7th Cir. 2020): Provided the de novo standard of review for summary judgment.
  • Miller v. Gonzalez, 761 F.3d 822 (7th Cir. 2014): Reiterated that courts may not weigh evidence or make credibility determinations at summary judgment.

2) The Fourteenth Amendment medical-care framework for pretrial detainees

  • Miranda v. County of Lake, 900 F.3d 335 (7th Cir. 2018): Anchored the governing approach for pretrial detainees’ medical-care claims under the Fourteenth Amendment’s Due Process Clause and emphasized the “division of labor” permitting nonmedical staff to “generally trust” medical professionals.
  • Pittman v. Madison County, 108 F.4th 561 (7th Cir. 2024) (“Pittman IV”): Supplied the operative articulation of the objective standard: whether defendants failed to take reasonable measures even though reasonable officers would have understood the high degree of risk. Critically, it clarified the claim is assessed objectively (no need to prove subjective awareness).

3) Qualified immunity doctrine and “clearly established law”

  • Harlow v. Fitzgerald, 457 U.S. 800 (1982): Classic formulation—officials are immune unless they violate clearly established rights a reasonable person would know.
  • Mullenix v. Luna, 577 U.S. 7 (2015): Reiterated qualified immunity protects all but the plainly incompetent or those who knowingly violate the law.
  • District of Columbia v. Wesby, 583 U.S. 48 (2018): Reaffirmed the two-step qualified-immunity framework and urged caution before deciding constitutional merits; the panel used this to justify resolving Boots and Schmidt primarily on “clearly established” grounds.
  • Ashcroft v. al-Kidd, 563 U.S. 731 (2011): Provided the “beyond debate” standard for clearly established law.
  • Camreta v. Greene, 563 U.S. 692 (2011): Quoted (via Wesby) for the admonition to think carefully before addressing merits when qualified immunity may resolve the case.

4) Personal involvement and supervisory liability under § 1983

  • Gentry v. Duckworth, 65 F.3d 555 (7th Cir. 1995): Required personal responsibility for § 1983 liability; no vicarious liability.
  • Jones v. City of Chicago, 856 F.2d 985 (7th Cir. 1988): Explained indirect supervisory liability requires more than negligence—supervisors must facilitate, approve, condone, or “turn a blind eye.” This framed why Sheriff Burkhart’s lack of involvement was dispositive.
  • Whitfield v. Spiller, 76 F.4th 698 (7th Cir. 2023): Reiterated that § 1983 liability is assessed defendant-by-defendant, supporting the panel’s individualized treatment of Burkhart, Boots, and Schmidt.

5) Deference by nonmedical officers to medical staff

  • Johnson v. Doughty, 433 F.3d 1001 (7th Cir. 2006): Key reliance case—nonmedical officials are not deliberately indifferent for failing to respond directly to medical complaints when the prisoner is already being treated by a doctor. The panel treated this as consistent with later Fourteenth Amendment developments.
  • Berry v. Peterman, 604 F.3d 435 (7th Cir. 2010): Emphasized the law “encourages” deference to professional medical judgment without fear of liability; central to rejecting the notion that officers must override medical staff.
  • Greeno v. Daley, 414 F.3d 645 (7th Cir. 2005): Quoted for the principle that nonmedical officials are generally justified in believing an inmate is in capable hands when treated by medical staff.
  • Spruill v. Gillis, 372 F.3d 218 (3d Cir. 2004): Cited (via Greeno) for similar deference logic, showing cross-circuit support for the “division of labor” concept.
  • King v. Kramer, 680 F.3d 1013 (7th Cir. 2012): Recognized a limit to deference: nonmedical staff may be liable if they have reason to believe medical staff are mistreating or not treating an inmate.
  • Riccardo v. Rausch, 375 F.3d 521 (7th Cir. 2004): Noted jail staff must distinguish serious risks from feigned ones and need not be “credulous” or flawless—used to contextualize Boots’s skepticism toward generalized complaints.
  • McGee v. Parsano, 55 F.4th 563 (7th Cir. 2022): Though post-dating the events, it synthesized King and reinforced that officers need not override medical judgment unless they have reason to know treatment is inadequate; the panel used it as an explanatory roadmap (not as the source of clearly established law in 2020).
  • Estate of Perry v. Wentzel, 872 F.3d 439 (7th Cir. 2017): Supported reliance on a nurse’s judgment even amid alarming symptoms; used to show that visible distress does not automatically negate deference when medical staff are engaged.
  • Arnett v. Webster, 658 F.3d 742 (7th Cir. 2011): Invoked to underscore that where medical staff are not “completely ignoring” the detainee, a nonmedical officer’s deference is generally not clearly unlawful.

