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Federal Appellate Court denies qualified immunity to Texas sheriff, jail staff for delayed medical transport of seriously ill detainee

The court was also highly critical of an alleged unwritten cost-cutting jail policy that caused delays in sending detainees to the hospital when necessary

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Rhonda Newsome was arrested for aggravated assault with a deadly weapon on March 9, 2018. Newsome was placed in pretrial detention at the Anderson County, Texas jail. Her jail intake form listed Addison’s disease as a medical condition.

According to the Fifth Circuit court, “If left untreated, Addison’s disease can accelerate into an ‘Addisonian crisis,’ which requires immediate medical intervention.” The court explained, “Addison’s disease requires lifelong treatment, which is primarily accomplished through administering steroid medications. When Addison’s disease patients are unmedicated for even brief periods of time, they can be at a high risk of experiencing an Addisonian crisis.” The court noted, “Plaintiffs allege that Newsome was never prescribed or systematically provided with steroids — the primary treatment for Addison’s disease — during her ninety-seven-day detention.”

Three months later, on June 15 at approximately 5:00 p.m., a jail officer found Newsome unresponsive and contacted Nurse Green [1] who instructed him to contact emergency medical services (EMS). Newsome was transported to a local hospital by EMS and pronounced dead at 5:37 p.m.

During the previous night, Newsome displayed symptoms that indicated she was very sick. She was unable to walk on her own; had vomited a black substance into a cup; and had a blood pressure reading of 80 over 40. Moreover, several detainees heard her repeatedly screaming that she needed help, was groaning with pain and wanted to go to the hospital. One detainee testified “that nearby jailers appeared to be ignoring Newsome’s cries and pleas for help.”

At 7:40 a.m. on June 15, Newsome was examined by Nurse Green. He found her nauseated and she vomited a brown colored fluid. She complained of a “right flank area pain.” He drew a blood sample and later claimed that he asked her if she wanted to go to the hospital, but she declined. After the exam, Green took the blood sample to the regional medical center for analysis.

The court noted that, “[t]he test results indicate that Newsome’s blood urea nitrogen level was critically high, and her potassium level was critically low. The blood work report’s notation indicates that lab technician Wesley Wood called Nurse Green at approximately 10:40 a.m. on June 15 and reported a “critical value,” which indicates a medical emergency that requires immediate attention. The report further indicates that Nurse Green “read back” the critical value to confirm understanding.” Green later repeatedly testified that he could not recall being informed of “any critical values on the morning of June 15.” Later during litigation, the defense asserted that Green learned of the blood test results after Newsome was found unresponsive.

Plaintiffs point out that shortly after Green received the morning call from the blood laboratory, he called Jail Captain Choate. Choate thereafter made unsuccessful efforts throughout the day to obtain a personal recognizance bond (PR bond) for Newsome from the district attorney’s office. The PR bond would have allowed the jail to send Newsome to the hospital without cost to the jail. Former jail officer Mobley later testified that Green once told him that Sheriff Taylor had limited his ability to send detainees to the hospital to cut jail costs.

The lawsuit and Court of Appeals Decision

Plaintiffs filed suit in federal court pursuant to 42 U.S.C. § 1983 (federal civil rights statute). They sued Anderson County, Sheriff Taylor, jail Doctor Corley, Nurse Green and several other jail officials. [2] They alleged a violation of the 14th Amendment for failure to treat Newsome’s chronic potentially serious illness during confinement which caused her death. The district court ruled in favor of all defendants at the summary judgement stage and dismissed the suit with prejudice. The Fifth Circuit Court of Appeals reversed [3] as to several defendants including, Sheriff Taylor, Nurse Green Doctor Corley, and Anderson County. [4]

Rationale for reversal for each defendant:

Doctor Adam Corley: Dr. Corley was the medical director for the jail. According to the court, “Anderson County Jail’s health services plan states that medical care is to be provided to detainees twenty-four hours a day, and detainees are to be medically screened upon admission. Detainees with chronic illnesses are to undergo a medical assessment, and the jail physician is tasked with instituting a treatment regimen. The court observed, “whether Dr. Corley committed a constitutional violation hinges on: (1) whether Dr. Corley’s knowledge that Newsome had Addison’s disease constituted subjective knowledge of a substantial risk of serious harm; and (2) whether Dr. Corley’s failure to provide any follow-up treatment or monitoring until the date of Newsome’s death constituted deliberate indifference. [5] We find that both questions can be answered in the affirmative.”

The court determined that based on the Plaintiffs’ submissions, a jury could find that Corley subjectively knew that Newsome had Addison’s disease that could become life-threatening if left untreated and did nothing to treat her serious illness. Accordingly, the court rejected Corley’s qualified immunity defense.

Nurse Timothy Green: The court determined that “Plaintiffs have presented sufficient evidence for a reasonable jury to conclude that Nurse Green’s actions on June 15, the day of Newsome’s death, constituted a violation of Newsome’s Fourteenth Amendment rights.” The court ruled that Green received the results from Newsome’s lab blood report at approximately 10:40 a.m. on June 15. The court explained that this creates a jury issue “regarding Nurse Green’s subjective knowledge that Newsome was at risk of an Addisonian crisis”; in critical condition; and in need of emergency care.

Moreover, the court observed that a jury could find that Green knew that Newsome had vomited a “brown colored fluid” and delayed sending her to the hospital due to cost restrictions issued by Sheriff Taylor. The court ruled that a jury could find that Green was deliberately indifferent to Newsome’s serious medical needs. The court rejected Green’s qualified immunity defense.

