Estate of Tanya Martinez et al v. Pueblo County, Board of County Commissioners et al
ORDER granting 28 Motion to Dismiss for Failure to State a Claim; denying as moot 50 Motion to Stay by Judge R. Brooke Jackson on 3/31/16.(jdyne, )
IN THE UNITED STATES DISTRICT COURT
FOR THE DISTRICT OF COLORADO
Judge R. Brooke Jackson
Civil Action No 15-cv-01140-RBJ
ESTATE OF TANYA MARTINEZ;
JUDY ARMIJO, as Personal Representative of the Estate of Tanya Martinez;
ESAI MARTINEZ, a minor, by and through his grandmother, Judy Armijo; and
KIRK TAYLOR, in his official capacity as Pueblo County Sheriff;
CORRECTIONAL HEALTHCARE COMPANIES, INC.;
CORRECTIONAL HEALTHCARE PHYSICIANS, P.C.;
CORRECT CARE SOLUTIONS, LLC;
MIKE WHITE, E.M.T., in his individual and official capacities;
JENNIFER SCOTT, R.N., in her individual and official capacities;
KIM MURRAY, L.P.N., in her individual and official capacities;
NORMA MOWER, PA-C, in her individual and official capacities;
DEPUTY CINDY GOMEZ, in her individual and official capacities;
DEPUTY DEANA COOK, in her individual and official capacities; and
DEPUTY ANNADENE LUCERO, in her individual and official capacities,
This matter is before the Court on defendants Sheriff Kirk Taylor, Deputy Cindy Gomez,
and Deputy Deana Cook’s motion to dismiss [ECF No. 28] and defendants’ motion to stay
discovery [ECF No. 50]. Jurisdiction is proper pursuant to 28 U.S.C. §§ 1331 and 1367. For the
reasons stated below, the motion to dismiss is granted. The motion to stay discovery is denied as
This claim arises out of the death of Ms. Tanya Martinez. ECF No. 1 at ¶ 1. Martinez
died on June 3, 2013 while she was housed at the Pueblo County Detention Facility (PCDF).
When she passed away, she was a pretrial detainee in the custody of the Pueblo County Sheriff’s
Office (PCSO). Id. at ¶¶ 1, 58. Martinez died from “an alcohol withdrawal related seizure”
while she was in “lockdown” in a jail cell. Id. at ¶ 1. She was thirty-six years old. Id.
Plaintiffs are Martinez’s mother, Judy Armijo, who serves as the personal representative
of her estate and Martinez’s two sons, Esai and Angel Martinez. Esai Martinez is a minor, and
Armijo represents him. Id. at ¶ 12–14.
Plaintiffs name a number of defendants. Correctional Healthcare Companies, Inc. (CHC)
had a contract with Pueblo County to “provide medical services to inmates and detainees at the
PCDF[.]” Id. at ¶ 16. CHC. “supervised and implemented” the medical services. Id.
Correctional Healthcare Physicians, P.C. provided “physician assistant services” to PCDF
inmates pursuant to a contract with defendant Norma Mower, PA-C. Id. at ¶ 17. In 2014 Correct
Care Solutions, LLC acquired CHC. Id. at ¶ 18. The Court will collectively refer to these
defendants as “CHC defendants.” At all relevant times, defendants Mike White, E.M.T.;
Jennifer Scott, R.N.; Kim Murray, L.P.N.; and Norma Mower, PA-C were employees of the
CHC defendants. Id. at ¶¶ 24–27.
Defendant Sheriff Kirk Taylor is Pueblo County’s sheriff and the “public figure
responsible for Pueblo County Sheriff’s Department and the PCDF.” Id. at ¶ 21. At all relevant
times, defendants Cindy Gomez, Deana Cook, and Annadene Lucero served as deputies at
PCDF. Id. at ¶¶ 28–30. The Court collectively refers to Deputies Gomez, Cook, and Lucero as
Martinez’s History of Alcohol Withdrawal.
“Alcohol withdrawal is a medical condition that occurs when an alcoholic reduces or
stops the consumption of alcohol.” Id. at ¶ 39. Alcohol withdrawal is a “common condition that,
when treated, rarely results in death[.]” Id. at ¶ 45. However, if it is “left untreated, or
improperly treated . . . alcohol withdrawal can result in disastrous consequences, including
seizures, strokes, and death.” Id. at ¶¶ 45, 46.
Martinez had a history of alcohol withdrawal. ECF No. 1 at 10. In May 2013 she was
admitted to Parkview Medical Center for alcohol withdrawal. Id. at ¶ 47. On discharge from
Parkview Medical Center, Martinez was diagnosed with “severe alcohol intoxication, alcoholic
liver disease, and acute liver damage, and alcoholism.” Id. at ¶ 52. Martinez also dealt with
“severe alcohol withdrawals” during previous incarcerations at PCDF. Id. at ¶ 54. PCDF
deputies, medical personnel, and other inmates were aware of her history of alcohol withdrawal.
Id. at ¶ 55.
Events of June 2, 2013.
On June 2, 2013 the Pueblo Police Department arrested Martinez and transported her to
PCDF. Id. at ¶¶ 56–57. She was intoxicated, and Deputy Sheryld Lamas asked medical
personnel to examine Martinez. Id. at ¶¶ 59–60. The initial medical screen occurred at 4:50
p.m., and Martinez stated “on the medical screen form that she had an alcohol problem.” Id. at ¶
61. She also indicated that she had “previously experienced a stroke, dizziness or fainting spells,
heart trouble or chest pain, and that she had recently been hospitalized.” Id. at ¶ 61. Nurse Kim
Murray took her vital signs, but she did not inquire about Martinez’s recent hospitalization or
alcoholism, and Nurse Murray “did not discuss alcohol withdrawal with Martinez.” Id. at ¶ 64.
