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Stojcevski v. County of Macomb

United States District Court, E.D. Michigan, Southern Division

September 30, 2019

DAFINKA STOJCEVSKI, as Persona Representative of the Estate of DAVID STOJCEVSKI, Plaintiff,



         On June 11, 2014, David Stojcevski (“David”) began serving a thirty-day sentence in the Macomb County Jail, which turned out to be a life sentence when he died sixteen days later from acute withdrawal from chronic benzodiazepine, methadone, and opiate medications. Claiming that Defendants' deliberate indifference to David's serious medical needs caused his death, the personal representative of David's estate (“Plaintiff”) filed this action under 42 U.S.C. § 1983[1] against two groups of defendants. The Court will refer to these two groups as the “Macomb County Defendants” and the “Correct Care Solutions Defendants” (hereafter “CCS Defendants”). The Macomb County Defendants currently remaining in this action are: County of Macomb; Macomb County Sheriff Anthony M. Wickersham (“Sheriff Wickersham”); Macomb County Jail Administrator Michelle M. Sanborn (“Administrator Sanborn”); and Macomb County Corrections Deputies Walter Oxley, Paul Harrison, John Talos, Morgan Cooney, Brian Pingilley, Brian Avery, Steven Vaneenoo, Mitchell Blount, Keith Ray, David White, and Larry (James) Helhowski.[2] The remaining CCS Defendants are: Correct Care Solutions, LLC (“CCS”); CCS Acting Director of Nursing Monica Cueny; CCS Medical Director Lawrence Sherman; CCS nurses Tiffany DeLuca, Mical Bey-Shelley, Vicky Bertram, Heather Erhlich, Sarah Breen, Thressa Williams, Linda Parton, and Amber Barber; CCS Health Services Administrator David Arft; CCS Mental Health Director Natalie Pacitto; and CCS Mental Health Professional Chantalle Brock.

         The matter is presently before the Court on dispositive motions filed by: (1) Sheriff Wickersham (“Wickersham MSJ”) (ECF No. 142); (2) Macomb County, Administrator Sanborn, and Sheriff Wickersham in their official capacities (“Macomb Cty. Official Capacity MSJ”) (ECF No. 143); (3) the corrections deputy defendants (“Deputies' MSJ”) (ECF No. 146); and (4) the CCS Defendants (“CCS Defs.' MSJ”) (ECF No. 148). The motions have been fully briefed. Finding the facts and legal arguments fully developed in the parties' briefs, the Court is dispensing with oral argument with respect to Defendants' motions pursuant to Eastern District of Michigan Local Rule 7.1(f).

         I. Summary Judgment Standard[3]

         Summary judgment pursuant to Federal Rule of Civil Procedure 56 is appropriate “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). The central inquiry is “whether the evidence presents a sufficient disagreement to require submission to a jury or whether it is so one-sided that one party must prevail as a matter of law.” Anderson v. Liberty Lobby, Inc., 477 U.S. 242, 251-52 (1986). After adequate time for discovery and upon motion, Rule 56 mandates summary judgment against a party who fails to establish the existence of an element essential to that party's case and on which that party bears the burden of proof at trial. Celotex Corp. v. Catrett, 477 U.S. 317, 322 (1986).

         The movant has the initial burden of showing “the absence of a genuine issue of material fact.” Id. at 323. Once the movant meets this burden, the “nonmoving party must come forward with specific facts showing that there is a genuine issue for trial.” Matsushita Electric Indus. Co. v. Zenith Radio Corp., 475 U.S. 574, 587 (1986) (internal quotation marks and citation omitted). To demonstrate a genuine issue, the nonmoving party must present sufficient evidence upon which a jury could reasonably find for that party; a “scintilla of evidence” is insufficient. See Liberty Lobby, 477 U.S. at 252. The court must accept as true the non-movant's evidence and draw “all justifiable inferences” in the non-movant's favor. See Liberty Lobby, 477 U.S. at 255.

