Colbruno v. Kessler , 928 F.3d 1155 ( 2019 )


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  •                                                                               FILED
    United States Court of Appeals
    PUBLISH                             Tenth Circuit
    UNITED STATES COURT OF APPEALS                       July 2, 2019
    Elisabeth A. Shumaker
    FOR THE TENTH CIRCUIT                         Clerk of Court
    _________________________________
    CHRISTOPHER COLBRUNO,
    Plaintiff - Appellee,
    No. 18-1056
    v.
    WILLIAM KESSLER, in his official and
    individual capacity; SAMANTHA
    KIELAR, in her official and individual
    capacity; TINA KLOSIEWSKI, in her
    official and individual capacity; RYAN
    SEWITSKY, in his individual and official
    capacity; THOMAS TINDALL, in his
    individual and official capacity; STEPHEN
    PETIT, in his individual and official
    capacity,
    Defendants - Appellants,
    and
    CITY AND COUNTY OF DENVER, a
    municipality; ELIAS DIGGINS,
    Defendants.
    _________________________________
    Appeal from the United States District Court
    for the District of Colorado
    (D.C. No. 1:17-CV-01072-WYD-MJW)
    _________________________________
    Michele A. Horn, Assistant City Attorney, Denver, Colorado (Melanie B. Lewis,
    Assistant City Attorney, Denver, Colorado on the briefs) for Defendants-Appellants.
    David A. Lane, Killmer, Lane & Newman, LLP, Denver, Colorado for Plaintiff-Appellee.
    _________________________________
    Before TYMKOVICH, Chief Judge, MURPHY, and HARTZ, Circuit Judges.
    _________________________________
    HARTZ, Circuit Judge.
    _________________________________
    Plaintiff Christopher Colbruno was in jail awaiting trial when he needed to be
    taken to the hospital for an urgent medical condition. Six deputies in the Denver
    Sheriff’s Department (Defendants) walked him through the public areas of the hospital
    completely unclothed except for an orange pair of mittens. Complaining that the deputies
    violated his constitutional rights, he sued them, among others, under 
    42 U.S.C. § 1983.1
    Defendants moved to dismiss for failure to state a claim on the ground that they were
    entitled to qualified immunity. The district court disagreed, and Defendants appealed to
    this court. Exercising jurisdiction under 
    28 U.S.C. § 1291
    , we affirm. Plaintiff’s
    complaint alleges facts supporting the inference that the public exposure of his naked
    body was wholly unjustifiable and therefore suffices to state a claim under the Fourteenth
    Amendment. Whether the evidence supports those allegations is a question for further
    proceedings.
    1
    Section 1983 provides in relevant part: “Every person who, under color of any statute,
    ordinance, regulation, custom, or usage, of any State or Territory or the District of
    Columbia, subjects, or causes to be subjected, any citizen of the United States or other
    person within the jurisdiction thereof to the deprivation of any rights, privileges, or
    immunities secured by the Constitution and laws, shall be liable to the party injured in an
    action at law, suit in equity, or other proper proceeding for redress.”
    2
    I.     BACKGROUND
    Although the district court characterized its decision (which addressed a variety of
    issues in addition to qualified immunity) as resolving motions for summary judgment, it
    is apparent from the record that the court resolved Defendants’ qualified-immunity
    motion solely on the basis of allegations made in Plaintiff’s complaint. We therefore
    consider this to be an appeal from the denial of a motion to dismiss under Federal Rule of
    Civil Procedure 12(b)(6). On review we accept the factual allegations of the complaint as
    true and draw all reasonable inferences in favor of the nonmoving party. See Doe v.
    Woodard, 
    912 F.3d 1278
    , 1285 (10th Cir. 2019).
    Plaintiff’s complaint alleges the following: On May 4, 2015, he was a pretrial
    detainee in the custody of the Denver Sheriff’s Department at the Van Cise-Simonet
    Detention Center. During an apparent psychotic episode, he swallowed metal
    components of an emergency call box in his jail cell. After jail officials learned of this at
    about 10:00 p.m., they contacted a physician at the Denver Health Medical Center and
    were told that he should be brought to the hospital for x rays and treatment within one
    hour. At 12:20 a.m., three of the Defendants removed him from his cell and placed him
    in a van to go to the hospital. On the way there, Plaintiff urinated and defecated on the
    smock he was wearing. The three transporting Defendants were met at the hospital by
    the other three Defendants. Defendants removed the smock and walked Plaintiff into the
    hospital without any clothes on except a pair of orange mittens, passing through the
    ambulance bay, entrance, atrium, and hallways before chaining him to a bed. Hospital
    3
    staff witnessed this conduct and reported it to the hospital risk manager because they
    found it disturbing.
    II.    DISCUSSION
    Defendants2 have asserted the defense of qualified immunity, which “protects
    government officials from liability for civil damages insofar as their conduct does not
    violate clearly established statutory or constitutional rights of which a reasonable person
    would have known.” Callahan v. Unified Gov’t of Wyandotte Cty., 
    806 F.3d 1022
    , 1026
    (10th Cir. 2015) (internal quotation marks omitted). “Because qualified immunity
    establishes immunity from suit rather than a mere defense to liability, a district court’s
    denial of a claim of qualified immunity is immediately appealable under 
    28 U.S.C. § 1291
    .” 