6) Negligence vs. constitutional wrongdoing under due process

  • Rosario v. Brawn, 670 F.3d 816 (7th Cir. 2012): Stressed that negligence cannot support a due process violation.
  • Daniels v. Williams, 474 U.S. 327 (1986): Foundational point: negligent conduct does not offend the Due Process Clause.
  • First Midwest Bank v. City of Chicago, 988 F.3d 978 (7th Cir. 2021): Highlighted the “high bar” for deliberate indifference; even gross negligence is insufficient.

7) Delay-of-care cases (what counts as constitutionally significant delay)

  • Mitchell v. Kallas, 895 F.3d 492 (7th Cir. 2018): Recognized resource constraints can make some delay inevitable.
  • Grieveson v. Anderson, 538 F.3d 763 (7th Cir. 2008): Illustrative of actionable delay where officers waited nearly two days despite knowing of a painful broken nose.
  • Knight v. Wiseman, 590 F.3d 458 (7th Cir. 2009): Found a roughly 2.5-hour delay not actionable; the panel used it to show short delays are not automatically unconstitutional.
  • Lewis v. McLean, 864 F.3d 556 (7th Cir. 2017): Allowed liability where an officer did literally nothing despite severe distress, contributing to a 1.5-hour delay—distinguished here because Zemlick was already under medical care and the nurse was directing transport decisions.

8) Eighth Amendment vs Fourteenth Amendment medical-care lineage

  • Estelle v. Gamble, 429 U.S. 97 (1976): Referenced to locate Johnson v. Doughty within Eighth Amendment doctrine while clarifying, via Pittman IV, that detainee claims are objective under the Fourteenth Amendment.

9) Monell and municipal-liability causation standards

  • Monell v. Dep't of Soc. Servs., 436 U.S. 658 (1978): Established that municipalities (and official-capacity defendants) are liable only for constitutional injuries caused by policy or custom.
  • Burks v. Raemisch, 555 F.3d 592 (7th Cir. 2009): Reiterated § 1983 does not allow vicarious liability for higher-level officials.
  • Walker v. Sheahan, 526 F.3d 973 (7th Cir. 2008): Emphasized the requirement that the deprivation be caused by the governmental unit’s own policy or custom.
  • Board of County Comm'rs v. Brown, 520 U.S. 397 (1997): Provided the “moving force” and “requisite degree of culpability” causation requirements; the panel used it to reject Zemlick’s unsupported staffing/training theories.

10) Procedural waiver and local practice (statement of claims) at summary judgment

  • Dysland v. Shelter Moving & Storage, Inc., 2022 WL 18540516 (S.D. Ind. Sept. 7, 2022): Cited to show S.D. Indiana routinely treats unlisted claims in the statement of claims as abandoned/forfeited/waived.
  • Jackson v. Regions Bank, 838 F. App'x 195 (7th Cir. 2021): Supported the district court’s discretion to enforce the statement-of-claims requirement.
  • Frakes v. Peoria School District No. 150, 872 F.3d 545 (7th Cir. 2017): Recognized district courts’ authority under Rule 83 to adopt local rules consistent with the Federal Rules.
  • Hinterberger v. City of Indianapolis, 966 F.3d 523 (7th Cir. 2020): Reaffirmed district courts may require strict compliance with local rules.
  • Alioto v. Town of Lisbon, 651 F.3d 715 (7th Cir. 2011): Clarified that complaints need not plead legal theories; used to justify the district court’s later requirement that Zemlick articulate theories in the statement of claims.
  • Elizarri v. Sheriff of Cook County, 901 F.3d 787 (7th Cir. 2018): Supported the district court’s discretion to require theory specification at a later procedural stage.
  • Keck Garrett & Assocs. v. Nextel Commc'ns, Inc., 517 F.3d 476 (7th Cir. 2008): Applied waiver at summary judgment where a party fails to defend a claim when challenged.

