Sims v. City of Jasper

Michael J. Truncale, United States District Judge

Thomas Dean Malone, Brandie Angelique Moser, Kristen Leigh Homyk, Michael Thomas O'Connor, Law Offices of Dean Malone, P.C., Dallas, TX, for Plaintiff.

William S. Helfand, Norman Ray Giles, Lewis Brisbois Bisgaard & Smith LLP, Houston, TX, Frank David Calvert, Calvert Eaves Clarke & Stelly, LLP, Beaumont, TX, for Defendants.

ORDER ON DEFENDANTS’ MOTION FOR SUMMARY JUDGMENT

Michael J. Truncale, United States District Judge Plaintiff Frances Earline Sims ("Plaintiff") filed this suit against Defendants after her son, Steven Mitchell Qualls ("Qualls"), died of a drug overdose while he was a pretrial detainee at the City of Jasper Jail. [See Dkt. 1]. Plaintiff sued the City of Jasper ("Jasper"), Sergeant Toderick D. Griffin, Officer Sterling Ramon Linebaugh, Dispatcher Heather O'Dell, and Detective Joshua L. Hadnot ("Individual Defendants") (collectively, "Defendants") for Qualls's death under 42 U.S.C. § 1983 (" Section 1983") based on violations of the Fourteenth Amendment to the United States Constitution. Before the Court is Defendants’ Motion for Summary Judgment. [Dkt. 63]. After considering the Motion and arguments from the parties, the Court GRANTS in part and DENIES in part the Motion.

Defendants previously moved to dismiss Plaintiff's complaint, and the Court granted Defendants’ motion in part, leaving only Plaintiff's Section 1983 claims. [See Dkt. 39].

I. BACKGROUND

This case arises from the death of a 28-year-old male with a known history of polysubstance abuse. After being arrested for public intoxication, Qualls was left in his street clothes and placed alone in a detox cell in the City of Jasper Jail. He remained there for thirty-four hours, over the course of three days, unable to stand or speak coherently. He moaned and yelled in pain, pleaded for help, vomited three times (once vomiting up part of a plastic bag), twitched and convulsed, hallucinated, and remained face-down on the floor or kneeling at the foot of the door for the most part outside of the view of video surveillance. The jailers periodically checked on Qualls through the cell's eye-level glass window and through video surveillance from the dispatch room. They also provided Qualls with food that he never ate, cleaned up his vomit, and disposed of the vomit-covered bag after they found it. At no point did the jailers seek emergency medical treatment for Qualls. Qualls ultimately died of a methamphetamine overdose and was found in his cell with rigor mortis already developed.

A. January 28, 2019

On January 28, 2019, about thirty-nine hours before Qualls's death, he was transported by an EMS unit to Jasper Memorial Hospital and admitted at 4:39 p.m. for chest pains, agitation, and tachycardia. [See Dkt. 63, Ex. L]. EMS stopped treatment when Qualls became combative and began hallucinating and refusing treatment. Around that time, non-defendant Jasper P.D. officers were dispatched to the hospital regarding Qualls's combative behavior in the ambulance.

i. Memorial Hospital

When the officers arrived at the hospital, Qualls was calm and no longer agitated. Medical records indicate there was a "strong smell" of methamphetamine on Qualls. Id. at 5–6, 10. The officers left the hospital but later returned at 5:05 p.m. because Qualls allegedly became disruptive again. Around 5:50 p.m., the officers contacted the Jasper County Sheriff's office because Qualls was originally picked up outside Jasper city limits and their shift was about to end.

At 6:40 p.m., Individual Defendants Sergeant Griffin and Officer Linebaugh arrived at the hospital. Sergeant Griffin and several hospital staff members were familiar with Qualls because he was a known drug user in the area. Sergeant Griffin told Officer Linebaugh, "I can't believe you don't know [Qualls]. Everybody knows him around here." The officers discussed Qualls's history with Jasper P.D. and advised Qualls that he must leave the hospital once he is discharged. The officers also discussed taking Qualls to a mental health facility called the Burke Center, but Sergeant Griffin responded, "They ain't going to take him if he's still high." During these interactions, Qualls's "speech [was] not great and his thoughts [were] delayed." Sergeant Griffin acknowledged that Qualls was intoxicated or under the influence of some drug. [See Dkt. 90, Ex. A] ("How long would it take him to come down off of whatever he is on?"); id. ("It's going to be at least three hours before he comes down off of anything."). After a nurse told the officers that Qualls had been given Ativan and would need a ride home later, the officers left the hospital.

At 8:30 p.m. Sergeant Griffin and Officer Linebaugh returned to the hospital because Qualls would not stay in his room, was agitated, and was talking to his reflection in the ER glass doors. An EMT told Sergeant Griffin that Qualls "seem[ed] just as bad as when we dropped him off hours ago," and a nurse responded, "because he's on meth." Hospital staff instructed the officers that Qualls should remain in the hospital for "four hours from coming in." The officers then left the hospital a second time.

At 9:50 p.m. Qualls was discharged from the hospital. His condition was listed as "improved" and his disposition listed as "self-care." [Dkt. 63, Ex. L]. Medical records indicate that Qualls was walking with a "steady gait," was "neurologically intact," and "no longer tachycardic." Id. at 10. At 9:52 p.m., Sergeant Griffin and Officer Linebaugh were dispatched to the hospital once again because Qualls refused to sign his discharge papers and leave the hospital. The officers escorted Qualls out and offered him a ride, but Qualls refused. At 10:05 p.m., the officers arrested Qualls for public intoxication.

ii. Book-in at Jasper City Jail

At 10:10 p.m., Sergeant Griffin and Officer Linebaugh arrived at the City of Jasper Police Department ("the City Jail") with Qualls. Qualls was able to walk on his own and sit down, though he was still "intoxicated badly." [Dkt. 63, Ex. M]. Officer Linebaugh filled out a Book-in Medical Form as he asked Qualls questions about his medical history, including whether Qualls had any drug addictions, needed medical treatment, or had ever attempted suicide. Qualls primarily responded "no," but at other times he either failed to respond or mumbled. At one point, Qualls stated that he "ain't alright in the head" and that he had previously tried to go to the Burke Center. The mental health section of the Medical Form states, "If yes to any questions below, Notify Supervisor, Magistrate, and Mental Health Officer." Id. Officer Linebaugh did not contact anyone regarding Qualls's mental health.

Following the book-in process, Sergeant Griffin conducted a two minute and fifteen second pat-down search of Qualls. He checked the inside of Qualls's pockets and removed his belt and shoes but did not require him to remove any other clothing. Because Qualls was intoxicated, Sergeant Griffin allowed Qualls to remain in his street clothes and did not dress him out in orange jail clothing. [See Dkt. 63, Ex. Q] ("Just felt like he needed to go ahead and get some rest, lay down ... didn't expect him to be long, be there in our custody long ....").

The officers then escorted Qualls into the detox cell at 10:17 p.m. This was the last time Qualls walked on his own. For the next thirty-four hours, from approximately 10:17 p.m. on January 28th to 7:38 a.m. on January 30th, Qualls remained on the floor of the detox cell.

B. January 29, 2019

For the first twenty hours of his detention, Qualls remained kneeling in the same spot at the base of the cell door. During this time, he never slept or ate any of the food he was given, and only a small portion of his lower body was in the view of the cell's surveillance camera.

Qualls was given breakfast, lunch, and dinner on January 29th. He was also given one cup of water at 10:19 on January 28th, but it is unclear whether he drank it.