         II. Factual Background

         David was arrested by Roseville Police Department officers on June 10, 2014, at which time he had an outstanding bench warrant for the civil infraction of failing to pay or appear in court on a careless driving charge. (Deputies' MSJ Exs. 1, 2, ECF Nos. 146-2, 146-3.) On Wednesday, June 11, 2014, a judge in Michigan's 39th District Court sentenced David to serve thirty (30) days in jail or pay $772.00 for the infraction. (Id. Ex. 1, ECF No. 146-3.) Later that day, David was transferred to the Macomb County Jail to serve his sentence, at which time Tiffany DeLuca, LPN (“Nurse DeLuca”) collected intake medical information from him. (Medical/Mental Health Records (hereafter “HR”) at 361, ECF No. 148-2.)[4]

         Nurse DeLuca noted the following at David's intake: (a) he weighed 195 pounds; (b) his blood pressure was 120/84, his pulse rate was 97, and his respiratory rate was 12; (c) he had been prescribed methadone prior to incarceration; (d) his mental status was noted as “Alert orientation, Affect appropriate, Logical thought processes, Speech Appropriate, Mood Appropriate, Activity Appropriate”; (e) there were no indicators that David was suicidal; and (f) no history of psychotropic medications, psychiatric hospitalization or outpatient mental health treatment (Id. at 362-63.) Nurse DeLuca initiated the Clinical Opiate Withdrawal Scale (“COWS”) protocol and ordered over-the-counter medications Meclizine, acetaminophen, and Loperamide for opiate withdrawal symptoms as needed. (Id. at 348-50, 392.)

         David had been incarcerated in the Macomb County Jail on several previous occasions between September 2, 2006 and August 2009. (Deputies' MSJ Ex. 3, ECF No. 146-4.) The jail's records reflect that David in fact had a psychiatric history of depression, anxiety, and substance abuse that required prescriptions for Xanax and Klonopin (both of which are benzodiazepines), psychiatric hospitalization, and outpatient mental health treatment. (Pl.'s Resp. to CCS Defs.' MSJ Ex. 9 at 198-99, ECF No. 158-9.) He also had a history of cerebral trauma and seizure. (Id.) According to those records, David's weight between September 2006 and August 2009 fluctuated between 175 and 190 pounds. (Id. at 184-207.) Nurse DeLuca did not review David's prior jail records at intake, nor did she check David's prescription history through the Michigan Automated Prescription System (“MAPS”). MAPS reflected that David was being prescribed Xanax, Klonopin, and methadone from January 2014 until his June 11, 2014 incarceration. (Id. Ex. 10, ECF No. 158-10.)

         Under the COWS protocol, a physician is to be notified if a prisoner has the potential for poly-substance withdrawal. (HR at 348.) Unaware of David's other medications, Nurse DeLuca did not notify CCS' Medical Director at the jail, Lawrence Sherman, MD (“Medical Director Sherman” or “Dr. Sherman”), or any other CCS staff of a potential for poly-substance withdrawal.

         At 8:00 p.m. on June 11, 2014, Heather Erhlich, LPN (“Nurse Erhlich”) performed a COWS assessment, noting that David's blood pressure was 132/90 and his pulse was 92. (HR at 398.) After assessing values to various conditions related to opiate withdrawal (e.g., sweating, restlessness, joint ache, tremors), Nurse Erhlich assigned David a COWS score of 4, which is ranked as “mild.”[5](Id.) Nurse Erhlich gave David acetaminophen and Meclizine at 10:22 p.m. (HR at 367.)

         On Thursday, June 12, at approximately 5:00 a.m., Nurse Ehrlich visited David again and measured his vital signs (blood pressure: 116/76; pulse: 70) and recalculated his COWS score (3). (HR at 398.) Nurse Ehrlich gave David acetaminophen, Loperamide, and Meclizine at 6:48 a.m. (HR at 367.) CCS' Acting Director of Nursing at the time, Monica Cueny, RN (“Nursing Director Cueny”), reviewed David's COWS protocol initiation paperwork at 9:35 a.m. on June 12. (HR at 348-50.) At 1:00 p.m., a nurse rechecked David's vital signs (blood pressure: 110/78; pulse: 100) and assigned him a COWS score of 3. (HR at 398.) At approximately 8:00 p.m., Thressa Williams, LPN (“Nurse Williams”) checked David's vital signs (blood pressure: 110/72; pulse: 74) and assigned him a COWS score of 2. (Id.) At 10:42 p.m., Nurse Williams gave David acetaminophen and Loperamide. (HR at 367.)

