Single-Incident Evidence and Unrelated Lawsuits Do Not Prove a Monell “Custom” of Delayed Outside Referrals for Jail Medical Care

Case: David Windom v. Orange County (11th Cir. May 21, 2026) (unpublished)

1. Introduction

In David Windom v. Orange County, the Eleventh Circuit affirmed summary judgment for Orange County on a § 1983 claim alleging deliberate indifference to an inmate’s serious medical needs. David Windom, formerly incarcerated at Orange County Jail (“OCJ”), contended that OCJ had internal money-saving policies and practices that discouraged referrals to outside medical providers, leading to delay in receiving specialized eye care and ultimately severe vision loss.

The appeal presented two central questions: (1) whether Windom properly challenged the district court’s summary-judgment inferences as being drawn against the nonmovant; and (2) whether Windom produced sufficient evidence of municipal liability—i.e., a County “policy or custom” under Monell v. Dep't of Soc. Servs.—causing a constitutional violation.

2. Summary of the Opinion

The Eleventh Circuit (per curiam) affirmed. It held:

• Issue abandonment: Windom’s argument that the district court failed to view the evidence in the light most favorable to him was not developed with record support and was therefore abandoned under Singh v. U.S. Atty. Gen. and Fed. R. App. P. 28(a)(8)(A).
• Municipal-liability failure: Windom did not create a genuine dispute that Orange County had a “persistent and wide-spread practice” (a “custom”) of deliberate indifference through discouraging outside referrals. His evidence—his own experience plus two other lawsuits alleging different policies—was insufficient.
• Scope of claim limited: The court emphasized that Windom’s theory was limited to delayed outside referral (not failure to provide eye drops), and it rejected attempts to shift theories at summary judgment or on appeal under Poer v. Jefferson Cnty. Comm'n and Access Now, Inc. v. Sw. Airlines Co..

3. Analysis

3.1. Precedents Cited

A. Summary judgment, record-based appellate review, and issue preservation

• Jones v. UPS Ground Freight: Supplies the de novo standard and the requirement to view evidence/inferences in the nonmovant’s favor. The court used it as the baseline rule but then found Windom failed to meaningfully apply the rule to the record.
• Ismael v. Roundtree and Young v. City of Palm Bay: Reinforce that a genuine dispute must be such that a reasonable jury could find for the nonmovant; a “mere scintilla” does not suffice. This framing supported the conclusion that Windom’s proof on municipal custom was too thin.
• Singh v. U.S. Atty. Gen.: The panel relied on this abandonment principle to decline review of Windom’s underdeveloped “light most favorable” argument.

B. Governing deliberate-indifference framework (individual constitutional violation)

• Estelle v. Gamble: The foundational rule that deliberate indifference to serious medical needs can violate the Eighth Amendment.
• Valderrama v. Rousseau: Provides the two-part structure—objective seriousness plus subjective deliberate indifference.
• Ireland v. Prummell: Supplies the articulation of the subjective inquiry and notes that “eventual care” does not automatically defeat a claim; delay must be evaluated by reason and medical need.
• Wade v. McDade (en banc): Tightens the subjective component by requiring “subjective recklessness as used in the criminal law.” The panel used this to describe the governing mental-state standard, though the dispositive holding turned on municipal policy/custom proof.
• Hamm v. DeKalb Cnty.: Addressed the Eighth/Fourteenth distinction. Because the record did not clarify whether Windom was convicted or a pretrial detainee, the court applied the same deliberate-indifference standard under either amendment, consistent with Hamm.

C. Municipal liability: policy/custom, persistence, and single-incident insufficiency

• Monell v. Dep't of Soc. Servs.: The controlling rule that municipalities are not liable under § 1983 on respondeat superior; liability requires a policy or custom causing the violation.
• Craig v. Floyd Cnty.: Quoted for the requirement to prove a “policy or custom” of deliberate indifference; also recognizes municipalities rarely have formal written policies endorsing constitutional violations, so plaintiffs usually must prove an unofficial custom.
• Sewell v. Town of Lake Hamilton (quoted in Ireland): Defines “custom” as a practice “so settled and permanent that it takes on the force of law.”
• Goebert v. Lee Cnty.: States plaintiffs must show a “persistent and wide-spread practice” to establish a custom.
• Myrick v. Fulton Cnty.: Reiterates that a single incident is insufficient to prove a policy or custom (unless the policy itself is unconstitutional). The panel used this to discount Windom’s reliance on his own episode alone.

D. Pleading/theory limits at summary judgment and on appeal

• Poer v. Jefferson Cnty. Comm'n: Plaintiffs may not raise new claims at the summary-judgment stage; this supported limiting Windom to his pleaded “outside referral” policy theory.
• Access Now, Inc. v. Sw. Airlines Co.: New arguments are generally not considered when raised for the first time on appeal.