    Id.
     (internal quotation marks and citation omitted). But our jurisdiction in such
    an interlocutory appeal is limited to the legal question of whether the alleged facts state a
    violation of clearly established law. See 
    id.
    “In resolving a motion to dismiss based on qualified immunity, the court considers
    (1) whether the facts that [Plaintiff] has alleged make out a violation of a constitutional
    2
    “Individual liability under § 1983 must be based on personal involvement in the alleged
    constitutional violation,” so “we must examine the allegations in the complaint as to each
    individual appellant to determine whether a plausible claim for relief is stated.” Wilson v.
    Montano, 
    715 F.3d 847
    , 854 (10th Cir. 2013) (internal quotation marks omitted). But
    because Plaintiff alleges that all six Defendants participated equally in walking him into
    the hospital without clothes on, and Defendants make no argument that they are
    differently situated with regard to liability, we will treat them all the same for purposes of
    this appeal. See Estate of Booker v. Gomez, 
    745 F.3d 405
    , 421–22 (10th Cir. 2014). Of
    course, evidence developed upon remand may make distinctions among them
    appropriate.
    4
    right, and (2) whether the right at issue was clearly established at the time of
    [Defendants’] alleged misconduct.” Keith v. Koerner, 
    707 F.3d 1185
    , 1188 (10th Cir.
    2013) (internal quotation marks omitted). The law was “clearly established” if it “was
    sufficiently clear that every reasonable official would understand that what he is doing is
    unlawful.” District of Columbia v. Wesby, 
    138 S. Ct. 577
    , 589 (2018) (internal quotation
    marks omitted); see 
    id. at 590
     (“The rule’s contours must be so well defined that it is
    clear to a reasonable officer that his conduct was unlawful in the situation he confronted.”
    (internal quotation marks omitted)). Generally, “[t]he plaintiff must show there is a
    Supreme Court or Tenth Circuit decision on point, or the clearly established weight of
    authority from other courts must have found the law to be as the plaintiff maintains.”
    Woodard, 912 F.3d at 1289 (internal quotation marks omitted). “Ultimately, we consider
    whether our precedents render the [il]legality of the conduct undebatable.” Lowe v.
    Raemisch, 
    864 F.3d 1205
    , 1211 (10th Cir. 2017). Our review is de novo. See Keith, 707
    F.3d at 1187.
    A.   Mistreatment of Detainees
    Plaintiff asserts that Defendants’ treatment of him violated the Fourth
    Amendment’s protection against unreasonable seizures and the Fourteenth Amendment’s
    Due Process Clause. To resolve what constitutional provision governs this case, we need
    to review the proper scope of the potentially applicable provisions. First, however, we
    should explain our nomenclature, because almost any federal constitutional claim against
    state officials is, strictly speaking, a claim under the Fourteenth Amendment. Although
    the provisions of the Bill of Rights are directed only to the federal government, see
    5
    Barron v. City of Baltimore, 32 U.S. (7 Pet.) 243, 247 (1833), the Supreme Court over the
    years has incorporated most of those provisions into the Fourteenth Amendment, see
    Timbs v. Indiana, 
    139 S. Ct. 682
    , 687 (2019) (“With only a handful of exceptions, this
    Court has held that the Fourteenth Amendment’s Due Process Clause incorporates the
    protections contained in the Bill of Rights, rendering them applicable to the States.”
    (internal quotation marks omitted)). Thus, even when dealing with state officials, it is
    common to say that a claim is based, say, on the First Amendment, Fourth Amendment,
    Sixth Amendment, or Eighth Amendment. We follow that practice here to add clarity to
    our discussion. When we speak of a Fourteenth Amendment claim in this opinion, we
    will be referring to a claim that is not based on incorporating the Bill of Rights into that
    amendment, but rather is based on the Due Process Clause in itself. We note, however,
    that courts analyze such claims against state officials essentially the same way as they
    analyze claims against federal officials under the Due Process Clause of the Fifth
    Amendment. See Ward v. Anderson, 
    494 F.3d 929
    , 932 n.3 (10th Cir. 2007) (“The Due
    Process Clause of the Fourteenth Amendment imposes no more stringent requirements
    upon state officials than does the Due Process Clause of the Fifth Amendment upon their
    federal counterparts.” (brackets and internal quotation marks omitted)).
    The essence of Plaintiff’s claim is that he was mistreated while in state custody.
    Alleged mistreatment of this type may be challenged under the Fourth Amendment,
    Eighth Amendment, or Fourteenth Amendment. The Fourth Amendment prohibits
    “unreasonable searches and seizures.” U.S. Const. amend. IV. Even one who has been
    properly searched or seized by police authorities (say, arrested on probable cause), can
    6
    claim that the search or seizure was unreasonable because of unreasonable treatment by
    officers in effecting the search or seizure. Typically, the mistreatment has been the use of
    excessive force; but “the interests protected by the Fourth Amendment are not confined
    to the right to be secure against physical harm; they include liberty, property and privacy
    interests—a person’s sense of security and individual dignity.” Holland ex rel. Overdorff
    v. Harrington, 
    268 F.3d 1179
    , 1195 (10th Cir. 2001) (internal quotation marks omitted)
    (abusive conduct of SWAT team while holding residents at gunpoint during execution of
    search and arrest warrants).
