Katie Kindl v. City of Berkley , 2015 FED App. 0192P ( 2015 )


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    Pursuant to Sixth Circuit I.O.P. 32.1(b)
    File Name: 15a0192p.06
    UNITED STATES COURT OF APPEALS
    FOR THE SIXTH CIRCUIT
    _________________
    KATIE KINDL,                                          ┐
    Plaintiff-Appellee,   │
    │
    │       No. 13-2234
    v.                                             │
    >
    │
    CITY OF BERKLEY, et al.                                 │
    Defendants, │
    │
    │
    KENT HERRIMAN; MICHAEL MOSCHELLI,                       │
    Defendants-Appellants. │
    ┘
    Appeal from the United States District Court
    for the Eastern District of Michigan at Detroit.
    No. 2:12-cv-13410—Bernard A. Friedman, District Judge.
    Argued: January 13, 2015
    Decided and Filed: August 18, 2015
    Before: SUHRHEINRICH, CLAY, and ROGERS, Circuit Judges.
    _________________
    COUNSEL
    ARGUED: Mary Massaron, PLUNKETT COONEY, Bloomfield Hills, Michigan, for
    Appellants. Donald M. Fulkerson, Westland, Michigan, for Appellee. ON BRIEF: Mary
    Massaron, PLUNKETT COONEY, Bloomfield Hills, Michigan, for Appellants. Donald M.
    Fulkerson, Westland, Michigan, for Appellee.
    CLAY, J., delivered the opinion of the court in which ROGER, J., joined, and
    SUHRHEINRICH, J., joined in the result.
    1
    No. 13-2234                          Kindl v. City of Berkley, et al.             Page 2
    _________________
    OPINION
    _________________
    CLAY, Circuit Judge.        Officer Kent Herriman and dispatcher Michael Moschelli
    (“Defendants,” collectively) appeal from the district court’s ruling denying their motions for
    qualified immunity, Michigan governmental immunity, and summary judgment in this suit
    arising from the death of Lisa Kindl (“Kindl”). Kindl died of delirium tremens, a severe form of
    alcohol withdrawal, within less than a day of being taken into custody—and after receiving no
    medical attention for her condition. For the reasons that follow, we DISMISS the appeal of the
    district court’s qualified immunity and summary judgment rulings for want of jurisdiction, and
    we AFFIRM the district court’s ruling denying Michigan governmental immunity.
    BACKGROUND
    Procedural History
    Following Lisa Kindl’s death, her daughter Katie Kindl (“Plaintiff”) filed the instant
    action in state court asserting constitutional violations under 42 U.S.C. § 1983 and gross
    negligence, the intentional infliction of emotional distress, and other claims under Michigan law.
    Defendants removed the case to federal court. Following discovery, the parties filed cross
    motions for summary judgment. As relevant to the present appeal, the district court ruled that
    Plaintiff’s individual claims of deliberate indifference and intentional infliction of emotional
    distress could proceed solely as to two officers, Herriman and Moschelli. The court dismissed
    the other claims and defendants from the case and denied Defendants’ claims to qualified
    immunity under § 1983 and governmental immunity under Michigan law. Upon Plaintiff’s
    motion for reconsideration, the district court reinstated her claim of gross negligence.
    Defendants timely noticed their interlocutory appeal. Plaintiff moved to dismiss the
    appeal, arguing that because the parties’ dispute about qualified immunity concerned factual
    issues rather than disputes about the clarity of existing law, we lacked subject matter jurisdiction
    to hear the appeal under Johnson v. Jones, 
    515 U.S. 304
    , 319-20 (1995). A motions panel denied
    the motion on the basis that “the factual-legal issue governing jurisdiction is a close call” in this
    No. 13-2234                          Kindl v. City of Berkley, et al.             Page 3
    case, judging it best to allow the merits panel to consider the jurisdictional issue with the benefit
    of the full briefing of the parties. (No. 13-2234, Order, at 2.) One of our colleagues dissented
    from the denial of the motion, arguing that Defendants have not presented a pure issue of law fit
    for interlocutory appellate review. The parties duly completed their briefing, and the appeal was
    presented to this panel for resolution.
    Factual Background
    Lisa Kindl reported to a probation appointment on the morning of July 12, 2010. She
    admitted to drinking vodka the evening before, and a breathalyzer test revealed a blood alcohol
    level of .053. She was arrested for violating a condition of her probation that she refrain from
    alcohol use, and she was placed in the custody of the Berkeley Department of Public Safety to
    await a court hearing the following day.
    The video recording of her booking shows Kindl telling an officer, who is identified by
    the parties as Officer Geary, that she was anxious and that she “might have a little alcohol
    withdrawal.” (R. 32-9 at 9:55 a.m.) After booking, Kindl was given a blanket and placed in cell
    one, which was subject to video monitoring and direct visual observation by the front desk.
