Kathy Dyer v. City of Mesquite Texas ( 2020 )


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  •      Case: 19-10280   Document: 00515376992     Page: 1   Date Filed: 04/09/2020
    IN THE UNITED STATES COURT OF APPEALS
    FOR THE FIFTH CIRCUIT   United States Court of Appeals
    Fifth Circuit
    FILED
    No. 19-10280                      April 9, 2020
    Lyle W. Cayce
    Clerk
    KATHY DYER; ROBERT DYER, Individually and as Representative of the
    Estate of Graham Dyer,
    Plaintiffs - Appellants
    v.
    RICHARD HOUSTON; ALAN GAFFORD; ZACHARY SCOTT; WILLIAM
    HEIDELBURG; PAUL POLISH; JOE BAKER,
    Defendants - Appellees
    Appeal from the United States District Court
    for the Northern District of Texas
    Before OWEN, Chief Judge, and BARKSDALE and DUNCAN, Circuit Judges.
    STUART KYLE DUNCAN, Circuit Judge:
    Plaintiffs Kathy and Robert Dyer (“the Dyers”) appeal the dismissal on
    qualified immunity grounds of their deliberate-indifference claims against
    paramedics and police officers employed by the City of Mesquite, Texas. The
    Dyers’ claims arise out of the death of their 18-year-old son, Graham, from self-
    inflicted head trauma while in police custody. We affirm in part, reverse in
    part, and remand for further proceedings.
    I.
    Graham died after violently bashing his head over 40 times against the
    interior of a patrol car while being transported to jail. The Dyers brought
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    various claims against the paramedics who initially examined Graham, the
    officers who transported him, and the City of Mesquite. Relevant here are the
    deliberate-indifference claims against paramedics Paul Polish and Joe Baker
    (“Paramedics”) and police officers Alan Gafford, Zachary Scott, and William
    Heidelburg (“Officers”). The district court granted the Paramedics’ motion to
    dismiss based on qualified immunity. The court later granted the Officers
    summary judgment, also based on qualified immunity. Because the dismissals
    occurred at different stages, we examine the facts separately as they relate to
    the Paramedics and the Officers.
    A.
    Regarding the Paramedics, we accept as true the allegations in the
    Dyers’ operative complaint. In re Katrina Canal Breaches Litigation, 
    495 F.3d 191
    , 205 (5th Cir. 2007). According to the complaint, Polish and Baker arrived
    on the scene in the late evening hours of August 13, 2013. There they found
    Graham already detained by police officers for exhibiting erratic behavior.
    After “learning that [Graham and his friend] had consumed LSD,” one
    “paramedic went over to examine Graham.” He summoned the second
    paramedic, after which they both “further examine[d] Graham.” Graham “had
    sustained a visible and serious head injury.” Moreover, the Paramedics “were
    aware that [Graham] had ingested LSD and was incoherent and screaming,”
    and “were aware that he was not rational and was in a drug induced psychosis.”
    “[B]oth examined [Graham], including his serious head injury.” According to
    video evidence referenced by the complaint, after the Paramedics “were
    finished looking at Graham,” he was “walked to the police car without
    resistance or struggle.” Graham was then driven to jail. The complaint
    contains no further allegations about the Paramedics.
    Based on these allegations, the Dyers claim the Paramedics violated
    Graham’s Fourteenth Amendment right not to have his serious medical needs
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    met with deliberate indifference. See Hare v. City of Corinth, 
    74 F.3d 633
    , 639
    (5th Cir. 1996) (en banc). They claim Polish and Baker “made no
    recommendations for further treatment or medical intervention, including
    sedation which would have calmed Graham down and allowed him to comply
    with instructions.” They further claim “Polish and Baker also knew of the
    substantial risk of serious harm that would result from ignoring the psychosis
    of someone who had ingested LSD, yet they did nothing to treat Graham [or]
    transport him for treatment.” Finally, they claim “Graham should have been
    given a sedative and transported to the emergency room” because the
    Paramedics “were aware of facts demonstrating a substantial risk of serious
    harm and disregarded the risk by failing to take reasonable measures to treat
    Graham.”
    B.