During his first night in the detox cell, Qualls frequently called out to Individual Defendants as well as other Jasper PD staff. When the staff chose to respond back, Qualls either mumbled incoherently or gave no response. Qualls would occasionally respond by moving his arm, which hung outside the cell door's meal slot. At other times, Qualls banged on the cell door, mentioned non-existent voices or other people, and twitched involuntarily. Qualls also yelled for help multiple times:

• 3:52 a.m.: "Hello? Help. Damn. I've been ... Help ...."

• 3:56 a.m.: "Help. Help. I've been ... I need my ... Think ... [inaudible]."

• 4:33 a.m.: "Hello? Ma'am? .... Help ... I need ... Ugh ... Excuse me ... I want ... I .... Hey. Hey ... Hey."

• 4:38 a.m.: "I need a hospital please. I [inaudible] and my leg ... [inaudible]."

• 4:40 a.m.: "Help. Help. Help. Help. I'm sick. I'm ... I think it's like a f*cking ... And you ... I, I ... Ugh. Ugh. I want to ... Ugh. Ugh. I'm not."

• 4:44 a.m.: "Hey, someone help, I don't know ... right here. Hello?"

• 4:54 a.m.: "Help. Please. Please. Ugh. Please. I ... Mister .. I'd like ... Ugh ..."

• 5:00 a.m.: Qualls banged on the detox cell door repeatedly and called out, "Hello? Hey."

• 5:33 a.m.: "Hello" followed by mostly unintelligible words, including "Let me tell you something" and "I need ...."

During the day on January 29th, Qualls remained at the foot of the detox cell door and continued to call out for help a few more times and mumble incoherently at jailers as they walked by. At 6:28 p.m., Qualls crawled to the center of the cell, where he became more visible in the cell's surveillance camera.

At 7:05 p.m. Qualls vomited a dark black liquid, which he smeared around on the floor and rubbed his face in. He can be heard on video saying "hello" loudly a couple of times. At 7:20 p.m., Detective Hadnot noticed the vomit via the surveillance camera. Before he left, Detective Hadnot instructed Dispatcher O'Dell to call Sergeant Griffin and Officer Linebaugh to come check on Qualls. At 7:35 p.m. O'Dell entered the book-in area to assess the situation. Without opening the cell door, she told Qualls to "roll over" because he was lying flat on his stomach in the vomit. Qualls attempted to comply but was unsuccessful. The officers arrived and entered the detox cell at 7:45 p.m. to clean the vomit. When the officers picked Qualls up by his arms and legs to clean, Qualls screamed in pain. The dinner delivered to Qualls earlier remained unopened on the toilet.

Once outside of the detox cell, Dispatcher O'Dell told the officers that Qualls "threw up that black stuff last time I think," and the officers discussed the possibility that Qualls consumed charcoal. Dispatcher O'Dell asked Sergeant Griffin if EMS was needed, and Sergeant Griffin declined, saying that Qualls was just "coming down" and was "dehydrated." Sergeant Griffin then stated, "well he vomited, it's on him. I'm not gonna clean him up; he's a grown man." Dispatcher O'Dell asked what she should do if Qualls threw up again, and Officer Linebaugh told her to "just let him throw up" and laughed about not wanting to "hold his hair."

From 7:46 p.m. to 10:31 p.m., Qualls remained face down on his stomach on the floor. During that time, the officers twice came into the book-in area to briefly check on Qualls through the cell window. At 10:31 p.m., Qualls vomited a dark substance for a second time, and he rubbed the vomit around the floor with his hand. Qualls remained face down in the vomit while his body twitched and moved. Dispatcher O'Dell observed the vomit via the surveillance camara and informed Sergeant Griffin and Officer Linebaugh. At 10:51 p.m., the officers returned to the book-in area and entered the detox cell to mop up the vomit. Qualls again screamed in pain when the officers moved him. While mopping, Sergeant Griffin noticed a small tied-off piece of a bag on the floor covered in Qualls's vomit. The bottom of the bag was missing, and the rest of the bag was empty. Plaintiff alleges this bag was used to hold illegal narcotics. While much of the officers’ conversation is inaudible, Sergeant Griffin states, "He's gonna throw the rest of this sh*t up." Officer Linebaugh then asked Sergeant Griffin, "You think possibly he was able to call an ambulance, and then he swallowed it before they got there?" After examining the bag and talking with Officer Linebaugh about it, Sergeant Griffin threw the bag away. From 10:54 p.m. to 2:40 a.m. the next day, the officers intermittently entered the book-in area and observed Qualls laying on his stomach on the floor.

Plaintiff alleges that Sergeant Griffin also stated, "That whole f*cking bag was full."

C. January 30, 2019

Qualls vomited for the third time at approximately 2:40 a.m. on January 30th. The vomit was a similar black color, and Qualls again rubbed it around the floor. The officers did not clean up this vomit. From about 5:58 a.m. to 7:35 a.m., Qualls became more vocal, exhaling loudly, humming, singing, moaning, and talking as though people were in his cell with him. For example, Qualls yelled, "Hello! Hello! Hello! Oh, come on .... Sh*t ... Hello ... Where are you? ... Hello! ... Help ...." During this time, Qualls was also rolling back and forth on the floor and moving in a half circle across the floor. From 6:36 a.m. onwards, Qualls called out "hello" at least forty times, "hey" at least nine times, "help" at least thirteen times, and made noises of pain such as "ah" and "ow" at least seventy times. At 7:15 a.m., after spending nearly twelve hours lying face down on the floor, Qualls rolled over in the center of the cell and started to convulse and moan loudly. Qualls yelled "Hello, please sir!" and continued to say "hello" repeatedly. At 7:28 a.m., Qualls repositioned himself in the corner of the cell leaving only his feet in the view of the cell camera. At 7:30 a.m., Qualls said "help" followed by a stream of faint "hello[s]," before falling silent and becoming motionless. Qualls died at 7:38 a.m. on January 30th.

At 8:41 a.m., Detective Hadnot walked to the detox cell door, looked through the window at Qualls, and asked non-defendant Officer Mike Peters if he was sure that Qualls was sleeping. After seeing that Qualls appeared to be deceased, Officer Peters yelled for dispatch to get an EMS unit. The unit arrived around 8:48 a.m., and an EKG showed a flatline at 8:58 a.m. Qualls was found dead with rigor mortis. At 8:53 a.m., as EMS worked on-scene, Officer Peters stated, "I should have looked, but, you know, oh well."

An autopsy of Qualls was conducted on January 30, 2019 by Forensic Medical Management Services of Texas, P.A. [Dkt. 90, Ex. P]. The report listed several pathologic diagnoses, including amphetamine and methamphetamine toxicity, mild pulmonary edema, and mild dehydrations. Id. One of the pathologic diagnoses reads, "Decedent is a known drug abuser." The final cause of death was listed as "[c]omplication of amphetamine and methamphetamine toxicity." Id. Justice of the Peace Jimmy Miller signed an Autopsy Authorization for Mitchell. [Dkt. 90, Ex. R]. The Authorization provides a time of death of 7:38 a.m. on January 30, 2019. Id. at 1. Judge Miller additionally included the handwritten phrase, emphasized with a star, "Known Drug User." Id. For "circumstances of death," the Authorization provides, "in jail couldn't keep food down. Last seen alive a 7:30 AM. Found unconscious unresponsive 8:46. Substantial amount of blood by his mat and his shirt. Look for signs of neglect." Id.