    Officer Geary remained the officer on duty at the front desk until 7 p.m. He testified in his
    deposition that he informed the desk officer replacing him, Officer Herriman, of Kindl’s
    comment about suffering from alcohol withdrawal. Herriman, however, denied in his deposition
    that he had knowledge about Kindl’s risk of alcohol withdrawal at the beginning of his shift.
    The video footage of Kindl’s time in cell one constitutes a significant, though notably
    imperfect, source of evidence in this case. The video is black and white and has no sound.
    Additionally, based on what appears to be a motion-activated aspect of the recording technology,
    the image (together with the time-stamp) frequently freezes for seconds or even minutes at a time
    when Kindl is lying down.
    Kindl spent much of the morning and afternoon of July 12, 2010 lying on the cement
    bench in various positions, covered by the blanket she was given by jail staff, or intermittently
    standing by the door to the cell, looking out through the small window in the door. Her
    condition worsened in the evening. At 7:46 p.m., the video shows her entire body jerking
    No. 13-2234                          Kindl v. City of Berkley, et al.             Page 4
    dramatically in an apparent seizure lasting about thirty seconds. Shortly after 8 p.m., Kindl
    began trying to get the attention of the officers. From the video it is apparent that her shorts were
    wet—she appeared to have urinated on herself. The video shows Kindl knocking on the large
    monitoring window four different times, repeatedly calling out, and peering through both that
    window and the smaller window in the door to her cell.
    Kindl eventually succeeded in speaking with Herriman and Moschelli. Because the video
    lacks audio, the conversation is not recorded. In a statement signed the following day, Herriman
    reported that Kindl told them that she had urinated on herself “and that she was concerned she
    may go into DTs [i.e., delirium tremens] at some point.” (R. 29-8, Herriman Statement & Dep.,
    PageID 473.) According to both officers’ statements, Moschelli asked Kindl what she needed,
    and Kindl asked for them to keep an eye on her. Moschelli assured her that he would. The
    officers repeated this version of events in their deposition testimony. Moschelli testified that he
    asked Kindl during this conversation “if she was having any symptoms as we spoke” and that she
    replied no. (R. 29-7, Moschelli Dep., PageID 437.) Herriman testified that he frequently
    checked Kindl by means of the video monitor and the cell window throughout the rest of his
    shift, which lasted until 1:30 a.m. Moschelli testified that he left the intercom on for Kindl’s cell
    so that they would hear anything that occurred.
    Kindl lay back down on the cement bench following her conversation with Defendants.
    Throughout the rest of the evening, the video shows her intermittently experiencing convulsions
    and seizures and, on a number of occasions, calling out or speaking. At 8:34 p.m., as she was
    lying on the bench, the video shows her body convulsing for about fifteen seconds. At 8:56 p.m.,
    she got up and leaned her face to the monitoring window as if attempting to look through. She
    appeared to shout, and then quickly returned to lying on the cement bench. At 10:25 p.m., as
    Kindl was lying on her side, her body began to convulse and she fell backwards off the cement
    bench onto the floor. After the fall, she picked herself up and sat on the opposite bench for a
    while, then appeared to speak, looking repeatedly at the monitoring window. After using the
    toilet, she walked over to the monitoring window and again seemed to speak. She did not stay
    standing long, but wrapped the blanket around herself and sat again on the cement bench, then
    eventually lay down again.
    No. 13-2234                         Kindl v. City of Berkley, et al.           Page 5
    During the hour and a half that followed, Kindl was almost exclusively lying down.
    Although the video quality is too poor to be certain, some of her movements are consistent with
    shaking. At 11:52 p.m., the video shows Kindl lying on the cement bench with her head close to
    the monitoring window. At 11:53:45 p.m., she experienced a violent seizure that lasted for
    approximately forty seconds. When the seizure ended, Kindl was lying on her stomach with her
    arms above the blanket at odd angles. Although the precise time of her death has not been
    determined, she did not move again after that seizure ended.
    Six hours passed before Kindl’s body was discovered in that same position by Herriman
    and another officer. Forensic pathologist Werner Spitz, M.D testified that Kindl died of delirium
    tremens. According to the National Institutes of Health, delirium tremens is “a severe form of
    alcohol withdrawal that involves sudden and severe mental or nervous system changes.” (R. 28-
    2, NIH Article, PageID 217.) The condition is “serious and may be life threatening” if treatment
    is not provided. (Id. at 218-19.) Spitz reviewed the video and testified in his deposition that
    Kindl displayed “classical manifestations” of delirium tremens, including sweating, urinary
    incontinence, tremors, and seizures. (R. 33-4, Spitz Deposition, PageID 1316-20.) Spitz also
    noted the possibility that Kindl experienced auditory or visual hallucinations based on her
    confused behavior.
