United States District Court, E.D. Wisconsin
Stadtmueller U.S. District Judge
Bryan Urquhart, alleges that he suffered a heart attack while
detained at the Sheboygan County Detention Center
(“SCDC”) in June 2017. (Docket #1 at 2-3). He
complains that he did not receive adequate healthcare for
this condition at SCDC, in large measure because he was seen
by nurses rather than doctors. Id. Plaintiff
maintains that he was properly attended to only once he was
transferred to Dodge Correctional Institution. Id.
at 3. Plaintiff's complaint states that he “is
asking the courts to order a change in procedure” for
the healthcare services at SCDC, in that he does not want
nurses to be used as a buffer between the inmates and the
physicians. Id. at 4. Plaintiff also requests
monetary damages. Id.
in Plaintiff's complaint does he attempt to state a claim
against any of the individuals directly responsible for his
healthcare. See generally Id. Instead, Plaintiff
sues Defendant Cory Roeseler (“Roeseler”), the
Sheboygan County Sheriff, and Advanced Correctional
Healthcare (“ACH”), a private company contracted
to provide medical services at SCDC. Id. at 1-2.
Plaintiff was allowed to proceed against both defendants on
the theory that their policies and practices led to the
violation of his Eighth Amendment right to adequate medical
care. (Docket #8 at 5-6).
legal basis for this theory of liability originates from
Monell v. Department of Social Services of the City of
New York, 436 U.S. 658 (1978). There, the Supreme Court
held that local government entities, such as municipalities
and counties, cannot be held vicariously liable for
constitutional violations committed by their employees.
Id. at 690. Such entities can, nevertheless, be
liable under Section 1983 if “the unconstitutional act
complained of is caused by: (1) an official policy adopted
and promulgated by its officers; (2) a governmental practice
or custom that, although not officially authorized, is
widespread and well settled; or (3) an official with final
policy-making authority.” Thomas v. Cook Cty.
Sheriff's Dep't, 604 F.3d 293, 303 (7th Cir.
2009) (citing Monell, 436 U.S. at 690). Such a claim is
colloquially referred to as a “Monell” claim.
Monell claims may be leveled against private companies as
well, if the company contracts to provide essential
government services like inmate healthcare. Shields v.
Ill. Dep't of Corr., 746 F.3d 782, 789 (7th Cir.
Defendants have filed motions for summary judgment seeking
dismissal of this action. (Docket #43 and #49). They deny
that Plaintiff suffered any heart attacks or that the care
provided to him was substandard. More important, however, is
their contention that even if Plaintiff's constitutional
rights were violated, he lacks evidence that the violation
was caused by a policy of SCDC or ACH, as required for
liability to attach under Monell.
opposition to both of Defendants' summary judgment
motions totals just thirty pages. (Docket #52 and #53). His
submissions offer absolutely no evidence to support his
policy claims under the second or third Monell variants. That
is to say, Plaintiff supplies no proof that his treatment was
the result of a consistent, though unauthorized, practice of
ignoring inmates' medical needs. Indeed, he appears to
expressly disclaim any desire to produce such evidence. See
(Docket #53 at 5) (“Plaintiff asks, is it necessary to
show multiple policy, practice or custom resulting in denial
of medical treatment? One instance is 1 too many.”).
Plaintiff also fails to allege, or offer any evidence for, a
theory that his alleged mistreatment was done at the hands of
an official with final policy-making authority.
Court is left, then, to assess whether Plaintiff could
proceed to trial on the first variant of a Monell claim: an
official policy adopted by Defendants that caused his
constitutional rights to be violated. The policy at
issue-using nurses to assess inmates in person and then pass
along information to doctors-does appear to be an official
policy. The problem for Plaintiff is that he cites no legal
authority for the proposition that using nurses in a
screening role violates the Eighth Amendment. To the
contrary, Defendants note that such policies have
consistently passed constitutional muster. See Gayton v.
McCoy, 593 F.3d 610, 622 (7th Cir. 2010)
(“Although mandating a doctor's visit or constant
prisoner checks would likely reduce the number of
illness-related deaths or injuries, it is neither
economically prudent nor feasible to put such policies in
place.”); Adams v. Ingram, No. 12-CV-162, 2015
WL 1256442 at *5 (S.D. Ill. Mar. 17, 2015) (the “common
triage practice” of using nurses to screen complaints
does not demonstrate deliberate indifference to their medical
needs, as it “allows inmates to receive nurse-level
medical treatment on demand but reserves higher level
treatment for cases that nurses, in their medical judgment,
believe require more medical expertise.”); Cook v.
S. Health Partners, No. 4:08CV-P128-M, 2009 WL 1409713
at *2 (W.D. Ken. May 20, 2009) (“A prisoner is entitled
to medical care. This does not mean, however, that a prisoner
is constitutionally entitled to see a doctor every time he
wishes. In many instances, evaluation by a trained nurse
prior to a doctor's examination may be sufficient medical
treatment for the purposes of the Eighth Amendment. A nurse
or physician's assistant may be able to effectively treat
a prisoner without requiring a doctor's assistance. In
this case, Southern Health Partners's policy did not deny
Plaintiff all medical care in violation of the Eighth
Amendment. Instead, Plaintiff simply alleges that the policy
deprived him of the ability to receive the type of care he
deemed necessary to treat his condition at that specific
time. Mere disagreement with the nature of one's medical
treatment is not sufficient, standing alone, to constitute
deliberate indifference to a serious medical
Plaintiff not only needs to establish that the
nurse-screening policy was defective, but that Defendants
were deliberately indifferent to the results of that
defectiveness, namely that inmates were consistently
receiving inadequate healthcare because of the policy.
Wilson v. Cook Cty., 742 F.3d 775, 781 (7th Cir.
2014). As noted above, Plaintiff supplies no evidence of
this, other than his own single instance of allegedly
improper care. In sum, regardless of the circumstances of
Plaintiff's particular interaction with the nursing staff
at SCDC, he has not created a triable issue as to whether the
nurse-screening policy itself was the source of a putative
violation of his constitutional rights.
has thus failed to support any theory of Monell liability
against Defendants for their policy of nurse-screening.
Defendants' motions for summary judgment must, therefore,
be granted. The Court will also deny as moot a prior motion
for judgment on the pleadings filed by Roeseler. (Docket
IT IS ORDERED that Defendants' motions for summary
judgment (Docket #43 and #49) be and the same are hereby
FURTHER ORDERED that Defendant Cory Roeseler's motion for
judgment on the pleadings (Docket #26) be and the same is
hereby DENIED as moot; and
FURTHER ORDERED that this action be and the same is hereby
DISMISSED with prejudice.
Clerk of the Court is directed to ...