Hammonds v. Dekalb County, Alabama et al

Filing 62

MEMORANDUM OPINION Signed by Chief Judge Karon O Bowdre on 10/16/17. (SAC )

FILED
2017 Oct-16 PM 04:18
U.S. DISTRICT COURT
N.D. OF ALABAMA

IN THE UNITED STATES DISTRICT COURT
FOR THE NORTHERN DISTRICT OF ALABAMA
MIDDLE DIVISION
STEPHEN HAMMONDS,
Plaintiff,
v.
DEKALB COUNTY, AL, et al.,
Defendants.

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CIVIL ACTION NO:
4:16-cv-1558-KOB

MEMORANDUM OPINION
This cause comes before the court on motions to dismiss Plaintiff Stephen Hammonds’s
Second Amended Complaint (doc. 39) filed by Defendants DeKalb County (doc. 45), Sheriff
Jimmy Harris (doc. 47), and Robert Theakston and Matthew Martin (doc. 49). Mr. Hammonds
alleges violations of his Fourteenth Amendment rights through § 1983 and discrimination
through the Americans with Disabilities Act (“ADA”) and Section 504 of the Rehabilitation Act.
While a pretrial detainee at the DeKalb County jail, Mr. Hammonds, a Type-I diabetic, suffered
a serious medical crisis, which, Mr. Hammonds claims, Defendants caused or failed to timely
address.
For the reasons stated in this Memorandum Opinion, the court will GRANT the County’s
and Sheriff Harris’s motions to dismiss and GRANT IN PART and DENY IN PART Dr.
Theakston and Mr. Martin’s motion to dismiss. Specifically, the court will DISMISS WITH
PREJUDICE Count I against all Defendants, Count II against the County, and Count III against
Sheriff Harris. However, Mr. Hammonds may proceed with his claims in Counts IV and V that

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Dr. Theakston and Mr. Martin, respectively, personally participated in the alleged constitutional
deprivations.
PROCEDURAL HISTORY
Mr. Hammonds brought this action pursuant to the ADA, Rehabilitation Act, and 42
U.S.C. § 1983. Defendants moved to dismiss Mr. Hammonds’s original complaint under
Fed. R. Civ. P. 12(b)(6). (Docs. 9, 11). This court granted the motions to dismiss as to Mr.
Hammonds’s ADA and Rehabilitation Act allegations and ordered Mr. Hammonds to provide a
more definite statement as to his § 1983 claims. (Doc. 27). Although the court originally
dismissed Mr. Hammonds’s ADA and Rehabilitation Act allegations with prejudice, it
reconsidered and permitted Mr. Hammonds to file an amended complaint. (Doc. 38). Mr.
Hammonds filed his Second Amended Complaint (doc. 39) and Defendants responded with their
second round of motions to dismiss (docs. 45, 47, 49), which are now fully briefed and under
submission.
STANDARD OF REVIEW
The court incorporates and adopts the standard of review outlined in its prior
Memorandum Opinion (doc. 26) addressing Defendants’ first motions to dismiss.
FACTS
Because the facts alleged by Mr. Hammonds in his Second Amended Complaint are
substantially the same as those in the original complaint, the court adopts its factual statement
from the prior Memorandum Opinion (doc. 26). The court likewise adopts its finding that it will
consider the July 2014 Department of Homeland Security report (“DHS Report”) referenced by
Mr. Hammonds’s complaints. Furthermore, the court adopts its previous findings about the DHS
Report’s weight with respect to Mr. Hammonds’s allegations.
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Briefly stated, Mr. Hammonds, who suffers from Diabetes Mellitus Type I, alleges that
the County, Sheriff Harris, Dr. Theakston, and Mr. Martin denied him access to the necessary
medical treatment for his condition while they detained him at the DeKalb County jail. As a
result, Mr. Hammonds suffered multiple diabetes-related complications, including diabetic
ketoacidosis (“DKA”), anemia, leukocytosis, and acute renal and kidney failure. Mr. Hammonds
alleges that he informed Defendants of his condition, but they failed to treat him properly.