    The parties dispute the knowledge about alcohol withdrawal and delirium tremens that
    can be attributed to Herriman and Moschelli. Chief of Police Richard Eshman testified that he
    required his officers to be medical first responders, a level of training between first aid and an
    emergency medical technician. Under his orders, two officers were required to go to every
    ambulance run in the city in order to increase the officers’ exposure to trauma and medical
    response. Although the department did not provide specific training to its officers about alcohol
    withdrawal, Eshman testified that he believes “everybody knows alcohol withdrawal and
    subsequent D.T.s is a serious medical condition.” (R. 29-17, Eshman Dep., PageID 618) Both
    Herriman and Moschelli testified that they were aware that alcohol withdrawal could be a serious
    and even deadly condition, though Moschelli asserted he did not know in July 2010 that alcohol
    withdrawal could be fatal. Both Defendants testified that they never saw Kindl have a possible
    seizure and that she never showed any signs of physical distress.
    No. 13-2234                         Kindl v. City of Berkley, et al.            Page 6
    The record also contains deposition testimony by two other detainees confined in the
    Berkeley Department of Public Safety that night. Michael McClanahan, who was detained in
    cell two beginning around 7:30 p.m. that evening, testified to hearing Kindl calling out for help,
    trying to get the officers’ attention, and moaning as if unwell for an hour or two until she
    eventually quieted down. He also testified to seeing her with the blanket wrapped around her
    shoulders, and described her as visibly sick, in “shock” with a “clammy look” and “just no
    expression.” (R. 33-7, McClanahan Dep., PageID 1333-36.) A second detainee, Andre Henry,
    testified that as he was being booked into the jail that evening, he heard a woman calling for help
    with no response from the officers, who told him that “she was a bug,” i.e., crazy. (R. 33-8
    Henry Dep., PageID 1337-40.) The video establishes, however, that Henry did not arrive to the
    Berkley Department of Public Safety until approximately 3:30 a.m., hours after Kindl suffered
    her final seizure.
    DISCUSSION
    I.      Qualified Immunity
    Defendants moved for summary judgment on the basis that they were entitled to qualified
    immunity with regard to Plaintiff’s deliberate indifference claim. Qualified immunity protects
    government officials sued under § 1983 from damages liability “insofar as their conduct does not
    violate clearly established statutory or constitutional rights of which a reasonable person would
    have known.” Pearson v. Callahan, 
    555 U.S. 223
    , 231 (2009) (quotation marks omitted). To
    qualify as clearly established, “‘[t]he contours of the right must be sufficiently clear that a
    reasonable official would understand that what he is doing violates that right.’” Brown v. Lewis,
    
    779 F.3d 401
    , 412 (6th Cir. 2015) (quoting Saucier v. Katz, 
    533 U.S. 194
    , 202 (2001)) (editing in
    original).
    Plaintiff asserts that Defendants violated her mother’s right to adequate medical treatment
    under the Fourteenth Amendment. To succeed on her claim, she must show that Defendants
    “acted with deliberate indifference to [Kindl’s] serious medical needs.” Estate of Carter v. City
    of Detroit, 
    408 F.3d 305
    , 311 (6th Cir. 2005) (quotation marks omitted). This task entails an
    objective showing that Kindl had a “sufficiently serious medical need,” and a subjective showing
    that “the defendant possessed a sufficiently culpable state of mind in denying medical care.” 
    Id. No. 13-2234
                             Kindl v. City of Berkley, et al.              Page 7
    (citations and quotation marks omitted). The district court held that Plaintiff established a
    dispute of material fact as to both prongs of this inquiry and denied Defendants’ request for
    qualified immunity on that basis.
    The denial of qualified immunity in a § 1983 case is a final, immediately appealable
    decision under the collateral order doctrine only to the extent the appeal presents a “neat abstract
    issue[] of law.” Johnson v. Jones, 
    515 U.S. 304
    , 317 (1995) (quotation marks omitted); see also
    Moldowan v. City of Warren, 
    578 F.3d 351
    , 369 (6th Cir. 2009) (“In considering the denial of a
    defendant’s claim of qualified immunity, . . . our jurisdiction is limited to resolving pure
    questions of law.”).    Thus, an interlocutory appeal of the denial of qualified immunity at
    summary judgment may typically only test “‘the substance and clarity of pre-existing law.’”
    Martin v. City of Broadview Heights, 
    712 F.3d 951
    , 957 (6th Cir. 2013) (quoting Ortiz v. Jordan,
    
    562 U.S. 180
    , 190 (2011)). We lack jurisdiction to review a summary judgment ruling on
    qualified immunity “insofar as that order determines whether or not the pretrial record sets forth
    a ‘genuine’ issue of fact for trial.” Johnson, 515 U.S at 319-20; see also Plumhoff v. Rickard,
    
    134 S. Ct. 2012
    , 2019 (2014) (discussing Johnson’s holding that “an order denying summary
    judgment based on a determination of ‘evidence sufficiency’ does not present a legal question”
    appropriate for review under the collateral order doctrine).