D. Video Surveillance

There is a surveillance camera in the detox cell that is monitored by dispatchers, such as Dispatcher O'Dell, from the dispatch room. The jail log indicates that surveillance video jail checks by dispatchers were done at least every hour while Qualls was in custody. The dispatch room is close to the detox cell and contains twelve to sixteen video screens that the on-duty dispatcher is required to monitor. The video screens are located at the top right corner of the room "just below the ceiling," and each screen is approximately half the size of a sheet of notebook paper. Only one of the screens displays the camera-feed from the detox cell. In addition to monitoring the screens, Plaintiff alleges that the on-duty dispatcher is responsible for answering and dispatching calls for service, doing laundry, feeding detainees, and checking on detainee's face to face, among other things. It is unclear how often the city policy requires dispatchers to check on detainees via the monitor and if city policy requires dispatchers to check on detainees in person.

There is also a recording audio box in the dispatch room that transmits audio from the book-in area and jail area. Dispatch receives audio from this recorder but keeps it turned down so that the noise does not interrupt "radio traffic." Dispatchers allege that "if it is turned up high it creates background noises, feedback, and squealing," and "it makes it hard to hear radio and emergency calls." [Dkt. 63, Ex. S]. Dispatcher DeLome, however, testified that the dispatchers "can still hear inmates [without the audio turned up] because "they are not that far away." [Dkt. 63, Ex. U].

II. LEGAL STANDARD

A motion for summary judgment should be granted when, after considering the materials in the record, including pleadings, discovery, and affidavits, "there is 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). The party moving for summary judgment under Federal Rule of Civil Procedure 56 has the burden of demonstrating that no material fact issue exists. Anderson v. Liberty Lobby, Inc. , 477 U.S. 242, 256, 106 S.Ct. 2505, 91 L.Ed.2d 202 (1986). If the moving party meets this burden, then the non-moving party must set out affirmative evidence to defeat the summary judgment motion. Id. at 257, 106 S.Ct. 2505.

Only a genuine dispute over a material fact—a fact that might affect the outcome of the suit under the governing substantive law—will preclude summary judgment. Id. at 248, 106 S.Ct. 2505. The dispute is genuine if the evidence is such that a factfinder, utilizing the proper evidentiary standard, could render a decision in the non-moving party's favor. See id. In determining whether there is a genuine issue for trial, the court must view all facts and the inferences to be drawn from them in the light most favorable to the non-moving party. Matsushita Elec. Indus. Co. v. Zenith Radio Corp. , 475 U.S. 574, 587, 106 S.Ct. 1348, 89 L.Ed.2d 538 (1986). However, only reasonable inferences in favor of the nonmoving party can be drawn from the evidence. Eastman Kodak Co. v. Image Tech. Servs., Inc. , 504 U.S. 451, 468, 112 S.Ct. 2072, 119 L.Ed.2d 265 (1992).

III. DISCUSSION

The Civil Rights Act of 1871, 42 U.S.C. § 1983, creates a private right of action for redressing the violation of federal law by those acting under color of state law. Dist. Atty's Office for Third Jud. Dist. v. Osborne , 557 U.S. 52, 65, 129 S.Ct. 2308, 174 L.Ed.2d 38 (2009) ; Monell v. Dep't of Soc. Servs. , 436 U.S. 658, 98 S.Ct. 2018, 56 L.Ed.2d 611 (1978). The statute is not itself a source of substantive rights; it merely provides a method for vindicating federal rights conferred elsewhere. Olabisiomotosho v. City of Hous. , 185 F.3d 521, 525 n.3 (5th Cir. 1999). Plaintiff brings her Section 1983 claims against Defendants based on their alleged violations of Qualls's Fourteenth Amendment rights while he was detained in the Jasper City Jail. Plaintiff's claims implicate the acts and omissions of both Individual Defendants and Jasper, as well as the jail's general conditions of confinement. Thus, the Court will consider whether Plaintiff raises a genuine dispute of material fact with respect to the alternate theories of unconstitutional episodic acts or omissions and conditions of confinement.

A. Episodic Acts or Omissions Claim Against Individual Defendants

Individual Defendants raise qualified immunity as a defense to Plaintiff's episodic acts or omissions claim against them. "Qualified immunity protects officers from suit unless their conduct violates a clearly established constitutional right." Est. of Bonilla by & through Bonilla v. Orange Cnty., Tex. , 982 F.3d 298, 306 (5th Cir. 2020) (quoting Hyatt v. Thomas , 843 F.3d 172, 177 (5th Cir. 2016)). "Once an official pleads the defense [of qualified immunity], the burden then shifts to the plaintiff, who must rebut the defense by establishing a genuine fact issue as to whether the official's allegedly wrongful conduct violated clearly established law." Brown v. Callahan , 623 F.3d 249, 253 (5th Cir. 2010). "The qualified immunity defense has two prongs: whether an official's conduct violated a statutory or constitutional right of the plaintiff; and whether the right was clearly established at the time of the violation." Dyer v. Houston , 964 F.3d 374, 380 (5th Cir. 2020) (quoting Brown , 623 F.3d at 253 ). A court may rest its analysis on either prong. Id. (citing Morgan v. Swanson , 659 F.3d 359, 385 (5th Cir. 2011) (en banc)).

i. Constitutional Violation

Episodic acts or omissions occur where the complained-of harm is a particular act or omission of one or more officials. Hare v. City of Corinth, Miss. , 74 F.3d 633, 645 (5th Cir. 1996). "[T]he Fourteenth Amendment protects pretrial detainees’ right to medical care." Bonilla , 982 F.3d at 304. Specifically, "[t]he Fourteenth Amendment guarantees pretrial detainees a right ‘not to have their serious medical needs met with deliberate indifference on the part of the confining officials.’ " Dyer , 964 F.3d at 380 (quoting Thompson v. Upshur Cnty., Tex. , 245 F.3d 447, 457 (5th Cir. 2001) ). "A government official violates a Fourteenth Amendment right when the official acts with deliberate indifference to a detainee's serious medical needs." Bonilla , 982 F.3d at 305. A serious medical condition or need is "one for which treatment has been recommended or for which the need is so apparent that even laymen would recognize that care is required." Carlucci v. Chapa , 884 F.3d 534, 538-40 (5th Cir. 2018) (quoting Gobert v. Caldwell , 463 F.3d 339, 345 n.12 (5th Cir. 2006) ).

Both Eighth Amendment and Fourteenth Amendment cases are relevant to Plaintiff's inadequate medical treatment claims. See Hare , 74 F.3d at 649.

"Deliberate indifference is an extremely high standard to meet." Domino v. Tex. Dep't of Crim. Just. , 239 F.3d 752, 756 (5th Cir. 2001). "To succeed on a deliberate-indifference claim, plaintiffs must show that (1) the official was ‘aware of facts from which the inference could be drawn that a substantial risk of serious harm exists,’ and (2) the official actually drew that inference." Dyer , 964 F.3d at 380 (quoting Domino , 239 F.3d at 755 ). "Whether a prison official had the requisite knowledge of a substantial risk is a question of fact subject to demonstration in the usual ways, including inference from circumstantial evidence ... and a factfinder may conclude that a prison official knew of a substantial risk from the very fact that the risk was obvious." Farmer v. Brennan , 511 U.S. 825, 842, 114 S.Ct. 1970, 128 L.Ed.2d 811 (1994). "[D]eliberate indifference cannot be inferred merely from a negligent or even a grossly negligent response to a substantial risk of serious harm." Thompson , 245 F.3d at 458 ; see also Gobert , 463 F.3d at 346 ("Unsuccessful medical treatment, acts of negligence, or medical malpractice do not constitute deliberate indifference, nor does a prisoner's disagreement with his medical treatment, absent exceptional circumstances."). Instead, "the plaintiff must show that the officials refused to treat him, ignored his complaints, intentionally treated him incorrectly, or engaged in any similar conduct that would clearly evince a wanton disregard for serious medical needs." Domino , 239 F.3d at 756. "A prison guard is deliberately indifferent if he intentionally denies or delays access to medical care." Estelle v. Gamble , 429 U.S. 97, 103, 97 S.Ct. 285, 50 L.Ed.2d 251 (1976).