Specifically, he contends that Dr. Theakston, a physician, placed him on a treatment regime for
Type-II diabetes patients. That regime was inadequate to treat Type-I diabetes and led to Mr.
Hammonds’s complications. Further, while Mr. Hammonds’s condition was deteriorating, Mr.
Hammonds’s family called 911 to report his condition. Mr. Martin got wind of the call and
threatened Mr. Hammonds’s family members with arrest and jail.
In Count I of the Second Amended Complaint, Mr. Hammonds alleges that all four
Defendants violated the ADA and the Rehabilitation Act by denying him proper care. In Count
II, Mr. Hammonds alleges that the County violated § 1983 and the Fourteenth Amendment by
depriving him of his fundamental right to adequate medical care. In Counts III, IV, and V, Mr.
Hammonds alleges that Sheriff Harris, Dr. Theakston, and Mr. Martin, respectively, acted to
deprive him of his fundamental right to adequate medical care. Mr. Hammonds appears to allege
that Sheriff Harris, Dr. Theakston, and Mr. Martin acted both personally and as supervisors to
injure him. Mr. Hammonds asks the court to enter a declaratory judgment that Defendants’
practices violate the Constitution, the ADA, and the Rehabilitation Act. Mr. Hammonds also
asks that the court enjoin Defendants’ practices, order the development and implementation of
appropriate practices, and award monetary damages and punitive damages, as well as attorneys’
fees, costs, and interest.
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DISCUSSION
A. Count I: ADA and Rehabilitation Act
According to Mr. Hammonds, Defendants violated Title II of the ADA and Section 504
of the Rehabilitation Act by failing to accommodate his Type-I diabetes and by discriminating
against him on the basis of his Type-I diabetes. Specifically, Mr. Hammonds states that
Defendants discriminated against him by placing him in administrative segregation and by
failing to provide a diabetes-compliant diet and space and permission to exercise. Mr.
Hammonds further alleges that Defendants discriminated against him because of his diabetic
condition by refusing to allow him access to “basic inmate services; regular mealtimes; the
opportunity to exercise; the ability [to] access [] the inmate kiosk and known needs for his
diabetic condition.” (Doc. 39 ¶ 163).
Defendants argue that Mr. Hammonds has failed to state a claim for relief because the
Second Amended Complaint fails to provide facts sufficient to draw a discriminatory connection
between the alleged denial of services and Mr. Hammonds’s condition. The court agrees. 1
“To state a claim under Title II of the ADA, a plaintiff must allege: (1) that he is a
‘qualified individual with a disability;’ (2) that he was excluded from participation in
or . . . denied the benefits of the services, programs, or activities of a public entity’ or otherwise
‘discriminated [against] by such entity;’ (3) ‘by reason of such disability.’” Shotz v. Cates, 256
F.3d 1077, 1079 (11th Cir. 2001) (quoting 42 U.S.C. § 12132). Similarly, a prima facie case for
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Defendants also contend that, at the time he arrived at the jail, Mr. Hammonds’s Type-I
diabetes was not a disability, although they acknowledge that it may qualify as one under certain
circumstances not present here. (See Doc. 46 at 8-9, 11 n.8). Because the court finds that Mr.
Hammonds fails to allege sufficient facts to show that Defendants discriminated against him
because of his disability, the court does not address that argument.
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discrimination under the Section 504 of the Rehabilitation Act requires a plaintiff to show (1)
that he is “handicapped” within the meaning of the Act and relevant regulations; (2) that he is
“otherwise qualified” to participate in the program or activity; (3) that the program or activity
received federal financial assistance; and (4) that he was adversely treated solely because of his
handicap. See Jackson v. Veterans Administration, 22 F.3d 277, 278 (11th Cir. 1994).