    Defendants’ principal arguments regarding qualified immunity reduce merely to a factual
    contention that Plaintiff cannot prove that they should have known of, much less that they were
    in fact aware of, Kindl’s serious medical need. We lack jurisdiction to consider these arguments.
    
    Johnson, 515 U.S. at 319-20
    . Defendants also attempt rather incredibly to argue that Kindl did
    not have a serious medical need. This, too, is a factual dispute that does not qualify as a pure
    question of law sufficient to create appellate jurisdiction at this stage of the proceedings.
    A.      Defendants’ Knowledge of Kindl’s Serious Medical Need
    At bottom, Defendants contest the sufficiency of Plaintiff’s evidence to establish their
    knowledge of Kindl’s condition. For example, they argue that Kindl’s statement during her
    booking about experiencing alcohol withdrawal is insufficient to establish that the officers knew
    she was suffering from a serious medical condition, that she only once sought the officers’
    attention and then only requested they keep an eye on her, and that no evidence in the record
    No. 13-2234                          Kindl v. City of Berkley, et al.              Page 8
    supports a conclusion that Kindl suffered from delirium tremens. These are arguments merely of
    “‘evidence sufficiency, i.e., which facts a party may, or may not, be able to prove at trial,’” and
    are therefore beyond our jurisdiction on this appeal. 
    Plumhoff, 134 S. Ct. at 2019
    (quoting
    
    Johnson, 515 U.S. at 313
    ); see also 
    Ortiz, 562 U.S. at 190-91
    (holding that the defendants did
    not raise a purely legal issue where the pre-existing law regarding deliberate indifference in a
    failure to protect context was “not in controversy” and defendants’ arguments instead addressed
    factual questions concerning what the officers knew and what they could have done to protect
    the plaintiff).
    Defendants make a number of arguments in an attempt to circumvent the jurisdictional
    bar. First, Defendants invoke the Supreme Court’s decision in Scott v. Harris, 
    550 U.S. 372
    (2007) as authorizing review of the district court’s factual determinations in this case. Scott
    came before the Supreme Court on an interlocutory appeal from the district court’s denial of
    qualified immunity in a § 1983 excessive force case concerning police conduct in a high-speed
    car chase. 
    Id. at 375-76.
    Relying on a video of that chase from the dashboard of a police
    vehicle, the Supreme Court rejected the trial court’s finding of a genuine issue of material fact
    because in light of the video, the plaintiff’s version of the facts was “so utterly discredited by the
    record that no reasonable jury could have believed him.” 
    Id. at 380.
    The Court found that the
    video conclusively established the dispositive fact that the plaintiff’s reckless driving during the
    chase placed “officers and innocent bystanders alike at great risk of serious injury,” and that, as a
    matter of pure law in light of that incontestable fact, the defendant acted reasonably under the
    Fourth Amendment by ramming the plaintiff’s car. 
    Id. at 380,
    383-84.
    Although the opinion in Scott did not discuss the jurisdictional question, because it
    reversed the district court’s holding that there was a genuine dispute of material fact precluding
    qualified immunity at the summary judgment stage, we have recognized that it represents an
    exception to Johnson. Austin v. Redford Twp. Police Dep't, 
    690 F.3d 490
    , 493 (6th Cir. 2012);
    
    Moldowan, 578 F.3d at 370-71
    .         That exception is narrow:         only “where the trial court’s
    determination that a fact is subject to reasonable dispute is blatantly and demonstrably false”
    based on irrefutable evidence such as clear video footage, “a court of appeals may say so, even
    on interlocutory appeal.” 
    Moldowan, 578 F.3d at 370
    (quotation marks omitted); see also Romo
    No. 13-2234                          Kindl v. City of Berkley, et al.              Page 9
    v. Largen, 
    723 F.3d 670
    , 675 (6th Cir. 2013) (construing Scott as a limited exception only
    applicable where there are “blatantly contradicted facts”); 
    Austin, 690 F.3d at 493
    (quoting 
    Scott, 550 U.S. at 380-82
    ) (“Although we must view the facts as assumed by the district court, to the
    extent this version of events is ‘blatantly contradicted’ by videotape evidence, we must ‘view[ ]
    the facts in the light depicted by the videotape.’”).
    Defendants first argue that the video of Kindl’s time in cell one conclusively establishes
    that she did not act in a way that would have alerted the two officers to her need for medical
    treatment. We need not decide whether a video with such frequent lapses as the one in this case
    may even qualify as the sort of irrefutable evidence that would come within the Scott exception
    because, upon our review, even with its imperfections, the video reflects that Kindl sought the
    attention of the officers after experiencing a seizure, that she urinated on herself, that she fell off
    the bench, and that she experienced additional seizures before her death. Moreover, the video
    does not conclusively establish, as Defendants claim, that she never again sought help after the
    8 p.m. conversation—to the contrary, it shows her apparently calling out on at least one
    occasion, and at other points the video footage would be consistent with her speaking.