    Regarding the Officers, we take the relevant facts from the summary
    judgment record, construed in favor of the non-movants. 1 Hanks v. Rogers, 
    853 F.3d 738
    , 743 (5th Cir. 2017) (citation omitted). Responding to the late evening
    911 call concerning Graham, Officer Gafford first arrived on the scene,
    observed Graham’s erratic behavior, and physically restrained him. Officer
    Houston arrived next and handcuffed Graham. During this encounter, Graham
    was “rolling” and “yelling” while officers tried to calm him down. Officers
    Heidelburg, Scott, and Fyall next arrived. The Paramedics then arrived,
    examined Graham, and released him to the police. See supra I.B.
    Graham was then placed in Heidelburg’s patrol car. While officers were
    trying to secure Graham, he bit Fyall on the finger. Graham was placed in leg
    restraints, but his seatbelt was not fastened. Heidelburg then drove off with
    1  The summary judgment record consists, in part, of affidavits and depositions of all
    officers involved, the police department internal investigation report (based in part on an in-
    car video of the incident from Officer Heidelburg’s patrol car), and the autopsy report.
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    Graham. Scott and Gafford followed in their own patrol cars. While Heidelburg
    was driving, Graham screamed, thrashed violently, and slammed his head
    multiple times against the interior of the car. Heidelburg told Graham to stop
    hitting his head, but Graham did not comply. Heidelburg testified he pulled
    the car over to “[t]ry to stop [Graham] from hitting his head on the cage.” Scott
    saw Heidelburg pull the car over and assumed he was doing so because
    Graham “was banging his head.” The internal investigation report prepared by
    the Mesquite Police Department (based in part on a video recording of the
    incident) reported that Graham slammed his head against the “metal cage,
    side window and back seat” 19 times before Heidelburg pulled over.
    At that point, Scott stopped to help “prevent [Graham] from banging his
    head on the back of the car.” Gafford also pulled over, seeking to help stop
    Graham from doing “further harm to himself.” Gafford testified he could
    “actually see the car shaking from side to side” as Graham flung himself
    around in the back seat. When the car stopped, Graham continued to “scream
    and thrash,” and the Officers tased him several times to regain control. 2 After
    re-securing Graham, Heidelburg resumed driving toward the jail and Graham
    continued to scream and slam his head against the car’s interior. According to
    the investigation report, Graham bashed his head another 27 times before they
    arrived at jail.
    All three Officers removed Graham from the patrol car and brought him
    into the sally port. Graham continued kicking and screaming as jail personnel
    tried to secure him. Graham was moved inside the jail, placed in a restraint
    chair, and eventually put in a padded cell. No evidence shows Graham caused
    2 The Dyers brought excessive force claims against the Officers based on their use of
    tasers to control Graham. Only the excessive force claim against Gafford survived summary
    judgment, given evidence that Gafford “tased Graham in the testicles for about eight seconds”
    when Graham was restrained by other officers and no longer actively resisting arrest. That
    claim has since been settled.
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    any further harm to himself once restrained. The Officers each said they had
    no recollection of reporting to the jail sergeant the fact that Graham had
    slammed his head repeatedly against the interior of the patrol car en route to
    jail. The investigation report states only that the jail sergeant was “[i]nformed
    by transport officers [Graham] had been medically cleared at the scene.”
    Just over two hours later, the sergeant noticed Graham’s breathing was
    labored and summoned paramedics, who arrived at 1:40 a.m. Graham was
    transported to a local hospital and died at 11:00 p.m. that evening. Among
    other injuries, the autopsy reported extensive blunt force injuries to Graham’s
    head and cranial hemorrhaging. The reported cause of death was
    craniocerebral trauma.
    Based on a review of a video recording from Heidelburg’s patrol car, the
    investigation report found that Graham hit his head on the metal cage, side
    window, and back seat of the car approximately 46 times.
    II.
    “We review a district court’s ruling on a motion to dismiss de novo,
    accepting all well-pleaded facts as true and viewing those facts in the light
    most favorable to the plaintiffs.” Anderson v. Valdez, 
    845 F.3d 580
    , 589 (5th
    Cir. 2016) (internal quotation marks and citation omitted). “To survive a
    motion to dismiss, a complaint must contain sufficient factual matter, accepted
    as true, to ‘state a claim to relief that is plausible on its face.’” Ashcroft v. Iqbal,
    
    556 U.S. 662
    , 678 (2009) (quoting Bell Atl. Corp. v. Twombly, 
    550 U.S. 544
    , 570
    (2007)). These standards are the same when a motion to dismiss is based on
    qualified immunity. See, e.g., Turner v. Lieutenant Driver, 
    848 F.3d 678
    , 684–
    85 (5th Cir. 2017) (citations omitted).