At this time, Martinez was still drunk, so she had yet to begin displaying the symptoms of
alcohol withdrawal. Id. at ¶ 63. Detention center personnel then placed Martinez in an intake
cell. Id. at ¶ 66.
No medical staff monitored Martinez until 10:02 p.m. when Emergency Medical
Technician (EMT) Michael White performed a second medical screen. Id. During EMT White’s
examination, Martinez “had an odor of alcohol on her breath and person.” Id. at ¶ 66. EMT
White took a second set of vitals, but because Martinez was still intoxicated, she had not started
to show “acute withdrawal symptoms.” Id. at ¶ 67. EMT White did not begin any alcohol
withdrawal protocol. 1 Id. at ¶ 75. Rather, he concluded that Martinez could join the general
prison population. Id. at ¶ 82. Therefore, Deputy Lamas conducted the booking process. Id. at ¶
86. Martinez was given a “risk score” to determine where she should be housed. Id. at ¶ 87.
Her score was “five,” meaning “that she should have been housed in Dorm A,” but Deputy
Lamas placed her on the 3C Wing, which is a “lockdown” floor. Id. at ¶¶ 88, 89–90. On a
lockdown floor, “inmates are locked in their cells,” and there is less staff monitoring than in the
dorms. Id. at ¶ 90.
Before being moved to the 3C Wing, Martinez was held in a cell in the intake area. Id. at
¶ 91. No medical staff checked on her while she was in the holding cell. Id. at ¶ 96. Deputy
Gomez “periodically checked on” Martinez during her time in the holding cell, but she had no
PCDF’s alcohol withdrawal protocol involves giving an individual a number of supplements and
medication, including “folic acid, prenatal vitamins, thiamine, vistaril, and the withdrawal medication
Librium[.]” Id. at ¶ 77.
specific training caring for an individual suffering from alcohol withdrawal. Id. at ¶¶ 92–93.
Martinez told Deputy Gomez about her recent hospitalization for alcohol withdrawal and that her
“liver levels” were heightened. Id. at ¶ 94. Martinez began to experience symptoms of alcohol
withdrawal, including shaking, while she remained in the holding cell. Id. at ¶ 95.
Events of June 3, 2013.
Around 4:21 a.m. on June 3, 2013, Deputy Gomez moved Martinez to the 3C Wing. Id.
at ¶ 97. By that time, Martinez was displaying more significant symptoms, including nausea and
continued shaking. Id. Deputy Cook was in charge of the 3C Wing that morning. Id. at ¶ 98.
Like Deputy Gomez, Deputy Cook did not have any targeted training on caring for a person
suffering from alcohol withdrawal. Id. at ¶ 99. Martinez asked Deputy Cook for her own cell
“in case she started throwing up.” Id. at ¶ 98. Martinez also told Deputy Cook that she was
“withdrawing from alcohol.” Id. Soon thereafter, Martinez began vomiting. Id. at ¶ 100. At
some time “well after” Martinez started to vomit and approximately three hours after Martinez
had been moved to the 3C Wing, Deputy Cook called medical to come check on Martinez. Id. at
¶¶ 101, 102.
Nurse Jennifer Scott arrived at 7:20 a.m., shortly after Deputy Cook called for medical
assistance. Id. at ¶ 103. Nurse Scott took Martinez’s vitals, which “were significantly elevated”
compared to her levels the night before. Id. at ¶ 106. Martinez’s vital signs “revealed an
increasing severity of her withdrawal symptoms[.]” Id. at ¶ 107. In particular, her pulse rate was
quite elevated at a rate of 135 beats per minute. Id. at ¶ 106. Martinez told Nurse Scott that she
consumed a pint of liquor daily. Id. at ¶ 109. On “the Problem Oriented Record form,” Nurse
Scott noted that Martinez “was tremulous, gastrointestinal, had tremors of hands, and was in
withdrawal.” Id. at ¶ 111.
Ten minutes later, at 7:30 a.m., Nurse Scott spoke with PA-C Mower about Martinez’s
status, and PA-C Mower ordered Nurse Scott to administer Librium to Martinez. Id. at ¶ 117.
Computer paperwork from June 3, 2013 shows that Martinez received an anti-nausea medication
at 7:47 a.m. Id. at ¶ 118 n.1. Plaintiffs state that it is unclear whether Nurse Scott did give
Librium to Martinez, but if she did, she did not provide it until 9:46 a.m, which is when Nurse
Scott returned. Id. ¶¶ 118 n.1; 124. The computer records from 9:46 a.m. show that Nurse Scott
administered folic acid, thiamin, prenatal vitamin, and vistaril. Id. at ¶¶ 118, 127. Much later,
computer records were produced to investigators that show that Nurse Scott did administer
Librium. Id. at ¶ 118. Nurse Scott found Martinez shaking so badly that she could not hold a
cup of water. Id. at ¶ 124. Nurse Scott did not take another set of vitals before leaving. Id.
