Toomey v. Dakota County

Background

On October 29, 2021, Nathan Toomey was booked into Dakota County's jail on shoplifting charges. A nurse named Jamie Janvrin completed a chemical withdrawal questionnaire noting Toomey's daily suboxone and fentanyl use and withdrawal symptoms including nausea, vomiting, and diarrhea. Toomey was placed under chemical withdrawal monitoring. Over the following six days, Toomey allegedly suffered severe withdrawal symptoms observed by more than 20 county correctional officers, but medical professionals Janvrin, Amanda Reiman, and Virginia Olson — all employed by MEnD Correctional Care, PLLC ("MEnD"), a third-party medical contractor — allegedly failed to recognize the severity and provide adequate care. On November 4, 2021, Toomey was found unresponsive and transferred to Regions Hospital, where he was diagnosed with dehydration, acute kidney failure, acidosis, acute respiratory failure with hypoxia, and pneumonitis due to aspiration. MEnD declared bankruptcy in November 2022.

Toomey filed suit on April 4, 2025, bringing four claims: (1) a Section 1983 constitutional civil rights claim against Janvrin, Reiman, and Olson for deliberate denial of medical treatment in violation of his Fourteenth Amendment rights; (2) a Monell claim against the County alleging an unconstitutional unofficial custom of denying adequate medical care to detainees; (3) a medical malpractice claim against all defendants; and (4) a standalone negligence claim against the County. The County moved for judgment on the pleadings — a procedural mechanism evaluated under the same standard as a motion to dismiss for failure to state a claim — as to Claims II, III, and IV.

Legal Standard

A Rule 12(c) motion for judgment on the pleadings is evaluated under the same standards as a Rule 12(b)(6) motion to dismiss. The court must accept all facts alleged by the non-moving party as true and grant all reasonable inferences in that party's favor, but the complaint must still state a claim that is "plausible on its face" under the standards set by Bell Atlantic Corp. v. Twombly and Ashcroft v. Iqbal.

Count II: Monell Claim — Dismissed Without Prejudice

Under Monell v. Department of Social Services of the City of New York, 436 U.S. 658 (1978), a local government (municipality) cannot be held liable under Section 1983 — a federal civil rights statute allowing suits against state and local officials — simply because it employs a wrongdoer. Instead, liability attaches only if the constitutional violation resulted from an official policy, an unofficial custom, or a deliberately indifferent failure to train or supervise.

The court construed Toomey as relying on the "unofficial custom" theory, which requires showing a widespread and persistent pattern of unconstitutional misconduct that policymakers were deliberately indifferent to or tacitly authorized, and that the custom was the "moving force" behind the violation.

The County first argued that acts by independent contractors cannot support a Monell claim. The court rejected this as both legally and factually incorrect: contracting out prison medical care does not eliminate the government's constitutional duty, and Toomey also alleged that the County's own correctional officers failed to render aid and that the County itself acted unconstitutionally by contracting with MEnD despite knowing of its inadequacies.

However, the court dismissed the Monell claim on two independent grounds:

First, Toomey identified only a single incident of unconstitutional conduct — his own experience — and identified no other detainees who received inadequate care. A single incident cannot establish an unofficial custom. Although Toomey alleged a "custom, pattern, and practice" of denying adequate care, the court held this was a legal conclusion dressed as a factual allegation, which courts are not bound to accept at the pleading stage. Similarly, Toomey's allegations about MEnD's systemic deficiencies did not allege that those deficiencies injured anyone other than Toomey himself.

Second, Toomey failed to allege when the County became aware of MEnD's shortcomings. Notice is the touchstone of deliberate indifference for a Monell claim. If the County first learned of MEnD's problems after Toomey's detention ended, it could not have been deliberately indifferent at the relevant time. The complaint provided no indication that the County had notice of MEnD's deficiencies as of October–November 2021.