    We review a summary judgment de novo, applying the same standards
    as the district court. Mason v. Lafayette City-Parish Consol. Gov’t, 
    806 F.3d 268
    , 274 (5th Cir. 2015) (citation omitted). “The court shall grant summary
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    judgment if the movant shows that there is no genuine dispute as to any
    material fact and the movant is entitled to judgment as a matter of law.” Fed.
    R. Civ. P. 56(a). “A dispute is genuine if the evidence is such that a reasonable
    jury could return a verdict for the nonmoving party.” Westfall v. Luna, 
    903 F.3d 534
    , 546 (5th Cir. 2018) (internal quotation marks and citation omitted). A fact
    “is material if its resolution could affect the outcome of the action.” Sierra Club,
    Inc. v. Sandy Creek Energy Associates, L.P., 
    627 F.3d 134
    , 134 (5th Cir. 2010)
    (citation omitted). “When an officer invokes [qualified immunity], ‘the burden
    then shifts to the plaintiff, who must rebut the defense by establishing a
    genuine fact [dispute] as to whether the official’s allegedly wrongful conduct
    violated clearly established law.’” McCoy v. Alamu, 
    950 F.3d 226
    , 230 (5th Cir.
    2020) (quoting Brown v. Callahan, 
    623 F.3d 249
    , 253 (5th Cir. 2010)). “We still
    draw all inferences in the plaintiff’s favor.” Taylor v. Stevens, 
    946 F.3d 211
    ,
    217 (5th Cir. 2019) (citation omitted).
    “The qualified immunity defense has two prongs: whether an official’s
    conduct violated a statutory or constitutional right of the plaintiff; and whether
    the right was clearly established at the time of the violation.” Brown, 
    623 F.3d at
    253 (citing Manis v. Lawson, 
    585 F.3d 839
    , 843 (5th Cir. 2009)). A court may
    rest its analysis on either prong. Morgan v. Swanson, 
    659 F.3d 359
    , 385 (5th
    Cir. 2011) (en banc) (citing Pearson v. Callahan, 
    555 U.S. 223
    , 236 (2009)).
    III.
    We first address whether the district court properly granted the
    Paramedics’ motion to dismiss based on qualified immunity. The court relied
    on the first prong, finding the amended complaint failed to state a plausible
    deliberate-indifference claim against the Paramedics. Specifically, the court
    found insufficient the allegations that, because the Paramedics observed
    Graham’s “serious head injury” and “LSD-induced behavior,” they should have
    provided additional care.
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    The Fourteenth Amendment guarantees pretrial detainees a right “not
    to have their serious medical needs met with deliberate indifference on the
    part of the confining officials.” Thompson v. Upshur Cty., Tex., 
    245 F.3d 447
    ,
    457 (5th Cir. 2001) (citing, inter alia, Estelle v. Gamble, 
    429 U.S. 97
    , 103
    (1976)). To succeed on a deliberate-indifference claim, plaintiffs must show
    that (1) the official was “aware of facts from which the inference could be drawn
    that a substantial risk of serious harm exists,” and (2) the official actually drew
    that inference. Domino v. Tex. Dep’t of Criminal Justice, 
    239 F.3d 752
    , 755 (5th
    Cir. 2001) (quoting Farmer v. Brennan, 
    511 U.S. 825
    , 837 (1994)). “Deliberate
    indifference is an extremely high standard to meet.” Id. at 756.
    We note that some of our cases have posited a third element—that the
    official “subjectively intended that harm occur.” See Garza v. City of Donna,
    
    922 F.3d 626
    , 635 & n.5 (5th Cir. 2019) (citing, inter alia, Tamez v. Manthey,
    
    589 F.3d 764
    , 770 (5th Cir. 2009)). A panel of our court, however, recently wrote
    that it “cannot endorse [this] analysis” because it “depart[s] from controlling
    Supreme Court and Fifth Circuit law.” Garza, 922 F.3d at 636 (collecting
    decisions). In this case, the district court invoked this additional “subjective
    intent” element, but that does not affect our disposition of the motion to
    dismiss. As we explain, the allegations against the Paramedics would fail
    under the established two-part standard. See id. at 635 (two-part test more
    consonant with “the weight of our case law and . . . the Supreme Court
    precedent from which our cases flow”); id. at 636 & n.6 (collecting decisions).