Legal Reasoning

1) The court’s operative constitutional test: objective reasonableness under the Fourteenth Amendment

Building on Miranda v. County of Lake and Pittman v. Madison County (“Pittman IV”), the court framed Zemlick’s claim as an objective inquiry: whether each defendant failed to take reasonable available measures to abate a serious risk of harm that reasonable officers would recognize, making the consequences obvious. This matters because Zemlick did not need to prove the officers’ subjective awareness, but he still had to show conduct that was objectively unreasonable—not merely imperfect, mistaken, or negligent.

2) Individual capacity: personal involvement and the Sheriff’s distance from care

As to Sheriff Burkhart, the court applied the bedrock § 1983 requirement of personal responsibility (Gentry v. Duckworth) and the limits on supervisory liability (Jones v. City of Chicago). Approving payment for elective surgery did not connect Burkhart to the subsequent alleged lapses in day-to-day wound care, antibiotic decisions, monitoring gaps, or transport decisions. Without evidence that Burkhart facilitated, condoned, or turned a blind eye to known unconstitutional conduct, the individual-capacity claim could not proceed.

3) Qualified immunity as the decisive filter for Boots and Schmidt

For Lieutenant Boots and Corporal Schmidt, the panel largely resolved the case at qualified immunity step two (clearly established law), following District of Columbia v. Wesby and the “beyond debate” formulation in Ashcroft v. al-Kidd.

a) Boots: deference to medical staff and generalized complaints

The reasoning proceeded in two moves:

  • Deference principle: The court treated existing precedent—particularly Johnson v. Doughty, Berry v. Peterman, Miranda v. County of Lake, Greeno v. Daley, and Estate of Perry v. Wentzel—as establishing that nonmedical officers are generally entitled (and encouraged) to rely on medical professionals who are actively treating an inmate/detainee.
  • No “reason to know” of mistreatment: Under the limiting principle of King v. Kramer, liability could arise if Boots had reason to believe medical staff were mistreating or not treating Zemlick. But Boots knew Zemlick was housed near medical staff and receiving ongoing care (including dressing changes and antibiotics), and Zemlick’s complaints were described as too general to clearly signal constitutionally inadequate treatment. At most, a failure to relay complaints sounded in negligence, and negligence is categorically insufficient (Daniels v. Williams; Rosario v. Brawn; reinforced by Miranda v. County of Lake).

Thus, even assuming Boots handled complaints poorly, precedent did not clearly require Boots to override or second-guess medical care in these circumstances.

b) Schmidt: a two-hour transport delay while following a nurse’s guidance

Zemlick’s theory against Schmidt focused on the roughly two-hour delay to await the 6 a.m. shift change and the failure to call an ambulance. The court surveyed delay-of-care cases:

  • Grieveson v. Anderson (nearly two days without treatment for a broken nose) exemplified actionable delay.
  • Knight v. Wiseman (about 2.5 hours to treatment) exemplified nonactionable short delay.
  • Lewis v. McLean (officer did “literally nothing” despite severe distress, contributing to 1.5-hour delay) illustrated that even shorter delays can be actionable when the officer is the sole gatekeeper to care.

The panel distinguished Schmidt’s situation from Lewis and Grieveson because Zemlick was already under medical supervision and the nurse advised that an ambulance was unnecessary and that transport could wait for the shift change. While the nurse also made a dramatic statement (“he’s going to die”), the court read the record as not establishing that she believed death was imminent or that immediate ambulance transport was required. With medical staff already engaged, and with no controlling precedent requiring a nonmedical officer to override a nurse’s non-emergent transport plan, the unlawfulness of Schmidt’s conduct was not clearly established.

Importantly, the court rejected the broader implication of Zemlick’s argument: a constitutional right for detainees to demand that nonmedical officers “veto” medical staff judgments and immediately transport them to the hospital upon request. The cited cases, especially Berry v. Peterman and Miranda v. County of Lake, point in the opposite direction—toward structured reliance on medical professionals.