    Defendants also argue that the video contradicts the district court’s reliance on the
    testimony of the other detainees, McClanahan and Henry.                 The video does not blatantly
    contradict McClanahan’s testimony. Although McClanahan acknowledged that he was unable to
    see Kindl except from a particular position, he was able to describe seeing her stand with her
    arms wrapped around her middle, seeing her seek attention from the camera and the officers, and
    seeing her with the blanket around her shoulders—all descriptions that coincide with events
    recorded by the video. And his testimony that he heard her call out for help and moan in
    discomfort over a period of hours is not contradicted by the silent video. Defendants appear to
    be correct that Henry’s testimony is irreconcilable with objective video evidence that Kindl’s
    final movements occurred hours before his arrival at the jail. Yet the district court’s error as to
    Henry is insufficient to trigger appellate jurisdiction under Scott. In Scott, the video evidence
    placed a dispositive fact beyond any dispute, leaving the record without any “‘genuine issue of
    material fact,’” and therefore permitting resolution of the Fourth Amendment issue as a pure
    question of 
    law. 550 U.S. at 380
    (quoting Anderson v. Liberty Lobby, Inc., 
    477 U.S. 242
    , 247-48
    No. 13-2234                         Kindl v. City of Berkley, et al.           Page 10
    (1986) (emphasis added by Scott)). Here, even if Henry’s testimony were eliminated, genuine
    disputes of material facts would remain, based on the video evidence and the other testimony in
    the case, precluding appellate jurisdiction at this stage in the proceedings. See id.; see also
    
    Moldowan, 578 F.3d at 370-71
    .
    Next, citing the concurring opinion in Romo, Defendants urge this Court to relax the
    jurisdictional boundaries imposed by Johnson v. Jones and review the “inferences” to be drawn
    from the factual record. See 
    Romo, 723 F.3d at 679
    (Sutton, J. concurring) (arguing that
    inferences derived from factual details in the record “remain subject to interlocutory review”).
    This argument is contrary to both Sixth Circuit and Supreme Court precedent.               Factual
    “inferences” capable of being drawn from the evidence are still inherently factual determinations
    about what parties “may, or may not, be able to prove at trial.” 
    Johnson, 515 U.S. at 313
    .
    Embracing appellate jurisdiction over “inferences” offers no principled limit to appellate review
    of factual disputes relevant to qualified immunity because in many cases, including this one, the
    “inferences” at issue are nothing more than aggregate factual questions. We are in no better a
    position than the district court—or more to the point, a jury—to determine whether based on
    Kindl’s statements, convulsions, alleged moans, requests for attention, and appearance,
    Defendants subjectively understood the gravity of her situation.        The ultimate “inference”
    regarding Defendants’ knowledge depends on credibility determinations as well as the composite
    of evidence ultimately put before a jury. Permitting interlocutory appellate review under the
    guise of considering only “inferences” would thus erase the well-established boundaries
    protecting the function of the ultimate factfinder and deviate from binding precedent set out in
    Johnson and its progeny.
    The majority in Romo declined to join the concurrence in anticipating Johnson’s
    
    overruling. 723 F.3d at 675
    (majority opinion) (“[T]o accept the reading of Johnson advocated
    by the concurrence, we would have to read Scott to have foreshadowed the overruling of
    Johnson's explicit holding.” (footnote omitted)). Subsequent developments have validated their
    caution.   The Supreme Court has since reaffirmed Johnson’s holding that a trial court’s
    determination that there is a genuine dispute of fact—“i.e., which facts a party may, or may not,
    be able to prove at trial”—is not fit for interlocutory review under the collateral order doctrine.
    No. 13-2234                              Kindl v. City of Berkley, et al.                 Page 11
    
    Plumhoff, 134 S. Ct. at 2019
    (applying Johnson and reviewing only the “legal issues” regarding
    the reasonableness of the use of force in a high speed car chase).
    B.       The Seriousness of Kindl’s Medical Condition
    Incredibly, Defendants also argue that Kindl did not have a serious condition entitling her
    to medical treatment—despite the undisputed evidence that her condition entailed incontinence
    and multiple seizures, and that it ultimately resulted in her death. This argument is without
    merit. A medical condition is sufficiently serious to confer constitutional protections where
    delay in treatment may cause “a serious medical injury.” See Blackmore v. Kalamazoo Cnty.,
    
    390 F.3d 890
    , 898 (6th Cir. 2004).1 This poses a question of fact capable of resolution by
    competent evidence, including, of course, evidence that the detainee died as a result of the
    medical condition. See 
    id. Thus, even
    if Defendants could credibly point to evidence that
    Kindl’s condition was not serious, such a fact-based question is beyond the scope of our
    jurisdiction under Johnson. 