E. How the court treated the “other lawsuits” evidence

Windom relied on two prior legal actions against OCJ:

• Muszinski v. Orange County (Case No. 6:03-cv-655-G_S-KRS): Alleged a policy of refusing methadone.
• Bryant v. Orange County (Case No. 6:17-cv-1423-GAP-LPH): Alleged a policy of minimizing documentation frequency.

The panel held these were not “sufficiently like” Windom’s asserted policy (discouraging outside referrals to save money). The analytic point is not that other litigation is categorically irrelevant; rather, it must be probative of the same custom—i.e., it must tend to show a persistent practice of the particular unconstitutional conduct at issue.

3.2. Legal Reasoning

A. The decision turned on the “policy or custom” element

Although the opinion recited the deliberate-indifference standard, the dispositive failure was Monell proof. The court framed Windom’s burden as establishing genuine disputes of material fact on three elements: (1) a constitutional violation; (2) a County policy/custom constituting deliberate indifference; and (3) causation. It affirmed because Windom did not raise a jury question on element (2).

B. Why Windom’s evidence failed under the “persistent and wide-spread practice” requirement

• Single episode limitation: Windom’s personal experience could be evidence but, standing alone, amounted to a single incident—insufficient under Myrick v. Fulton Cnty. and the broader Goebert v. Lee Cnty. requirement of persistence and breadth.
• Lack of fit from prior suits: The two cited actions concerned different alleged practices (methadone denial; documentation frequency) and did not show a consistent, settled practice of discouraging outside referrals.
• Theory discipline: The panel confined the case to the referral-delay theory because Windom pleaded that OCJ dissuaded referrals; it rejected any pivot to a different theory (e.g., non-provision of drops) as procedurally improper under Poer v. Jefferson Cnty. Comm'n and Access Now, Inc. v. Sw. Airlines Co..

C. The abandoned “light most favorable” argument

The panel enforced appellate briefing requirements: a generalized assertion that the district court favored the movant, without record citations or examples, is not enough. Under Fed. R. App. P. 28(a)(8)(A) and Singh v. U.S. Atty. Gen., the court treated the issue as abandoned. Practically, this underscores that summary-judgment appeals are won or lost on concrete, record-anchored disputes of fact and law.

3.3. Impact

• Reinforces the evidence threshold for Monell customs in jail-medical cases: Plaintiffs alleging cost-driven referral delays must marshal evidence beyond their own treatment—e.g., multiple similar incidents, consistent decisionmaker testimony, written or de facto referral constraints, statistical patterns, or admissions reflecting a settled practice.
• Clarifies relevance of other litigation: Prior lawsuits may have limited value unless they involve materially similar conduct; generalized “the jail has been sued before” will not establish a custom.
• Procedural discipline matters: The opinion is also a cautionary precedent on (a) confining the case to the pleaded theory, and (b) preserving issues through developed argument with record citations.
• Unpublished but instructive: Though “NOT FOR PUBLICATION,” the decision reflects the Eleventh Circuit’s continuing insistence on rigorous Monell proof and careful issue preservation in § 1983 appeals.

4. Complex Concepts Simplified

• Deliberate indifference: More than negligence or medical malpractice. It requires awareness of a substantial risk of serious harm and a reckless disregard of that risk (as described in Ireland v. Prummell and Wade v. McDade).
• Objective vs. subjective components: The condition must be serious (objective), and officials must have the culpable mental state (subjective) (Valderrama v. Rousseau).
• Monell “policy or custom”: A county is liable only for its own decisions or settled practices—not automatically for employees’ mistakes. A “custom” is an unwritten but entrenched practice that effectively operates like law (Monell v. Dep't of Soc. Servs.; Sewell v. Town of Lake Hamilton).
• Persistent and wide-spread practice: Courts generally require multiple similar events or other strong proof that the challenged conduct is routine and known, not a one-off mistake (Goebert v. Lee Cnty.).
• Summary judgment: A case-ending ruling when no reasonable jury could find for the nonmoving party on a material fact, even viewing evidence favorably to the nonmovant (Jones v. UPS Ground Freight).
• Issue abandonment on appeal: If an appellant does not substantively argue an issue with record citations and legal reasoning, the court may treat it as forfeited (Singh v. U.S. Atty. Gen.).

5. Conclusion

David Windom v. Orange County underscores a recurring barrier to municipal liability in jail medical-care litigation: proving a Monell custom. The Eleventh Circuit held that Windom’s single experience—supplemented only by two unrelated prior lawsuits alleging different policies—could not demonstrate the “persistent and wide-spread practice” required to attribute deliberate indifference to the County itself. The decision also highlights two procedural fundamentals: appellate arguments must be developed with record support, and plaintiffs cannot retool their theory at summary judgment or on appeal. In the broader legal context, the case illustrates the evidentiary and procedural rigor that § 1983 plaintiffs must satisfy to move from an alleged individual wrong to municipal responsibility.