The Kingsleyer: Should Kingsley v. Hendrickson Apply to Inadequate Medical Care Claims Brought By Pretrial Detainees Under § 1983?

By Elisher J. Williams, Associate Editor

Before 2015, little consistency existed in the constitutional standard applied to excessive force claims brought by pretrial detainees under 42 U.S.C. §1983.[1]  The Supreme Court settled the confusion in Kingsley v. Hendrickson.  In Kingsley, the Supreme Court held that, to prevail on an excessive force claim, a pretrial detainee plaintiff need only show the force used by the officer was “objectively excessive.” This holding erased the uncertainty in considering a police officer’s subjective belief of reasonableness.[2]

However, circuit court responses to Kingsley created a split regarding the standard for analyzing §1983 claims brought for inadequate medical care provided to pretrial detainees. Some circuits apply the Kingsley “objectively unreasonable” standard to inadequate medical care, while others continue to use a “deliberate indifference” standard.  Under the “deliberate indifference” standard, a plaintiff must show both that he or she had a serious medical need (the objective prong) and that the defendants were aware of this serious medical need (the subjective prong).[3]  The Supreme Court recently denied certiorari in a Sixth Circuit case where the court effectively asked the Supreme Court to decide on the proper standard.[4]  Even though the Supreme Court declined to review Powell, it must soon decide that the Kingsley “objectively unreasonable” standard applies to §1983 claims for inadequate medical care during pretrial detainment.

A.  Objectively Unreasonable vs. Deliberate Indifference

The standard a court applies to §1983 cases involving state actors, such as prison guards and police officers, changes based on the plaintiff’s status.  Before conviction, whether before the arrest or before a criminal trial, the Fourth and Fourteenth Amendments govern the plaintiff’s rights. After conviction, the Eighth Amendment govern the plaintiff’s rights, assuming the §1983 claim arose from conduct while the plaintiff was in state custody.

The Fourth Amendment “governs a free citizen’s claim that law enforcement officials used excessive force in the course of making an arrest, investigatory stop, or other ‘seizure’ of his person.”[5]  The Fourteenth Amendment requires the government to treat any injuries caused by officers during an arrest.[6]  Courts use the “objectively unreasonable” standard for claims arising under these two amendments.  In short, “a pretrial detainee can prevail by providing only objective evidence that the challenged governmental action is not rationally related to a legitimate governmental objective or that it is excessive in relation to that purpose.”[7] The Supreme Court has consistently found that actions not “rationally related to a legitimate nonpunitive governmental purpose” equates to punishment, which the Due Process Clause of both the Fourth and Fourteenth Amendments prohibit against “a person who... has been accused by not convicted of a crime.”[8] In this type of case, the intent or mental state of the prison official or police officer is irrelevant, effectively making this standard more plaintiff-friendly.

Conversely, the Eighth Amendment guarantees freedom from cruel and unusual punishment and protects the rights of convicted persons. The Eighth Amendment requires “that punishment for crime should be graduate and proportioned to [the] offense.”[9] Under the Eighth Amendment, the deliberate indifference standard governs a court’s analysis through a two-pronged approach: the objective component, which is, effectively, identical to the objectively unreasonable standard; and the subjective component, that the state actor had the requisite mental state for liability.  In other words, “this state of mind requires that the official ‘consciously disregard’ a substantial risk of serious harm.”[10] By requiring a plaintiff to prove the defendant’s mental state, the deliberate indifference standard is a significantly harder standard to satisfy than the objectively unreasonable standard.

B.  Kingsley v. Hendrickson Starts Changing Applicable Standards

Michael Kingsley was a pretrial detainee in Monroe County, Wisconsin after being arrested on drug charges.[11] After a cell check, a corrections officer told Mr. Kingsley to remove a piece of paper covering the light fixture, Mr. Kingsley refused this order, and multiple subsequent orders.[12] Eventually, four officers handcuffed Mr. Kingsley and moved him to a different cell.[13] Mr. Kingsley maintained throughout his trial he never resisted the officers, but they still slammed his head into a concrete bunk, injured his foot, and tased him.[14] The officers contended he did resist and they never slammed his head into anything, though they do acknowledge tasing Mr. Kingsley.[15]

In response, Mr. Kingsley filed a §1983 complaint, alleging the officers used excessive force in violation of the Fourteenth Amendment.[16] After the jury returned a defense verdict, Mr. Kingsley appealed citing incorrect jury instructions. He argued the proper standard for a pretrial detainee’s excessive force claim is one of objective unreasonableness. The Court of Appeals disagreed, holding that the applicable standard required a “’subjective inquiry’ into the officer’s state of mind. There must be ‘an actual intent to violate [the plaintiff’s] rights or reckless disregard for his rights.”[17] The Supreme Court granted certiorari to resolve the question of whether a §1983 claim brought by a pretrial detainee must satisfy both a subjective and objective prong, or only the objective prong.[18] The Supreme Court held that a pretrial detainee must only satisfy the objective standard to succeed in an excessive force §1983 case.[19]