For the same reasons as discussed in the court’s prior Memorandum Opinion (doc. 26 at
12-16), Mr. Hammonds has failed to state a claim for relief under the ADA and the
Rehabilitation Act. A defendant does not violate the ADA or Rehabilitation Act merely because
it failed to provide medical care to disabled prisoners or detainees. See Cash v. Smith, 231 F.3d
1301, 1305 & n.2 (11th Cir. 2000) (observing that discrimination claims under the Rehabilitation
Act are governed by the same standards used in ADA cases and that cases decided under the
Rehabilitation Act are precedent for cases under the ADA); see also Bryant v. Madigan, 84 F.3d
246, 249 (7th Cir. 1996) (“The ADA does not create a remedy for medical malpractice.”);
Fitzgerald v. Corr. Corp. of Am., 403 F.3d 1134, 1144 (10th Cir. 2005) (holding that “purely
medical decisions” do not ordinarily fall within the scope of the ADA).
To state a claim under the ADA and or Rehabilitation Act Mr. Hammonds would need to
bring non-conclusory allegations that Defendants treated him worse than other prisoners because
of Mr. Hammonds’s Type-I diabetes. Mr. Hammonds identifies a potential disability (diabetes)
and several adverse actions (e.g., the misdiagnosis, the placement of Mr. Hammonds in
administrative segregation, and his restriction from using the prisoner-services kiosk), but he
does not allege facts that suggest Defendants chose to mistreat him because he had diabetes.
Accordingly, the court finds that Count I is due to be DISMISSED WITH PREJUDICE
in favor of all Defendants. See Ashcroft v. Iqbal 556 U.S. 662, 678 (2009) (stating that a claim
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must contain enough facts that “allow[ ] the court to draw the reasonable inference that the
defendant is liable for the misconduct alleged.”).
B. Count II: § 1983 Deliberate Indifference to Serious Medical Needs (DeKalb County)
Mr. Hammonds bases his first § 1983 claim on the County’s alleged deliberate
indifference to his serious medical needs as a pretrial detainee, in violation of the Fourteenth
Amendment. He states that “[p]ursuant to DeKalb County’s jail policy and long-standing
policy” he “was not identified” as a Type-I diabetic and did not receive the appropriate treatment
or management. (Doc. 39 ¶ 176). Mr. Hammonds repeats his contention that the County has
such a policy several times. Mr. Hammonds also alleges that the County “owns and funds the
operation of the jail, its personnel, including medical staff, and employs Dr. Theakston for the
part time provision of medical care for persons incarcerated there.” (Doc. 39 ¶ 170). Mr.
Hammonds further contends that the County “had a policy and practice of not adequately
funding inmate medical care with deliberate indifference to the serious medical needs of inmates
. . . .” (Doc. 39 ¶ 171).
The County disputes the legal accuracy of Mr. Hammonds’s allegations, arguing that, as
a matter of law, it cannot be liable for incidents in the county jail. It contends that Mr.
Hammonds’s claims arise out of the jail’s day-to-day operations and that, under Alabama law,
the County does not employ Sheriff Harris and has no role in his supervision of jail employees,
including Dr. Theakston. In the County’s view, its role is limited to building, maintaining, and
funding the jail; it does not have a duty to provide jailers and medical staff with adequate
training or any similar “ministerial” responsibility related to day-to-day jailhouse operations.
To state a claim under 42 U.S.C. § 1983, a plaintiff must allege: “(1) a violation of a
constitutional right; and (2) that the alleged violation was committed by a person acting under
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the color of state law or a private individual who conspired with state actors.” See Melton v.
Abston, 841 F.3d 1207, 1220 (11th Cir. 2016). Mr. Hammonds alleges that the County violated
his right to be free from deliberate indifference to his serious medical needs. See id. (“As a
pretrial detainee . . . , [the plaintiff’s] rights arose under the due process clause of the Fourteenth
Amendment rather than the Eighth Amendment.”). To state a claim for deliberate indifference to
a serious medical need, a plaintiff must sufficiently allege: “(1) a serious medical need; (2) a
defendant’s deliberate indifference to that need; and (3) causation between that indifference and
the plaintiff’s injury.” Id.