Over the next five hours, no medical staff visited Martinez. Id. at ¶ 128. Her vomiting
ceased, but she “continued to experience other severe withdrawal symptoms during this fivehour period.” Id. at ¶ 129. She mostly remained on her cot and only got up to go to the
bathroom. Id. At lunchtime, Deputy Cook helped Martinez unwrap her sandwich because
Martinez’s hands were still shaking. Id. at ¶ 130. Deputy Cook also stopped by Martinez’s cell
during her rounds to “make sure that [she] was still breathing.” Id. at ¶ 131. Around 2:52 p.m.,
Nurse Scott gave Martinez another dose of Librium. Id. at ¶ 136. Nurse Scott was with
Martinez for “less than one minute[,]” and she did not take her vitals. Id. at ¶ 137.
At approximately 3:00 p.m., Deputy Lucero took over Deputy Cook’s shift. Id. at ¶ 143.
At that time, Martinez was still experiencing symptoms of withdrawal, and she had been
“shaking for at least eleven hours.” Id. at ¶ 144. Deputy Cook told Deputy Lucero that Martinez
had made frequent visits to the bathroom that day to vomit. Id. at ¶ 145. Martinez informed
Deputy Lucero that she drank half a large bottle of liquor every day, and that she was
experiencing bad alcohol withdrawal. Id. at ¶¶ 146–47. Deputy Lucero let Martinez use the
restroom several times, and when Martinez got up to travel to the bathroom, she was “breathing
hard,” and the trip to the bathroom was “exhausting.” Id. at ¶ 148.
Deputy Lucero observed that Martinez’s hands began to cramp up, which Martinez
described as “lobster hands” because they were “twisted and contorted.” Id. at ¶¶ 149–50.
Deputy Lucero then called medical to come to 3C Wing. Id. at ¶ 151. She believed that
Martinez was dehydrated and encouraged her to drink water. Id. at ¶ 152. After radioing
medical, Deputy Lucero locked Martinez back in her cell. Id. at ¶ 155.
Nurse Scott responded to the radio call but said that she “was busy checking blood sugar
levels of other inmates[.]” Id. at ¶ 156. She asked if another medical staffer could respond to the
medical call. Id. Nurse Murray replied over the radio, and she said that she would respond. Id.
at ¶ 157. However, Nurse Murray first called the third-floor control room to inquire about which
inmate needed to be checked. Id. at ¶ 158. The control room operator did not know Martinez’s
name. Id. Nurse Murray decided that she did not need to follow up on the radio call about an
inmate in the 3C Wing. Id. at ¶ 159. No one came to check on Martinez. Id. at ¶ 160.
Fifteen or twenty minutes after Deputy Lucero called for medical, Deputies Lucero and
Janese Dickenson began to serve dinner. Id. at ¶ 167. When Deputy Lucero unlocked
Martinez’s cell to serve her dinner, Martinez was unresponsive on her cot. Id. at ¶ 170. She
“was not breathing, had no pulse, and a trickle of blood was coming out of the side of her
mouth.” Id. Martinez “was already cyanotic and blue in the face.” Id. Deputy Lucero radioed a
“code one,” and Nurses Scott and Murray and EMT Steve Halloway responded quickly. Id.
They attempted cardiopulmonary resuscitation and used an Automatic External Defibrillator to
no avail. Id. at ¶ 172. Martinez was pronounced dead at 5:37 p.m. Id. at ¶ 173. Her official
cause of death was “an alcohol withdrawal-related seizure.” Id. at ¶ 175.
Plaintiffs filed this lawsuit on June 1, 2015, alleging violations of Martinez’s
constitutional rights pursuant to 42 U.S.C. § 1983 and raising other state claims. ECF No. 1.
They allege that Martinez’s death was “preventable,” and that she died “because of Defendants’
deliberate indifference to her medical needs , and other negligent conduct.” Id. at ¶ 2.
Defendants filed a motion to dismiss on August 7, 2015. ECF No. 28. The parties
subsequently stipulated to the dismissal of plaintiffs’ Third Claim (deprivation of life without
due process) against all defendants. ECF No. 29 at 2. At the same time, the parties also
stipulated to the dismissal of three of plaintiffs’ claims as against Deputies Gomez, Cook, and
Lucero: (1) Claim Five (negligence); (2) Claim Seven (wrongful death pursuant to C.R.S. § 13–
21–202); and (3) Claim Eight (survival). Id. On November 24, 2015, the parties stipulated to
the dismissal of original defendant Board of County Commissioners of Pueblo County,
Colorado. ECF No. 49.
Standard of Review
To survive a 12(b)(6) motion to dismiss, the complaint must contain “enough facts to
state a claim to relief that is plausible on its face.” Ridge at Red Hawk, L.L.C. v. Schneider, 493
F.3d 1174, 1177 (10th Cir. 2007) (quoting Bell Atlantic Corp. v. Twombly, 550 U.S. 544, 570
(2007)). While the Court must accept the well-pleaded allegations of the complaint as true and
construe them in the light most favorable to the plaintiff, Robbins v. Wilkie, 300 F.3d 1208, 1210
(10th Cir. 2002), purely conclusory allegations are not entitled to be presumed true. Ashcroft v.
Iqbal, 556 U.S. 662, 681 (2009). However, so long as the plaintiff offers sufficient factual
allegations such that the right to relief is raised above the speculative level, he has met the
threshold pleading standard. See, e.g., Twombly, 550 U.S. at 556; Bryson v. Gonzales, 534 F.3d
1282, 1286 (10th Cir. 2008). Importantly, “a well-pleaded complaint may proceed even if it
strikes a savvy judge that actual proof of those facts is improbable, and that a recovery is very
remote and unlikely.” Twombly, 550 U.S. at 556 (internal quotation marks omitted); accord
Robbins v. Okla. ex. rel. Dep’t of Human Servs., 519 F.3d 1242, 1247 (10th Cir. 2008). “The
court's function on a Rule 12(b)(6) motion is not to weigh potential evidence that the parties
might present at trial, but to assess whether the plaintiff’s complaint alone is legally sufficient to
state a claim for which relief may be granted.” Sutton v. Utah State Sch. for the Deaf & Blind,
173 F.3d 1226, 1236 (10th Cir.1999) (internal citation omitted).
Motion to Dismiss.