         On Friday, June 13, Nurse Williams visited David but apparently was not able to measure his vitals or assess his COWS score. (See id. at 398.) At 11:23 a.m., Amber Barber, LPN “(Nurse Barber”) gave David acetaminophen. (Id. at 367.) At 1:00 p.m., Nurse Barber checked David's vital signs (blood pressure: 108/72; pulse: 88) and calculated his COWS score as 2. (Id. at 398.)

         On Saturday, June 14, Linda Parton, LPN (“Nurse Parton”) checked David's vital signs (blood pressure: 120/84; pulse 84) and recalculated David's COWS score as “0.” (Id.) At 1:00 p.m., another nursed checked David's vitals (blood pressure 130/84; pulse: 105) and recalculated his COWS score as 2. (Id.) The same nurse gave David acetaminophen at 1:33 p.m. (Id. at 367.) Nurse Barber visited David at 8:00 p.m., but was unable to assess him. (Id. at 398.)

         Nurse Barber checked David's vital signs (blood pressure: 114/90; pulse: 98) and assessed his COWS score as 2 the following morning at 5:00 a.m., Sunday, June 15. (Id.) Another nurse checked David at 1:00 p.m., at which time his blood pressure was 134/78, his pulse was 97, and his COWS score was 2. (Id.) David received acetaminophen at 1:19 p.m. (Id. at 398.) Because the nursing staff assessed David's COWS score below 12 for 72 hours, he was deemed to have completed the detoxification protocol and jail command was so notified. (Id. at 360.)

         There are no entries in David's medical records for Monday, June 16, 2014. At approximately 7:50 a.m. the following day, however, Corrections Deputy William Licavoli requested assistance from medical staff after observing David “laying on his back on his bunk blinking his eyes” and seemingly “unable to speak or move.” (CCS Defs.' Mot. Ex. C, ECF No. 148-4 at Pg ID 4094.) Mical Bey-Shelley, LPN (“Nurse Bey-Shelley”) responded to David's cell. (HR at 395.)

         In a late entry to David's medical records the following day, June 18, Nurse Bey-Shelley indicated that she responded to Deputy Licavoli's call to David's cell on June 17, at which time she took David's vitals and placed an ammonia inhalant under his nose, which caused him to “open[] his eyes wide.” (Id.) Nurse Bey-Shelley reported that David continued to stare at the medical and corrections staff, but would not respond to the medical staffs' questions. (Id.) Nurse Bey-Shelley had David taken to the medical clinic in a wheelchair for further observation and to be seen by Medical Director Sherman.

         During his deposition in this case, Dr. Sherman testified that he examined David in the medical clinic on June 17, although Dr. Sherman did not document his assessment at that time. (Sherman Dep. at 107, ECF No. 148-14 at Pg ID 4380.) While Dr. Sherman stated that he is “normally … very fastidious about writing [his] notes as [he] see[s] the patient, ” he claimed that he failed to do so in this case because it was late in the day and the exam did not occur in his office. (Id. at 108, Pg ID 4380.)

         At 7:29 p.m. on June 24, 2014, Dr. Sherman made a late entry in David's medical records regarding his assessment of David on June 17.[6] Dr. Sherman wrote:

I went to see this patient who was being observed in the Medical Unit for questionable seizures. I observed him fluttering his eyes in what was certainly not a seizure but what was most likely his poor attempt to feign one. I shook his shoulders and told him to sit up, at which point he suddenly stopped the eye fluttering behavior and exclaimed, “What's happening?” as if he were unaware.

(HR at 393.) Dr. Sherman concluded that no further treatment was needed and instructed that David be returned to his general population housing. (Id.) According to Nurse Bey-Shelley's entry in David's medical records-also made late, but only one day after the June 17 encounter-David verbalized his understanding and was able to stand and walk back to the housing unit “with a steady gait.” (HR at 395.)