    The Eighth Amendment prohibits the infliction of “cruel and unusual
    punishments.” U.S. Const. amend. VIII. It applies to those who have been convicted of
    crime, so they usually cannot complain of confinement itself. But see Hawkins v.
    Hargett, 
    200 F.3d 1279
    , 1282 (10th Cir. 1999) (Eighth Amendment protects against
    sentence that is grossly disproportionate to the offense). It does, however, protect against
    unjustifiable conditions of confinement, such as “the unnecessary and wanton infliction
    of pain,” Hudson v. McMillian, 
    503 U.S. 1
    , 5 (1992) (internal quotation marks omitted),
    or deliberate indifference to an excessive risk to a prisoner’s health, see Farmer v.
    Brennan, 
    511 U.S. 825
    , 837 (1994). When a prisoner challenges a particular use of force
    by prison officials, the prisoner can establish an unnecessary and wanton infliction of
    pain by showing that the action was taken “maliciously and sadistically to cause harm.”
    Hudson, 
    503 U.S. at 7
    . We have held that psychological harm, as well as physical injury,
    can implicate the Eighth Amendment. See Benefield v. McDowall, 
    241 F.3d 1267
    , 1272
    (10th Cir. 2001); see also Hudson, 
    503 U.S. at 16
     (Blackmun, J., concurring in the
    7
    judgment) (“It is not hard to imagine inflictions of psychological harm—without
    corresponding physical harm—that might prove to be cruel and unusual punishment.”)
    For those in pretrial confinement, such as Plaintiff, claims regarding mistreatment
    while in custody generally do not come within the protection of the Fourth Amendment
    or the Eighth Amendment. As explained in Porro v. Barnes, 
    624 F.3d 1322
    , 1325–26
    (10th Cir. 2010) (Gorsuch, J.), “[T]he Fourth Amendment . . . pertains to the events
    leading up to and including an arrest of a citizen previously at liberty,” while the Eighth
    Amendment is the source of protection for “prisoners already convicted of a crime who
    claim that their punishments involve excessive force.” Thus, when a “plaintiff finds
    himself in the criminal justice system somewhere between the two stools of an initial
    seizure and post-conviction punishment[,] we turn to the due process clauses of the Fifth
    or Fourteenth Amendment and their protection against arbitrary governmental action by
    federal or state authorities” to evaluate claims of mistreatment. 
    Id. at 1326
    . That is
    Plaintiff’s situation, so we assess his claim under the Fourteenth Amendment. See Fisher
    v. Washington Metro. Area Transit Auth., 
    690 F.2d 1133
    , 1142 (4th Cir. 1982) (assessing
    under the Fourteenth Amendment a pretrial detainee’s claim of unwarranted forced
    nudity), abrogated on other grounds by Cty. Of Riverside v. McLoughlin, 
    500 U.S. 44
    , 50
    (1991).
    Although the full scope of protection provided by the Due Process Clauses to
    pretrial detainees may be to some extent uncertain, the Supreme Court has been
    categorical in one respect: “[A] detainee may not be punished prior to an adjudication of
    guilt in accordance with due process of law.” Bell v. Wolfish, 
    441 U.S. 520
    , 535 (1979)
    8
    (emphasis added). Thus, in analyzing a condition of pretrial confinement, “[a] court must
    decide whether the disability is imposed for the purpose of punishment or whether it is
    but an incident of some other legitimate governmental purpose.” 
    Id. at 538
    . “Absent a
    showing of an expressed intent to punish on the part of detention facility officials, that
    determination generally will turn on whether an alternative purpose to which the
    restriction may rationally be connected is assignable for it, and whether it appears
    excessive in relation to the alternative purpose assigned to it.” 
    Id.
     (brackets and internal
    quotation marks omitted). “[I]f a restriction or condition is not reasonably related to a
    legitimate goal—if it is arbitrary or purposeless—a court permissibly may infer that the
    purpose of the governmental action is punishment that may not constitutionally be
    inflicted upon detainees qua detainees.” 
    Id. at 539
    .
    We applied those principles to a claim of excessive force in Blackmon v. Sutton,
    
    734 F.3d 1237
     (10th Cir. 2013) (Gorsuch, J.). An 11-year-old pretrial detainee claimed
    that detention-center officials had unconstitutionally punished him by repeatedly placing
    him in a restraint chair (and in one instance by having a guard sit on his chest) without
    any legitimate penological purpose. See 
    id.
     at 1242–43. We held that these would be
    Fourteenth Amendment violations. See 
    id.
     at 1240–44. We explained that a pretrial
    detainee can establish that official actions constitute unconstitutional punishment either
    by showing that “an expressed intent to punish on the part of detention facility officials
    exists,” or “by showing that the restriction in question bears no reasonable relationship to
    any legitimate governmental objective.” 
    Id. at 1241
    .
    9
    Bell and Blackmon are not entirely clear about whether a pretrial detainee could
    sustain a due-process claim for mistreatment without showing that the custodians
    intended their actions as punishment. Both opinions could be read as requiring an intent
    to punish the pretrial detainee although allowing such intent to be inferred from the
    absence of a legitimate purpose behind the offensive conduct. See Kingsley v.