    The district court’s invocation of the subjective intent element, however, does
    affect our disposition of the summary judgment for the Officers. See infra IV.B.
    We agree with the district court that the Dyers’ complaint fails to allege
    facts that plausibly show the Paramedics’ deliberate indifference. The thrust
    of the complaint is that, after examining Graham and observing his head
    injury and drug-induced behavior, the Paramedics should have provided
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    additional care—such as sending Graham to the hospital, accompanying him
    to jail, providing “further assessment or monitoring,” or sedating him. At most,
    these are allegations that the Paramedics acted with negligence in not taking
    further steps to treat Graham after examining him. Our cases have
    consistently recognized, however, that “deliberate indifference cannot be
    inferred merely from a negligent or even a grossly negligent response to a
    substantial risk of serious harm.” Thompson, 
    245 F.3d at
    458–59 (citing Hare,
    
    74 F.3d at 645
    ); see also, e.g., Delaughter v. Woodall, 
    909 F.3d 130
    , 136 (5th
    Cir. 2018) (clarifying that “mere disagreement with one’s medical treatment is
    insufficient to show deliberate indifference”); Gobert v. Caldwell, 
    463 F.3d 339
    ,
    346 (5th Cir. 2006) (explaining that “[u]nsuccessful medical treatment, acts of
    negligence, or medical malpractice do not constitute deliberate indifference”)
    (citations omitted). For instance, in Stewart v. Murphy, 
    174 F.3d 530
    , 533–534
    (5th Cir. 1999), we held that a prison physician’s failure, among other things,
    to discover earlier the ulcers that led to a prisoner’s death “might constitute
    negligence, [but] not the requisite deliberate indifference.” Finally, with
    particular salience here, we have long held that “the decision whether to
    provide additional treatment ‘is a classic example of a matter for medical
    judgment,’” which fails to give rise to a deliberate-indifference claim. Gobert,
    
    463 F.3d at 346
     (quoting Domino, 
    239 F.3d at 756
    ).
    Measured against these standards, we cannot say the complaint
    plausibly states a deliberate-indifference claim against the Paramedics. We
    therefore affirm the district court’s dismissal of those claims.
    IV.
    We next address the district court’s grant of summary judgment to the
    Officers based on qualified immunity. On prong one of the qualified immunity
    standard, the district court found genuine disputes of material fact as to
    whether Officers Heidelburg and Gafford acted with deliberate indifference to
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    Graham’s serious medical needs. But, as to Officer Scott, the district court
    found the Dyers “failed to present evidence that [he was] aware of facts
    indicating a risk of injury and inferred a risk of injury to Graham.” On prong
    two, however, the district court concluded all three Officers were entitled to
    qualified immunity. Pointing to inconsistency in our court’s deliberate-
    indifference standards, the district court reasoned that “there is no clearly
    established right in the Fifth Circuit to be free from medical inattention by
    officers who do not actually intend to cause harm.” The court therefore granted
    summary judgment dismissing the Dyers’ deliberate-indifference claims
    against all three Officers.
    A.
    Turning first to the district court’s prong one ruling, we agree that the
    record discloses genuine disputes of material fact regarding whether Officers
    Heidelburg and Gafford acted with deliberate indifference. But we disagree as
    to Officer Scott, finding similar fact disputes as to him.
    The district court correctly found a genuine dispute concerning whether
    Gafford and Heidelburg were deliberately indifferent to the serious medical
    needs of a detainee in their custody. A reasonable trier of fact could find that
    those Officers were aware that Graham, in the grip of a drug-induced
    psychosis, struck his head violently against the interior of Heidelburg’s patrol
    car over 40 times en route to jail and thereby sustained severe head trauma.
    Both Officers told Graham to stop hitting his head and Heidelburg even pulled
    his patrol car over in an effort to stop him. Gafford acknowledged that, during
    his encounter with Graham, he knew “[t]here could be some inherent dangers”
    associated with head trauma; Heidelburg testified that what Graham was
    doing “certainly could” cause a head injury. Yet the Officers sought no medical
    care for Graham when they arrived at the jail. Nor did they alert jail officers
    (who had no way of knowing what had happened en route to the jail) of the
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    possibility that Graham had seriously injured himself. The record instead
    reflects that the jail sergeant was “[i]nformed by [the] transport officers [that]
    Dyer had been medically cleared at the scene.”
