Hill v. Clayton County Georgia

IN THE UNITED STATES DISTRICT COURT

FOR THE NORTHERN DISTRICT OF GEORGIA

ATLANTA DIVISION

TIANA HILL, individually and as

mother and next friend of D.H.,

Plaintiff,

v. CIVIL ACTION FILE

NO. 1:21-CV-5300-TWT

CLAYTON COUNTY, GEORGIA, et al.,

Defendants.

OPINION AND ORDER

This is a civil rights action. It is before the Court on Defendants

CorrectHealth Clayton, LLC and Dr. Charles Clopton’s (“Medical Defendants”)

Motion to Dismiss [Doc. 48] and on Defendants Clayton County, Clayton

County Board of Commissioners, and Clayton County Sheriff Victor Hill’s

(“County Defendants”) Motion to Dismiss [Doc. 49]. For the reasons set forth

below, the Medical Defendants’ Motion to Dismiss [Doc. 48] is GRANTED, and

County Defendants’ Motion to Dismiss [Doc. 49] is GRANTED in part and

DENIED in part.

I. Background1

Beginning in September 2019, the Plaintiff, Tiana Hill, alleges that she

was detained at the Clayton County Jail (“Jail”) for a violation of probation and

1 The Court accepts the facts as alleged in the Corrected Amended

Complaint as true for purposes of the present Motions to Dismiss.

, 941 F.3d 1116, 1122 (11th Cir. 2019).

for a pending criminal charge. (Corrected Am. Compl. ¶¶ 25–26). Upon her

admission to the Jail, Hill informed the Jail staff that she was pregnant, which

was noted on her intake documentation. ( ¶ 27). Hill claims that on

numerous occasions between September and December 2019, she asked for

prenatal care for herself and her unborn child but that she received no such

care. ( ¶¶ 4–5).

On December 28, 2019, Hill claims that she “informed the jail staff that

she was bleeding vaginally, that she was pregnant, and that she needed

medical care” but that she was denied that care. ( ¶¶ 33–34). Then, on

December 29, Hill alleges that she went into labor in her jail cell and that when

she pleaded to be taken to the hospital, the Jail staff told her that she was not

pregnant and to go back into her cell. ( ¶¶ 35–37). After being denied the

medical care she requested, Hill claims that it was not until her fellow

detainees began banging on the walls and doors of their cells to get the jail

staff’s attention that Hill was taken to the jail infirmary. ( ¶¶ 38–41). Hill

requested that she be taken to a hospital or another medical facility more

suitable for labor and child delivery, but her request was denied. ( ¶ 41).

Ultimately, Hill gave birth in the jail infirmary the following day on

December 30. ( ¶ 52). Tragically, the baby, D.H., died on January 3, 2020.

( ¶ 55). As a result, Hill now brings constitutional and state law claims

against Clayton County (“County”), the Clayton County Board of

Commissioners (“Board”), Clayton County Sheriff Victor Hill, CorrectHealth

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Clayton, LLC (“CorrectHealth”), Dr. Charles Clopton, and various unnamed

“John Doe” Defendants. ( ¶ 9). The Medical Defendants and the County

Defendants now seek the dismissal of certain claims against them.

II. Legal Standard

A complaint should be dismissed under Rule 12(b)(6) only where it

appears that the facts alleged fail to state a “plausible” claim for relief.

, 556 U.S. 662, 678 (2009); Fed. R. Civ. P. 12(b)(6). A complaint may

survive a motion to dismiss for failure to state a claim, however, even if it is

“improbable” that a plaintiff would be able to prove those facts; even if the

possibility of recovery is extremely “remote and unlikely.”

, 550 U.S. 544, 556 (2007). In ruling on a motion to dismiss, the court

must accept the facts pleaded in the complaint as true and construe them in

the light most favorable to the plaintiff.

, 711 F.2d 989, 994–95 (11th Cir.

1983); , 40 F.3d

247, 251 (7th Cir. 1994) (noting that at the pleading stage, the plaintiff

“receives the benefit of imagination”). Generally, notice pleading is all that is

required for a valid complaint. , 753

F.2d 974, 975 (11th Cir. 1985), , 474 U.S. 1082 (1986). Under notice

pleading, the plaintiff need only give the defendant fair notice of the plaintiff’s

claim and the grounds upon which it rests. , 551 U.S.

89, 93 (2007) (citing , 550 U.S. at 555).