    Hendrickson, 
    135 S. Ct. 2466
    , 2477–78 (2015) (Scalia, J., dissenting) (discussing Bell).
    But the Supreme Court in Kingsley eliminated any ambiguity. Reviewing a claim of
    excessive force brought by a pretrial detainee, the Court declined to read Bell as meaning
    “that proof of intent (or motive) to punish is required for a pretrial detainee to prevail on
    a claim that his due process rights were violated.” 
    Id. at 2473
    . Rather, a pretrial detainee
    can establish a due-process violation 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.” 
    Id.
     at 2473–74.3 In
    particular, there is no subjective element of an excessive-force claim brought by a pretrial
    detainee. See 
    id. at 2476
    .
    B.     Public Exposure of Nude Body of Detainee
    In our view, any reasonable adult in our society would understand that the
    involuntary exposure of an adult’s nude body is a significant imposition on the victim.
    3
    The dissent argues that the proper approach to Fourteenth Amendment claims against
    executive action would be to determine whether the action shocks the conscience.
    Kingsley, however, is to the contrary for claims relating to the treatment of pretrial
    detainees.
    10
    And law-enforcement officers in this circuit have been taught this lesson repeatedly. In
    Shroff v. Spellman, 
    604 F.3d 1179
    , 1184 (10th Cir. 2010), the plaintiff had been placed in
    a holding cell after her arrest, awaiting transfer to the city jail. She told the arresting
    officer that she needed to pump breastmilk to be used by her infant child in her absence.
    See 
    id.
     He required her to do so under the observation of a female cadet, even though she
    could have been afforded privacy in a room with a guard outside. See 
    id. at 1191
    . We
    held that the officer had violated the Fourth Amendment, because he had “not
    demonstrated any justification for requiring [the plaintiff] to expose her breasts to a
    female cadet while she performed an essential bodily function in providing milk for her
    baby.” Id.; see May v. City of Nahunta, Geo., 
    846 F.3d 1320
    , 1331 (11th Cir. 2017)
    (woman subject to mental-health detention forced to disrobe in presence of male officer);
    see also Los Angeles Cty., Cal. v. Rettele, 
    550 U.S. 609
    , 615 (2007) (in holding that
    officers did not act improperly in executing search warrant, Court notes that officers did
    not delay detainees from putting on clothes “longer than necessary to protect their
    safety”).
    Similarly, in Hill v. Bogans, 
    735 F.2d 391
    , 393 (10th Cir. 1984), a man arrested on
    a bench warrant for traffic violations was forced to “drop his pants and undershorts” as
    part of the booking process in a jail’s “lobby area where he observed ten to twelve people
    in the immediate vicinity.” We held that his Fourth Amendment rights had been violated
    because the search was unnecessary to discover contraband or weapons, and took place in
    front of multiple people in a public area. See 
    id.
     at 394–95.
    11
    We have recognized the significance of such an imposition even on prisoners after
    they have been convicted and are serving time in prison. In Farmer v. Perrill, 
    288 F.3d 1254
    , 1257 (10th Cir. 2002), a female inmate challenged a prison’s alleged policy of
    requiring a “visual search” of inmates’ naked bodies in view of other inmates after trips
    to the prison yard. We held that she had “the right not to be subjected to a humiliating
    strip search in full view of several (or perhaps many) others unless the procedure is
    reasonably related to a legitimate penological interest.” 
    Id. at 1260
     (emphasis omitted).
    It appears, although it is not certain, that our decision in that case relied on the Fourth
    Amendment; but several other circuits have recognized that officials can violate the
    Eighth Amendment by forcing inmates to expose their naked bodies for the purpose of
    humiliation. See Calhoun v. DeTella, 
    319 F.3d 936
    , 939 (7th Cir. 2003); Kent v.
    Johnson, 
    821 F.2d 1220
    , 1227–28 (6th Cir. 1987); Lee v. Downs, 
    641 F.2d 1117
    , 1119
    (4th Cir. 1981). And in Cumbey v. Meachum, 
    684 F.2d 712
    , 713 (10th Cir. 1982), we
    considered a prisoner’s complaint that his constitutional rights had been violated because
    female prison guards “are assigned to posts where they observe[d] him dressing and
    undressing and using the toilet and the shower.” We held that the complaint was
    improperly dismissed as frivolous, saying that “[a]lthough the inmates’ right to privacy
    must yield to the penal institution’s need to maintain security, it does not vanish
    altogether.” 
    Id. at 714
    . We did not reference any particular provision of the Constitution.
    All we need to take from these cases is a conclusion that was obvious without
    them: exposing a person’s naked body involuntarily is a severe invasion of personal
    privacy. The conclusion that Defendants’ alleged conduct constituted a violation of the
    12
    Fourteenth Amendment readily follows. The only issue is whether the exposure of
    Plaintiff’s body was “not rationally related to a legitimate governmental objective or
    [was] excessive in relation to that purpose.” Kingsley, 
    135 S. Ct. at
    2473–74. In our
    view, the facts alleged in the Complaint satisfy this condition.