a. Officer Linebaugh and Sergeant Griffin

The record raises genuine disputes of material fact regarding whether Officer Linebaugh and Sergeant Griffin acted with deliberate indifference towards the serious medical needs of Qualls. Linebaugh and Griffin were the two officers who originally went to the hospital and arrested Qualls. Both officers were on duty from 6:00 p.m. to 6:00 a.m. both nights during Qualls's detention, and after booking Qualls's into the jail, they were in and out of the book-in area. In addition to observing Qualls's conduct and composure at the hospital and during his detention, a nurse at the hospital stated that Qualls was on meth in front of Linebaugh and Griffin, although they now contend they were not paying attention to that comment. Additionally, Qualls was a known drug user that the officers had encountered before. The book-in form indicated that Qualls was "intoxicated badly," and Griffin did not smell alcohol on Qualls's breath. The officers later confirmed in their depositions that they knew Qualls was under the influence of something. A reasonable juror could, therefore, draw an inference that the officers knew Qualls was on drugs.

After book-in, Linebaugh and Griffin put Qualls in the detox cell. Both officers allege they consistently checked on him throughout his detention. However, the only way to see inside the cell was through a small window, and in most instances, the officers checked on Qualls for only a few seconds at a time. And during those checks, the officers only twice opened the cell door after Qualls vomited on himself. For the majority of his thirty-four detention, Qualls remained in the same position on his stomach on a mat on the floor. At other times, he can be seen on the floor with his arm hanging out of the food-slot in the cell door or heard mumbling incoherently as the officers walked by or in response to their questions.

The first time Qualls vomited, he screamed when Linebaugh and Griffin lifted Qualls to clean the floor. Qualls screamed again when moved after he vomited the second time. At that time, Griffin and Linebaugh noticed an empty plastic bag in Qualls's vomit. It is disputed whether they knew what was in the bag, and it is unclear from the video/audio recording what they said about it. It is clear, however, that Griffin believed that Qualls would "throw the rest of that sh*t up" and that the officers contemplated whether he could have ingested it before he went to the hospital. A reasonable jury could conclude that Linebaugh and Griffin knew that drugs were in the bag.

At various times on the videos, Qualls can be heard asking for help. For example, at one point around 4:40 a.m. the first morning, he says "I need a hospital." It is disputed whether anyone heard his requests for a hospital or any of his cries for help. When these cries were made, Griffin and Linebaugh were on duty, but no one was in the book-in area. However, off-camera conversations can be heard, and on one occasion Griffin went to check on Qualls after he called for help. A reasonable jury could conclude that Linebaugh and Griffin heard Qualls's cries for help.

Therefore, a reasonable trier of fact could find that Linebaugh and Griffin were aware that Qualls was intoxicated on meth when he arrived, observed him getting worse instead of better over the duration of his detention in the detox cell, heard him yell for help and ask for a hospital, saw that he vomited black liquid multiple times, and knew he had swallowed a bag full of drugs. Yet the officers sought no medical care for Qualls for the thirty-four hours he was in the detox cell. The officers’ argument that Qualls's prior medical treatment by EMS and at the hospital necessarily negates deliberate indifference is without merit. While unsuccessful or inadequate medical treatment negates deliberate indifference, that is not the scenario here. Here, Plaintiff alleges that Qualls swallowed the bag of drugs after he left the hospital and that his medical condition deteriorated accordingly. Thus, any treatment he may have received at the hospital prior to being taken into custody and swallowing the drugs is irrelevant. See Dyer , 964 F.3d at 381–82 (holding that paramedics were not deliberately indifferent for failing to provide additional care but that there was a genuine dispute concerning whether officers who knew an inmate was injured but failed to seek medical care were deliberately indifferent).

Additionally, a reasonable jury could also find that Qualls's injuries were so severe and their cause so plainly evident to the officers, that they acted with deliberate indifference by failing to seek medical attention. Id. at 382. Reasonable minds may differ on the issue, but Plaintiff has presented enough evidence to survive summary judgment that the officers were aware of a risk of injury to Qualls that they did nothing to alleviate. See id. Viewing all facts and drawing all reasonable inferences in the favor of Plaintiff, the record demonstrates that the officers failed to provide treatment to, and ignored the complaints of, a clearly ill inmate they knew had a history of drug use and had likely swallowed a bag of drugs. See Stewart v. Guzman , 555 F. App'x 425, 432 (5th Cir. 2014) (summary judgment improper because genuine issues of material fact existed as to whether prison officers were deliberately indifferent to prisoner's health and safety by repeatedly delaying providing prisoner with medical treatment, even though they were aware that he frequently suffered from asthma attacks). This conduct, if believed, is sufficient to meet the deliberate indifference threshold. See Easter v. Powell , 467 F.3d 459, 464 (5th Cir. 2006) (holding that officials were deliberately indifferent by failing to provide medical care when prison medical staff were actually aware of the detainee's heart condition, and the detainee presented obvious signs of serious cardiac health risks); Austin v. Johnson , 328 F.3d 204, 210 (5th Cir. 2003) (holding that a defendant's failure to call an ambulance for almost two hours while plaintiff lay unconscious and vomiting rises to the level of deliberate indifference); Harris v. Hegmann , 198 F.3d 153, 159–60 (5th Cir. 1999) (concluding that ignoring an inmate's repeated requests for medical treatment and complaints of excruciating pain satisfied the deliberate indifference standard). But cf. Tamez v. Manthey , 589 F.3d 764, 771 (5th Cir. 2009) (holding that detectives were not deliberately indifferent when they had no reason to know detainee had swallowed a bag of cocaine before his arrest and only symptom detainee exhibited was pupil dilation); Sanchez v. Young Cnty., Tex. , 866 F.3d 274, 280 (5th Cir. 2017) (finding no subjective deliberate indifference when county had detainee examined by a medic who found normal vital signs and detainee was responsive and coherent and repeatedly denied the need to go to the hospital).

In sum, viewing the evidence in the light most favorable to Plaintiff, there are genuine disputes of material fact as to whether Officer Linebaugh and Sergeant Griffin acted with deliberate indifference to Qualls's serious medical needs. This satisfies prong one as to Officer Linebaugh and Sergeant Griffin.

b. Dispatcher O'Dell

There are also genuine disputes of material fact regarding whether O'Dell acted with deliberate indifference. She had interactions at the jail with Qualls on at least one prior occasion where he was intoxicated. O'Dell was present at the jail from the time Qualls was brought in until shortly before his death. Qualls attempted to talk to her a couple times, but his words were unintelligible. She knew Qualls did not eat while he was in the detox cell. O'Dell alerted Linebaugh and Griffin after Qualls vomited the first time. She then asked Griffin if she needed to call EMS and Griffin said no. There is conflicting testimony on whether O'Dell knew about the plastic bag in Qualls's vomit before his death; O'Dell says she did not know but Dispatcher Gray, the dispatcher with the shift after O'Dell, says O'Dell updated her about the plastic bag before ending her shift.

From around 6:36 a.m. to when Qualls died at 7:38 a.m., O'Dell was in the dispatch room when Qualls rolled on the floor, convulsed, and became increasingly more vocal. There is a fact dispute about whether O'Dell heard and/or saw this activity. Although she claims she could not, Dispatcher Gray has since admitted that she and O'Dell could see Qualls on the dispatch room surveillance monitors and could hear him from his cell during that time. Additionally, although O'Dell was not in the detox cell or book-in room during that time, conversation can be heard in the background and a reasonable juror could conclude O'Dell could hear Qualls. Another dispatcher, DeLome, also testified that while they kept the volume down on the audio box in the dispatch area, the dispatchers can still hear the inmates because they are "not that far away."

