by Douglas Ankney

In an important decision, the U.S. Court of Appeals for the Fourth Circuit ruled on December 8, 2023, that pretrial detainees no longer need show that a detention official “knew of and disregarded a substantial risk to the inmate’s health or safety” to state a claim of deliberate indifference to a serious medical need. Rather, the Court replaced that subjective standard with an objective one, asking only if the detainee’s treatment was tantamount to punishment, since that is forbidden before criminal conviction.

During Victoria Short’s intake at North Carolina’s Davie County Detention Center (DCDC) in August 2016, Sgt. Teresa Morgan learned Short had recently been hospitalized for an attempted suicide; that she was addicted to drugs and experiencing withdrawals; and that she felt she was worthless. Any one of those made Short a suicide risk, and DCDC Policy Section 4:10 said that meant she was to be “placed in a populated cell, never … in a single cell.” DCDC guards also were to check on her every 10-­to-­15 minutes, logging their rounds and “remov[ing] all articles” which “may be used to commit suicide.”

However, Lt. Dana Recktenwald placed Short in an isolation cell by herself for “being mouthy.” Checks at 10-­to-­15-­minute intervals were not performed. Nor did guards remove bedsheets from Short’s cell. Surveillance video recorded her as she hanged herself from the cell door with a bedsheet. She was taken to a hospital, where she died two weeks later without regaining consciousness.

Her husband, Charles Willis Short, filed suit against County Sheriff J.D. Hartman and various employees, including, Recktenwald and Morgan. The 42 U.S.C. § 1983 complaint accused Defendants of deliberate indifference to Short’s serious medical needs in violation of her Fourteenth Amendment rights. Defendants moved for judgment on the pleadings, pursuant to Fed. Rule of Civ. Proc. 12(c). The district court dismissed the suit for failure to state a claim.

Plaintiff appealed, arguing he had properly alleged that Morgan violated Short’s rights. The Fourth Circuit requested additional briefing addressing whether its precedent had been abrogated by the Supreme Court of the U.S. (SCOTUS) in Kingsley v. Hendrickson, 576 U.S. 389 (2015). The high court first recognized a claim for deliberate indifference to a prisoner’s serious medical needs in an Eighth Amendment claim in Estelle v. Gamble, 429 U.S. 97 (1976), and the Fourth Circuit extended that to Fifth and Fourteenth Amendment Due Process Clause claims, reasoning that “due process is at least as coextensive” in Loe v. Armistead, 582 F.2d 1291 (4th Cir. 1978). In Whisenant v. Yuam, 739 F.2d 160 (4th Cir. 1984), the Court “adopted an objective test for Fourteenth Amendment claims of deliberate indifference.” The main distinction: whereas the Eighth Amendment protects postconviction prisoners only from “cruel and unusual punishment,” the Fourteenth Amendment’s due process clause protects pretrial detainees from being punished at all, as SCOTUS held in Bell v. Wolfish, 441 U.S. 520 (1979).

Applying that, the Fourth Circuit said that to prevail on a deliberate indifference claim under the Fourteenth Amendment, Plaintiff must show a particular condition or restriction was “(1) imposed with an expressed intent to punish or (2) not reasonably related to a legitimate nonpunitive objective, in which case an intent to punish may be inferred,” as held in Martin v. Gentile, 849 F.2d 863 (4th Cir. 1988).

However, the Court continued, “deliberate indifference to serious medical needs” violates the Fourteenth Amendment even absent subjective intent to punish, since “no legitimate nonpunitive goal is served by a denial or unreasonable delay in providing medical treatment.” In jail suicide cases, the question is whether Defendants knew, “or reasonably should have known, of the detainee’s suicidal tendencies,” per Gordon v. Kidd, 971 F.2d 1087 (4th Cir. 1992).

Then SCOTUS held in Farmer v. Brennan, 511 U.S. 825 (1994), that Eighth Amendment claims require a showing that a prison official “knows of and disregards an excessive risk to inmate health or safety”—an “inquiry into the official’s state of mind” necessary to determine whether this amounted to “cruel and unusual punishment.” Circuits unanimously applied this subjective deliberate indifference standard to Fourteenth Amendment claims—until Kingsley “reiterated that a pretrial detainee may state a claim under the Fourteenth Amendment by satisfying Bell’s objective standard.” Because the Fourth Circuit had replaced Bell’s objective deliberate indifference standard with Farmer’s subjective deliberate indifference standard, it was impossible to reconcile its precedent with Kingsley.

Therefore, the Court concluded, to “state a claim for deliberate indifference,” a pretrial detainee must plead (1) a condition posing a substantial risk of serious harm which (2) “the defendant intentionally, knowingly, or recklessly acted or failed to act appropriately to address,” even though (3) “the defendant knew or should have known” both the detainee’s condition and the risk defendant’s action or inaction posed, as a result of which (4) “the detainee was harmed.”

In the present case this meant that Short had stated a claim for his wife’s death at the jail. Accordingly, the district court’s decision was reversed and the case remanded. Before the Court, Short was represented by Raleigh attorney William Ellis Boyle of Ward & Smith PA. See: Short v. Hartman, 87 F.4th 593 (4th Cir. 2023). A request for rehearing before the full Fourth Circuit en banc was denied on January 9, 2024; SCOTUS denied a petition for a writ of certiorari to hear the case on June 10, 2024. See: Short v. Hartman, 2024 U.S. App. LEXIS 604 (4th Cir.); and Hartman v. Short, 2024 U.S. LEXIS 2526.  

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