The court must dismiss Mr. Hammonds’s claim against the County to the extent he bases
it on the County’s employment of the individual defendants or other unnamed persons. See Bd.
of County Comm’rs v. Brown, 520 U.S. 397, 403 (1997) (holding that local government bodies
may not be held liable under § 1983 solely because they employ a tortfeasor); Monell v. New
York City Dept. of Social Servs., 436 U.S. 658, 689 (1978). Instead, a plaintiff must allege a
“direct causal link” between a county policy or custom and the alleged constitutional
deprivations. Young v. City of Augusta, Ga., 59 F.3d 1160, 1171 (11th Cir. 1995).
That is, a plaintiff must allege “that the failing was a conscious choice by policymakers
among alternative courses of action, which in turn, caused the jailers’ deliberate indifference.”
Id. at 1171-72. “Before it may be said that a municipality has made a deliberate choice among
alternative courses of action, its policymakers must have had ‘actual or constructive notice that
the particular omission is substantially certain to result in the violation of the constitutional rights
of their citizens.’” Id. at 1172.
First, Mr. Hammonds’s contention that the County had a “long-standing policy” of
ignoring patients with medical needs is unsupported by any specific factual allegations, and,
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moreover, contrary to the duties Alabama counties have regarding county jails. Under Alabama
law, a county government is obligated to provide funding for a county jail, but it does not
supervise the jail’s day-to-day operations. See, e.g., Ala. Code §§ 11-14-10 (stating that the
county has a duty to build and maintain a jail); 11-12-15(a) (detailing various appropriations for
county jails). Although the county appropriates funds for a sheriff and his subordinates’ salaries,
the duty of Alabama counties to pay those salaries “does not translate into control over them.”
McMillian v. Monroe Cty., Ala., 540 U.S. 781, 791 (1997). Instead, the sheriff, who the state
controls rather than the county, maintains responsibility for day-to-day supervision. See Ala.
Code § 14-6-1; Turquitt v. Jefferson County, Ala., 137 F.3d 1285, 1289 (11th Cir. 1998) (“The
[c]ounty has no authority to manage the sheriff’s employees. . . . A state agency . . . oversees the
county jails and has the authority to regulate them.”).
Essentially then, the County’s obligations regarding the DeKalb County jail are “limited
to funding the operation of the jail and to providing facilities to house the jail.” Turquitt, 137
F.3d at 1289 (quoting Stark v. Madison County, 678 So. 2d 787, 787 (Ala. Civ. App. 1996)); see
also Keeton v. Fayette Cnty., 558 So. 2d 884, 886 (Ala. 1989). Mr. Hammonds’s allegation that
the County nevertheless had the ability to implement policies and procedures at the jail fails
because it is an unsupported legal conclusion, not a factual assertion that the court must take as
true when evaluating a motion to dismiss. See Iqbal, 556 U.S. at 678 (noting that the court does
not have to accept as true legal conclusions even when “couched as [] factual allegation[s]”).
Notwithstanding the County’s lack of legal control, Mr. Hammonds still fails to allege
with any specificity any county policy or procedure that would have caused or enhanced his
injuries. Trimmed of its conclusory fat, the Second Amended Complaint says that Dr. Theakston
misdiagnosed Mr. Hammonds and that Mr. Martin ignored signs of that misdiagnosis, causing or
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enhancing Mr. Hammonds’s injuries. Mr. Hammonds does not connect Dr. Theakston’s or Mr.
Martin’s acts to any specific policy or procedure implemented by the County.
Second, Mr. Hammonds has also failed to state a plausible allegation that the County
inadequately funded the jail’s medical facilities. Mr. Hammonds alleges that the County did not
provide sufficient funding for the jail to buy the necessary insulin for his condition. Mr.
Hammonds connects the County’s failure to provide that insulin as a reason for his treatment for
the wrong type of diabetes. And Mr. Hammonds is correct that the lack of proper medical
supplies could explain why Dr. Theakston chose to treat him for Type-II diabetes rather than
Type-I diabetes.