    Defendants argue that Plaintiff needed medical treatment urgently, and that
    finding another covering for him before transporting him through the hospital would have
    taken too much additional time and effort. But Plaintiff has alleged facts supporting the
    reasonable inference that no vital urgency justified Defendants’ actions. His complaint
    states that Defendants took more than two hours to transport him to the hospital. It also
    alleges that at the end of his walk through the hospital he was chained to a hospital bed,
    not immediately x-rayed or provided with treatment. The district court ruled that these
    allegations were sufficient to support the inference that Plaintiff’s condition was not so
    urgent that Defendants could not have delayed walking him into the hospital for “[t]he
    additional moment that would have been required to locate and place a smock” on him.
    District Court Order at 17. We agree with the district court. It is common sense that
    acquiring some replacement clothing at a hospital would be at most a matter of minutes,
    and we can reasonably infer from the long delay in transporting Plaintiff that Defendants’
    actions were not based on a medical need so pressing that they could not spare a little
    time to obtain a dignified covering.
    C.     Qualified Immunity
    There remains the question whether Defendants are entitled to qualified immunity.
    Was the law clearly established that their conduct (as alleged by Plaintiff) violated the
    13
    Fourteenth Amendment? Ordinarily the answer is no unless there is precedent of the
    Supreme Court or of this court declaring that there would be a violation under closely
    similar facts. Fortunately, however, not every constitutional violation has factual
    antecedents. We can occasionally rely on the general proposition that it would be “clear
    to a reasonable officer that his conduct was unlawful in the situation he confronted . . .
    even though existing precedent does not address similar circumstances.” Wesby, 
    138 S. Ct. at 590
     (internal quotation marks omitted); see Lowe, 864 F.3d at 1210–11 (“[T]he
    constitutional violation may be so obvious that similar conduct seldom arises in our
    cases,” and “it would be remarkable if the most obviously unconstitutional conduct
    should be the most immune from liability only because it is so flagrantly unlawful that
    few dare its attempt.” (internal quotation marks omitted)). We must be careful not to do
    so when there are any relevant ambiguities, such as whether physical force is justified for
    a particular purpose or in a particular context, see Aldaba v. Pickens, 
    844 F.3d 870
    , 879
    (10th Cir. 2016) (use of taser to subdue person needing medical care), or whether force
    used constituted deadly force, see Thomson v. Salt Lake County, 
    584 F.3d 1304
    , 1315–17
    (10th Cir. 2009) (whether use of police dog constituted deadly force); Wilson v. City of
    Lafayette, 510 F. App’x 775, 778 (10th Cir. 2013) (Gorsuch, J.) (whether tasing
    amounted to use of deadly force). Here, however, there are no relevant ambiguities
    regarding the manner in which Defendants allegedly took Plaintiff from the police
    vehicle to his hospital room.
    The Fourteenth Amendment is violated if a pretrial detainee is subjected to “a
    restriction or condition . . . not reasonably related to a legitimate goal.” Bell, 
    441 U.S. at
    14
    539; see Kingsley, 
    135 S. Ct. at
    2473–74. To be sure, some restrictions or conditions
    may be too insignificant to be the predicate for a Fourteenth Amendment violation. But
    common sense tells us that parading someone nude in public is not so insignificant, and
    the above-referenced Fourth Amendment jurisprudence makes the point crystal clear.
    We therefore proceed as we did in Blackmon. As previously noted, that case involved a
    juvenile pretrial detainee. The evidence supported the inference that on occasion the
    plaintiff had been shackled to a restraint chair “for long stretches when there was no hint
    he posed a threat of harming himself or anyone else.” Blackmon, 734 F.3d at 1242.
    Further, on one occasion he “was stripped out of his clothes and forced to wear a paper
    gown while restrained in the chair,” id., and on another a corrections worker sat on him
    “without any penological purpose,” id. at 1243. Even in the absence of any precedential
    opinions holding that there had been a Fourteenth Amendment violation under similar
    facts, we denied qualified immunity, saying: “On the frugal record we have, we (like the
    district court before us) are again left unable to exclude the possibility that a defendant
    used force against Mr. Blackmon as punishment. And that is enough to preclude granting
    qualified immunity at summary judgment under Bell’s plain terms.” Id. at 1244. Bell in
    itself sufficed as clearly established law in that context. There is little subtlety in a
    standard requiring merely a rational relationship to a legitimate objective. In our view,
    Bell suffices here as well, particularly given the additional precedential authority of
    Blackmon.
    On one possible aspect of Plaintiff’s claim, however, we do not think Defendants’
    actions were governed by clearly established law. To the extent that Plaintiff claims that
    15
    his constitutional rights were violated by being chained in the hospital bed to which he
    was taken, we dismiss the claim as barred by qualified immunity. Given Plaintiff’s status
    as one facing criminal charges, and the apparent risk he posed to himself, there was
    certainly a legitimate purpose for the constraints. Also, his nude body was presumably
    then exposed only to his hospital caregivers, who could best determine what, if any, garb
    or covering was appropriate for his treatment and care. Given the much more limited
    nature of Plaintiff’s exposure, the legitimate reasons for the restraint, and the change in
    caretaker upon Plaintiff’s delivery to the room, it is not obvious that Defendants denied
    him due process in the manner that they left him in the hospital bed.
    III.   CONCLUSION
    We AFFIRM the denial of qualified immunity except to the extent that Plaintiff’s
    claim is based on his treatment after being taken to his hospital room.