Plaintiffs assert a sole claim against the deputy defendants: pursuant to 42 U.S.C. § 1983,
plaintiffs allege that Deputies Gomez, Cook, and Lucero violated Martinez’s “clearly established
right under the Fourteenth Amendment to the U.S. Constitution to be free from deliberate
indifference to her known serious medical needs.” ECF No. 1 at ¶¶ 222–26. Plaintiffs bring six
claims against Sheriff Taylor in his official capacity: Claim Two for a violation of the Fourteenth
Amendment by failing to provide medical care; Claim Four for medical negligence; Claim Five
for negligence; Claim Six for negligent training and supervision; Claim Seven for wrongful
death pursuant to C.R.S. § 13–21–202; and Claim Eight for survival. The deputy defendants and
Sheriff Taylor seek the dismissal of the claims against them for failure to state a claim on which
relief could be granted and on qualified immunity grounds. ECF No. 28 at 9.
A. Claim One – Deputy Defendants’ Failure to Provide Medical Care and Treatment.
The qualified immunity doctrine “shields government officials performing discretionary
functions from liability for damages insofar as their conduct does not violate clearly established
statutory or constitutional rights of which a reasonable person would have known.” Toevs v.
Reid, 685 F.3d 903, 909 (10th Cir. 2012) (internal quotations and citations omitted). By
asserting qualified immunity, a defendant “trigger[s] a well-settled twofold burden” that the
plaintiff is “compelled to shoulder.” Cox v. Glanz, 800 F.3d 1231, 1245 (10th Cir. 2015). The
burden shifts to the plaintiff to show (1) “that the defendant’s actions violated a specific statutory
or constitutional right,” and (2) that the right was “clearly established at the time of the conduct
at issue.” Steffey, 461 F.3d at 1221. Courts have discretion to address either prong of this
standard first. Cox, 800 F.3d at 1246.
The relevant constitutional issue here is a prisoner’s right to adequate medical care for
serious medical needs. Prisoners, because of their confinement, cannot provide for their own
medical care. “[T]he treatment a prisoner receives in prison and the conditions under which he is
confined are subject to scrutiny under the Eighth Amendment.” 2 Farmer v. Brennan, 511 U.S.
Because Martinez was a pretrial detainee at the time of her death, her constitutional claim arises under
the Due Process Clause of the Fourteenth Amendment, which affords “the same degree of protection
against denial of medical care as that afforded to convicted inmates under the Eighth Amendment.”
Estate of Hocker ex rel. Hocker v. Walsh, 22 F.3d 995, 998 (10th Cir. 1994). The Eighth Amendment
825, 832 (1994). The Supreme Court has held that the Eighth Amendment prohibits
“unnecessary and wanton infliction of pain,” including “deliberate indifference to serious
medical needs of prisoners.” Estelle v. Gamble, 429 U.S. 97, 104 (1976).
The test for deliberate indifference requires the satisfaction of both an objective and
subjective component. Mata v. Saiz, 427 F.3d 745, 751 (10th Cir. 2005) (internal quotations and
citations omitted). First, the objective component requires that the prisoner “produce objective
evidence that the deprivation at issue was in fact ‘sufficiently serious.’” Id. A medical need is
sufficiently serious if “it is one that has been diagnosed by a physician as mandating treatment or
one that is so obvious that even a lay person would easily recognize the necessity for a doctor's
attention.” Id. A delay in medical care “only constitutes an Eighth Amendment violation where
the plaintiff can show that the delay resulted in substantial harm.” Oxendine v. Kaplan, 241 F.3d
1272, 1276 (10th Cir. 2001). Second, the subjective component is satisfied when a prison
official has a culpable mind, meaning that the official “knows of and disregards an excessive risk
to inmate health or safety.” Id. The Tenth Circuit has emphasized that “the official must both be
aware of facts from which the inference could be drawn that a substantial risk of serious harm
exists, and he must also draw the inference. Deliberate indifference requires more than mere
negligence.” Sealock v. Colorado, 218 F.3d 1205, 1211 (10th Cir. 2000).
Additionally, “[i]ndividual liability under § 1983 must be based on personal involvement
in the alleged constitutional violation.” Schneider v. City of Grand Junction Police Dep’t, 717
F.3d 760, 768 (10th Cir. 2013) (internal citation omitted). “A plaintiff must show that an
affirmative link exists between the constitutional deprivation and either the defendant’s personal
governs the analytic framework for a claim for deliberate indifference to medical needs. Lopez v.
LeMaster, 172 F.3d 756, 759 n. 2 (10th Cir. 1999).
participation, his exercise of control or direction, or his failure to supervise.” Ledbetter v. City of
Topeka, 318 F.3d 1183, 1187 (10th Cir. 2003) (internal citations and quotations omitted). For
the purposes of the present motion, the Court will assume that plaintiffs sufficiently allege that
there is an “affirmative link” between each deputy defendant’s conduct and the constitutional
deprivation even though the deputies’ roles in the events leading to Martinez’s death were
limited. Defendants do not raise this issue in the motion to dismiss.