    See 515 U.S. at 317
    .
    Defendants attempt to circumvent both the facts and the jurisdictional limitations of this
    Court by selective citation to cases which they argue suggest that alcohol withdrawal is not a
    serious medical condition for which a detainee has a right to be treated. There is no merit to their
    arguments.
    In a case not cited by Defendants, this Court unequivocally recognized—prior to Kindl’s
    detention—that “delirium tremens . . . is a life-threatening condition caused by acute alcohol
    withdrawal.”      Smith v. Cnty. of Lenawee, 
    600 F.3d 686
    , 688 (6th Cir. 2010) (“County of
    Lenawee”); see also Spears v. Ruth, 
    589 F.3d 249
    , 254 (6th Cir. 2009) (“[W]e have found that a
    detainee lying face down, unresponsive and exhibiting symptoms of delirium tremens showed
    medical need sufficient for lay people to recognize he needed medical attention.”) (citing Bertl v.
    City of Westland, No. 07-2547, 
    2009 WL 247907
    , at *5 (6th Cir. Feb. 2, 2009)). The substance
    1
    A medical need may also qualify as objectively serious “if it is ‘one that has been diagnosed by a
    physician as mandating treatment or one that is so obvious that even a lay person would easily recognize the
    necessity for a doctor’s attention.’” 
    Blackmore, 390 F.3d at 897
    (quoting Gaudreault v. Municipality of Salem,
    
    923 F.2d 203
    , 208 (1st Cir. 1990)) (emphasis added by Blackmore). For all the reasons discussed above with regard
    to Defendants’ knowledge, material disputes of fact about the obviousness of Kindl’s distress would preclude our
    jurisdiction over the application of this test, as well.
    No. 13-2234                          Kindl v. City of Berkley, et al.            Page 12
    and clarity of existing law in this context is thus not reasonably in dispute. See 
    Ortiz, 562 U.S. at 190-91
    .
    The cases cited by Defendants do not suggest that there is any genuine question of law
    related to a detainee’s right to receive medical treatment for acute alcohol withdrawal or delirium
    tremens. They principally rely on Speers v. County of Berrien, 196 F. App’x 390 (6th Cir. 2006)
    (per curiam), yet in that case we explicitly recognized that delirium tremens is a severe form of
    alcohol withdrawal and is unquestionably a serious medical condition within the meaning of the
    Fourteenth Amendment:
    With regard to the objective inquiry—was the threat sufficiently serious?—the
    district court correctly held that a material fact dispute exists. The cause of Speers'
    death, to be sure, is disputed. But taking the facts in the light most favorable to the
    plaintiffs, we must assume as their experts attest that Speers was suffering from a
    serious condition—“delirium tremens . . . a well recognized manifestation of
    alcohol withdrawal.” Expert testimony showed that delirium tremens, if untreated,
    is often fatal—which assuredly makes it a “serious” medical condition.
    196 F. App’x at 394 (citations omitted). Defendants emphasize a passage in Speers in which we
    acknowledged that the terms “alcohol withdrawal” and the “D.T.s” are often used
    interchangeably—for this reason, we explained, an official’s use of the term “D.T.s” did not
    indicate, without more, that the official was aware that the patient’s condition was acute. See 
    id. at 395.
    Thus, the distinction was relevant only to evidence of the official’s knowledge—not to
    the objective seriousness of the medical need. See 
    id. Defendants also
    misleadingly cite our
    statement in Speers that “general alcohol withdrawal [] typically may be managed in a prison
    setting” to suggest that they were not under a duty to provide Kindl with medical attention. 
    Id. The quotation
    must be placed in context: Speers received medical treatment at the prison. He
    was placed on sick call, examined by a doctor, given medication, and placed in the medical
    observation cell. 
    Id. at 392.
    Moreover, in Speers, we affirmed the denial of qualified immunity
    to two officers who were responsible for monitoring the inmate in the hours before his death
    during a period when another prisoner testified he was exhibiting serious symptoms, including
    collapsing, a seizure, “having a strange look,” and foaming at the mouth. 
    Id. at 398.
    We
    explained that based on these symptoms, a jury could “fairly infer . . . that Speers faced a
    substantial risk of serious harm.” 
    Id. The guards’
    knowledge about alcohol withdrawal as a
    No. 13-2234                        Kindl v. City of Berkley, et al.           Page 13
    condition was not dispositive: “With or without alcohol withdrawal, with or without training,
    the symptoms that Warner reported establish a triable issue of fact about whether the guards
    should have contacted medical personnel in response to this problem or at least should have tried
    to engage Speers verbally or entered his cell.” 
    Id. at 398
    (emphasis added). Thus, nothing in
    Speers suggests that there exists a “neat abstract issue[] of law” about the objective seriousness
    of alcohol withdrawal as a medical condition. 