    16
    18-1056, Colbruno v. Kessler
    TYMKOVICH, Chief Judge, dissenting.
    This case presents a classic variation on the theme that “bad facts make bad law.”
    The experiences alleged by Mr. Colbruno, if inflicted with malice, would trouble anyone.
    If, on the other hand, deputies sought only to make the best of a bad situation in obtaining
    emergency medical care for him, few would be alarmed.
    In my view, Mr. Colbruno has not adequately alleged malicious conduct.
    Applying the appropriate legal framework under the Fourteenth Amendment, the deputies
    should therefore be entitled to qualified immunity. As the majority explains, Mr.
    Colbruno must allege some violation of a clearly established constitutional right. But the
    complaint fails to allege facts sufficient to state a claim for substantive due process under
    the Fourteenth Amendment, let alone one that was clearly established at the time of the
    events in question.
    I begin by reiterating the appropriate legal framework for a complaint like this one,
    which alleges official misconduct. I then contrast this approach with the framework
    adopted by the majority. Ultimately, I conclude that—when either standard is faithfully
    applied—Mr. Colbruno has failed to allege a violation that was clearly established.
    A. Fourteenth Amendment Violation
    The majority is correct in concluding these allegations are best analyzed under the
    Fourteenth Amendment’s provision for due process. But I believe the majority has
    applied the wrong due-process framework.
    1. The Appropriate Framework
    The Supreme Court has read the Fourteenth Amendment to authorize challenges to
    abusive or arbitrary governmental conduct through claims of substantive due process.
    E.g., Cty. Of Sacramento v. Lewis, 523 U.S. (1998). Governmental conduct may prove
    sufficiently abusive or arbitrary so as to violate substantive due process in one of two
    ways—from (1) legislative acts that infringe upon a personal right without sufficient
    justification, or (2) official conduct that deprives a person of life, liberty, or property in a
    manner so arbitrary as to shock the judicial conscience. E.g., United States v. Salerno,
    
    481 U.S. 739
    , 746 (1987) (“‘[S]ubstantive due process’ prevents the government from
    engaging in conduct that ‘shocks the conscience’ or interferes with rights ‘implicit in the
    concept of ordered liberty.’”) (citations omitted).
    These allegations do not involve legislative action, so they must be evaluated
    under the cases that consider official conduct. See Lewis, 523 U.S. at 846–47; see also
    Browder v. City of Albuquerque, 
    787 F.3d 1076
    , 1079 n.1 (10th Cir. 2015). These cases
    emphasize that “only the most egregious official conduct can be said to be ‘arbitrary’ in
    the constitutional sense.” Onyx Props. LLC v. Bd. of Cty. Commr’s of Elbert Cty., 
    838 F.3d 1039
    , 1048–49 (10th Cir. 2016). In evaluating allegations of official misconduct,
    we apply the “shocks the conscience” standard.1
    1
    See Nathan S. Chapman & Michael W. McConnell, Due Process as Separation
    of Powers, 
    121 Yale L.J. 1672
    , 1788 (2012) (explaining Lewis’s holding “that substantive
    due process claims against the executive—usually law enforcement officers—are
    -2-
    Conduct “shocks the conscience” when it demonstrates such “a degree of
    outrageousness and a magnitude of potential or actual harm” that it “shocks the
    conscience of federal judges.” Uhlrig v. Harder, 
    64 F.3d 567
    , 573–74 (10th Cir. 1995)
    (quoting Collins v. City of Harker Heights, 
    503 U.S. 115
    , 126 (1992)) (internal quotation
    marks omitted); see also Halley v. Huckaby, 
    902 F.3d 1136
    , 1155 (10th Cir. 2018)
    (“Conduct that shocks the judicial conscience is deliberate government action that is
    arbitrary and unrestrained by the established principles of private right and distributive
    justice.”) (quoting Hernandez v. Ridely, 
    734 F.3d 1254
    , 1261 (10th Cir. 2013)) (internal
    quotation marks omitted).
    This standard is exacting, in large part because the complete universe of state-law
    torts might otherwise then be distorted into constitutional violations of due process.
    Dawson v. Bd. of Cty. Commr’s of Jefferson Cty., 732 F. App’x 624, 634 (10th Cir. 2018)
    (Tymkovich, C.J., concurring), cert denied — U.S. — , 
    139 S. Ct. 862
     (2019). We have
    therefore observed that only the most genuinely egregious abuse or misuse of
    governmental power will be sufficient to clear the burden required to shock the judicial
    conscience. E.g., Lindsey v. Hyler, 
    918 F.3d 1109
    , 1116 (10th Cir. 2019).
    This complaint cannot clear such a high standard. Mr. Colbruno alleges the
    deputies moved him from the ambulance bay to his hospital room without clothing or
    otherwise covering his body. This contention supports an inference of indifference or
    governed by a ‘shocks the conscience’ test”).
    -3-
    callousness, but no more. Mr. Colbruno does not allege any intent to humiliate or punish
    lay behind this decision. Nor does he contend the deputies prolonged his exposure to
    potential onlookers, either through needless delay or circuitous travel through the
    hospital. Nor, lastly, does he allege that anyone beyond hospital personnel witnessed any
    of these events. All of which presumably transpired within seconds.