Like with Linebaugh and Griffin, a reasonable trier of fact could find that O'Dell was aware that Qualls was a drug user, observed him getting worse instead of better over the duration of his detention in the detox cell, heard him scream for help and ask for a hospital, saw that he vomited multiple times, and knew he had swallowed a bag full of drugs. Yet she also sought no medical care for Qualls for the thirty-four hours he was in the detox cell. Thus, viewing the evidence in the light most favorable to Plaintiff, there are genuine disputes of material fact as to whether O'Dell acted with deliberate indifference to Qualls's serious medical needs. This satisfies prong one as to O'Dell.

c. Detective Hadnot

Unlike Linebaugh, Griffin, and O'Dell, Detective Hadnot worked the day shift at the jail. He worked from 8:00 a.m. until about 7:20 p.m. January 29, 2019. He was not present when Qualls first called for help and asked for a hospital or when Qualls started asking for help soon before his death. Detective Hadnot was the first person to notice Qualls was surrounded by a dark-color liquid. After checking that it was not blood, he asked O'Dell to have Griffin come and check on Qualls and then left because his shift was over. Detective Hadnot had no communications with Qualls, and he never personally checked on him. He was not present when Griffin and Linebaugh found the plastic bag in the vomit, and he only learned of it after Qualls's death when he was investigating. There is no evidence that Detective Hadnot knew Qualls had ingested meth, called for help, vomited a plastic bag, or that he was otherwise in substantial risk of serious harm. Thus, there is no genuine issue of material fact that Detective Hadnot was deliberately indifferent, and he is entitled to qualified immunity.

ii. Clearly established

"Turning to prong two of the qualified immunity standard, we ask whether there are genuine disputes of material fact as to whether ‘the unlawfulness of the [Officers’] conduct was ‘clearly established at the time.’ " See Dyer , 964 F.3d at 383 (quoting Rich v. Palko , 920 F.3d 288, 294 (5th Cir. 2019) ). "To be clearly established, a right must be sufficiently clear that every reasonable official would have understood that what he is doing violates that right." Reichle v. Howards , 566 U.S. 658, 664, 132 S.Ct. 2088, 182 L.Ed.2d 985 (2012) (cleaned up). While Plaintiff need not identify a case "directly on point," "existing precedent" must "place[ ] the statutory or constitutional question beyond debate." Morgan v. Swanson , 659 F.3d 359, 372 (5th Cir. 2011) (quoting Ashcroft v. al-Kidd , 563 U.S. 731, 741, 131 S.Ct. 2074, 179 L.Ed.2d 1149 (2011) ). That precedent, moreover, must "define[ ] the contours of the right in question with a high degree of particularity." Id. at 371–72. [O]fficials can still be on notice that their conduct violates established law even in novel factual circumstances. Hope v. Pelzer , 536 U.S. 730, 741, 122 S.Ct. 2508, 153 L.Ed.2d 666 (2002). In sum, "the salient question" we ask at prong two is whether the state of the law at the time of the incident "gave [the Officers] fair warning that their alleged treatment of [Qualls] was unconstitutional." Id.

"Since Estelle v. Gamble , 429 U.S. 97, 104, 97 S.Ct. 285, 50 L.Ed.2d 251 (1976), state officers have been on notice that deliberate indifference to a prisoner's serious medical needs violates the Eighth Amendment." Austin , 328 F.3d at 210. Qualls "had a clearly established right ‘not to have [his] serious medical needs met with deliberate indifference on the part of the confining officials.’ " Bonilla , 982 F.3d at 307 (quoting Dyer , 964 F.3d at 380 ); see also Thompson , 245 F.3d at 457.

At the time Linebaugh, Griffin, and O'Dell denied Qualls treatment, the law was clearly established that a prison inmate could demonstrate a constitutional violation by showing that a prison official " ‘refused to treat him, ignored his complaints, intentionally treated him incorrectly, or engaged in any similar conduct that would clearly evince a wanton disregard for any serious medical needs.’ " Easter , 467 F.3d at 465 (quoting Domino , 239 F.3d at 756 ). Viewing the summary judgment record in favor of Plaintiff, Linebaugh, Griffin, and O'Dell ignored the cries for help of an inmate who had ingested a lethal dose of methamphetamine and vomited part of a plastic bag. A jury could find that after finding such a bag in an intoxicated detainee's vomit, all reasonable officers would have called for emergency medical services, especially considering Qualls's known history of substance abuse, his persistent state of intoxication and progressively worsening symptoms, his loud calls for help and sounds of distress, and that Qualls did not eat yet continued to vomit. This is some evidence that no reasonable official could have believed such conduct was lawful in light of clearly established law. Because there is evidence that the officers’ conduct was not objectively reasonable, they are not entitled to summary judgment based on qualified immunity. Easter , 467 F.3d at 465.

B. Claims Against the City of Jasper

Municipalities and other local governments are "persons" within the meaning of Section 1983 and can therefore be held liable for violating a person's constitutional rights. Monell v. Dep't of Soc. Servs. of City of New York , 436 U.S. 658, 690, 98 S.Ct. 2018, 56 L.Ed.2d 611 (1978) ; Bonilla , 982 F.3d at 308. Municipalities are, however, responsible only for "their own legal acts." Covington v. City of Madisonville, Tex. , 812 F. App'x 219, 225 (5th Cir. 2020) (quoting Pembaur v. City of Cincinnati , 475 U.S. 469, 479, 106 S.Ct. 1292, 89 L.Ed.2d 452 (1986) ). They cannot be held liable on a respondeat superior theory solely because they employ a constitutional tortfeasor. Monell , 436 U.S. at 691–92, 98 S.Ct. 2018.

Plaintiff's Section 1983 case against Jasper invokes two alternative theories of liability for the death of Qualls: the "episodic acts and omissions" of City jailers, and the unconstitutional "conditions of confinement" at the City jail. See Flores v. Cnty of Hardeman, Tex. , 124 F.3d 736, 738 (5th Cir. 1997). Plaintiff's episodic acts and omissions theory "requires a finding that particular jailers acted or failed to act with deliberate indifference to the detainee's needs" and—notably—that this conduct is attributable to the enforcement of a municipal policy, practice, or custom. Sanchez v. Young Cnty., Tex. , 866 F.3d 274, 279 (5th Cir. 2017). Plaintiff's conditions of confinement theory, in contrast, does not rest on the fault of individual jailers. Id. Rather, it challenges the conditions, practices, rules or restrictions of pretrial confinement imposed by Jasper that, together, "impose[ ] what amounts to punishment in advance of trial." Id. Under both theories, Plaintiff must show "(1) that a constitutional violation occurred and (2) that a municipal policy was the moving force behind the violation." Sanchez v. Young County, Texas , 956 F.3d 785, 791 (5th Cir. 2020) (quoting Monell , 436 U.S. at 694, 98 S.Ct. 2018 ).

i. Episodic Acts or Omissions Claim Against Jasper

In an episodic acts or omissions claim against a municipality, "an actor usually is interposed between the detainee and the municipality, such that the detainee complains first of a particular act of, or omission by, the actor and then points derivatively to a policy, custom, or rule (or lack thereof) of the municipality that permitted or caused the act or omission." Scott v. Moore , 114 F.3d 51, 53 (5th Cir. 1997). To hold a municipal entity liable under this standard, the plaintiff must establish: "(1) a governmental employee acted with subjective deliberate indifference; and (2) the employee's act resulted from a policy or custom adopted or maintained with objective deliberate indifference to the plaintiff's constitutional rights." Olabisiomotosho v. City of Houston , 185 F.3d 521, 526 (5th Cir. 1999). For reasons specified in the preceding section, the first prong regarding the alleged deliberate indifference of Jasper employees must be submitted to a jury. However, Plaintiff's episodic acts or omissions claim fails on the second prong.