The Court reasoned, essentially, that precedent dictated this result.[20] The Court based its reasoning through a discussion of Bell v. Wolfish.[21] It explained that a person may not be punished until they have been convicted, even if that person is held in jail as a pretrial detainee.[22] Though “punishment” often involves specific intent by the actor, it can also be shown as actions that are not rationally related to a legitimate nonpunitive purpose, or actions that appear excessive for the stated purpose.[23] The court continued citing various Amici Curiae briefs that showed many corrections officers are already trained to adhere to an objective reasonableness standard.[24]  It also explained how the objective reasonableness standard will still protect officers that act in good faith by directing lower courts to judge from the perspective, and with the knowledge, of the defendant, and avoid relying on the clarity of hindsight.[25] Lastly, the Court pointed to qualified immunity as yet another protection for the defendants, demonstrating that a lower standard of proof does not mean the defendants are out in the cold and likely to be found liable often.[26]

Though Justices Scalia, Roberts, and Thomas dissented in the decision, the Court concluded that objectively unreasonable is the proper standard in which to analyze an excessive force claim brought by a pretrial detainee.[27] However, it also noted that courts must account for legitimate interests in preserving internal order, discipline, and safety, as well as avoid relying on hindsight. Instead, courts should focus only on what the defendant officers knew at the time.[28] The Court found a way to thread the needle between ensuring proper constitutional protections but preventing a flood of frivolous excessive force litigation.

C.  The Circuit Split

Though Kingsley did solve a circuit split for excessive force claims, it created more confusion in §1983 denial of, or inadequate, medical care claims brought by pretrial detainees. Some circuits read the Kingsley holding narrowly, applying only to excessive force, while others apply the new excessive force standard to medical care claims as well, and yet still others consistently “punt” this confusion and essentially ask the Supreme Court to resolve this issue. The Fifth, Eighth, and Eleventh Circuits all read Kingsley as narrowly as possible and still apply the deliberate indifference standard to §1983 medical care claims brought by pretrial detainees.[29] The Second, Seventh, and Ninth Circuits read Kingsley more broadly, applying the Court’s reasoning to pretrial detainee’s medical care claims.[30] Lastly, the Fourth and Sixth Circuits have punted on whether to apply Kingsley to medical care claims.[31] The Sixth Circuit specifically said it “recognize[s] that this shift in Fourteenth Amendment deliberate indifference jurisprudence calls into serious doubt whether [the plaintiff] need even show that the individual defendant-officials were subjectively aware of her serious medical conditions and nonetheless wantonly disregarded them.”[32] Until the Supreme Court decides this specific issue, Circuits like the Fourth and Sixth will continue to apply the deliberate indifference standard for §1983 medical care claims “without grappling with the potential implications of Kingsley.”[33]

D.  The Kingsley Reasoning Should Apply to §1983 Claims Over Inadequate Medical Care.

The Kingsley court’s reasoning for the “objectively unreasonable” standard is equally applicable to inadequate medical care claims brought under §1983.[34]  The Supreme Court explained that the Due Process Clause protects pretrial detainees from force that amounts to punishment.[35]  The Court defined punishment as actions unrelated to a “legitimate nonpunitive governmental purpose.”[36]  This means “a pretrial detainee can prevail by providing only objective evidence that the challenged governmental action is not rationally related to a legitimate government objective.”[37]  Applying that reasoning to inadequate medical care, requires only a slight change in language to the Supreme Court’s explanation.  Instead of saying the due process clause protects against force that amounts to punishment, substitute “conditions” for “force.” Thereby the Supreme Court’s explanation of the Due Process Clause protection would be that it protects pretrial detainees from conditions that amount to punishment.  Denial of medical care, or inadequate medical care, in the absence of a legitimate governmental objective, should be considered punitive conditions in violation of the Fourteenth Amendment. This reasoning supports the idea that a plaintiff need only show the denial of medical care was objectively unreasonable.  In both situations, excessive force and inadequate medical care, the state actor creates the situation that amounts to punishment, violating the pretrial detainee’s due process rights.