    In short, as the complaint now stands, we know the deputies were responding to a
    medical emergency; we know Mr. Colbruno—after ingesting metal objects in the midst of
    a pyschotic episode—had soiled himself while in transit from pretrial detention to the
    hospital; and we know the deputies decided to rush him into the emergency room,
    unclothed. We do not know why they made the decisions they did; we do not know
    whether a suitable gown was readily available; and we do not know whether time was
    really of the essence. Perhaps further investigation prior to filing this lawsuit would have
    shed light upon some of these missing facts. Taken together, the answers to the questions
    could very well allow for a permissible inference of conscience-shocking conduct.2
    But in the absence of such additional factual context, I would conclude the
    complaint fails to allege the requisite inference of malice that is necessary to conclude the
    deputies might have engaged in conduct that shocks the conscience. In sum, Mr.
    2
    Mr. Colbruno was likewise obligated to plead specific facts that plausibly allege
    a constitutional violation as to each defendant. See, e.g., Ashcroft v. Iqbal, 
    556 U.S. 662
    ,
    676 (2009). He did not do so. The complaint alleges only that Officer Petit, as ranking
    officer, made the decision to remove Mr. Colbruno from the van without a smock.
    -4-
    Colbruno has not adequately alleged a violation of his constitutional rights to substantive
    due process under the Fourteenth Amendment.
    2. The Majority Framework
    Given the limitations of the complaint, the majority acknowledges difficulty in
    identifying which constitutional provision should entitle Mr. Colbruno to relief. He
    alleged violations of both his Fourth Amendment right to be free of unreasonable
    searches and his Fourteenth Amendment right to bodily integrity. The district court, in
    turn, accepted the Fourth Amendment rationale and did not conduct an independent
    analysis of the Fourteenth Amendment claim. But because Mr. Colbruno was neither
    searched nor seized in any conventional sense, it is obvious—as explained above—that
    any relief must stem from the Fourteenth Amendment’s protections against official
    misconduct; and not the Fourth Amendment’s familiar assurances against unreasonable
    search or seizure.
    The majority understandably turns to a line of cases involving the rights of pre-trial
    detainees. Relying upon Bell v. Wolfish, 
    441 U.S. 520
    , 535 (1979), and Kingsley v.
    Hendrickson, 
    135 S. Ct. 2466
     (2015),3 the majority concludes “[a] detainee may not be
    3
    Because Kingsley was decided after the events alleged in the complaint, Bell
    remains the applicable Supreme Court precedent. Kingsley likewise addressed the state-
    of-mind requirement for an excessive-force claim brought under the Fourteenth
    Amendment. Because the complaint does not allege excessive force, the relevance of
    Kingsley—beyond its restatement of the general principles articulated in Bell—is not
    obvious.
    -5-
    punished prior to an adjudication of guilt in accordance with due process of law.” Maj.
    Op. 8–9. (emphasis in original) (quoting Bell, 
    441 U.S. at 535
    ). In Bell, the Supreme
    Court explained that—when a person is confined while awaiting trial—the government
    must respect the presumption of his innocence. Accordingly, only those restraints against
    liberty that advance legitimate institutional interests will be constitutionally permissible.
    But “if a restriction or condition is not reasonably related to a legitimate goal—if it is
    arbitrary or purposeless—a court permissibly may infer that the purpose of the
    governmental action is punishment that may not constitutionally be inflicted upon
    detainees qua detainees.” 
    Id. at 539
    .
    The majority also points to a case not briefed by either party to apply the principles
    outlined in Bell. Relying on Blackmon v. Sutton, 
    734 F.3d 1237
     (10th Cir. 2013), the
    majority concludes Mr. Colbruno’s treatment as detailed in his complaint was tantamount
    to punishment. In Blackmon, we concluded that a juvenile detainee who claimed repeated
    punishment through sometimes-lengthy placement in a restraint chair had successfully
    alleged a violation of his due-process rights under the Fourteenth Amendment.
    But a close reading of Blackmon offers little support for the majority’s application
    here. The Blackmon panel concluded the plaintiff’s allegations were so egregious that
    they would have cleared the more demanding hurdle of stating an Eighth Amendment
    violation. It therefore followed necessarily that the plaintiff had made out a violation of
    his substantive due process rights under the Fourteenth Amendment, since “a pretrial
    -6-
    detainee enjoys at least the same constitutional protections as a convicted criminal.” 
    Id.
    at 1241–42, 42–43. In other words, the circumstances alleged by the plaintiff proved so
    egregious that the test from Bell was beside the point.
    It bears mentioning, as well, that Blackmon arose during a period of uncertainty
    surrounding the propriety of applying the shocks-the-conscience standard as the sole test
    for official misconduct. See Dias v. City and Cty. Of Denver, 
    567 F.3d 1169
    , 1182 (10th
    Cir. 2009) (“We held . . . that application of a ‘shocks the conscience’ standard in cases
    involving executive action is not to the exclusion of the foregoing [‘rights’] framework.”).