         At 3:48 p.m. on June 17, Corrections Deputy Campau observed David “[h]allucinating” and “talking to ppl [people] not there[.]” (HR at 366.) According to Deputy Campau, David also stated “that he died earlier today.” (Id.) Deputy Campau completed a form referring David to the jail's mental health unit, checking “Other Inappropriate Behavior” as the reason for the referral.[7] (Id.) The form reflects that “Danielle from MH [Mental Health]” instructed Deputy Campau to place David in “HIG [High Observation Green], ” which is for inmates exhibiting active suicidal behavior and/or verbalizations. (Id.) Inmates in HIG are placed in anti-suicide gowns. (Pacitto Dep. at 96, ECF No. 148-7 at Pg ID 4170.) They cannot possess sheets, blankets, or personal property and are placed in a cell where they are continuously monitored (i.e., twenty-four hours a day/seven days a week) via closed circuit television by deputies on “mental health control duty.” (Id.; HR at 359; see also Avery Dep. at 11, ECF No. 162-9 at Pg ID 5580.)

         The deputies assigned mental health control duty work at a desk or counter across the hall from three video-monitored male mental health unit cells: “MH-1, ” “MH-2, ” and “MH-3”. (Harrison Dep. at 12, ECF No. 162-19 at Pg ID 5780; Deputies' MSJ Ex. 19, ECF No. 162-20.) There are seven television monitors on the desk or counter that provide video feeds from the mental health unit cells. David was housed in MH-1, which was approximately six or seven feet from the monitoring location. (Harrison Dep. at 20, ECF No. 162-19 at Pg ID 5782.) From their duty station, the control officers can see into MH-1, which has a window that is approximately four feet tall by two or three feet wide. (Id. at 30-31, Pg ID 5785.) A “mental health runner” also is responsible for completing rounds of the unit every fifteen minutes to check on the inmates. (Harrison Dep. at 29, Pg ID 5785.)

         Natalie Pacitto, CCS' Director of Mental Health at the Macomb County Jail during David's incarceration (“Director Pacitto”), testified that there are many reasons why an inmate may require high observation other than being suicidal; however, the jail's form only identifies that one reason for HIG placement. (Pacitto Dep. at 103, ECF No. 148-7 at Pg ID 4172.) At their depositions in this matter, the deputy defendants testified that they understand that an inmate in High Observation Green is suicidal and they were not advised otherwise in David's case. (See, e.g., Avery Dep. at 21; ECF No. 162-9 at Pg ID 5583; Ray Dep. at 9-11, ECF No. 162-10 at Pg ID 5597; Harrison Dep. at 28-29, ECF No. 162-19 at Pg ID 5784-85.) Director Pacitto testified that when an inmate is placed in HIG, the jail's mental health professionals receive a referral and are responsible for evaluating the inmate. (Pacitto Dep. at 133, ECF No. 148-7 at Pg ID 4180.) In David's case, however, CCS' mental health professionals sent daily memos to jail command requiring them to keep David in HIG because they reportedly were unable to assess his mental health status. (See HR at 351-59; see Pacitto Dep. at 69-, ECF No. 158-17 at Pg ID 5282.)

         At approximately 7:25 p.m. on June 17, Deputy Paul Harrison observed David “twitching on the ground” in his mental health unit cell. (CCS Defs.' Mot. Ex. E, ECF No. 148-6 at Pg ID 4144.) Deputy Harrison entered the cell and asked David if he was ok, but David did not respond. (Id.) Deputy Harrison called nursing staff to his location. (Id.)

         Vicky Bertram, RN (“Nurse Bertram”), Nurse Bey-Shelley, and Sara Breen, LPN, responded to Deputy Harrison's call. When they arrived, David was sitting on the floor of the cell and stated that “all his organs, but 10% of his heart was removed and his arms shreaded [sic] a couple days ago” while in the jail. (HR at 396.) David also told the nurses that he was taking “4 mg of [X]anax daily for anxiety and oxycodones for pain.” (Id.) Nurse Bertram documented David's vital signs (blood pressure: 150/98; pulse: 77; respiratory rate: 18; pulse oximetry: 99), noted that his pupils were reactive bilaterally, and instructed David “to let corrections/medical staff know if symptoms worsen.” (Id.) According to Plaintiff's summary of the cell video, the nurses spent seven minutes with David on this occasion. (Pl.'s Resp. to CCS Defs' Mot. Ex. 7 at 9, ECF No. 158-7 at Pg ID 4971.)

         At 2:15 p.m. the following day, Wednesday, June 18, Mental Health Professional Chantalle Brock (“MHP Brock”) visited David to assess his mental health status. (HR at 387.) David was lying on the lower bunk and exhibiting “rapid eye movement.”[8] (Id.) MHP Brock reported that she was “unable to assess” David because he “refused to engage” with her. (Id.)