    A reasonable jury could find that Graham’s injuries—from which
    Graham would die within roughly 24 hours—were so severe, and their cause
    so plainly evident to the Officers, that the Officers acted with deliberate
    indifference by failing to seek medical attention, by failing to inform jail
    personnel about Graham’s injuries, and by informing jail personnel only that
    Graham had been “medically cleared” before arriving at the jail. 3 A reasonable
    jury could find otherwise, of course, but the district court correctly concluded
    that the Dyers presented enough evidence that the Officers “were aware of a
    risk of injury to Graham that they did nothing to alleviate,” allowing the Dyers
    to survive summary judgment on prong one. 4
    We disagree, however, with the ruling as to Officer Scott. The district
    court found the Dyers “failed to present evidence that [Scott was] aware of facts
    indicating a risk of injury and inferred a risk of injury to Graham.” True, Scott’s
    affidavit stated he “never observed anything or any action by anyone which
    might cause a head injury on the part of [Graham],” nor did he “observe[]
    anything to indicate [Graham] might have any serious injury.” But his
    3 See, e.g., Gobert, 
    463 F.3d at 346
     (deliberate indifference shown through evidence
    that officials “refused to treat [prisoner], ignored his complaints, intentionally treated him
    incorrectly, or engaged in any similar conduct that would clearly evince a wanton disregard
    for any serious medical needs”) (quoting Domino, 
    239 F.3d at 756
    ); Nerren v. Livingston Police
    Dept., 
    86 F.3d 469
    , 473 (5th Cir. 1996) (deliberate indifference shown when detainee’s “face
    and chest were marred with abrasions, he was in pain, and he informed the Arresting Officers
    that he needed medical attention,” especially because “police had subjective knowledge that
    [detainee] had recently been involved in a multiple vehicle injury accident”).
    4 The district court based its prong one analysis on our precedent’s more common
    deliberate-indifference test that does not require subjective intent to cause harm. See, e.g.,
    Olabisiomotosho v. City of Hous., 
    185 F.3d 521
    , 526 (5th Cir. 1999); see also Garza, 
    922 F.3d 626
    , 635–36 & nn.5–6 (discussing differing strands of our precedent).
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    deposition testimony was quite different. Scott testified he assumed
    Heidelburg pulled the patrol car over because Graham “was banging his head.”
    Scott also testified he tried “to prevent [Graham] from banging his head on the
    back of the car.” Lastly, Scott stated he did not tell the jail sergeant about
    Graham slamming his head, nor did he recall hearing anyone else report it.
    In sum, viewing the evidence in the light most favorable to the Dyers, we
    conclude there are genuine disputes of material fact as to whether Officer
    Scott, like Gafford and Heidelburg, acted with deliberate indifference to
    Graham’s serious medical needs. The district court therefore erroneously
    granted Scott summary judgment on prong one.
    B.
    Turning to prong two of the qualified immunity standard, we ask
    whether there are genuine disputes of material fact as to whether “the
    unlawfulness of the [Officers’] conduct was ‘clearly established at the time.’”
    Rich v. Palko, 
    920 F.3d 288
    , 294 (5th Cir.), cert. denied, __ U.S. __, 
    140 S. Ct. 388
     (2019) (quoting District of Columbia v. Wesby, __ U.S. __, 
    138 S. Ct. 577
    ,
    589 (2018)). “To be clearly established, a right must be sufficiently clear that
    every reasonable official would have understood that what he is doing violates
    that right.” Reichle v. Howards, 
    566 U.S. 658
    , 664 (2012) (cleaned up). While
    the Dyers need not identify a case “directly on point,” “existing precedent” must
    “place[ ] the statutory or constitutional question beyond debate.” Morgan, 659
    F.3d at 372 (quoting Ashcroft v. al-Kidd, 
    563 U.S. 731
    , 741 (2011)). That
    precedent, moreover, must “define[ ] the contours of the right in question with
    a high degree of particularity.” 
    Id.
     at 371–72. In sum, “the salient question” we
    ask at prong two is whether the state of the law at the time of the incident
    “gave [the Officers] fair warning that their alleged treatment of [Graham] was
    unconstitutional.” Hope v. Pelzer, 
    536 U.S. 730
    , 741 (2002); accord Morgan, 659
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    F.3d at 372 (“The sine qua non of the clearly-established inquiry is ‘fair
    warning.’”) (citing Hope, 
    536 U.S. at 741
    ).