    But any residual uncertainty has since been foreclosed by Browder v. City of
    Albuquerque, 787 F.3d at 1079 n.1 (10th Cir. 2015) (Gorsuch, J.) (“[T]he “arbitrary or
    conscience shocking” test is the appropriate one for executive action.”); accord Dawson,
    732 F. App’x at 636 (Tymkovich, C.J., concurring) (“If a claim challenges executive
    action, we apply only the ‘shocks the conscience’ test.”) (emphasis added).
    But even if Blackmon represented a correct and straightforward application of Bell,
    there exist myriad factual differences between the circumstances detailed in Blackmon
    and the allegations in this case. In Blackmon, for instance, the plaintiff’s lawsuit arose
    specifically from the conditions of his confinement. Here, by contrast, Mr. Colbruno
    never alleges his treatment arose as a condition of his confinement. And whereas
    Blackmon entailed repeated and systematic punishment within the confines of a detention
    facility, Mr. Colbruno details what would be a single constitutional violation separate and
    -7-
    apart from the place of his confinement.
    Finally—perhaps because Blackmon offers so few analogous facts—the majority
    turns to several Fourth Amendment strip-search cases. It asserts “the conclusion [that
    deputies’] alleged conduct constituted a violation of the Fourteenth Amendment readily
    follows” from these cases. Maj. Op. 12. But violations of the Fourth Amendment are
    evaluated only for reasonableness. See, e.g., Lewis, 523 U.S. at 842–43 (noting the
    difference between the Fourth Amendment’s “reasonableness” standard and the
    Fourteenth Amendment’s shocks-the-conscience standard). The Fourth Amendment
    accordingly provides no support for a due-process claim involving official misconduct of
    the type alleged here.
    B. Clearly Established Violation
    No matter how we analyze his claims, Mr. Colbruno has failed to allege the
    violation of a clearly established constitutional right. The Supreme Court has explained
    that “[a] clearly established right is one that is sufficiently clear that every reasonable
    official would have understood that what he is doing violates that right.” E.g., Mullenix
    v. Luna, 
    136 S. Ct. 305
    , 308 (2015) (citations and quotation marks omitted).
    Although we need not “require a case directly on point,” it is nonetheless the case
    that “existing precedent must have placed the statutory or constitutional question beyond
    debate.” 
    Id.
     (citations and quotation marks omitted). This is because qualified immunity
    is meant to “protect[] all but the plainly incompetent or those who knowingly violate the
    -8-
    law.” 
    Id.
     (citations and quotation marks omitted). The Supreme Court has “repeatedly
    told courts . . . not to define clearly established law at a high level of generality.” 
    Id.
    (citations and quotation marks omitted). And the Court has likewise emphasized “[t]he
    dispositive question is whether the violative nature of particular conduct is clearly
    established.” 
    Id.
     (citations and quotation marks omitted) (emphasis in original). Such an
    inquiry “must be undertaken in light of the specific context of the case, not as a broad
    general proposition.” 
    Id.
     (citations and quotation marks omitted) (emphasis added). The
    Court has also observed that—in the related Fourth Amendment context—“specificity is
    especially important,” as “it is sometimes difficult . . . to determine how the relevant legal
    doctrine . . . will apply to the factual situation the officer confronts.” 
    Id.
     (citations and
    quotation marks omitted).
    The violation proposed by the majority—of a right to be free from “a restriction or
    condition . . . not reasonably related to a legitimate goal” Maj. Op. 14—is far too broad.
    While I am certainly sympathetic to the privacy interests asserted by Mr. Colbruno, no
    precedential case has clearly established a constitutional violation at the appropriate level
    of specificity under the facts alleged here.
    To avoid this conclusion, the majority asserts the deputies’ violation of Mr.
    Colbruno’s rights was so obvious that we need not point to a closely aligned case. It is, of
    course, correct that some “constitutional violation[s] may be so obvious that similar
    conduct seldom arises in our cases,” such that “it would be remarkable if the most
    -9-
    obviously unconstitutional conduct should be the most immune from liability only
    because it is so flagrantly unlawful that few dare attempt.” Lowe v. Raemisch, 
    864 F.3d 1205
    , 1210-11 (10th Cir. 2017) (citations and quotation marks omitted). But this
    exception is exceedingly narrow, as we must effectively conclude “our precedents render
    the legality of the conduct undebatable.” See 
    id.
     at 1211 (citing Aldaba v. Pickens, 
    844 F.3d 870
    , 877 (10th Cir. 2016)).
    In its effort to clear this hurdle, the majority again looks to Blackmon. But the
    circumstances depicted there could not credibly alert the deputies of misconduct, absent
    some punitive intent. Whereas punishment sat at the center of the dispute in Blackmon,
    Mr. Colbruno has not alleged facts that would suggest the deputies intended to punish
    him; or, for that matter, any other state of mind that would meet the constitutional
    standard for egregiousness. And whereas at least one official in Blackmon engaged in
    repeated, systematic, and gratuitous misconduct, Mr. Colbruno details what would be—at
    most—a single discrete incident that lasted only for a matter of moments.
    In sum, absent plausible allegations of intentional and abusive misconduct, clearly-
    established law could not have alerted the deputies they were violating Mr. Colbruno’s
    right to substantive due process. As troubling as these allegations—if true—would be,
    the complaint fails to tie the invasion of Mr. Colbruno’s privacy to the constitutional
    requirement for intent.
    -10-