But, Mr. Hammonds fails to allege any relevant facts that would have put the County on
notice that it inadequately funded the jail’s medical facilities. See Young, 59 F.3d at 1172; see
also McDowell v. Brown, 392 F.3d 1283, 1291-92 (11th Cir. 2004) (holding that a county’s
liability “cannot be dependent on the scant likelihood that its budget decisions will trickle down
the administrative facets and deprive a person of his constitutional rights”). On that point, Mr.
Hammonds relies on the DHS Report. But the DHS Report does not note any deficiencies
related to the provision of medical supplies at the jail.
For those reasons, Count II in the Second Amended Complaint will be DISMISSED
WITH PREJUDICE.
C. Counts III, IV, and V: § 1983 Deliberate Indifference to Serious Medical Needs
Mr. Hammonds’s final three claims allege that Sheriff Harris, Dr. Theakston, and Mr.
Martin, respectively, violated § 1983 because they were deliberately indifferent to his serious
medical need. Defendants assert that qualified immunity applies because no law clearly
established that their conduct violated the Constitution. The court agrees that Sheriff Harris is
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entitled to qualified immunity because Mr. Hammonds has failed to state a claim that Sheriff
Harris violated his constitutional rights under either a personal participation or supervisory
theory.
However, Mr. Hammonds has stated a plausible claim for relief against Dr. Theakston
and Mr. Martin. Mr. Hammonds alleges specific facts that, when taken as true, establish that Dr.
Theakston and Mr. Martin personally participated in grossly incompetent treatment of Mr.
Hammonds’s Type-I diabetes. And because Mr. Hammonds’s right to adequate medical care
under these circumstances is “clearly established,” Dr. Theakston and Mr. Martin are not entitled
to qualified immunity if Mr. Hammonds’s allegations hold true.
The applicability of qualified immunity is a question of law. Willingham v. Loughnan,
261 F.3d 1178, 1184 (11th Cir. 2001). To receive qualified immunity, a government officer
must first establish that he was acting within the scope of his discretionary authority when the
alleged wrongful acts occurred. Lee v. Ferraro, 284 F.3d 1188, 1194 (11th Cir. 2002). The
burden then shifts to the plaintiff to show that qualified immunity is inappropriate. Id. Mr.
Hammonds and the individual defendants agree that the individual defendants were acting in the
scope of their discretionary authority when the wrongful acts occurred.
Qualified immunity is only inappropriate if the plaintiff has alleged the deprivation of a
clearly-established constitutional right. See Saucier v. Katz, 533 U.S. 194, 201 (2001); see also
Pearson v. Callahan, 555 U.S. 223, 236 (2009). Accordingly, the court asks whether the facts
“[t]aken in the light most favorable to the party asserting the injury . . . show the officer’s
conduct violated a constitutional right” and that the right was clearly established. Gonzalez v.
Reno, 325 F.3d 1228, 1234 (11th Cir. 2003) (citing Saucier, 533 U.S. at 201).

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All three individual defendants argue that they did not personally participate in any
unconstitutional conduct and that their actions as supervisors had no causal connection to the
alleged constitutional violation. The court addresses this § 1983 and qualified immunity issue in
the following order: (1) whether the individual defendants personally participated in
unconstitutional conduct; (2) whether the individual defendants’ actions as supervisors had a
causal connection to the alleged constitutional violation; and (3) whether any right the individual
defendants violated was clearly established.
1. Denial of Constitutional Right: Personal Participation
Mr. Hammonds first premises the individual defendants’ liability on their personal
participation in the alleged deliberate indifference to a serious medical need. To show that a
defendant was deliberately indifferent to a serious medical need, a plaintiff must plead specific
facts that the jail official possessed a “subjective awareness” of facts signaling a serious medical
need. See Taylor v. Adams, 221 F.3d 1254, 1258 (11th Cir. 2000). The jail official must have
drawn an inference from his “subjective awareness” to the plaintiff’s need for medical attention.