    The district court’s prong two analysis was legally erroneous. Instead of
    asking whether controlling authority placed the unconstitutionality of the
    Officers’ alleged conduct “beyond debate,” Morgan, 659 F.3d at 372, the court
    instead found that our deliberate-indifference case law was too muddled even
    to attempt the inquiry. Specifically, the district court pointed to “confusion” in
    our cases over whether deliberate indifference requires proof of an officer’s
    “actual intent to cause harm in medical-inattention claims.” The court
    therefore concluded that “there is no clearly established right in the Fifth
    Circuit to be free from medical inattention by officers who do not actually
    intend to cause harm.”
    We disagree with the district court’s prong two analysis. Admittedly, the
    district court was correct that our deliberate-indifference cases are not a
    paradigm of consistency. As discussed supra, a panel of our court recently
    observed that, whereas many of our decisions hew to the traditional deliberate-
    indifference standard from Farmer v. Brennan, 
    511 U.S. 825
     (1994), others
    appear to add the element that the officer “subjectively intended that harm
    occur.” See generally Garza, 922 F.3d at 626, 634–36 & nn. 5–6; compare
    Delaughter, 909 F.3d at 136 (deliberate indifference present “only if [official]
    knows that inmates face a substantial risk of serious harm and disregards that
    risk by failing to take reasonable measures to abate it”) (citing Farmer, 
    511 U.S. at 847
    ), with Tamez, 
    589 F.3d at 764, 770
     (deliberate indifference also
    requires showing official “subjectively intended that harm occur”) (citing
    Thompson, 
    245 F.3d at
    458–59). Contrary to the district court’s reasoning,
    however, this apparent tension in our cases does not ipso facto “doom[ ]” the
    Dyers’ deliberate-indifference claim. To the contrary, the district court was still
    required to analyze whether the Officers’ alleged conduct contravened clearly
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    established law as set by the controlling precedents of this court and the
    Supreme Court.
    Reviewing the record de novo, we conclude a reasonable jury could find
    the Officers’ conduct contravened clearly established law. In Thompson v.
    Upshur County, Texas, our court confronted a deliberate-indifference claim
    after a detainee, Thompson, died in jail from a seizure brought on by delirium
    tremens (“DTs”). 
    245 F.3d at
    452–54. We found genuine disputes of material
    fact as to the jail sergeant, Whorton, who was aware that Thompson had
    elevated blood-alcohol content, was “hallucinating,” and “was injuring himself
    in his cell.” 
    Id. at 452, 463
    . In particular, Whorton knew Thompson had
    “beg[u]n to collide with objects in his cell, sometimes falling and striking his
    head against the window, floor or concrete bench.” 
    Id. at 454
    . Whorton provided
    some care to Thompson—she placed him in a straitjacket (but not an available
    helmet), had extra mattresses placed in his cell, dressed his head wound, and
    even claimed to seek advice from a hospital, 
    id.
     at 453–54, 463—but when
    Whorton’s shift ended, she instructed her colleagues not to summon medical
    help without contacting her and only if Thompson was “dying.” 
    Id. at 454
    .
    Seven hours later, Thompson died from a seizure brought on by DTs. 
    Id.
     We
    found a jury question as to whether Whorton’s behavior was objectively
    unreasonable, given “[c]learly established law forbids a significantly
    exacerbating delay or a denial of medical care to a detainee suffering from
    DTs.” 
    Id. at 463
    . Any reasonable jailer, we explained, “would have recognized
    the constitutional obligation to summon medical assistance well before
    Thompson died,” and also would not have instructed subordinates not to get
    help unless Thompson “was on the verge of death.” 
    Id. at 464
    .
    Thompson defines clearly established law in sufficient detail to have
    notified the Officers that their actions were unconstitutional. See, e.g., Morgan,
    659 F.3d at 372 (controlling precedent must define pertinent right “with a high
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    degree of particularity”). Similar to the jail sergeant in Thompson, here the
    Officers had custody of a delusional detainee who was severely harming
    himself, and yet—despite being aware of the detainee’s dire condition—they
    did nothing to secure medical help. Arguably, this situation presents a clearer
    case of deliberate indifference than Thompson. There, although providing
    Thompson some care, the jailer recklessly misjudged the severity of
    Thompson’s condition that led to the seizure that caused his death. 