    Johnson, 515 U.S. at 317
    .
    Defendants’ citation to Meier v. County of Presque Isle, 376 F. App’x 524 (6th Cir. 2010)
    and Smith v. Pike County, Kentucky, 
    338 F. App'x 481
    (6th Cir. 2009) (per curiam) (“Pike
    County”) is similarly unavailing. In Meier, we affirmed summary judgment awarded to the
    defendants on a deliberate indifference claim arising from Meier’s falling into a coma as a result
    of alcohol withdrawal. 376 F. App’x at 531. In that case, where Meier was arrested with a BAC
    level of .31 but “cooperated, communicated effectively, and walked unassisted,” we held that the
    plaintiff had not established evidence that the arresting officer had knowledge of the seriousness
    of the detainee’s medical condition. 
    Id. at 529-30.
    Thus, Meier turned on the sufficiency of the
    evidence with regard to the officer’s knowledge—a factual issue that was properly before us on
    review of a final judgment. The case in no way suggests any legal basis for questioning the
    seriousness of the detainee’s medical need. See 
    id. Pike County,
    too, affirmed the award of
    summary judgment to the defendants where “[t]he evidence [did] not establish that [the] jail
    officials were aware that Roberts had a sufficiently serious medical need or that they acted in
    conscious disregard by refusing medical care.” 338 F. App’x at 482.
    In sum, Defendants fail to identify any pure question of law that might entitle them to
    qualified immunity on the objective element of the deliberate indifference claim. The cases they
    cite in aid of their appeal do not cast into doubt the seriousness of alcohol withdrawal as a
    medical condition, much less overcome the existence of evidence supporting the district court’s
    conclusion that Plaintiff met her summary judgment burden in establishing that Kindl had a
    serious medical need. Instead, each case cited by Defendants discusses whether the particular
    evidence in the record was sufficient to show that the defendants “appreciated” the detainee’s
    medical needs. See, e.g., Meier, 376 F. App’x at 529. Defendants’ arguments in reliance on
    these cases, at bottom, repackage their factual dispute with regard to the subjective prong of
    No. 13-2234                          Kindl v. City of Berkley, et al.            Page 14
    Plaintiff’s deliberate indifference claim.     Because Defendants are simply making another
    “impermissible argument[] regarding disputes of facts,” Estate of 
    Carter, 408 F.3d at 310
    , we do
    not have jurisdiction over their appeal of the district court’s denial of qualified immunity.
    II.    Michigan Governmental Immunity
    In addition to the federal Fourteenth Amendment claim, Plaintiff has also asserted two
    claims under Michigan law: gross negligence and intentional infliction of emotional distress.
    The district court held that both claims survived summary judgment, and that Defendants were
    not entitled to Michigan governmental immunity on either claim. Under Sixth Circuit precedent,
    a district court’s ruling denying Michigan governmental immunity under Michigan Compiled
    Laws § 691.1407 is a “final order” that may be immediately appealed under 28 U.S.C. § 1291.
    County of 
    Lenawee, 600 F.3d at 689-90
    . We review the denial of governmental immunity at the
    summary judgment stage de novo, drawing all inferences in favor of the non-moving party.
    Younes v. Pellerito, 
    739 F.3d 885
    , 890 (6th Cir. 2014). “[W]here a plaintiff has made a
    sufficient showing to create a genuine issue of fact,” summary judgment on the basis of
    governmental immunity is precluded. 
    Id. (quotation marks
    omitted).
    Michigan law on governmental immunity for public officials contains different tests for
    negligence claims and intentional torts. Mich. Comp. Laws § 691.1407(2) & (3); see also Odom
    v. Wayne Cnty., 
    760 N.W.2d 217
    (Mich. 2008) (discussing both tests in depth). The standard
    applicable to negligence claims is spelled out at § 691.1407(2) and includes the following three
    requirements:
    (a) The officer, employee, member, or volunteer is acting or reasonably believes
    he or she is acting within the scope of his or her authority.
    (b) The governmental agency is engaged in the exercise or discharge of a
    governmental function.
    (c) The officer’s, employee’s, member’s, or volunteer’s conduct does not amount
    to gross negligence that is the proximate cause of the injury or damage.