An official policy "usually exists in the form of written policy statements, ordinances, or regulations, but may also arise in the form of a widespread practice [of city officials or employees] that is ‘so common and well-settled as to constitute a custom that fairly represents municipal policy.’ " James v. Harris Cnty. , 577 F.3d 612, 617 (5th Cir. 2009) (quoting Piotrowski v. City of Houston , 237 F.3d 567, 579 (5th Cir. 2001) ). Whatever its form, the policy must have been the "moving force" behind the plaintiff's constitutional violation. Piotrowski , 237 F.3d at 580 (quoting Monell , 436 U.S. at 694, 98 S.Ct. 2018 ). Stated differently, Plaintiff "must show direct causation, i.e., that there was ‘a direct causal link’ between the policy and the violation." See James , 577 F.3d at 617 (quoting Piotrowski , 237 F.3d at 580 ). The policy must also have been "promulgated with deliberate indifference to the known or obvious consequences that constitutional violations would result." Piotrowski , 237 F.3d at 579 (internal quotation marks omitted). Mere negligence, even gross negligence, is not sufficient to establish deliberate indifference. Brown v. Bryan Cnty., Okla. , 219 F.3d 450, 460–63 (5th Cir. 2000).

"In limited circumstances, a local government's decision not to train certain employees about their legal duty to avoid violating citizens’ rights may rise to the level of an official government policy for purposes of § 1983." Connick v. Thompson , 563 U.S. 51, 61, 131 S.Ct. 1350, 179 L.Ed.2d 417 (2011). This is because "the city's ‘policy of inaction’ in light of notice that its program will cause constitutional violations ‘is the functional equivalent of a decision by the city itself to violate the Constitution.’ " Id. (cleaned up). To support liability under this theory, the city's decision not to adopt or promulgate a policy must "amount to an intentional choice, not merely an unintentionally negligent oversight." Rhyne v. Henderson Cnty. , 973 F.2d 386, 392 (5th Cir. 1992) (citing City of Canton, Ohio v. Harris , 489 U.S. 378, 387, 109 S.Ct. 1197, 103 L.Ed.2d 412 (1989) ). "A failure to adopt a policy rises to the level of deliberate indifference ‘when it is obvious that the likely consequences of not adopting a policy will be a deprivation of civil rights.’ " Evans v. City of Marlin, Tex. , 986 F.2d 104, 108 (5th Cir. 1993) (quoting Rhyne , 973 F.2d at 392 ).

In their motion for summary judgment, Defendants argue that Plaintiff cannot establish that any policy adopted by a policymaker was promulgated with deliberate indifference. In response, Plaintiff alleges that Jasper's decision not to have a detoxification protocol can support its failure-to-train claim. Based on the evidence presented, the Court will assume, without deciding, that Jasper's lack of a detoxification policy caused its jail staff to unconstitutionally deprive Qualls of essential medical care. Nonetheless, Plaintiff's claim fails because it cannot establish that Jasper was deliberately indifferent to the constitutional rights of its detainees in adopting its training procedures.

As Defendants correctly point out, the Court dismissed Plaintiff's failure-to-train claim regarding the alleged inadequacy of officer training on substance abuse and mental health issues of detainees. [Dkt. 39, pp. 16–17; see Dkt. 95, p. 12]. However, Plaintiff seems to also assert a separate, but related, theory to support her failure-to-train claim: that the City of Jasper failed to adopt any detoxification protocol whatsoever. The Court did not dismiss this theory. [See Dkt. 39, p.12] (finding that Plaintiff set forth a plausible claim against Jasper for episodic acts and omissions).

Establishing deliberate indifference on the part of a municipality generally requires a "pattern of similar violations" arising from a policy "so clearly inadequate as to be ‘obviously likely to result in a constitutional violation.’ " Burge v. Saint Tammany Par. , 336 F.3d 363, 370 (5th Cir. 2003) (quoting Thompson v. Upshur Cnty. , 245 F.3d 447, 459 (5th Cir. 2001) ). A narrow ‘single incident’ exception to the pattern requirement, however, has been recognized. Id. at 372–73 ; Covington v. City of Madisonville, Tex. , 812 F. App'x 219, 225 (5th Cir. 2020). For deliberate indifference to be based on a single incident, "it should have been apparent to the policymaker that a constitutional violation was the highly predictable consequence of a particular policy." Alvarez v. City of Brownsville , 904 F.3d 382, 390 (5th Cir. 2018) (quoting Burge , 336 F.3d at 373 ); see Connick , 563 U.S. at 64, 131 S.Ct. 1350 ("[T]he unconstitutional consequences of failing to train could be so patently obvious that a city could be liable under § 1983 without proof of a pre-existing pattern of violations."). Because Plaintiff attempts to satisfy the single incident exception, Jasper bears the burden to show that there is no genuine dispute as to whether the constitutional violation allegedly suffered by Qualls was the "highly predictable" consequence of Jasper's decision not to adopt or promulgate a policy. See Valle v. City of Houston , 613 F.3d 536, 549 (5th Cir. 2010). Jasper has met that burden.

In City of Canton v. Harris , 489 U.S. at 386–92, 109 S.Ct. 1197, the Supreme Court provided an example of a training failure that would be "so obvious" to support liability based on a single incident:

For example, city policymakers know to a moral certainty that their police officers will be required to arrest fleeing felons. The city has armed its officers with firearms, in part to allow them to

accomplish this task. Thus, the need to train officers in the constitutional limitations on the use of deadly force can be said to be "so obvious," that failure to do so could properly be characterized as "deliberate indifference" to constitutional rights.

Id. at 390 & n.10, 109 S.Ct. 1197 (internal citation omitted). This showing is "especially difficult." Anderson v. Marshall Cnty., Miss. , 637 F. App'x 127, 134 (5th Cir. 2016). "A municipality's culpability for a deprivation of rights is at its most tenuous where a claim turns on a failure to train." Connick , 563 U.S. at 61, 131 S.Ct. 1350 ; see also Walker v. Upshaw , 515 Fed. App'x 334, 341 (5th Cir. 2013) ("[T]he possibility of single-incident liability based on a failure to train is rare ...."). "It is not enough to say that more or different training or supervision would have prevented" Qualls's injuries. Estate of Davis ex rel. McCully v. City of N. Richland Hills , 406 F.3d 375, 386 (5th Cir. 2005). More specificity is required. Id. Plaintiff must show that Jasper should have predicted, and then did disregard, the "known and obvious" consequence that a particular omission in their training program would cause city employees to violate citizens’ constitutional rights in the way Individual Defendants allegedly did. See Anderson , 637 F. App'x at 134. Put differently, Plaintiff must show that, absent further training, it was "highly predictable" that Jasper jailers would be "confounded" by decisions about whether to summon emergency medical care. Cardenas v. Lee Cnty., Tex. , 569 F. App'x 252, 258 (5th Cir. 2014) (quoting Connick , 563 U.S. at 61, 131 S.Ct. 1350 ).

