McKee v. Brady

Background

Jessica Ann McKee was booked into the Steele County Detention Center in September 2019. At booking, she reported no medical issues, medications, or current physician. The opinion states that McKee had Crohn’s disease but had been in remission for about three years and had not been taking her prescribed medication.

McKee first told medical staff about her Crohn’s disease on November 20, 2019, when she requested a lower bunk because of reported seizures and malnutrition. On December 8, she reported that her Crohn’s was worsening and that she was experiencing blood loss and lightheadedness. Medical staff approved a vegetarian diet. On December 16, McKee reported that the diet appeared to worsen the bleeding, asked to return to her previous diet, and asked about obtaining sulfasalazine. Nurse Jessica J. Brady requested medical records from Mayo Clinic and forwarded them to Advanced Correctional Healthcare, whose physician could prescribe medication. No prescription was ordered.

On January 9, 2020, McKee reported that her condition continued to worsen and requested nutritional support. The next day, she told Brady that she was constantly thirsty, had temperature fluctuations, and had severe stabbing abdominal pain. Brady contacted an Advanced Correctional Healthcare physician and arranged for McKee to be taken by ambulance to Mayo Clinic. McKee received a blood transfusion for anemia, underwent a colonoscopy, developed sepsis, and spent time in intensive care. She was discharged after ten days.

Claims and Legal Standards

McKee alleged that the defendants were deliberately indifferent to her medical needs in violation of the Eighth Amendment and that their conduct was objectively unreasonable under the Fourteenth Amendment. She also alleged that Steele County had an unofficial practice or custom of failing to provide adequate medical care to pretrial detainees.

The court considered the defendants’ motion under the summary-judgment standard. Summary judgment is appropriate when the evidence shows no genuine dispute about a fact that could affect the result and the moving party is entitled to judgment as a matter of law. The court must view the evidence and reasonable inferences in favor of the party opposing the motion.

For a pretrial detainee’s Fourteenth Amendment medical-care claim, the detainee must show an objectively serious medical need and that the official was subjectively aware of it but deliberately disregarded it. Deliberate disregard requires more than negligence or gross negligence and involves a mental state similar to criminal recklessness. A government official may avoid liability by responding reasonably to a medical risk, even if the harm is not ultimately prevented.

Eighth Amendment Claim

The court granted summary judgment on McKee’s Eighth Amendment claim. It concluded that because McKee was a pretrial detainee, her right to adequate medical care was properly and fully considered under the Fourteenth Amendment. The Eighth Amendment claim was dismissed with prejudice as to both defendants.

Fourteenth Amendment Claim Against Brady

The court denied summary judgment on McKee’s Fourteenth Amendment claim against Brady. Brady asserted qualified immunity, which can protect a government official from civil liability unless the official violated a constitutional right that was clearly established at the time.

The court held that McKee had a clearly established right to adequate medical care. It also found that Crohn’s disease was a serious medical condition. The evidence could support McKee’s position because she reported a flare-up in November and bleeding in December, while Brady did not offer an appointment until December 19, and Brady acknowledged that a bleeding issue would require immediate medical attention.

The evidence could also support Brady’s position. Brady testified that she was not subjectively aware of the risk and responded to each of McKee’s explicit requests, including the request for a vegetarian diet. Because a reasonable jury could decide for either side, the court concluded that Brady had not established entitlement to summary judgment on qualified-immunity grounds. McKee’s Fourteenth Amendment claim against Brady therefore survived summary judgment.

Fourteenth Amendment Claim Against Steele County

The court granted summary judgment to Steele County. A county may be liable under 42 U.S.C. § 1983 when its own policy, unofficial custom, or deliberately indifferent failure to train or supervise causes a constitutional violation. It is not automatically liable for an employee’s actions.

McKee claimed that the violation resulted from an unofficial custom of failing to provide adequate medical care. The court explained that such a claim requires evidence of persistent and widespread unconstitutional practices; one isolated incident is not enough. McKee did not respond to the defendants’ argument that she had not shown a pattern of failures, so the court treated that claim as waived. The court alternatively held that the claim failed because McKee identified no record evidence supporting a countywide custom beyond the events involving her own medical care.

The Fourteenth Amendment claim against Steele County was dismissed with prejudice, and Steele County was terminated as a party.

Disposition

The defendants’ motion for summary judgment was granted in part and denied in part: it was granted as to McKee’s Eighth Amendment claim and her Fourteenth Amendment claim against Steele County, and denied as to her Fourteenth Amendment claim against Brady. The defendants’ request for costs and disbursements was denied.