    § 691.1407(2) (emphasis added). For purposes of the immunity statute, gross negligence occurs
    when a defendant’s conduct is “so reckless as to demonstrate a substantial lack of concern for
    whether an injury results.” § 691.1407(8)(a). Where material disputes of fact exist as to whether
    the conduct was grossly negligent, award of governmental immunity at summary judgment is
    No. 13-2234                            Kindl v. City of Berkley, et al.        Page 15
    improper. Oliver v. Smith, 
    810 N.W.2d 57
    , 62 (Mich. Ct. App. 2010). A jury could find that
    Defendants displayed “a substantial lack of concern for whether an injury results” when they
    failed to seek or provide any medical assistance for Kindl despite having been alerted to her
    condition (both by Kindl and, allegedly, by Officer Geary) and despite her visible symptoms
    including multiple seizures, urinary incontinence, and falling off the bench. Additionally, a jury
    could credit McClanahan’s testimony that Kindl was calling for help, and they could interpret the
    video evidence as corroborating his testimony. These permissible factual findings would support
    a conclusion that Defendants failed to adequately monitor Kindl’s condition, or that they were
    aware of her condition but chose not to act, or even that they ignored her direct requests for help
    knowing that she was suffering from alcohol withdrawal—all of which could constitute gross
    negligence within the meaning of §§ 691.1407(2)(c) and (8)(a).            Moreover, Defendants’
    contention that their failure to provide needed and potentially life-saving treatment to a detainee
    within their custody was not “the” proximate cause of Kindl’s death is entirely without merit.
    Dominguez v. Corr. Med. Servs., 
    555 F.3d 543
    , 552-53 (6th Cir. 2009). Defendants were under a
    duty to provide Kindl with needed medical care, and Plaintiff has proffered evidence that their
    failure to do so resulted in Kindl’s death. Governmental immunity on this count was properly
    denied.
    Defendants’ claim of governmental immunity with regard to Plaintiff’s claim of
    intentional infliction of emotional distress is governed by the common law. § 641.1407(3);
    
    Odom, 760 N.W.2d at 223
    . Under Odom, an official is entitled to governmental immunity for an
    intentional tort if he establishes the following:
    (a) The acts were undertaken during the course of employment and the employee
    was acting, or reasonably believed that he was acting, within the scope of his
    authority,
    (b) the acts were undertaken in good faith, or were not undertaken with malice,
    and
    (c) the acts were discretionary, as opposed to 
    ministerial. 760 N.W.2d at 228
    . The district court held that if the jury found that Defendants “ignored
    [Kindl’s] pleas for help under the circumstances as described by inmates McClanahan and
    Henry, then the jury could also find that these defendants did not act in good faith (and are
    No. 13-2234                           Kindl v. City of Berkley, et al.         Page 16
    therefore not entitled to immunity).” (R. 41 at 1761.) As discussed earlier, the jury could not
    credit Henry’s testimony because it is contradicted by objective video evidence. However, the
    jury could still credit McClanahan’s testimony to reach the same determination. Governmental
    immunity was properly denied on this claim as well. We do not address the substantive elements
    of the claim for intentional infliction of mental distress.
    III.   Pendent Jurisdiction
    Defendants ask us to exercise pendent jurisdiction to review the district court’s denial of
    summary judgment on Plaintiff’s claims. Because the denial of a motion for summary judgment
    is not an appealable order, we may exercise pendent jurisdiction to review the ruling on collateral
    review of an immunity ruling only where the appealable and non-appealable issues are
    “inextricably intertwined,” meaning that “the appealable issue at hand cannot be resolved
    without addressing the nonappealable collateral issue.” Chambers v. Ohio Dep’t of Human
    Servs., 
    145 F.3d 793
    , 797 (6th Cir. 1998); see also Law v. Nat’l Collegiate Athletic Ass’n, 
    134 F.3d 1025
    , 1028 (10th Cir. 1998) (“[A] pendent appellate claim can be regarded as inextricably
    intertwined with a properly reviewable claim on collateral appeal only if the pendent claim is
    coterminous with, or subsumed in, the claim before the court on interlocutory appeal—that is,
    when the appellate resolution of the collateral appeal necessarily resolves the pendent claim as
    well.” (citation and quotation marks omitted)). If this standard is met, we may exercise pendent
    jurisdiction as a discretionary matter. 
    Id. Plaintiff’s deliberate
    indifference claim is not inextricably intertwined with Defendant’s
    claim of Michigan governmental immunity on the tort claims—the only issue over which we
    have freestanding jurisdiction in this appeal—because the two are governed by distinct standards
    and different bodies of law. Compare Estate of 
    Carter, 408 F.3d at 311
    with Mich. Comp. Laws
    §§ 691.1407(2) & (3); see also Reilly v. Vadlamudi, 
    680 F.3d 617
    , 627 (6th Cir. 2012)
    (distinguishing between deliberate indifference under the federal constitution and gross
    negligence under Michigan law). We need not decide whether the substantive state law claims
    are inextricably intertwined with the Michigan governmental immunity analysis because we
    would decline in any event to exercise our discretion to review the district court’s summary
    judgment ruling on those claims. See 
    Chambers, 145 F.3d at 797
    .
    No. 13-2234                      Kindl v. City of Berkley, et al.       Page 17
    CONCLUSION
    For the foregoing reasons, we DISMISS the appeal of the district court’s qualified
    immunity and summary judgment rulings for want of jurisdiction, and we AFFIRM the district
    court’s ruling denying Michigan governmental immunity.