First and foremost, Jasper Police Department did have policies in place for the safe incarceration of inmates. There is undisputed testimony to support the existence of a Jasper policy that officers must summon paramedics or EMS if they experience "doubt about the health or medical conditions of a detainee" or if the detainee becomes unresponsive or requests medical assistance. This policy covers pretrial detainees placed in the detox cell. There was also a policy that jailers must provide detainees in the detox cell with food and water and monitor them throughout the day through either the cell window or video surveillance. There is no controverting evidence that these policies were implemented with deliberate indifference toward the plight of intoxicated detainees. See City of Okla. City v. Tuttle , 471 U.S. 808, 823, 105 S.Ct. 2427, 85 L.Ed.2d 791 (1985) ("[I]t is ... difficult in one sense even to accept the submission that someone pursues a ‘policy’ of ‘inadequate training,’ unless evidence be adduced which proves that the inadequacies resulted from conscious choice—that is, proof that the policymakers deliberately chose a training program which would prove inadequate."). At most, these policies were not strictly followed by Individual Defendants on the morning of Qualls's death. Had they been Qualls would likely have received life-saving medical treatment. See Alvarez , 904 F.3d at 390–91 (reversing the denial of summary judgment in part because the "series of interconnected errors within the Brownsville Police Department that involved individual officers was separate from the [city's] general policy" (emphasis added)); Anderson , 637 F. App'x at 135 (denying single-incident Monell liability because the county could not have predicted that its officer would "ignore [the plaintiff's] litany of obvious ailments" and not call for help "when help [was] obviously required").

A violation of a city policy, in the Court's view, is much more likely to indicate that Jasper intended that its policy be followed but that it has failed to be sufficiently diligent in ensuring that such is the case. See Harris , 489 U.S. at 391, 109 S.Ct. 1197 (describing that liability does not attach when "an otherwise sound program has occasionally been negligently administered"); Evans v. City of Marlin, Tex. , 986 F.2d 104, 108 (5th Cir. 1993) (affirming summary judgment in favor of the city because the city did, in fact, have "policies in place for the safe incarceration of inmates"). Arguably a jury could conclude that Jasper was negligent in not promulgating a separate detoxification policy. But that, of course, is not the sort of "deliberate indifference" necessary to impose Monell liability on a municipality.

The record only vaguely references officer training and contains no evidence of objective jail standards requiring formal detoxification policies, nor any evidence about the population that passes through Jasper's detox cell from which "the possibility of recurring situations threatening to constitutional rights might be assessed." Garza v. City of Donna , 922 F.3d 626, 638 (5th Cir. 2019) ; see Benavides v. Cnty of Wilson , 955 F.2d 968, 973 (5th Cir. 1992) (finding no liability absent a showing that the "legal minimum of training was inadequate to enable [the officers] to deal with the ‘usual and recurring situations’ faced by jailers and peace officers"). Therefore, even reading the facts in the light most favorable to Plaintiff, Jasper did not engage in a "deliberate" or "conscious" choice to disregard the "highly predictable" consequences of its policy decision. See Rhyne , 973 F.2d at 392 ("The County was not indifferent in the literal sense of the word to the known risk of suicide: its policy ... was to [frequently] check on suicidal inmates .... This effort indicates not apathy, but concern.").

Although Jasper charged its officers with the difficult task of monitoring intoxicated detainees, this Court must narrowly apply Monell liability in this context. See Garza , 922 F.3d at 638 ("As we have emphasized, deliberate indifference may be inferred this way ‘only in narrow and extreme circumstances,’ and decisions by our court drawing the inference are rare." (quoting Littell v. Houston Indep. Sch. Dist. , 894 F.3d 616, 624 (5th Cir. 2018) )); Bd. of Cnty. Comm'rs of Bryan Cnty., Okla. v. Brown , 520 U.S. 397, 415, 117 S.Ct. 1382, 137 L.Ed.2d 626 (1997) ("Where a court fails to adhere to rigorous requirements of culpability and causation, municipal liability collapses into respondeat superior liability."). Without further guidance from a higher court on a sufficiently similar situation, the Court is reluctant to find this to be an "egregiously apparent case[ ]" in which the municipality may be held liable for an episodic acts or omissions claim. See Cardenas v. Lee Cnty., Tex. , 569 F. App'x 252, 258 (5th Cir. 2014).

Therefore, as terrible as these facts are, they do not meet the heavy burden that a plaintiff must bear to establish municipal liability under the narrow range of "single-incident" liability contemplated in Harris. Because the evidence is insufficient to create a jury question concerning deliberate indifference, Defendants’ motion for summary judgment is granted with respect to Plaintiff's episodic acts or omissions claim against Jasper.

ii. Conditions of Confinement Claim Against Jasper

A challenge to a condition of confinement is a challenge to "general conditions, practices, rules, or restrictions of pretrial confinement." Hare v. City of Corinth , 74 F. 3d 633, 644–45 (5th Cir. 1996). The issue is whether the conditions "amount to punishment." Bell , 441 U.S. at 535, 99 S.Ct. 1861. To prove a conditions of confinement claim, the plaintiff must show (1) a rule or restriction, an intended condition or practice, or a de facto policy as evidenced by sufficiently extended or pervasive acts of jail officials, (2) not reasonably related to a legitimate governmental objective, and (3) that violated [the detainee's] constitutional rights. Shepherd v. Dallas Cnty. , 591 F.3d 445, 452, 454–55 (5th Cir. 2009). In the Fifth Circuit, a conditions of confinement claim "requires no showing of specific intent on the part of the [municipality]." Sanchez , 866 F.3d at 279 ; Edler v. Hockley Cnty. Comm'rs Ct. , 589 F. App'x 664, 669 (5th Cir. 2014) ("[U]nlike an episodic-act-or-omission claim, a plaintiff is not required to prove deliberate indifference.").

Plaintiff's claim implicates Jasper's system of providing medical care to highly intoxicated detainees. Specifically, Plaintiff claims that Jasper's de facto customs or policies for evaluating and monitoring intoxicated detainees are constitutionally inadequate and, together, were the moving force behind Qualls's death. These alleged policies include, for instance, placing highly intoxicated detainees into detox cells without proper medical or mental health assessment or treatment, allowing dispatchers to turn down the audio transmitted from the detox cell, requiring dispatchers to fulfill duties of supervision and care of detainees in addition to their other duties, inadequate monitoring of detainees in the detox cell, and placing a camera in the detox cell at a location which would allow inmates to not be visible via video surveillance. For the reasons set forth below, the Court holds that several fact issues exist that preclude summary judgment on this claim.

This Court previously identified seventeen policies, practices, and customs of Jasper pled by Plaintiff. Eight of those alleged policies were dismissed. [See Dkt. 39]. In its response brief, Plaintiff attempts to raise other jail conditions to support its claim. However, because those conditions were not pled by Plaintiff, they are not properly before the Court.

Although an unlawful condition or practice is often explicit, a "formal, written policy is not required." Montano v. Orange Cnty., Tex. , 842 F.3d 865, 875 (5th Cir. 2016) ; see Shepherd , 591 F.3d at 452. A condition may "reflect an unstated or de facto policy, as evidenced by a pattern of acts or omissions ‘sufficiently extended or pervasive, or otherwise typical of extended or pervasive misconduct by [jail] officials, to prove an intended condition or practice.’ " Shepherd , 591 F.3d at 452 (quoting Hare , 74 F.3d at 645 ). Jasper primarily argues that Plaintiff's claim fails because there is no evidence of other detainees who suffered Qualls's fate as a result of a de facto policy. But, as noted by the Fifth Circuit, "such specific examples are not required to meet the ‘conditions or practice’ element" when there is consistent testimony of jail employees, Montano , 842 F.3d at 877, or the policy maker knows about a misconduct yet fails to take remedial action, Sanchez , 956 F.3d at 793–94. Evidence of both exists here.

