Regal v. County of Santa Clara

Background

Frederick Regal died after attempting suicide while detained in a County of Santa Clara jail. The plaintiffs are his children. They asserted claims under 42 U.S.C. § 1983, a federal civil-rights statute, against the County and Consuelo Garcia, a County therapist who evaluated Regal while he was in custody.

At intake, Regal was described as showing signs of drug intoxication and bizarre or aggressive behavior. A mental-health assessment noted current suicidal thoughts, several acute risk factors, protective factors, and no reported suicide plan. The assessment rated him as a moderate suicide risk. He did not qualify for an involuntary psychiatric hold under California Welfare and Institutions Code § 5150 and was housed in a risk-management unit cell with an upper bunk and bedsheets. The cell did not have internal video or audio monitoring.

Garcia later reviewed Regal’s records and met with him. Regal continued to report suicidal thoughts but denied having a plan. Garcia concluded that he still did not qualify for a § 5150 hold, ordered that fifteen-minute checks continue, and recommended a psychiatry referral. During a later check, jail staff found Regal hanging from a bedsheet tied to the upper bunk. He was taken to a hospital and remained on life support until it was removed on August 5, 2020.

Claims Remaining Before the Court

After earlier rulings on motions to dismiss, the remaining claims were: (1) a § 1983 deliberate-indifference claim against Garcia; (2) a § 1983 loss-of-familial-association claim against Garcia; and (3) a § 1983 municipal-liability claim against the County based on an allegedly unconstitutional custom, practice, or policy.

Garcia’s Liability

The court applied the deliberate-indifference standard for a pretrial detainee’s medical-care claim. That standard requires more than negligence but less than intentional misconduct: the plaintiff must show that the defendant failed to take reasonable available measures despite an objectively high risk of serious harm.

The court concluded that Garcia had no reasonable alternative measures available under the undisputed facts. Regal was correctly classified as a moderate-risk individual, while County policy limited Ferguson gowns and blankets to high-risk individuals and, as of July 29, 2020, limited their use to the acute psychiatric unit. Because bedsheets could not be removed without providing a Ferguson blanket, the court found that Garcia could not simply order the sheets removed. The court also found that Garcia lacked authority to place Regal in the restrictive housing unit and that placement in the acute psychiatric unit required a § 5150 hold, for which Regal did not qualify.

The court held that Garcia reasonably chose among the options available to her by continuing fifteen-minute checks and requesting a psychiatry consultation. It concluded that her conduct did not amount to deliberate indifference and did not find a constitutional violation. The court therefore granted summary judgment to Garcia on the deliberate-indifference claim. Because the familial-loss claim was derivative of that claim, the court also granted summary judgment to Garcia on the familial-loss claim. Having found no constitutional violation, the court did not need to decide whether the constitutional right was clearly established for qualified-immunity purposes.

County’s Municipal-Liability Claim

A municipal-liability, or Monell, claim may hold a municipality responsible under § 1983 for a constitutional injury caused by an official policy, a widespread custom or practice, inadequate training or supervision, or a decision by a final policymaker. The plaintiffs’ theory was that the County’s custom and practice of housing moderately suicidal people in cells with obvious hanging points, together with written policies that did not require additional precautions in those circumstances, failed to provide reasonable measures to reduce a known suicide risk.

The court rejected the County’s argument that Garcia’s lack of individual liability defeated the claim. A municipality may be liable based on its own collective inaction even when an individual employee is not held liable.

The court found genuine disputes of material fact on each relevant part of the municipal-liability analysis. A reasonable factfinder could determine that the County failed to take reasonable measures for a moderate-risk person housed in a cell with an obvious hanging point. The parties also presented conflicting evidence about possible preventive measures, including modifying bunk beds, using single-bed cells, staggering suicide-watch checks, retaining access to Ferguson blankets for moderate-risk individuals, and constructing more suicide-resistant cells.

The court further found a factual dispute about whether the County had actual or constructive notice of the particular risk. The plaintiffs presented evidence concerning prior jail suicides by hanging, including the use of upper bunks and bedsheets, as well as information provided by a suicide-prevention expert. The court concluded that a reasonable factfinder could determine that the County’s data put it on notice of the risk created by housing moderately suicidal individuals in cells with obvious hanging points without additional preventive measures.

Because disputed facts also concerned whether the alleged policy or practice was sufficiently connected to Regal’s death, the court held that the “moving force” requirement could not be resolved on summary judgment. It therefore denied the defendants’ motion for summary judgment on the Monell claim against the County.

Request to Amend

The plaintiffs asked to amend their familial-loss claim to add the County. The court did not rule on that request at this time and directed the plaintiffs either to seek a stipulation or to file a separate motion to amend.

Disposition

The court ordered that the defendants’ motion for summary judgment on all claims against Consuelo Garcia was granted. It ordered that the defendants’ motion for summary judgment on the plaintiffs’ Monell claim against the County was denied.