         At her deposition in this case, MHP Brock was questioned about her indication that David “refused to engage” with her. MHP Brock testified that she believed David was able to respond to her, but chose not to do so. When asked what criteria she used to make that determination, MHP Brock provided that David was looking at her while she spoke to him from outside his cell, his eyelids were moving, and she spoke loudly.[9] (Brock Dep. at 59-61, ECF No. 158-12 at Pg ID 5090.) MHP Brock acknowledged, however, that she did not know if David was in a state of reality or psychosis and able to understand her at the time. (Id.) MHP Brock referred David for a medical evaluation to determine whether he was detoxing or there was some other medical problem inhibiting his ability to respond to her. (Id.)

         At 2:57 p.m. on June 18, Nurse Bey-Shelley and Nursing Director Cueny visited David. In a June 24, 2014 late entry to the health record, Nursing Director Cueny noted that David was lying on the lower bunk with his eyes closed and began “flutter[ing] his eyelids” open and closed when she approached him. (HR at 394.) Nursing Director Cueny recorded David's vitals (“Respirations even/nonlabored. Radial pulse strong, regular. BP 138/88 HT 98 reg SpO2 98% on room air”) and reported that he did not appear to be experiencing auditory or visual hallucinations and was “not engaging initially with [her].” (Id.) David then told Nursing Director Cueny and Nurse Bey-Shelley that he “take[s] Klonopin 2-3 tabs at home, last taken 2 weeks ago for anxiety.” (Id.) Although David stated that he had been prescribed Klonopin, he was unable to provide the name or location of the pharmacy where he filled the prescription. (Id.) Nursing Director Cueny did not recall asking David the dosage of his medications and her record does not include that information. (Id.; see also Cueny Dep. at 90-92, ECF No. 148-3 at Pg ID 4040.) She did ask David if he had ever had a psychiatric hospitalization for anxiety, and he nodded “yes, ” but was unable to state where or when. (Id.)

         Nurse Bey-Shelley and Nursing Director Cueny “encouraged” David to drink two 6-ounce glasses of water, which he “tolerated without difficulty.” (Id.) They then instructed David to notify staff of any changes and notified the corrections deputies to inform the medical staff of any changes. (Id.) Nursing Director Cueny testified that she immediately went back to the medical clinic after visiting David, reviewed his medical chart, and telephoned Dr. Sherman who did not issue any additional orders. (Cueny Dep. at 103-07; see also HR at 394.) In her June 24, 2014 late entry to David's medical records regarding her June 18 assessment of him, Nursing Director Cueny wrote: “Continue with COW[S] protocol as ordered.” (HR at 456.) As indicated, however, the COWS protocol had been terminated several days earlier, on June 15.

         Later in the evening on June 18, Nurse Bertram and two other nurses visited David in his cell. (Bey-Shelley Dep. at 178-80, ECF No. 148-9 at 4307; Cell video at 19:21 on 6/18/14.)[10] No. entries were made in the health record reflecting this visit.

         At 9:50 a.m. on Thursday, June 19, Mental Health Professional Danyelle Nelson visited David. (HR at 385-86.) MHP Nelson noted that David was “laying on the floor naked in his room with one arm half in the air with rapid eye movement” and that he “refused to engage with [her].” (Id. at 386.) MHP Nelson reported that she was “unable to assess” David's mental status, noting that he “refused.” (Id. at 385-86.)

         A notation in the Mental Health Log Book at 12:00 p.m. on June 19 reads that David was “more coherent” and was “[a]dvised he needs to eat.” (CCS Defs.' Mot. Ex. G at 159, ECF No. 148-8 at Pg ID 4220.) At 12:43 p.m., David is seen eating the meal delivered to his cell. This is the first time he had eaten since entering the observation cell on June 17.