Count III: Medical Malpractice — Dismissed Without Prejudice

The County argued that the Minnesota Municipal Tort Liability Act ("MTLA"), Minn. Stat. § 466.01 et seq., bars malpractice claims against the County based on acts of its independent contractors. The MTLA makes municipalities liable for the torts of their "officers, employees and agents acting within the scope of their employment," but explicitly excludes "independent contractors" from that definition.

Toomey did not dispute — and in fact affirmatively alleged — that Janvrin, Reiman, and Olson were independent contractors employed by MEnD, not by the County. The contract between MEnD and the County confirmed this. The court therefore held that the MTLA bars the malpractice claim against the County.

The court rejected Toomey's three attempts to avoid this conclusion:

- Nondelegable duty argument: Toomey argued that because the duty to provide inmates with medical care is constitutionally nondelegable, the MTLA should not apply. The court found that the cases Toomey cited addressed Section 1983 liability, not state tort law, which is a separate question.

- Westby argument: Toomey cited Westby v. Itasca County, 290 N.W.2d 437 (Minn. 1980), which held a municipality liable for independent contractors performing nondelegable duties. The court noted that the MTLA's independent-contractor exclusion was not enacted until 1988 — after Westby was decided — and therefore abrogated Westby's holding on this point.

- Apparent authority argument: Toomey argued the contractors were the County's agents under apparent authority principles. The court rejected this because the MTLA explicitly carves independent contractors out of the definition of "employee, officer, or agent," regardless of the agency relationship.

Count IV: Negligence — Granted in Part, Denied in Part

The court identified two distinct negligence theories in Count IV:

Theory 1 — County liable for medical malpractice of contractors: This mirrors Count III and is likewise barred by the MTLA. This portion of Count IV was dismissed.

Theory 2 — County liable for correctional officers' failure to render aid: The court found this theory was not barred by the MTLA, since the MTLA does allow suits based on the acts of the County's own employees. Toomey alleged that more than 20 county correctional officers — who were tasked with monitoring his withdrawal — observed his severe medical distress over six days and took no steps to intervene to provide adequate medical treatment.

Under Minnesota negligence law, a plaintiff must allege: (1) a duty of care; (2) breach of that duty; (3) an injury; and (4) the breach as the proximate cause of the injury. The court found all four elements adequately pleaded:

- Duty: Minnesota law and federal constitutional law both impose a duty on county officials to provide adequate medical care to inmates. - Breach: Toomey alleged officers witnessed him having seizures, found him unresponsive multiple times, and knew the medical treatment he was receiving was inadequate, yet failed to do more. - Injury: Toomey alleged he nearly died of dehydration and suffered multiple serious medical conditions. - Causation: The injuries were alleged to be foreseeable results of inadequate medical care.

The court analogized to Erickson v. Pope County, No. 19-cv-3061 (D. Minn. 2022), where a similar negligence claim against a county for a detainee's alcohol withdrawal death survived to trial. The court rejected the County's argument that contacting MEnD nurses multiple times satisfied the officers' duty, noting that whether those contacts were sufficient is a factual question for after discovery.

The court also noted it could construe Count IV as a negligent-selection-of-contractor claim but declined to address that theory because Toomey's counsel disclaimed it at oral argument.

Dismissal With or Without Prejudice

The court dismissed Counts II and III (and the first theory of Count IV) without prejudice, meaning Toomey may attempt to file an amended complaint curing the identified deficiencies. The court reasoned that dismissals at the pleading stage are generally without prejudice absent persistent pleading failures or incurable defects, and Toomey had not yet had an opportunity to amend his complaint.

Result

The County's motion was granted as to the Monell claim (Count II) and the medical malpractice claim (Count III), both dismissed without prejudice. The motion was denied as to the negligence claim premised on the correctional officers' conduct. The Section 1983 claim against Janvrin, Reiman, and Olson (Count I) was not at issue in this motion and remains pending.