The Sixth Circuit Court of Appeals held that nurses working for Southern Health Partners, Inc. (SHP) were not deliberately indifferent to a prisoner’s detox condition that led to seizures.

The court’s September 21, 2020, opinion was issued in an appeal brought by Austin C. Griffith. He was arrested on November 8, 2015, and booked into Kentucky’s Franklin County Regional Jail (FCRJ) on charges of robbery and assault.

In the two hours before his arrest and during the police investigation, Griffith was vomiting. During a deposition, he attributed his vomiting to nerves because he had ‘‘never been in legal trouble.’’ After he was booked into FCRJ, Griffith was placed in a detox cell and on moderate observation for 48 hours. Over the 10-hour period after he was placed in detox, guards witnessed and registered in the log that Griffith vomited seven times. He never told jail officials that he was hit in the back with a baseball bat while trying to escape from a robbery attempt.

Griffith was seen by registered nurse Heather Sherrow eight hours after arriving at FCRJ. She noted his nausea and vomiting but otherwise found nothing abnormal. Three hours later, Griffith was seen for a sick call request to complain of stomach issues, diarrhea, and vomiting. He was given Imodium and Mylanta. No drug withdrawal issues were noted.

A second sick call request resulted in Griffith being seen on his second day in jail because he was unable to urinate. He was seen again the next day, a urine sample was taken, and he was prescribed Cipro by licensed practical nurse Sabina Trivette.

Griffith was moved to open population with no problems for the next three days. Then, on November 14, Griffith had a seizure. He was stabilized, but he had a second seizure almost three hours later. He was sent to a local emergency room.

He had a third seizure at the hospital and was airlifted to the University of Kentucky Hospital. Griffith was diagnosed with acute renal failure, seizure disorder, posterior reversible encephalopathy syndrome, hypomagnesemia, and anion gap metabolic acidosis. It was unclear from the hospital records the cause of Griffith’s initial illness and vomiting, the cause of the renal failure, and the cause of the seizures.

The district court granted the defendants summary judgment because Griffith: (1) failed to demonstrate that his medical care was so insignificant that it demonstrated deliberate indifference by medical staff; (2) failed to adequately advocate for himself in the general population because he did not submit a medical slip requesting to be seen by a nurse during that time; and (3) failed to introduce evidence demonstrating that he was harmed by any delay in treatment.

Sherrow was faulted by Griffith for not placing him on the list to be seen by the advanced registered practice nurse (ARPN) following his urine test. The Sixth Circuit found Griffith failed to present any evidence that he was suffering from drug withdrawal. Sherrow, aside from the vomiting that Griffith attributed to nerves, was not shown to have known that the vomiting evinced a threat to Griffith’s health. The court said that while her treatment may have been suboptimal, it was not unconstitutional.

Trivette was alleged to be deliberately indifferent because she did not call Dr. Waldridge or an ARPNwhen she saw Griffith on the third day at the jail and failed to assure he was placed in a wet cell. The Sixth Circuit found she was not deliberately indifferent to Griffith’s condition.

As to LPN Brittany Mundine, Griffith alleged she failed to follow procedures. The Sixth Circuit said “the failure to follow internal policies, without more, [does not] constitute deliberate indifference”. [Winkler, 893 F.3d at 891]

Dr. Waldridge could not be found liable based on a theory of supervisory liability without being directly involved. SHP, likewise, could not be held liable under a Monell theory for failure to train based on the facts presented in this case.

The district court’s order was affirmed. See: Griffith v. Franklin County, Case No. 19-5440 (6th Cir. 2020)

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