Id. Finally, the jail official’s response must have been objectively insufficient. Id.
a. Sheriff Harris’s Personal Participation
Mr. Hammonds does not allege any fact suggesting that Sheriff Harris possessed a
subjective awareness that he had a serious medical need. Mr. Hammonds implies that Sheriff
Harris should have known about Mr. Hammonds’s medical treatment or lack thereof because he
was “responsible for the care and custody of inmates in the DeKalb County jail.” (See Doc. 55 at
28). But “imputed or collective knowledge cannot serve as the basis for a claim of deliberate
indifference.” See Burnette v. Taylor, 533 F.3d 1325, 1331 (11th Cir. 2008).

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Mr. Hammonds also says that his condition was “made known multiple times” to Sheriff
Harris, but does not allege how. (See, e.g., Doc. 39 ¶¶ 252, 259, 282). Although Sheriff Harris
had notice that Mr. Hammonds had Type-I diabetes, none of the circumstances noted in the
Second Amended Complaint suggest that anyone ever made Sheriff Harris aware of Mr.
Hammonds’s health situation as it deteriorated. Without any supporting facts, the court has no
plausible grounds to infer that Mr. Hammonds’s misdiagnosis and critical condition was ever
“made known” to Sheriff Harris. See Bell Atlantic Corp. v. Twombly, 550 U.S. 544, 555 (2007)
(stating that courts will ask only “for plausible grounds to infer” conclusions and that such
requirement “simply calls for enough fact to raise a reasonable expectation that discovery will
reveal” facts proving the conclusion).
Because Sheriff Harris did not have a subjective awareness that Mr. Hammonds had a
serious medical need that nobody was appropriately attending, the Second Amended Complaint
does not state a deliberate indifference claim against Sheriff Harris under a personal participation
theory.
b. Dr. Theakston’s Personal Participation
Next, the Second Amended Complaint states a claim that Dr. Theakston provided grossly
inadequate medical treatment to Mr. Hammonds. Medical malpractice alone cannot support a
claim for deliberate indifference. See Mandel v. Doe, 888 F.2d 783, 788 (11th Cir. 1989).
However, the provision of grossly inadequate medical care can rise to deliberate
indifference. See Melton, 841 F.3d at 1223 (observing that deliberately indifferent conduct
includes grossly inadequate medical care). Mr. Hammonds told Dr. Theakston that he had TypeI diabetes, but Dr. Theakston treated for Type-II diabetes. Presupposing that the treatments for
Type-I diabetes and Type-II diabetes are not substitutes, the court can infer that Dr. Theakston, a
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physician, knew that treating Mr. Hammonds for Type-II diabetes when he had Type-I diabetes
could or likely would lead to Mr. Hammonds’s serious medical complications.
Dr. Theakston characterizes his misdiagnosis as a “disagreement” on the course of
treatment between doctor and patient. At this stage, however, the court must draw all inferences
in Mr. Hammonds’s favor, and so the facts suggest that Dr. Theakston’s treatment was not an
alternative treatment, but an objectively wrong treatment. Accordingly, the court finds that the
Second Amended Complaint states a plausible claim that Dr. Theakston acted with deliberate
indifference to Mr. Hammonds’s serious medical need.
c. Mr. Martin’s Personal Participation
Mr. Hammonds also pleads sufficient facts to state a claim that Mr. Martin violated the
Constitution by failing to act when informed that Mr. Hammonds was suffering a serious
medical crisis. See Mandel, 888 F.2d at 789 (stating that defendant’s cavalier disregard of
repeated indications that the plaintiff’s condition was serious or more serious than original
diagnosis concluded could amount to deliberate indifference).
According to the Second Amended Complaint, Mr. Hammonds’s family called 911
because of their concern for Mr. Hammonds’s health. Somebody told Mr. Martin about the call.
