The Georgia Court of Appeals recently reaffirmed the high burden of proof required in a § 1983 claim. McKuhen v. TransformHealthRX, Inc., 2016 WL 3877289 (Ga. Ct. App. 2016). On January 30, 2012, Carol McKuhen, a prisoner in Effingham County jail, was found dead in her isolation cell. An autopsy determined that she died of chronic ethanolism with hypertensive heart disease. McKuhen's surviving spouse and the co-administrators of her estate, filed a civil action under 42 U.S.C. § 1983 against the jail personnel (collectively “Jail Defendants”), TransformHealthRX, Inc. (“THRX”), and the medical staff employed by THRX (collectively “Medical Defendants”).
The McKuhen’s alleged that the Medical Defendants committed malpractice and that all of the named defendants were deliberately indifferent to McKuhen’s needs, which was a violation of the fourteenth amendment. The Court held that the Medical Defendants were entitled to summary judgment on the malpractice claims and all defendants, except for the jail’s primary doctor, were entitled to summary judgment on the § 1983 claims.
The Court defined deliberate indifference, in the context of a § 1983 claim against prison officials for violation of Eighth Amendment, as having three components: (1) subjective knowledge of a risk of serious harm, (2) disregard of that risk, (3) by conduct that is more than mere negligence. When the conduct in question does not violate this three-part test, or any other clearly established statutory or constitutional right, then government officials, including jail personnel, are entitled to immunity from personal liability under § 1983. The Jail Defendants testified that they were not aware of McKuhen’s alcohol withdraws and believed she was acting similarly to a typical prisoner in an isolation cell. Further, they were not trained on identifying the symptoms of alcohol withdraw and believed that she was experiencing a “normal” detoxification. The Court held that the record was devoid of any evidence that the defendants subjectively knew of the risks of alcohol withdrawal, or that they ignored those risks; therefore, they were entitled to immunity and summary judgment. Interestingly, the Court was clear that the Jail Defendants’ behavior was “deeply troubling;” however, the Court felt constrained to affirm the grant of summary judgment.
The McKuhens presented expert testimony that the Medical Defendants deviated from the applicable standard of care and that such deviation was the proximate cause of the injury. However, the Court found that the doctor presented was not a qualified expert as to any of the Medical Defendants. For three of the last five years, Dr. Donald Kern had not practiced, taught, or supervised in the practice area or specialty in which he was giving his expert opinion. Because Kern was found to not be qualified to give expert opinion, the McKuhen’s failed to meet the threshold requirement under OCGA § 9–11–9.1 and their medical malpractice claims failed as a matter of law. James v. Hospital Authority of City of Bainbridge, 629 S.E.2d 472, 474 (Ga. Ct. App. 2006).
The Court found that nothing in the evidence rose to the level of deliberate indifference for all of the defendants, except for Dr. Myra Pope. The evidence shows that Pope was on site after McKuhen was placed in the isolation cell; however, she did not read the full intake notes and she never actually saw or assessed McKuhen's status. Pope assumed that the jail staff would monitor McKuhen and provide updates to Pope; however, Pope never ensured that the jail staff was properly trained to identify signs and symptoms. Pope also ignored the fact that no routine withdrawal assessments were done and that no one took vital signs routinely. Based on these facts, the Court found there to be a genuine issue of material fact as to whether Pope’s inactions constituted deliberate indifference and remanded this issue for the trial court.
The Court’s decision is important because it highlights the need for stringent training and record keeping. The Jail Defendants were entitled to immunity because their actions did not reach the level of deliberate indifference; however, the Court appears to admonish their behavior. Based on this decision, government officials should push their employees to record or report any issue they encounter so that there is no question that they did not act with deliberate indifference.
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