4) Official capacity / Monell: waiver plus failure of proof

The court affirmed on two independent grounds:

  • Procedural waiver: The district court enforced its case management order requiring a “statement of claims” identifying the legal theories for trial. Zemlick pursued one theory (resource/staffing priorities) but opposed summary judgment using a different theory (training failures). Under the Southern District of Indiana’s practice (Dysland v. Shelter Moving & Storage, Inc.), and Seventh Circuit approval of strict enforcement (Jackson v. Regions Bank; Hinterberger v. City of Indianapolis; consistent with Rule 83 as discussed in Frakes v. Peoria School District No. 150), the new theory could be treated as waived. Separately, by not defending the original theory in summary judgment briefing, Zemlick waived it as well (Keck Garrett & Assocs. v. Nextel Commc'ns, Inc.).
  • Merits failure under Monell causation standards: Even without waiver, Zemlick offered no evidence of a policy/custom causing the deprivation (Monell v. Dep't of Soc. Servs.; Walker v. Sheahan), nor “deliberate conduct” that was the “moving force” behind a constitutional violation (Board of County Comm'rs v. Brown). The record instead indicated training to alert medical staff, escalation procedures, hourly rounds, and round-the-clock access to medical staff—facts undermining a claim of deliberate institutional indifference through staffing or training.

Impact

1) Reinforcement of “medical deference” in the post-Miranda, objective Fourteenth Amendment era

The opinion strengthens a practical rule for detainee medical-care litigation in the Seventh Circuit: even under an objective standard, nonmedical officers generally remain entitled to rely on active medical treatment unless there are concrete indicators that medical staff are not treating or are providing obviously inadequate care. The decision aligns the older Eighth Amendment “reliance” cases (e.g., Johnson v. Doughty) with the Fourteenth Amendment objective framework by treating them as relevant to what was “clearly established” for qualified immunity purposes.

2) Qualified immunity’s “clearly established” requirement as the decisive battleground

By resolving Boots’s and Schmidt’s claims at step two, the panel underscores a recurring dynamic: plaintiffs may plausibly argue that better action was available, but still lose because no prior case makes the unlawfulness of the precise conduct “beyond debate.” In medical-care cases involving coordination with medical staff, that hurdle is especially high.

3) Delay claims: context matters—especially whether medical staff are already engaged

The decision signals that short delays (on the order of hours) are unlikely to defeat qualified immunity where (i) medical staff are already aware and involved, and (ii) officers act consistently with medical guidance. Plaintiffs aiming to impose liability for short delays will likely need facts closer to Lewis v. McLean—where the officer is the functional gatekeeper and does “literally nothing”—or longer delays akin to Grieveson v. Anderson.

4) Monell pleading vs. Monell preservation: procedural discipline in S.D. Indiana

The opinion highlights a litigation trap: while a complaint need not plead legal theories (Alioto v. Town of Lisbon), a district court can require later theory specification in a “statement of claims” (Elizarri v. Sheriff of Cook County) and can deem unpreserved theories waived. For civil-rights litigators, the case is a cautionary precedent about aligning discovery, expert proof, and summary-judgment briefing with the theories preserved in court-ordered case statements.

Complex Concepts Simplified

  • Deliberate indifference (pretrial detainee / Fourteenth Amendment): Here it means objectively unreasonable failure to take reasonable measures to address a serious medical risk. It is more demanding than malpractice or negligence.
  • Objective vs. subjective standards: Under Pittman v. Madison County (“Pittman IV”) and Miranda v. County of Lake, the court asks what a reasonable officer would understand and do (objective), rather than what the officer actually knew or intended (subjective).
  • Qualified immunity: Even if a plaintiff alleges a constitutional violation, officials are immune unless prior law clearly put them on notice that the specific conduct was unlawful. “Clearly established” typically requires closely analogous precedent.
  • Nonmedical deference to medical staff: Jails operate with a division of labor. Officers generally may rely on nurses and doctors already treating a detainee, unless there are clear reasons to think care is being denied or is plainly inadequate.
  • Monell claim: An official-capacity claim is really a claim against the governmental entity. Liability requires that a policy/custom (not just an employee’s mistake) caused the constitutional injury, and that the policy/custom was the “moving force.”
  • Waiver at summary judgment: If a party changes theories late or fails to defend a theory when challenged, courts may treat the claim/theory as waived—even if it was loosely referenced earlier.

Conclusion

The Seventh Circuit’s decision affirms a protective rule for nonmedical jail personnel: absent concrete notice that medical staff are failing to treat or are providing obviously inadequate care, officers may generally defer to medical professionals without exposing themselves to personal liability—particularly where qualified immunity’s “clearly established law” requirement is not met. The case also underscores the procedural rigor of Monell litigation: plaintiffs must both preserve theories in required case statements and produce evidence of an actionable policy/custom that is the moving force behind a constitutional violation.