For the purpose of this motion, the Court also assumes that the deprivation in question
was sufficiently serious to meet the objective prong of the deliberate indifference test.
Obviously death constitutes a serious harm. Additionally, plaintiffs offer numerous objective
facts about the dangerous symptoms and effects of alcohol withdrawal. Defendants concede this
point. ECF No. 41 at 52.
The remaining question then is whether plaintiffs have plausibly alleged that the deputy
defendants possessed the requisite mental culpability to satisfy the subjective component of
deliberate indifference. The subjective component is “akin to recklessness in the criminal law,
where, to act recklessly, a person must consciously disregard a substantial risk of serious harm.”
Self v. Crum, 439 F.3d 1227, 1231 (10th Cir. 2006) (internal citations and quotations omitted).
The subjective component “presents a high evidentiary hurdle to the plaintiffs: a prison official
must know about and disregard a substantial risk of serious harm. . . . A claim is therefore
actionable only in cases where the need for additional treatment or referral to a medical specialist
is obvious.” Id. at 1232. Deliberate indifference is characterized by “obduracy and
wantonness.” Whitley v. Albers, 475 U.S. 312, 319 (1986). A prison official acts with deliberate
indifference “only if he knows that inmates face substantial risk of serious harm and disregards
that risk by failing to take reasonable measures to abate it.” Farmer, 511 U.S. at 847. However,
“an inadvertent failure to provide medical care does not rise to a constitutional violation.”
Martinez v. Beggs, 563 F.3d 1082, 1088 (10th Cir. 2009) (internal quotations and citations
In Mata, the Tenth Circuit held that a prison official who acts “solely . . . as a gatekeeper
for other medical personnel capable of treating the condition may be held liable under the
deliberate indifference standard if she delays or refuses to fulfill that gatekeeper role.” 427 F.3d
745, 751 (10th Cir.2005) (internal quotations and citation omitted). But the gatekeeper theory
does not entirely eliminate the subjective component of deliberate indifference. A prison official
can be liable if the prison official “knows that [her] role in a particular medical emergency is
solely to serve as a gatekeeper for other medical personnel capable of treating the condition, and
if [she] delays or refuses to fulfill that . . . role due to deliberate indifference.” Sealock, 218 F.3d
at 1211. The Mata panel reasoned that,
What is significant is that the evidence presented to the district court supports the
conclusion that [the nurse] was in fact aware Ms. Mata was suffering from severe
chest pains and required medical attention. Ms. Mata personally reported as much
to [the nurse].
427 F.3d at 756. After Mata, the Tenth Circuit clarified that in order to establish “gatekeeper
liability,” a plaintiff must still allege that the need for medical care was “obvious” to the prison
official. Self, 439 F.3d at 1232.
Plaintiffs make multiple claims about all three deputy defendants. They attest that each
deputy defendant “knew or should have known that Ms. Martinez was experiencing severe
alcohol withdrawal, or at least bore a high risk therefor, and the deleterious consequences of not
properly treating that medical condition.” ECF No. 1 at ¶ 225. Additionally, plaintiffs allege
that despite the deputy defendants’ “knowledge of [Martinez’s] serious medical needs,” they
acted with deliberate indifference by failing to “properly examine, monitor, treat, and care” for
Martinez. Id. at ¶ 226. Plaintiffs claim that all deputy defendants failed to follow prison policy
that provides that inmates displaying “acute withdrawal symptoms” should be taken to an
observation unit. Id. at ¶ 113. Additionally, plaintiffs argue that the Court should consider the
failure to follow department policy as “strong circumstantial evidence” that the prison officials
“knew of and disregarded a substantial risk of serious harm.” ECF No. 38 at 10. Finally,
plaintiffs argue that the subjective component of deliberate indifference can be satisfied through
“showing that a delay in treatment caused either unnecessary pain or worsening of [Martinez’s]
The Court proceeds by considering plaintiffs’ allegations as they apply to each deputy.
1. Deputy Gomez.
Plaintiffs’ allegations regarding Deputy Gomez relate to the time that Martinez was in the
holding cell before she was moved to 3C Wing. Id. at ¶ 92–97. Plaintiffs’ claim against Deputy
Gomez is not one of delay. Rather, plaintiffs allege that Deputy Gomez failed to contact medical
personnel to check on Martinez altogether. Id. at ¶ 96. Deputy Gomez “periodically checked on
Ms. Martinez” while she was in the holding cell. Id. at ¶ 92. Plaintiffs allege that Martinez told
her about her hospitalization in May 2013 for alcohol withdrawal and also informed Deputy
Gomez that her liver levels were really elevated. Id. at ¶ 94. Plaintiffs also attest that Martinez
began to exhibit symptoms while in the holding cell, and that she was shaking and experiencing
nausea by the time Deputy Gomez took her to 3C Wing. Id. at ¶¶ 95, 97.
Even when taking these allegations as true, plaintiffs fail to plausibly allege that Deputy
Gomez not only knew that Martinez was suffering from alcohol withdrawal but that she actually
drew the inference that a “substantial risk of serious harm exists.” Plaintiffs point to Martinez’s
informing Deputy Gomez of her hospitalization and liver levels as evidence that Deputy Gomez
subjectively knew of the risk of alcohol withdrawal and consciously disregarded it. They rely on
the conclusory statement that Martinez’s relaying this information to Deputy Gomez “provided
further evidence that Ms. Martinez suffered from alcoholism and needed to be treated
aggressively.” Id. at ¶ 94. What is missing is a factual allegation that makes plausible the
conclusory allegations about conscious disregard and knowledge that Ms. Martinez needed
aggressive medical treatment at that time.