         At 9:50 a.m. on Friday, June 20, MHP Nelson visited David again. (Id. at 383-84.) David was lying on the floor with his anti-suicide gown draped over his body. (Id.) MHP Nelson noted that he again “refused” to engage with her. (Id.) The Mental Health Log Book reflects that a nurse “cleared” David at 1:35 p.m. (CCS Defs.' Mot. Ex. G at 164, ECF No. 148-8 at Pg ID 4225), although there are no notations in David's medical records recording this visit. A review of the cell video reflects that this visit lasted forty seconds. At 6:12 p.m., David is seen in the jail video eating the meal delivered to his cell. At 10:21 p.m., another nurse is seen on the video visiting David for seven minutes, measuring his vital signs, and providing him with something to drink. (Cell video at 22:21 on 6/20/14.)

         On Saturday, June 21, MHP Brock saw David at 9:35 a.m. (HR at 381-82.) She described David as “lying on the floor naked with rapid eye movement.” (Id. at 382.) MHP Brock documented that David asked if he “will be receiving medication within the facility” and “after learning medication has not been ordered at this time, … ended contact and refused to fully engage with [her].” (Id.) MHP Brock further documented that she had “received collateral information that [David] fully engaged with nursing staff prior to [her] visit[.]” (Id.) She therefore “suspect[ed]” and reported that David was “exaggerating sx's [symptoms] for secondary gain[.]” (Id.)

         The cell video shows Nurse Bey-Shelley visiting David at 1:59 p.m. on June 21 for approximately five minutes. (Cell video at 13:59 on 6/21/14.) There are no notations in the health record documenting this visit.

         On Sunday, June 22, 2014, an unidentified officer attempted to interview David to complete the Macomb County Jail Classification Checklist. (Pl.'s Resp. to Deputies' MSJ Ex. 1 at ¶ 40, ECF No. 162-2.)[11] The officer indicated on the form that he or she was “unable” to interview David because he was “incoherent.” (Id.)

         At 9:15 a.m. on the same date, MHP Brock visited David again. (HR at 379-80.) According to MHP Brock's notes, David was lying naked on the lower bunk and “refused” to engage with her. (Id.) In her notes, MHP Brock also repeated her assessment that David was exaggerating his symptoms for secondary gain. (Id.) No. deputies or health care staff entered David's cell on this date.

         At 11:00 a.m. the following day, June 23, MHP Nelson saw David, who was naked and lying on the lower bunk. (HR at 377-78.) MHP Nelson was “unable to assess” David's mental status, noting that he “refused” to engage with her. (Id.) Nurse DeBene saw David at 3:47 p.m. and spent approximately two minutes with him. (Cell video at 3:47 p.m. 6/23/14; CCS Defs.' Mot Ex. G at 177, ECF No. 148-8 at Pg ID 4238.) There are no notations in David's health records regarding this visit. However, there is a notation in the Mental Health Log Book at the same time as Nurse DeBene's visit stating that David was “up and aware and drinking water.” (CCS Defs.' Mot. Ex. G at 177, ECF No. 1488 at Pg ID 4238.)

         David had defecated and urinated on the bunk shortly before Nurse DeBene visited him and he is seen in the jail video attempting to clean the mattress with toilet paper after Nurse DeBene left his cell. At 5:04 p.m., Nurse DeBene visited David again and took him to the medical unit for a shower. (Id. at 178, Pg ID 4239.) The jail cell video shows David eating an apple when he returned to his cell. At 8:14 p.m. on June 23, David can be seen lying down on the lower bunk, where he remained until 12:45 p.m. the following day.

         On that date, Tuesday, June 24, MHP Brock visited David at 10:50 a.m., but he again “refused” to engage with her. (HR at 375-76.) MHP Brock noted that David was lying naked on the lower bunk. (Id.) The jail video reflects that David ate at 1:00 p.m. At 4:36 p.m., David lay on the floor, where he remained until 2:10 p.m. the following day. A nurse and two corrections officers entered David's cell at 9:34 p.m. on June 24, although there are no notations in his health records regarding this visit and it is not evident from the video whether David's vitals were checked or if any other assessment(s) was made regarding his condition. (Cell video at 9:34 p.m. 6/24/14.) The nurse filled a cup of water for David and placed it on the counter. (Id.)