Rather than intervening by, for example, forwarding the information to another administrative
official or directing a subordinate to reexamine Mr. Hammonds, Mr. Martin told the Hammonds
family to leave him alone. 2 Mr. Hammonds’s family pled with Mr. Martin to intervene, or to
permit them to provide the necessary medication. Mr. Martin did nothing. Further, Mr. Martin
2

Mr. Martin contends that upon learning about Mr. Hammonds’s health crisis, he had
Mr. Hammonds transferred to a medical ward. Mr. Martin omits that the medical ward was
empty, that Mr. Martin then threatened Mr. Hammonds, and that Mr. Hammonds did not receive
treatment at that time.
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personally “threatened and mocked” Mr. Hammonds after his phone call with Mr. Hammonds’s
family.
Taking Mr. Hammonds’s allegations as true, Mr. Martin had the ability, once informed
about Mr. Hammonds’s deteriorating condition, to intervene and direct a change in treatment.
Mr. Martin, as the Chief Jail Administrator and Dr. Theakston’s supervisor, was “in a position to
take steps that could have averted” Mr. Hammonds’s injuries but failed to do so despite his
“duties, discretion, and means.” See Rodriguez v. Sec’y for Dep’t of Corr., 508 F.3d 611, 622
(11th Cir. 2007); McElligott v. Foley, 182 F.3d 1248, 1255 (11th Cir. 1999) (stating that an
official’s actions amount to deliberate indifference when he “knows that an inmate is in serious
need of medical care, but he fails or refuses to obtain medical treatment for the inmate”);
Waldrop v. Evans, 871 F.2d 1030, 1033 (11th Cir. 1989) (“Failure to respond to a known
medical problem can also constitute deliberate indifference.”).
Finally, although Mr. Hammonds eventually received medical treatment, it was too little,
too late. The Eleventh Circuit has consistently found delays in medical care to be
constitutionally cognizable injuries. See McElligott, 182 F.3d at 1255 (“Even where medical
care is ultimately provided, a prison official may nonetheless act with deliberate indifference by
delaying the treatment of serious medical needs[.]”). The court thus finds that the Second
Amended Complaint states a plausible claim that Mr. Martin violated Mr. Hammonds’s
constitutional rights.
2. Denial of Constitutional Right: Causal Connection Between Supervisors and Alleged
Constitutional Deprivation
As another basis for liability, Mr. Hammonds alleges that the individual defendants’
actions as supervisory officials had a causal connection to his injuries. “[S]upervisory officials
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are not liable under § 1983 for the unconstitutional acts of their subordinates on the basis of
respondeat superior or vicarious liability.” Cottone v. Jenne, 326 F.3d 1352, 1360 (11th Cir.
2003) (quoting Hartley v. Parnell, 193 F.3d 1263, 1269 (11th Cir. 1999)). Instead, liability
outside a supervisory defendant’s personal participation requires a “causal connection between
the actions of a supervising official and the alleged constitutional deprivation.” Id. A plaintiff
can establish a causal connection when: (1) the supervisor had notice of a widespread history of
abuse that he failed to correct; (2) the supervisor implemented a custom or policy that resulted in
deliberate indifference to constitutional rights; or (3) the facts support “an inference that the
supervisor directed the subordinates to act unlawfully or knew that the subordinates would act
unlawfully and failed to stop them from doing so.” Id. (quoting Gonzalez, 325 F.3d at 1234-35).
First, Mr. Hammonds offers a conclusory statement that the DeKalb County jail under
Sheriff Harris has a widespread history of medical mistreatment. However, Mr. Hammonds does
not elaborate. Mr. Hammonds alludes to other incidents of prisoner mistreatment, but provides
zero examples beyond his own. The DHS Report is unhelpful to Mr. Hammonds for the reasons
stated in the court’s first Memorandum Opinion (doc. 26). That is, although the DHS Report
notes that the prisoners’ initial medical examinations were untimely, that is not a harm that Mr.
Hammonds suffered. Rather, Mr. Hammonds alleges that Dr. Theakston examined him on his
arrival, but misdiagnosed and improperly treated him.