Similarly, plaintiffs suggest that Deputy Gomez was aware of Martinez’s “obvious
symptoms” because Martinez was shaking and experiencing nausea by the time Deputy Gomez
took her to the 3C Wing. However, there are no specific allegations that Deputy Gomez actually
took note of the symptoms, and even if she did, that she drew the inference that Martinez’s
symptoms demonstrated that she was, at that time, in serious danger. In sum, plaintiffs’
Complaint is devoid of specific facts from which the Court could infer that Deputy Gomez was
deliberately indifferent to a serious medical need that Ms. Martinez was experiencing when the
deputy saw her.
2. Deputy Cook.
When Martinez arrived on 3C Wing where Deputy Cook was in charge, her condition
began to worsen. Id. at ¶ 100. Martinez informed Deputy Cook that she was suffering from
alcohol withdrawal and requested a private cell in case she began to vomit. Id. at ¶ 98. Soon,
Martinez did vomit and started to show more pronounced symptoms. Id. at ¶ 100. Plaintiffs
claim that, despite the fact that Martinez was having “obvious symptoms” of alcohol withdrawal,
Deputy Cook only called for medical help once, and that was after three hours or more had
passed. Id. at ¶ 102. Nurse Scott responded to the call and examined Martinez at 7:20 a.m. Id.
at ¶¶ 102, 106. At lunchtime Deputy Cook assisted Martinez with unwrapping her sandwich
because her hands were shaking. Id. at ¶ 130. Deputy Cook also periodically checked on
Martinez to determine if she “was still breathing.” Id. at ¶ 131. During this time, other inmates
noticed that Martinez was visibly sweating, shaking “uncontrollably,” and looked “really bad.”
Id. at ¶ 133. Nurse Scott returned at 2:52 p.m. to give Martinez some Librium, but Nurse Scott
“did not instruct Deputy Cook to pay careful attention to Ms. Martinez.” Id. at ¶ 139.
No facts are alleged that plausibly suggest that Deputy Cook consciously disregarded a
serious risk to Martinez’s health during the initial three hours. She did summon a nurse, and
plaintiffs do not allege facts suggesting that Deputy Cook had reason to disagree with the nurse’s
assessment of the situation. The nurse returned, and again, there are no factual allegations
suggesting that Deputy Cook had reason to challenge the nurse’s assessment. That is why there
are medical personnel stationed in the jail. In sum, plaintiffs fail to offer specific facts to make it
plausible that Deputy Cook consciously disregarded a serious risk.
3. Deputy Lucero.
When Deputy Lucero relieved Deputy Cook around 3:00 p.m. on June 3, Deputy Cook
informed her that Martinez had been vomiting throughout the day. Id. at ¶¶ 143, 145. Martinez
told Deputy Lucero that she consumed “half a big bottle of vodka” daily, and that she was “very
sick from alcohol withdrawal.” Id. at ¶¶ 146, 147. Deputy Lucero let Martinez out of her cell a
number of times to go to the bathroom, and Martinez was “breathing hard” when she got up to
travel to the restroom. Id. at ¶ 148. Plaintiffs allege that Deputy Lucero personally observed
Martinez’s severe symptoms, including her cramping and “contorted” hands. Id. at ¶ 151. It was
only then that Deputy Lucero called for medical attention. Id. Deputy Lucero “opined” that
Martinez was “simply dehydrated and advised her to drink water.” Id. at ¶ 152. Plaintiffs allege
that Deputy Lucero locked Martinez in her cell despite her urgent need for medical attention. Id.
at ¶ 145. Deputy Lucero did not check on Martinez for the 15 or 20 minutes between when
Deputy Lucero called medical and when Martinez died. Id. at ¶ 168.
Plaintiffs’ Complaint is devoid of facts that make it plausible that Deputy Lucero actually
drew the inference that Martinez was in serious danger. For example, plaintiffs allege that her
“contorted hands and difficulty breathing were additional signs . . . that she badly needed
medical treatment.” Id. at ¶ 152. However, plaintiffs do not allege that Deputy Lucero actually
made this connection. In fact, according to plaintiffs’ version of the facts, at the time she called
medical, it was Deputy Lucero’s opinion that Martinez was merely dehydrated. See Self, 439
F.3d at 1232 (holding that a claim for gatekeeper liability is actionable “where the need for
additional treatment  is obvious”). Regardless, Deputy Lucero summoned medical personnel.
There is no indication that she was in any way responsible for the 15 to 20 minute delay in
medical’s response or that it was obvious to Deputy Lucero that Ms. Martinez was in such dire
straits that she could not wait for 15 or 20 minutes for medical to arrive. Plaintiffs fail to allege
that Deputy Lucero’s conduct rises to the level of wanton or reckless disregard for Martinez’s
In sum, even taking plaintiffs’ well-pled factual allegations as true and construing
inferences in their favor, the Court concludes that they do not plausibly establish that the
deputies were deliberately indifferent in failing to perform their gatekeeper role. Perhaps the
allegations as to one or more of them might survive a motion to dismiss a negligence claim, but
they do not meet the more demanding constitutional violation standard. Therefore, the Court
dismisses Claim One as against the three deputies. As such, the Court need not reach the
remainder of the qualified immunity analysis.