E.  Conclusion

In §1983 cases, plaintiffs have to survive qualified immunity claims, usually at the summary judgment stage. For a claim to survive a qualified immunity defense, the plaintiff must show the right violated was “clearly established” at the time of the violation.[38] A right is only clearly established when the right’s contours are specific enough that any reasonable officer in the situation would have known he violated that right.[39] Because there is inherent confusion in Fourteenth Amendment jurisprudence involving pretrial detainee’s right to medical care, there is little possibility of a plaintiff being able to prove the right to adequate medical care is “clearly established.” This overall lack of clarity makes it nearly impossible for a pretrial detainee plaintiff to maintain an inadequate medical care claim under the Fourteenth Amendment. The only way to find consistency in deciding these constitutional cases is for the Supreme Court to take the question up and provide an answer. Unfortunately, the Supreme Court declined to review Powell in the upcoming term, leaving the uncertainty in place for at least another year.[40]

Footnotes

[1][1] Irene M. Baker, Wilson V. Span: Will Pretrial Detainees Escape The Constitutional “Twilight Zone”?, 75 St. John’s L. Rev. 449, 449 (2002); See also Graham v. Connor, 490 U.S. 386, 394 (1989) (ruling excessive force during an arrest is governed by the Fourth Amendment); Tennessee v. Garner, 471 U.S. 1, 8 (1995) (analyzing the use of deadly force under the Fourth Amendment); Ingraham v. Wright, 430 U.S. 651, 664, 671 n.40 (1977) (holding that the Eighth Amendment only applies after the State satisfies all procedural demands of the Constitution); Whitley v. Albers, 475 U.S. 312, 318 (1986) (Eighth Amendment only applies after conviction); Rochin v. California, 341 U.S. 165 (1952) (applying the Fourteenth Amendment to excessive force claims).

[2] Kingsley v. Hendrickson, 135 S. Ct. 2466, 2468 (2015).

[3] See Powell v. Med. Dep’t Cuyahoga Cty. Corr. Ctr., No. 18-3783, 2019 U.S. App. LEXIS 10461, *4 (6th Cir. April 8, 2019).

[4] Powell v. Med. Dep’t Cuyahoga Cty. Corr. Ctr., No. 18-3783, 2019 U.S. App. LEXIS 10461 (6th Cir. Apr. 8, 2019) (cert. denied 205 L. Ed. 2d 183, (Oct. 7 2019) (noting that the Court presumed without deciding that the Eight Amendments “deliberate indifference” standard would control the case unless the Supreme Court rules differently, even if “deliberate indifference” for pretrial detainees is easier to satisfy under the Fourteenth Amendment than the Eighth)).

[5] Graham v. Connor, 490 U.S. 386, 388 (1989).

[6] Revere v. Mass. Gen. Hosp., 463 U.S. 239, 244 (1983).

[7] Kingsley, 135 S. Ct. at 2473-4.

[8] Id. at 2474. See also, Bell v. Wolfish, 441 U.S. 520, 538, 99 S. Ct. 1861, 60 L. Ed. 2d 447 (1979) where the Supreme Court explains that “a court may permissibly infer” the use of force against pretrial detainees not related to a legitimate governmental interest is punishment and may be unconstitutional.

[9] Graham v. Florida, 560 U.S 48, 59, 130 S. Ct. 2011, 176 L. Ed. 2d 825 (2010) (quoting Weems v. United States, 217 U.S. 349, 367, 30 S. Ct. 544, 54 L. Ed. 793 (1910)).

[10] Brooks v. Celeste, 39 F.3d 125, 128 (6th Cir. 1994).

[11] Kingsley, 135 S. Ct. at 2470.

[12] Id.

[13] Id.

[14] Id.

[15] Id.

[16] Kingsley, 135 S. Ct. at 2471

[17] Id.

[18] Id. at 2472.

[19] Id. at 2474.

[20] Id. at 2473.

[21] Id.

[22] Kingsley, 135 S. Ct. at 2473.

[23] Id.

[24] Id. at 2474.

[25] Id.

[26] Id.

[27] Id. at 2468, 1. of the Syllabus.

[28] Id. at 1(a) of the Syllabus.

[29] See Whitney v. City of St. Louis, 887 F.3d 857, 860 n.4 (8th Cir. 2018); Nam Dang v. Sheriff, Seminole Cty. Fla., 871 F.3d 1272, 1279 n.2 (11th Cir. 2017); Alderson v. Concordia Parish Corr. Facility, 848 F.3d 415, 419 n.4 (5th Cir. 2017). 

[30] Miranda v. Cty. of Lake, 900 F.3d 335, 351-2 (7th Cir. 2018). 

[31] Id. at 352.

[32] Richmond v. Huq, 885 F.3d 928, 949 n.3 (6th Cir. 2018).

[33] Miranda, 900 F.3d at 352. 

[34] Kingsley, 135 S. Ct. at 2473.

[35] Id.

[36] Kingsley, 135 S. Ct. at 2473 (citing Bell 441 U.S. at 561). 

[37] Id. at 2473-74

[38] District of Columbia v. Wesby, 138 S. Ct 577, 589 (2018).

[39] City of Escondido v. Emmons, 139 S. Ct. 500, 503 (2019).

[40] Powell v. Med. Dep’t Cuyahoga Cty. Corr. Ctr., No. 18-3783, 2019 U.S. App. LEXIS 10461 (6th Cir. Apr. 8, 2019) (cert. denied 205 L. Ed. 2d 183, (Oct. 7 2019)