Second, Mr. Hammonds repeatedly contends that jail officials mistreated patients under
the “prevailing policy and practice.” The only detail, however, that Mr. Hammonds offers on
that “prevailing policy and practice” is an “emergency medical plan,” which Mr. Hammonds
indicates told jail staff to contact medical staff and complete written reports when an emergency

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presented. (Doc. 39 ¶¶ 336, 395). That plan is not a plausible cause of Mr. Hammonds’s
injuries.
Third, beyond the conduct already discussed above regarding Dr. Theakston’s and Mr.
Martin’s personal participation, Mr. Hammonds does not allege any facts indicating that the
individual defendants directed their subordinates to act unlawfully. Although Mr. Hammonds
appears to contend that the individual defendants failed to adequately train their subordinates, he
fails to draw a connection between their lack of training and his injuries. Dr. Theakston, a
trained physician, examined Mr. Hammonds and chose to treat Mr. Hammonds for Type-II
diabetes rather than Type-I diabetes. Mr. Hammonds does not explain how additional training
for the jail officers would have changed Dr. Theakston’s prescription or Mr. Martin’s inaction.
Similarly, Mr. Hammonds alleges that “under the practice established by [Sheriff] Harris,
medicine is administered by jailers and not trained medical staff.” (Doc. 39 ¶ 261). Again, Mr.
Hammonds fails to connect to his injuries the jail staff’s implementation of Dr. Theakston’s
misdiagnosis and treatment plan.
For all those reasons, Mr. Hammonds cannot proceed under § 1983 on a theory that the
individual defendants caused his injuries as supervisors. Because Mr. Hammonds cannot show
that Sheriff Harris personally participated in the alleged conduct or that his actions as a
supervisor caused Mr. Hammonds’s injuries, the court need not continue its qualified immunity
analysis as to Sheriff Harris. Count III, which contains Mr. Hammonds’s § 1983 claims against
Sheriff Harris, will be DISMISSED WITH PREJUDICE. Mr. Hammonds can, however,
proceed on a theory that Dr. Theakston and Mr. Martin caused his injuries by personally
participating in the alleged unconstitutional conduct.

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3. Clearly Established Right
Lastly, the provision of grossly inadequate medical care that causes an inmate to
unnecessarily suffer severe pain is a clear violation of a prisoner’s rights. See Melton, 841 F.3d
at 1226-27. Mr. Hammonds, who suffered acute kidney and renal failure among other injuries,
has pleaded facts that he endured severe pain because of Dr. Theakston’s grossly inadequate
medical care and Mr. Martin’s failure to intervene when put on notice of Mr. Hammonds’s
serious medical need.
Under Melton and similar cases involving failures to intervene, Mr. Hammonds’s right to
adequate medical care was sufficiently “clearly established” that a reasonable official would
understand that what he was doing in the alleged circumstances violated Mr. Hammonds’s rights.
See Mandel, 888 F.2d at 788; McElligott, 182 F.3d at 1255; see also Steele v. Shah, 87 F.3d
1266, 1269-70 (holding that deliberate indifference may be established when an official took an
easier but less effective course of treatment); Waldrop, 871 F.2d at 1034-35 (same).
Accordingly, neither Dr. Theakston nor Mr. Martin is entitled to qualified immunity.
CONCLUSION
For the reasons stated, the court will GRANT DeKalb County’s and Sheriff Harris’s
motions to dismiss. As to Dr. Theakston and Mr. Martin, the court will GRANT IN PART and
DENY IN PART.
Counts I, II, and III will be DISMISSED WITH PREJUDICE. Because no claims remain
against DeKalb County and Sheriff Harris, they will be dismissed as parties. Mr. Hammonds
may proceed with Counts IV and V only as they pertain to Dr. Theakston’s and Mr. Martin’s
personal participation in the alleged unconstitutional conduct.
The court will enter a separate Order consistent with this Memorandum Opinion.
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Dated this 16th day of October 2017.

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KARON OWEN BOWDRE
CHIEF UNITED STATES DISTRICT JUDGE

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