Sheriff Greg Taylor and Anderson County: The court first focused on potential municipal liability for Anderson County and stated, “To establish municipal liability under 42 U.S.C. § 1983, a plaintiff must show: ‘(1) an official policy (or custom), of which (2) a policy maker can be charged with actual or constructive knowledge, and (3) a constitutional violation whose ‘moving force’ is that policy (or custom).’” [6] Moreover, the court added, “[A] plaintiff must show that the policy was implemented with “deliberate indifference” to the “known or obvious consequences” that a constitutional violation would result.” The court explained that “deliberate indifference” may be shown by a series or pattern of similar violations or a single incident wherein the injury suffered was “highly predictable.”

In the instant matter the court observed, “Jail Captain Choate admitted that Anderson County Jail seeks PR [7] bonds ‘[a]nytime that [jail staff] believe someone is going to go to the hospital.’ Furthermore, Choate admitted that this practice was carried out due to jail staffing [cost] concerns, and Nurse Green allegedly admitted that his ability to send detainees to the hospital was curtailed by Sheriff Taylor. Sheriff Taylor also admitted to participating in the process of coordinating a PR bond for Newsome. Because Plaintiffs have presented evidence that this policy existed, that Sheriff Taylor seemingly knew of the policy, and that the delay caused by the policy contributed to Newsome’s death,” [8] the district court was wrong in dismissing the municipal liability claim against the county.

The court similarly ruled against Sheriff Taylor regarding the personal supervisory liability [9] claim lodged against him and rejected his qualified immunity defense. The court determined that plaintiffs’ complaint against Taylor sufficiently alleged that he “implemented the policy of delaying care for detainees with serious medical needs [to avoid paying for medical care], and that he was personally involved in Newsome’s delay of care on the date of her death.”

Lessons learned

1. Jail and prison medical officials must carefully evaluate new inmates and detainees medical histories and current conditions when they enter the facility.

2. If an inmate/detainee’s medical history or current condition warrants close scrutiny while that individual remains in confinement, a treatment plan should be immediately created and carefully followed during the duration of the individual’s incarceration.

3. Written facility guidelines should be created that require periodic scheduled physical examinations by both facility nurses and doctors when serious medical conditions are detected for inmates/detainees. A written record should be created for each examination and maintained by the facility.

4. If an inmate/detainee requires prescription medications or other daily/weekly treatments, an electronic system should be instituted to record that the medications etc., were delivered as required.

5. If an inmate/detainee requires emergency medical treatment at a hospital or other outside medical facility, transportation to the hospital should be instituted immediately. Facility budgetary and cost considerations should never be a factor in delaying emergency medical treatment.

6. Establishing a written or word-of-mouth policy or practice that requires or causes delays in moving an inmate/detainee facing a medical emergency to the hospital will be used against the municipality and the policy-maker in future civil/ criminal litigation.


1. “The County… employed Timothy Green, a registered nurse who worked at the jail part time.”

2. Eight other jail officials were sued but analysis of the lawsuit in this article is limited to the defendants discussed herein.

3. Ford v. Anderson County, Texas, (No. 22-40559) (5th Cir. 2024).

4. The court reversed regarding plaintiffs’ nonsupervisory claims against Dr. Corley but affirmed dismissal for him regarding supervisory claims.

5. The court stated that “[o]n May 11, about two months into Newsome’s detention, Dr. Corley personally examined Newsome for the first and only time at the jail.” He also acknowledged that Newsome was afflicted with Addison’s disease.

6. The court cited, Newbury v. City of Windcrest, 991 F.3d 672, 680 (5th Cir. 2021) (quoting Pineda v. City of Houston, 291 F.3d 325, 328 (5th Cir. 2002)).

7. A PR bond, (i.e. personal recognizance bond from the District Attorney), would eliminate the cost to the county for a hospital transfer and stay of an inmate.

8. The court further observed that it had previously held “that a delay in medical care to a critically ill detainee can constitute deliberate indifference, [and found] that a constitutional violation would be a ‘highly predictable’ consequence of a policy that purposefully delays emergency care to detainees requiring hospitalization.”

9. The court explained that “[Supervisory] Liability may be found where ‘supervisory officials implement a policy so deficient that the policy ‘itself is a repudiation of constitutional rights’ and is ‘the moving force of the constitutional violation.’” Thompkins v. Belt, 828 F.2d 298, 304 (5th Cir. 1987) (quoting Grandstaff v. City of Borger, 767 F.2d 161, 169, 170 (5th Cir. 1985)). Furthermore, ‘[i]n order to establish supervisor liability for constitutional violations committed by subordinate employees, plaintiffs must show that the supervisor act[ed], or fail[ed] to act, with deliberate indifference to violations of others’ constitutional rights committed by their subordinates.’ “Porter v. Epps, 659 F.3d 440, 446 (5th Cir. 2011) (quoting Gates v. Tex. Dep’t of Protective & Regul. Servs., 537 F.3d 404, 435 (5th Cir. 2008)).”

John Michael Callahan served in law enforcement for 44 years. His career began as a special agent with NCIS. He became an FBI agent and served in the FBI for 30 years, retiring in the position of supervisory special agent/chief division counsel. He taught criminal law/procedure at the FBI Academy. After the FBI, he served as a Massachusetts Deputy Inspector General and is currently a deputy sheriff for Plymouth County, Massachusetts. He is the author of two published books on deadly force and an upcoming book on supervisory and municipal liability in law enforcement.

Contact Mike Callahan.