B. Claim Two – Sheriff Taylor’s Failure to Provide Medical Care and Treatment.
In contrast to their state counterparts, county officials may be sued in their official
capacity. Meade v. Grubbs, 841 F.2d 1512, 1529 (10th Cir. 1988). Colorado law provides that
sheriffs have the “authority and responsibility to oversee county jails.” Estate of Began v. Lake
County, Colorado Sheriff's Office, 2008 WL 2690702, at *6 (D. Colo. 2008) (citing C.R.S. § 30–
10–511). Some courts have considered a sheriff’s acts as representative of official policy
because a sheriff typically assumes the role of the “final policymaker” in charge of the
operations of a county jail. See, e.g., Cortese v. Black, 838 F.Supp. 485, 496 (D. Colo. 1993). In
essence, a suit against a sheriff in his official capacity is an action against the entity that employs
him—here, Pueblo County. Pietrowski v. Town of Dibble, 134 F.3d 1006, 1009 (10th Cir. 1998)
(internal citation omitted).
In order to state a claim for municipal liability, a plaintiff must allege the existence of (1)
an official policy or custom; (2) a direct causal link between the policy or custom and the
constitutional injury alleged; and (3) deliberate indifference on the part of the municipality.
Schneider v. City of Grand Junction Police Dep’t, 717 F.3d 760, 769 (10th Cir. 2013) (a plaintiff
must “show that the policy was enacted or maintained with deliberate indifference to an almost
inevitable constitutional injury”). The “official policy or custom” requirement “was intended to
distinguish acts of the municipality from acts of employees of the municipality, and thereby make
clear that municipal liability is limited to action for which the municipality is actually
responsible.” Pembaur v. City of Cincinnati, 475 U.S. 469, 479 (1986) (emphasis in original). A
plaintiff may allege the existence of a municipal policy or custom in the form of (1) an officially
promulgated policy; (2) an informal custom amounting to a widespread practice; (3) the
decisions of employees with final policymaking authority; (4) the ratification by final
policymakers of the decisions of their subordinates; or (5) the failure to adequately train or
supervise employees. Bryson v. City of Oklahoma City, 627 F.3d 784, 788 (10th Cir. 2010).
Plaintiff must also allege a direct causal link between the municipal policy and the injury
alleged. Bd. of Cty. Comm'rs of Bryan Cty., Okl. v. Brown, 520 U.S. 397, 404 (1997). That is,
the municipality must be the “direct cause” or “moving force” behind the constitutional
violation. Smedley v. Corr. Corp. of Am., 175 F. App'x 943, 946 (10th Cir. 2005); City of
Canton, Ohio v. Harris, 489 U.S. 378, 385 (1989) (“It is only when the ‘execution of the
government’s policy or custom . . . inflicts the injury’ that the municipality may be held liable
under § 1983.”). Furthermore, “where the policy relied upon is not itself unconstitutional,
considerably more proof than the single incident will be necessary in every case to establish both
the requisite fault on the part of the municipality, and the causal connection between the ‘policy’
and the constitutional deprivation.” City of Okla. City v. Tuttle, 471 U.S. 808, 824 (1985).
Finally, plaintiff must allege the requisite degree of culpability on the part of the county.
Schneider, 717 F.3d at 769. “[T]he prevailing state-of-mind standard for a municipality is
deliberate indifference regardless of the nature of the underlying constitutional violation.” Id. at
771 n.5. Further,
The deliberate indifference standard may be satisfied when the municipality has
actual or constructive notice that its action or failure to act is substantially certain
to result in a constitutional violation, and it consciously or deliberately chooses to
disregard the risk of harm. In most instances, notice can be established by
proving the existence of a pattern of tortious conduct. In a narrow range of
circumstances, however, deliberate indifference may be found absent a pattern of
unconstitutional behavior if a violation of federal rights is a highly predictable or
plainly obvious consequence of a municipality's action or inaction[.]
Id. at 771 (quoting Barney v. Pulsipher, 143 F.3d 1299, 1307 (10th Cir. 1998)). Deliberate
indifference for municipal liability purposes—in contrast to the analysis under the Eighth
Amendment—is evaluated from an objective standpoint. Barney, 143 F.3d at 1308 n.5.
Regarding medical care specifically, a county can be liable indirectly through the nondelegable duty doctrine. The state’s duty to provide adequate medical care is non-delegable.
“Contracting out prison medical care does not relieve the State of its constitutional duty to
provide adequate medical treatment to those in its custody, and it does not deprive the State’s
prisoners of the means to vindicate their Eighth Amendment rights.” West v. Atkins, 487 U.S.
42, 56 (1988); see also Nieto v. Kapoor, 268 F.3d 1208, 1216 (10th Cir. 2001). “[T]he State
cannot, by choosing to delegate its constitutional duties to the professional judgment of others,
thereby avoid all liability flowing from the attempted fulfillment of those duties under Section
1983.” Anglin v. City of Aspen, Colo., 552 F.Supp.2d 1229, 1244 (D. Colo. 2008) (citing West,
487 U.S. at 56 n.14). Simply put, “if a local government delegates final policy-making authority
to a particular employee, any custom or policy created by that employee is the custom or policy
of the local government as well.” Herrera v. Cnty. of Santa Fe, 213 F.Supp.2d 1288, 1292 (D.
Even if the Court were to find that plaintiffs sufficiently allege the first two components
of a municipal liability claim—the existence of an official policy or custom and causation—their
claim must fail because no facts are alleged that plausibly suggest that Sheriff Taylor possessed
the requisite culpable mind. 3 Therefore, the Court finds that plaintiffs have not stated a
constitutional claim against Sheriff Taylor.