         At 2:10 p.m. on Wednesday, June 25, David got up and drank from the sink. Six minutes later, the video shows him lying down on the floor naked and experiencing convulsions that last almost a minute. Approximately thirty minutes later, Mental Health Professional Kelly Mann conducted the daily assessment of David. (HR at 373-74.) According to her report, David was still lying naked on the floor. (Id.) MHP Mann recorded that David “refused” to engage with her. (Id.) At 9:34 p.m., two deputies and a nurse entered David's cell for thirty seconds. David, who is still lying naked on the floor, is unresponsive. There is no notation in the health records regarding this visit, but notes were made in the Mental Health Log Book that David's vital check was “good.” (CCS Defs.' Mot. Ex. G at 188, ECF No. 148-8 at Pg ID 4240.)

         On Thursday, June 26, Medical Director Sherman, Director of Nursing Cueny, Mental Health Director Pacitto, Health Services Administrator David Arft, RN, and CCS' psychiatrist at the jail (“Dr. Haque”) attended a “Care Team” meeting between 11:50 a.m. and 12:30 p.m. (CCS Defs.' Mot. Ex. J, ECF No. 148-11 at Pg ID 4313-16.) During the “open floor” portion of the meeting, Dr. Sherman brought up David and expressed that he feels David is “faking seizures, not even pseudo-seizures.” (Id. at 3, Pg ID 4315.) Dr. Sherman stated that David's vitals were normal and that he (Dr. Sherman) was “[n]ot concerned.” (Id.) Dr. Sherman added that the mental health staff indicated that David was “refusing or unable to engage in visiting with them” and suspected David was “med seeking.” (Id. at 3-4, Pg ID 4315-16.) “[T]o rule out any possible new MH [mental health] condition[, ]” the committee discussed David being seen by Dr. Haque on Monday, June 30. (Id.)

         At 1:50 p.m. on June 26, MHP Nelson conducted the daily mental health assessment of David and found him lying on the floor of the cell, partially covered by the anti-suicide gown, “mildly shaking with eye flutters.” (HR at 371-72.) David in fact had been lying on the floor on his stomach since 2:16 p.m. the day before. David was still in the same position at 11:23 p.m. on June 26, when a deputy entered the cell for thirty seconds. It appears from the cell video that the deputy attempted to engage David, who was unresponsive, and may have checked David's wristband for the headcount reflected at the same time in the Mental Health Log Book. (See CCS Defs.' Mot. Ex. G at 188, ECF No. 148-8 at Pg ID 4249.) At this point, David had been lying on the cell floor, primarily on his stomach, for almost twenty-nine hours. He had not eaten since 1:00 p.m. on June 24, and had not consumed fluids since 2:10 p.m. on June 25.

         At 10:40 a.m. on Friday, June 27, MHP Brock conducted the daily mental health assessment of David, who was still lying on the floor naked, but had moved under the bunk. (HR at 369-70.) MHP Brock noted “eye fluttering movements” and that David “refused” to engage with her. (Id.) She therefore wrote that she was “unable to assess” his mental status. (Id.) A review of the video from this date shows David apparently sweating and experiencing significant twitching, convulsions, and involuntary movements of his arms and legs. He seems to be writhing across the cell floor at times and his breathing appears labored. At approximately 5:20 p.m., two deputies entered David's cell and found him unresponsive and without a heartbeat or pulse. (HR at 400-02, 454-55.) The deputies called for medical staff assistance and began performing CPR, which the medical staff continued when they arrived. (Id.) An ambulance was summoned, and David was transported at 5:50 p.m. to the hospital, where he was pronounced dead.

         Mary E. Piettangelo, MD, Deputy Medical Examiner for the Macomb County Medical Examiner's Office, performed on autopsy on June 30, 2014. (Autopsy Report, ECF No. 148-12.) David weighed 151 pounds at the time of his death. In a report dated August 21, 2014, Dr. Piettangelo determined that the cause of David's death was acute withdrawal from chronic benzodiazepine, methadone, and opiate medications. (Id. at 2, Pg ID 4320.) Dr. Piettangelo's final diagnosis of David's condition was: “Acute Withdrawal from Chronic Benzodiazepine, Methadone and Opiate Medications[, ] Dehydration with hypernatremia[, and] Seizure/Seizure-like activity.” (Id.)

         III. Applicable Law

         A. 42 U.S.C. § 1983 Generally

         Plaintiff asserts § 1983 claims against Defendants for the violation of David's rights under the Eighth and Fourteenth Amendments. Specifically, Plaintiff alleges that Defendants were ...

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