by Mark Wilson

On March 7, 2022, a federal court approved a $3.8 million settlement between a Michigan county and the estate of a detainee left to die of delirium tremens (DTs) in the county lockup.

The settlement followed a decision by the U.S. Court of Appeals for the Sixth Circuit on January 4, 2022, affirming denial of summary judgement to several employees of the Crawford County Jail who recognized that the detainee, Dwayne Greene, was suffering from DTs, which is brought on by alcohol withdrawal and characterized by intense confusion. Yet they provided no medical care, even as his condition worsened over four days, until he suffered acute respiratory failure and died.

On Monday, December 4, 2017, the 33-year-old Greene appeared before the Crawford County Circuit Court to plead guilty to a charge that he’d been operating an ATV while drunk the previous summer. The judge ordered a breath test, which registered a .194 BAC, even though Green had by then been at the courthouse for 3-4 hours. For showing up drunk to court, the judge revoked Greene’s bond and ordered him detained.

Greene was booked into the jail later that afternoon by a guard who understood Greene would suffer from alcohol withdrawal during confinement. She placed him in an observation cell until he could be seen by medical staff.

A part-time nurse who was onsite only on Mondays and Fridays had already left by the time Greene was booked, and she would not return until Friday, December 8, 2017. However, detainees may be taken offsite to see a nurse practitioner or doctor, and guards did not need to seek supervisor approval to call a nurse.

By Wednesday, Green began “acting erratic” and hallucinating as his condition deteriorated, according to court documents. All jail staff appeared to understand these were symptoms of alcohol withdrawal, but nobody summoned medical assistance for him.

Guard Larry Foster saw Greene “having a conversation with the wall” at 4:30 a.m. on Thursday. Foster also knew Greene was withdrawing from alcohol, but he requested a mental health evaluation. Greene’s condition continued to worsen until 2:11 p.m., when Nanci Karczewski, a limited-license professional counselor with North Lakes Community Mental Health Authority (CMH), arrived to evaluate Greene’s “risk of harm to self or others.”

She noted “he is delusional while experiencing alcohol withdrawal” and added that it was “very difficult” to assess Greene “due to his delusional behavior while going through the DTs.” But jail staff incorrectly interpreted “DTs” in her notes to mean “detox.”

Karczewski told jail administrator Cpt. Randell Baerlocher that Greene’s delusions were “the result of alcohol withdrawal…and not mental.” Still he and other guards believed Greene would be fine because “the nurse was coming the next day.”

But of course, Greene was not fine. Guards found him unresponsive in his cell at 7:30 a.m. Friday morning, before the nurse arrived. He was transported to a hospital, where he was diagnosed with “acute respiratory failure and severe cerebral anoxia.” He remained on a ventilator until his family took him off life support on December 12, 2017.

A Family’s Legal Battle

Greene’s mother, Cheryl, filed suit on behalf of his estate in federal court for the Eastern District of Michigan, accusing jail staff, Karczewski and other CMH employees of deliberate indifference to Greene’s serious medical needs by failing to intervene to help him. Municipal liability claims were also brought against the County and CMH for maintaining an unconstitutional policy of not providing medical care to prisoners suffering from DTs.

The district court granted summary judgement to CMH, its employees and four jail employees. But it denied summary judgement to five other jail employees and the County. Defendants filed an interlocutory appeal.

Taking up the case then, the Sixth Circuit noted it has “long recognized” that DTs “is an objectively serious medical need,” pointing to its ruling in Kindl v. City of Berkley, 798 F3d 391 (6th Cir. 2015). Moreover, the Court explained that in Brawner v. Scott Cnty., Tennessee, 14 F.4^th 585 (6th Cir. 2021), it held that the Supreme Court’s decision in Kingsley v. Hendrickson, 576 U.S. 389 (2015), required “[m]odification of the subjective prong of the deliberate indifference test for pretrial detainees,” so that now one “must prove ‘more than negligence but less than subjective intent—something akin to reckless disregard.’”

The Court rejected Defendants’ argument that this language was merely “non-binding dictum,” and concluded that it was “bound by that decision.” It then affirmed the grant of summary judgment to three jail employees but reversed as to Foster, allowing that he “presents the closest call,” but saying “a jury could still find that Foster recklessly failed to seek medical assistance for Greene.”

The Court also affirmed the denial of summary judgment to Baerlocher and four other County Defendants, concluding that a jury could find they “‘recklessly failed to act with reasonable care’ in failing to render or seek any basic medical assistance for Greene while he continued to suffer from [DTs] following Karczewski’s mental health evaluation,” again quoting the Brawner decision.

The Court next affirmed the grant of summary judgement to Karczewski and the other CMH Defendants because she “is a limited license professional counselor, not a medical professional,” and the record was clear that CMH provided mental health, not medical, services to the jail.

“Even if the estate was correct that CMH should have trained its employees to seek medical care for inmates experiencing withdrawal or [DTs],” the Court explained, “it points to no evidence of ‘prior instances of unconstitutional conduct’ involving CMH that would have placed CMH ‘clearly on notice that the training in this particular area was deficient and likely to cause injury.’”

Finally, the Court dismissed the County’s interlocutory appeal for lack of jurisdiction, saying the district court had not certified that its denial of summary judgment on that claim was a final judgment. See: Greene v. Crawford Cty., 22 F.4th 593 (6th Cir. 2022).

The parties then proceeded to reach their settlement agreement, under which $232,532.70 was paid for costs to Plaintiff’s counsel, Fieger, Fieger, Kenney and Harrington, P.C., plus another $1,189,155.77 for the firm’s fees. Another $10,715.95 went for satisfaction of a Medicaid lien.

Of the balance, half was designated for Cheryl Greene and her husband, John, Dwayne’s parents. The other half was split between Pamela Greene and a trust for Nicole M. Greene, with $1,400 of the latter amount paid to Bieber & Czechowski, PLLC, for legal work to create the trust. All funeral and burial costs had by then been paid.

Additional representation was provided to Greene and her son’s estate by Christian P. Collis of Giroux Amburn, P.C., in Southfield. See: Greene v. Crawford Cty., USDC (E.D. Mich.), Case No. 1:18-cv-11008. 

Subscribe today

Already a subscriber? Login

Related legal case