- The 4th US Circuit Court of Appeals will allow the estate of a former jail inmate to pursue a lawsuit against Davie and Stokes counties, along with several individual defendants.
- A trial judge had dismissed David Ray Gunter's lawsuit. Gunter blamed the counties, the contractor who provided medical services for their jails, and multiple individual defendants for blood clots that required multiple surgeries after he spent two weeks behind bars in 2012.
- The split 2-1 decision allows Gunter's estate to pursue a Monell claim against the counties. That type of claim accuses a government of maintaining a policy, custom, or practice that violates civil rights.
A federal Appeals Court will allow a former jail inmate’s lawsuit to proceed against Davie and Stokes counties. The suit alleges that the counties bear legal responsibility for inadequate medical treatment that required surgery after the inmate left custody in 2012.
Thursday’s split 2-1 opinion from the 4th US Circuit Court of Appeals reversed a trial judge’s decision dismissing David Ray Gunter’s complaint against the counties and other defendants.
Gunter had lived with a mechanical heart valve since 1990. It required daily doses of Coumadin or Warfarin to prevent dangerous blood clots, according to court records.
In November 2012 Gunter was arrested in Forsyth County based on a bench warrant. The following morning he was transferred to the Davie County Detention Center. Nine days later, Gunter headed to the Stokes County Detention Center.
After roughly two total weeks behind bars, Gunter was released from jail. The 4th Circuit opinion offered details about lapses in Gunter’s Coumadin intake during his time behind bars.
Eight days after his release, Gunter went to Wake Forest Baptist Medical Center for treatment of a blood clot. The clot required surgery. Gunter returned to the hospital two months later for another surgery that required removal of part of his bowel.
Gunter filed suit in 2015 “alleging that his injuries resulted from the care he received during his detainment at DCDC and SCDC,” the appellate decision explained. Gunter’s suit targeted the two counties and county employees along with Southern Health Partners, the contractor that provided medical treatment in the two county jails. The suit also named individual medical professionals involved in Gunter’s treatment.
“Gunter alleged Public Appellees and Medical Appellees acted with deliberate indifference toward his constitutional right to adequate medical care,” wrote 4th Circuit Judge Roger Gregory. “Gunter further alleged a Monell claim against Davie and Stokes Counties, as well as a medical malpractice claim.”
A Monell claim is a form of civil rights lawsuit based on an alleged government policy, custom, or practice. This type of claim targets a government or agency rather than an individual.
US District Judge William Osteen ruled against Gunter and in favor of all defendants.
“The district court erred in dismissing Gunter’s § 1983 claim for deliberate indifference under the Fourteenth Amendment against Medical Appellees,” Gregory wrote. “The district court likewise erred in dismissing Gunter’s § 1983 Monell claim against Davie and Stoke Counties and medical malpractice claim against SHP.”
“Here, the record indicates that several SHP employees … had actual knowledge of Gunter’s condition and medication needs,” Gregory explained. “A reasonable jury could therefore find that the available medical information put Medical Appellees on sufficient notice that depriving Gunter of Coumadin would incite acute health issues.”
“As we have frequently explained, ‘no legitimate nonpunitive goal is served by a denial or unreasonable delay in providing medical treatment where the need for such treatment is apparent,’” the majority opinion added.
Gregory explained why the suit can continue against the two county governments.
“Gunter has brought a Monell claim against Davie and Stokes Counties, arguing that they contracted out their authority and obligation to provide adequate medical care to inmates at their jails to SHP, whose decisions, a reasonable jury could find, resulted in his injuries. We agree,” Gregory wrote.
“Evidence in the record suggests that SHP had a custom and practice of taking days to get inmates their medication, and of not having a medical professional available to treat inmates during weekends,” the majority opinion added. “A reasonable jury could find that these decisions were ‘the “moving force”’ behind Gunter not receiving adequate medical care and suffering serious injuries.”
Judge DeAndrea Gist Benjamin joined Gregory’s opinion. Judge Julius Richardson concurred with part of the majority’s decision but issued a partial dissent.
Richardson would have allowed Gunter’s lawsuit to proceed against two individual medical defendants. He would have upheld the trial judge’s decision to dismiss the rest of the case.
Neither county government should face any legal liability, according to the dissent.
“Gunter challenges four sets of ostensible County policies: (1) the decision to enter a contract with SHP to provide medical care in county jails, (2) the decision to understaff the medical personnel at the county jails, (3) the failure to prepare adequate transfer and discharge paperwork, and (4) the failure to recognize anticoagulation therapy as a serious medical condition,” Richardson wrote. “The Majority addresses the alleged understaffing policy and invents an additional ‘custom,’ not included in the briefs, of ‘taking days to get inmates their medication.’ None are sufficient for Monell liability here.”