First, there is consistent jail testimony that intoxicated detainees are placed in detox cells until they sober up, and that jailers intermittently check on detainees through either the small eye-level glass window in the cell door or the surveillance camera from the dispatch room. And while audio from the cell and book-in area is transmitted to the dispatch room, dispatchers consistently turn this audio down. Additionally, video evidence confirms that for most of Qualls's detention only a small portion of his body was visible to dispatchers due to the location of the surveillance camera. Viewing the facts most favorably to Plaintiff, these conditions and policies allowed Qualls to access and consume a lethal dose of drugs while in custody and, at times, resulted in the only jailer assigned to monitor the cell being unable to see Qualls or hear his pleas for help. Qualls's body was not even discovered until over an hour after his death and was found with rigor mortis. At least one reasonable inference a jury could draw is that these de facto policies allowed jailers to inadequately monitor Qualls's medical needs.

The evidence also supports that Jasper's alleged de facto policy is at odds with its own written policy, which requires jailers to summon help when in doubt of a detainee's condition. "[T]the existence of written monitoring policies does not, as a matter of law, negate" Plaintiff's conditions of confinement claim. Sanchez , 956 F.3d at 793 ("A jury might conclude that such written policies undercut Plaintiff's failure-to-monitor theory, but the written policies do not compel that conclusion."). Jailers witnessed Qualls's worsening symptoms, allegedly ignored his pleas for help, discovered a baggie in his vomit, and at one point discussed whether Qualls needed to return to the hospital—yet the jailers repeatedly resolved any doubt in favor of doing nothing. When multiple employees act in the same unconstitutional manner, that is indicative of a de facto city policy. See id. (finding that evidence that the county's written policies were ignored created fact-issues as to whether the jail had a de facto policy of inadequately monitoring intoxicated detainees). But c.f. Est. of Bonilla by & through Bonilla v. Orange Cnty., Tex. , 982 F.3d 298, 311 (5th Cir. 2020) (denying condition of confinement claim where plaintiff exhibited no signs of intoxication, suicidal tendencies, or symptoms of withdrawal, and where there was no evidence or consistent jailer testimony to support plaintiff's theory of municipal liability).

Second, none of the Individual Defendants faced any reprimand after Qualls's death, nor did Jasper take any evident action to correct the jail's alleged deficiencies. This, too, indicates that the jailers’ conduct conformed to a de facto policy. See Sanchez , 956 F.3d at 793 (finding that "fail[ure] to take remedial action ... arguably shows acquiescence to the misconduct such that a jury could conclude that it represents official policy.") (citing Grandstaff v. City of Borger , 767 F.2d 161, 171 (5th Cir. 1985) (holding that, because the city policymaker failed to change policies or to discipline or reprimand officials, the jury was entitled to conclude that the complained-of practices were "accepted as the way things are done and have been done in" that city)). As in Sanchez , the jailers here did "nothing to confirm their suspicion that the detainee [was] merely intoxicated or to confirm that the detainee [was] not too intoxicated to safely sleep it off." Sanchez , 956 F.3d at 795–96 ; see Montano , 842 F.3d at 879 (faulting the defendant for not addressing why, under its policies, "detainees were expected to heal themselves, particularly when the assumed drug influence was never established").

Under Jasper's apparent policies, it is unclear how jailers could ever detect that an intoxicated detainee took a fatal dose of drugs while in their custody, absent an explicit request for emergency medical care by the detainee. Jasper does not conduct a follow-up assessment of an intoxicated detainee's medical condition after he is placed in a detox cell to "sober up," other than periodic monitoring—and such monitoring is claimed to be sporadic and pervasively inadequate. From this evidence, a jury could reasonably infer the existence of de facto jail policies that deprived highly intoxicated individuals of essential medical care. See Montano , 842 F.3d at 875 ("Given the striking uniformity of the jail employees’ testimony, further evidence was not required for a reasonable juror to infer a de facto policy for conditions or practices."); Sanchez , 956 F.3d at 794 (noting that the jury must resolve whether the city's "sleep it off" policy is pervasive and whether jailer testimony is consistent). Accordingly, fact issues exist over whether Jasper has a pervasive policy of failing to adequately evaluate and monitor intoxicated detainees.

Given the various ways Jasper's alleged confinement conditions might interact, a jury could also reasonably find that the jail conditions were the moving force behind Qualls's denial of medical care and, ultimately, his death. See Sanchez , 956 F.3d at 791 ("We do not require a plaintiff to show that a ‘policy or practice [was] the exclusive cause of the constitutional deprivation.’ Courts ‘may ... consider how individual policies or practices interact with one another within the larger system.’ " (citations and quotations omitted)). Therefore, a fact issue exists regarding whether Jasper's policies were "the direct causal link" behind Qualls's denial of medical care. See Bonilla , 982 F.3d at 311.

Finally, there is also a fact issue concerning whether Jasper's de facto policies were without legitimate governmental interests. To be sure, Jasper has legitimate administrative and operational interests, such as detaining accused persons, inmate safety, and the allocation of its limited fiscal resources. However, "if a restriction or condition is not reasonably related to a legitimate goal—if it is arbitrary or purposeless—a court permissibly may infer that the purpose of the government action is punishment that may not constitutionally be inflicted upon detainees.’ " Bell v. Wolfish , 441 U.S. 520, 539, 99 S.Ct. 1861, 60 L.Ed.2d 447 (1979) ; Garza v. City of Donna , 922 F.3d 626, 632 (5th Cir. 2019). Based on the evidence, a reasonable juror could infer that Jasper's conditions of confinement were grossly inadequate and therefore not reasonably related to a legitimate, non-punitive government interest. See Montano , 842 F.3d at 878–79 (finding no legitimate government interest in detainee safety where detoxifying inmates were detained for "as long as it takes" and "expected to heal themselves"); see also Duvall v. Dallas Cnty., Tex. , 631 F.3d 203, 207 (5th Cir. 2011) (finding no legitimate government purpose when a county allowed a staph infection to persist within a jail); Shepherd , 591 F.3d at 452 ("[I]ntent [to punish] may be inferred from the decision to expose a detainee to an unconstitutional condition.").

The Court is aware that Plaintiff's conditions of confinement claim poses a high hurdle to surmount. See Shepherd , 591 F.3d at 454–55. But it is not the province of the Court to make credibility determinations or improperly weigh the evidence at this stage. The onus of those tasks falls squarely on the jury, who are "free to choose among reasonable constructions of the evidence." Sanchez , 956 F.3d at 795 (quotations omitted). If Jasper wishes to incarcerate intoxicated pretrial detainees in its detox cell, it has a constitutional responsibility to ensure that its conditions do not amount to "punishment" in advance of trial. And the protections of the Fourteenth Amendment do not hinge on whether a detainee makes an explicit request for medical care—especially when, as here, the detainee has ingested a lethal dose of drugs and will never regain coherence.

In sum, Plaintiff presents sufficient evidence to create fact issues regarding whether Jasper had de facto policies of failing to evaluate and/or monitor the medical needs of highly intoxicated detainees, whether these policies interacted to deny Qualls essential medical care, and whether they served a legitimate governmental interest. Defendants’ motion for summary judgment is, therefore, denied with respect to Plaintiff's conditions of confinement claim.

IV. CONCLUSION

It is therefore ORDERED that Defendants Motion for Summary Judgment [Dkt. 63] is hereby GRANTED IN PART as to Plaintiff's episodic acts or omissions claim against Joshua L. Hadnot and the City of Jasper; and DENIED IN PART as to Plaintiff's episodic acts or omissions claim against Toderick D. Griffin, Sterling Ramon Linebaugh, and Heather O'Dell, as well as Plaintiff's conditions of confinement claim against the City of Jasper.