Background
Brad Passwater, an inmate with paranoid schizophrenia at Plainfield Correctional Facility, was placed on constant suicide watch after expressing suicidal thoughts. During a psychotic episode, he was administered emergency psychotropic medication by a nurse under the direction of a remote psychiatrist, Dr. Rippetoe. Passwater later suffered severe self-inflicted injuries, including gouging out his eyes and removing his testicles, while a suicide companion sat outside his cell instead of standing as required by policy. Passwater sued Dr. Rippetoe for failing to provide follow-up care and Deputy Warden Tricia Pretorius for failing to enforce the suicide companion policy.
The court’s reasoning
The court reviewed the district court’s grant of summary judgment de novo. Regarding Dr. Rippetoe, the court held that while his failure to follow up might constitute negligence, it did not rise to the level of deliberate indifference required for an Eighth Amendment violation. The record lacked evidence that no minimally competent physician would have failed to check the medical records or that the doctor deliberately avoided them. Regarding Deputy Warden Pretorius, the court acknowledged evidence of a systematic lapse in enforcing the two-hour shift policy for suicide companions. However, the court found that the companion’s refusal to stand and observe the inmate was a superseding intervening act that severed the causal link between the warden’s alleged inaction and the injuries. The injuries began before the two-hour shift would have ended, meaning the companion’s standing would have allowed observation regardless of the policy violation.
What it means going forward
The ruling reinforces the high evidentiary burden for proving deliberate indifference in medical care cases involving remote providers and clarifies that systemic policy failures may not support liability if an independent intervening act breaks the chain of causation.