Plaintiffs argue that CHC has a “long history” of providing inadequate medical care in
various prisons. Id. at ¶ 199. They list numerous examples from facilities in Colorado and
across the country to show that “CHC Defendants and the counties that employ them are
deliberately indifferent in their policies, customs, and practices with respect to the medical needs
of inmates.” Id. at ¶¶ 199; 201–219. Additionally, plaintiffs describe multiple investigations,
audits, and reviews conducted by various governmental entities into the adequacy of medical
care provided by CHC-related companies. Id. at ¶¶ 210–216. While none of these incidents or
investigations occurred in Pueblo County, plaintiffs allege that, had Sheriff Taylor engaged in
“any kind of due diligence before contracting with CHC-related companies,” he would have
known of these “serious issues.” Id. at ¶ 217. They further attest that Sheriff Taylor “had all of
the above-described knowledge and notice” prior to Martinez’s death which was “the result of
In claiming that PCDF and CHC had policies or customs that led to the alleged constitutional
deprivation, plaintiffs attest that Pueblo County’s contract with the CHC defendants created financial
incentives that resulted in deficient care. ECF No. 1 at ¶ 180. In McGill v. Correctional Healthcare
Companies, Inc., No. 13-cv-1080-RBJ-BNB, 2014 WL 2922635, at *8 (D. Colo. June 27, 2014), this
Court found allegations about the incentives created by a contract with CHC to be sufficient—albeit
barely—at the motion to dismiss stage. Plaintiffs argue that the allegations in McGill and those here are
“nearly identical[.]” ECF No. 38 at 11. I disagree. Here, plaintiffs rely on conclusory statements about
how the contract created the alleged incentives without providing factual support. See ECF No. 1 at ¶¶
180, 181, 236. In contrast, the McGill complaint included specific details from the contract to support the
allegation that incentives did exist, and that they plausibly discouraged the imposition of sanctions for the
provision of improper care and the hospitalization of inmates requiring emergent care. See First Amend.
Compl., Case No. 13-cv-01080-RBJ-BNB, ECF No. 42 at ¶¶ 202, 203, 204, 236 and 237.
longstanding, systemic deficiencies in the medical care provided to inmates by CHC[.]” Id. at ¶
Essentially, plaintiffs’ allegations suggest that Sheriff Taylor knew or should have known
of the risk of contracting with CHC. I agree with defendants that this is too “tenuous” to state a
municipal liability claim. ECF No. 28 at 11–12. The Court recognizes that a sheriff should
conduct some amount of due diligence before entering into a contract for the provision of
medical care. However, plaintiffs’ allegations about Sheriff Taylor’s deliberate indifference are
too conclusory to survive dismissal. Plaintiffs fail to offer additional factual support that, even if
he had actual or constructive knowledge of CHC’s troubling past, Sheriff Taylor would have
then been “on notice” that contracting with the CHC defendants was “substantially certain to
result in a constitutional violation” at PCDF. See Schneider, 717 F.3d at 771.
In sum, by failing to sufficiently allege Sheriff Taylor’s deliberate indifference, plaintiffs
fail to state a constitutional claim against Sheriff Taylor in his official capacity.
State Law Claims
Sheriff Taylor moves for dismissal of the remaining five state law claims against him.
See ECF No. 28 at 12–16. Plaintiffs bring these claims against the Sheriff in his official capacity
for medical negligence, negligence, negligent training and supervision, wrongful death under
C.R.S. § 13–21–202, and survival. See ECF No. 1 at 37–44.
“Seeking to vindicate values of economy, convenience, fairness, and comity underlying
the judicially-created doctrine of pendent jurisdiction, Congress granted statutory authority to
district courts to hear claims that form ‘part of the same case or controversy’ as the claims on
which original federal jurisdiction is based.” Estate of Harshman v. Jackson Hole Mountain
Resort Corp., 379 F.3d 1161, 1164 (10th Cir. 2004) (citing 28 U.S.C. § 1367). In addition to
providing supplemental jurisdiction, § 1367 also provides that a district court may decline to
exercise supplemental jurisdiction where “the district court has dismissed all claims over which
it has original jurisdiction.” § 1367(c)(3). Additionally, the “Supreme Court repeatedly has
determined that supplemental jurisdiction is not a matter of the litigants’ right, but of judicial
discretion.” Estate of Harshman, 349 F.3d at 1165 (internal citation omitted). Because I am
dismissing Claims One and Two, there are no remaining federal questions. There is no diversity
of citizenship between the parties. Therefore, no alternative basis for federal jurisdiction exists,
and I decline to exercise supplemental jurisdiction over the remaining state law claims.
Motion to Stay Discovery.
On March 2, 2016, Sheriff Taylor and the deputy defendants filed a motion to stay
discovery. ECF No. 50. Defendants claim that the Court should exercise its discretion in staying
discovery while this motion to dismiss is pending. Id. at 3. Because the Court decides the
motion to dismiss in the present order, the motion to stay discovery is moot.
For the reasons stated above, the motion to dismiss [ECF No. 28] is GRANTED as to the
federal law claims against defendants Deputy Lucero, Deputy Cook, Deputy Gomez, and Sheriff
Taylor. The motion to stay discovery [ECF No. 50] is DENIED as MOOT.
DATED this 31st day of March, 2016.
BY THE COURT:
R. Brooke Jackson
United States District Judge
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