    245 F.3d at
    453–54, 463–64. Here, the Officers actually witnessed Graham violently
    slamming his head against the patrol car over and over again, inflicting the
    cerebral trauma that would kill him within about a day’s time. 5 And yet,
    instead of seeking medical assistance, the Officers deposited Graham at the
    jail, told jailers nothing about what Graham had done to himself en route, and
    informed the jail sergeant only that Graham “had been medically cleared at
    the scene.” In sum, Thompson gave officers “fair warning,” Morgan, 659 F.3d
    at 372, that their behavior was deliberately indifferent to Graham’s serious
    medical needs. 6
    Compare this case with our decision in Wagner v. Bay City, Texas, 
    227 F.3d 316
     (5th Cir. 2000). There, officers pepper sprayed the plaintiff, cuffed
    5 This case is thus quite different from cases where officers had no reason to suspect
    a detainee’s underlying medical condition. See, e.g., Tamez, 
    589 F.3d at
    770–71 (no evidence
    of deliberate indifference where pupil dilation could “mean a lot of things” and therefore did
    not alert officers that detainee had ingested an open cocaine baggy); Simmons v. City of
    Columbus, 425 F. App’x 282, 283–84 (5th Cir. 2011) (unpublished) (officers entitled to
    qualified immunity because they were unaware the detainee was suffering from subdural
    hematoma, or “invisible brain bleed”); Arshad ex rel. Arshad v. Congemi, 
    2009 WL 585633
    ,
    at *7–*8 (5th Cir. 2009) (unpublished) (officers entitled to qualified immunity for failure to
    seek medical attention for heart condition unknown to them, especially because detainee was
    breathing, walking and talking in normal manner).
    6  It makes no difference that Thompson also found the sergeant acted unreasonably
    by telling subordinates to get help only if Thompson was “on the verge of death.” 
    245 F.3d at 464
    . Here, again, the Officers’ actions arguably manifested equal, if not greater, indifference.
    A reasonable jury could find the Officers misstated the severity of Graham’s condition by
    telling the sergeant only that Graham had been “medically cleared” at the scene.
    14
    Case: 19-10280     Document: 00515376992      Page: 15   Date Filed: 04/09/2020
    No. 19-10280
    him, and placed him on his chest in the back of the patrol car. Id. at 319.
    Instead of taking the plaintiff to the hospital to flush out the pepper spray, the
    officers drove him to jail. Id. There, they discovered the plaintiff had stopped
    breathing and attempted CPR; the plaintiff later died at the hospital. Id. at
    318–19. We concluded the officers were entitled to qualified immunity against
    a deliberate-indifference claim. Id. at 324–25. Among other reasons, we
    explained that the officers heard the plaintiff moaning during the trip to jail
    (indicating he was still breathing), and that, when the officers realized he had
    stopped breathing in jail, they “immediately began CPR.” Id. at 325. Further,
    the suggestion that the officers take the plaintiff to the hospital was “based
    solely on a need to decontaminate the effects of the pepper spray,” and there
    was no evidence “that the delay in the decontamination caused [the plaintiff]
    to stop breathing.” Id. Thus, we concluded there was no evidence that the
    officers “had knowledge that [the plaintiff] was in need of any other immediate
    medical attention.” Id.
    By contrast, in this case a reasonable jury could find that (1) Graham
    violently bashed his head against the interior of Officer Heidelburg’s patrol car
    over 40 times while en route to jail; (2) Officers Heidelburg, Gafford, and Scott
    were fully aware of Graham’s actions and of their serious danger; (3) the
    Officers sought no medical attention for Graham; and (4) upon arriving at jail,
    the Officers failed to inform jail officials what Graham had done to himself,
    telling them only that Graham had been “medically cleared” at the scene. From
    this evidence, a reasonable jury could conclude that the Officers “were either
    aware or should have been aware, because it was so obvious, of an unjustifiably
    high risk to [Graham’s] health,” did nothing to seek medical attention, and
    even misstated the severity of Graham’s condition to those who could have
    sought help. Tamez, 
    589 F.3d at 770
     (cleaned up) (discussing Thompson).
    V.
    15
    Case: 19-10280    Document: 00515376992    Page: 16   Date Filed: 04/09/2020
    No. 19-10280
    For the foregoing reasons, we AFFIRM the district court’s order
    dismissing the deliberate-indifference claims against the Paramedics. We
    REVERSE the summary judgment dismissing the deliberate-indifference
    claims against the Officers, and REMAND for further proceedings consistent
    with this opinion.
    AFFIRMED in part; REVERSED and REMANDED in part.
    16