Background
Dirk Alan Christianson was incarcerated at McLean County Detention Center from December 2018 to April 2019. While in custody, he requested medical attention multiple times for a fever and leg pain. Despite receiving some care, his condition worsened, leading to a diagnosis of severe sepsis and necrotizing fasciitis. His leg was amputated above the knee in April 2019. Christianson sued the county, the sheriff, medical staff, and a clinic under 42 U.S.C. Section 1983 and for medical malpractice under North Dakota state law.
The court’s reasoning
The court reviewed the Monell claim de novo and found the complaint failed to state a plausible claim because it lacked specific facts showing a widespread custom of misconduct or notice to policymakers. Regarding the individual defendants, the court applied the deliberate indifference standard, requiring proof of an objectively serious medical need and that the defendant knew of and disregarded that need. The court found no evidence that the sheriff knew of the need or that the nurses disregarded it, noting that their actions constituted professional judgment rather than criminal recklessness. The court also affirmed the denial of leave to amend the complaint to add John Doe defendants due to undue prejudice and the untimely filing. Finally, the court dismissed the state medical malpractice claim because the plaintiff failed to serve an expert affidavit within the statutory three-month period, and the plaintiff had waived arguments regarding the Supreme Court’s decision in Berk v. Choy.
An exercise of professional judgment, even if negligent, falls well short of deliberate indifference.
A.H. v. St. Louis Cnty., 891 F.3d 721, 727 (8th Cir. 2018)
The dissent
I would vacate the grant of summary judgment as to the Doe defendants and remand for the district court to dismiss the claims without prejudice instead.
Kelly
What it means going forward
The decision reinforces the high burden for plaintiffs to prove municipal liability under Monell and clarifies that medical malpractice or negligence by jail staff does not automatically equate to a constitutional violation of deliberate indifference.