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Duty to intervene applies in jails

Tragedy might have been avoided if correctional officers had pressed medical staff for a more thorough check of an inmate’s condition

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This article was featured in Lexipol’s Xiphos newsletter, a monthly legal-focused law enforcement newsletter authored by Ken Wallentine. Subscriptions are free for public safety officers, educators and public attorneys. Subscribe here!

McGee v. Parsano, 2022 WL 17688361 (7th Cir. 2022)

Officers arrested Michael Carter on a warrant for attempted cocaine distribution. Carter’s jail intake form stated he was diabetic and used two medications to manage his diabetes: Metformin and Glyburide.

Over the next few days, Carter intermittently received Metformin but never Glyburide. A call from Carter’s mother prompted a jail nurse to examine Carter. Observing tachycardia and low blood pressure, she moved Carter into the medical unit for observation. A doctor briefly examined Carter. The doctor mistakenly believed Carter had been experiencing only respiratory symptoms.

A nurse told jail officers Carter could be returned to his cell. An officer ordered Carter to get up and move, but Carter did not. A supervisor arrived. Carter was sitting near the shower, leaning against the wall and the toilet. The nurse said Carter was “playing possum” and she put smelling salts under his nose. Carter stirred slightly. Another officer arrived and said Carter appeared to be sick. The nurse again said Carter was faking illness. A second supervisor and another officer arrived.

When the nurse tried to place a pulse oximeter on Carter’s finger, she was unable to do so. An officer applied a pressure-point technique designed to encourage Carter to stand. This proved unsuccessful, so two officers dragged Carter to the door of his cell. The officers subsequently placed Carter in a wheelchair and moved him to a holding area, where another officer recommended Carter be taken to the medical unit. The officers opted to leave Carter in place.

An officer who believed Carter was diabetic urged a reluctant nurse to check Carter for low blood sugar. The officer told the nurse Carter had not eaten his meals. When the officer asked the nurse to check Carter’s blood-glucose level, she replied, “If you want me to, I guess I can.” Carter’s blood-glucose level exceeded the glucometer’s maximum reading of 500 milligrams per deciliter. Diabetic ketoacidosis, a process where acid accumulates in the bloodstream, is associated with levels above 300. The officers didn’t understand the high reading and the nurse did not seem alarmed.

The nurse administered a shot of insulin. A second blood-glucose test still showed extremely high levels. An officer who was also diabetic understood Carter’s blood sugar levels were dangerously high. He called for other officers and a wheelchair to move Carter to a patrol car for transportation to the hospital. When they checked for a pulse and found none, the officers used an automated external defibrillator and performed CPR. Carter died.

Carter’s family sued, claiming the five correctional officers should have known that Carter was receiving inadequate medical care and that the officers had a duty to intervene. The court accepted that the correctional officers had a duty to intervene if the officers were aware of inadequate care. The same duty would apply to officers who witnessed excessive force applied to an inmate.

Nonetheless, the officers were not obliged to intervene when the medical staff opined that the care was adequate. The court held, “Corrections officers are not constitutionally obligated to override the judgment of medical professionals unless they have reason to know that an inmate is receiving inadequate treatment. This remains true even when an inmate is in obvious distress and even when the medical staff has misdiagnosed an inmate—or worse, accused him of faking a very real illness.” Because the officers deferred to the judgment of medical professionals, they were entitled to qualified immunity.

Nonetheless, perhaps tragedy might have been avoided by pressing the medical staff for a more thorough check of Carter’s condition. As we often hear, “predictable is preventable,” and with over 10% of the U.S. population suffering from a form of diabetes, and the ease of misinterpreting diabetic crisis symptoms both on the street and in a jail, both patrol officers and corrections officers would benefit from training on diabetic emergencies. At least one of the officers here had personal experience about what might be happening with Carter, but his involvement apparently came too late to prevent a potentially predictable and possibly preventable death.

Ken Wallentine is the chief of the West Jordan (Utah) Police Department and former chief of law enforcement for the Utah Attorney General. He has served over three decades in public safety, is a legal expert and editor of Xiphos, a monthly national criminal procedure newsletter. He is a member of the Board of Directors of the Institute for the Prevention of In-Custody Death and serves as a use of force consultant in state and federal criminal and civil litigation across the nation.

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