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III. Discussion

The Medical Defendants move to dismiss Hill’s claims against the John

Doe Defendants and her claim for false imprisonment. (Br. in Supp. of Med.

Defs.’ Mot. to Dismiss, at 1). The County Defendants move to dismiss all of

Hill’s claims against them on various grounds. (Br. in Supp. of Cnty. Defs.’ Mot.

to Dismiss, at 3–4). The Court proceeds by addressing each of the Medical and

County Defendants’ arguments in turn.

A. Hill’s Claims Against the John Doe Defendants

Both the Medical Defendants and the County Defendants move to

dismiss Hill’s claims against the John Doe Defendants. (Br. in Supp. of Med.

Defs.’ Mot. to Dismiss, at 1; Br. in Supp. of Cnty. Defs.’ Mot. to Dismiss, at 5).

They argue that the practice of naming fictitious individuals or entities as

parties in pleadings is not permitted in federal court. (Br. in Supp. of Med.

Defs.’ Mot. to Dismiss, at 2 (citing , 598 F.3d 734, 738

(11th Cir. 2010)); Br. in Supp. of Cnty. Defs.’ Mot. to Dismiss, at 5 (citing

, 114 F.3d 1092, 1094 n.1 (11th Cir. 1997))). The

Medical Defendants also argue that the limited exception for fictitious names

that are “so specific as to make the fictitious name[s], at the very worst,

surplusage” is inapplicable because the Corrected Amended Complaint

indicates that Hill “intends to identify additional defendants who are ‘not

limited to deputies, jailers and medical staff members.’” (Br. in Supp. of Med.

Defs.’ Mot. to Dismiss, at 2–3 (quoting , 786 F. App’x

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935, 939 (11th Cir. 2019), and Corrected Am. Compl. ¶ 19)).

Indicating that she intends to file for leave to amend after she obtains

names of additional parties through discovery, Hill opposes dismissal of the

John Doe Defendants. (Pl.’s Resp. Br. in Opp’n to Med. Defs.’ Mot. to Dismiss,

at 4; Pl.’s Resp. Br. in Opp’n to Cnty. Defs.’ Mot. to Dismiss, at 8–9). Hill relies

primarily on , 611 F. Supp. 2d 216, 220 (D. Conn. 2009), arguing

that naming pseudonymous defendants does not destroy complete diversity

and that she should be allowed to name anonymous defendants because she

was harmed by them through no action of her own. (Pl.’s Resp. Br. in Opp’n to

Med. Defs.’ Mot. to Dismiss, at 4; Pl.’s Resp. Br. in Opp’n to Cnty. Defs.’ Mot.

to Dismiss, at 8–9). In reply, the County Defendants argue that the present

case is not before the Court on diversity jurisdiction and that does not

otherwise support Hill’s naming of John Doe Defendants in the case. (Reply

Br. in Supp. of Cnty. Defs.’ Mot. to Dismiss, at 3).

The Court agrees with the County Defendants. The case addresses

only the issue of whether the existence of John Doe defendants in a case defeats

diversity jurisdiction. , 611 F. Supp. 2d at 219. Because Hill’s

constitutional claims are properly before the Court under federal question

jurisdiction and because the Court may exercise supplemental jurisdiction over

her state law claims, does not govern the present case. Instead, the Court

finds that the case is analogous to the present case. ,

598 F.3d at 738. In , the Eleventh Circuit Court of Appeals affirmed

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the dismissal of the plaintiff’s claims against “John Doe (Unknown Legal

Name), Guard, Charlotte Correctional Institute,” despite the fact that the

plaintiff later referred to the John Doe defendant by his actual name, because

the complaint’s description was insufficient to identify the individual

defendant. Here, Hill’s description of the “deputies, jailers, and medical

staff members” is equally undescriptive, and Hill makes no allegations in her

Corrected Amended Complaint that would identify any of the individuals.

Under the circumstances, the Court concludes that dismissal of Hill’s claims

against the John Doe Defendants is appropriate.

B. Hill’s Claims for False Imprisonment

The Medical Defendants next argue that Hill’s claim for false

imprisonment of baby D.H. should be dismissed because D.H. was unaware of

any confinement that occurred. (Br. in Supp. of Med. Defs.’ Mot. to Dismiss, at

3–4). Hill argues, in response, that baby D.H.’s detention was presumptively

against his will because he was under the age of consent. (Pl.’s Resp. Br. in

Opp’n to Med. Defs.’ Mot. to Dismiss, at 7–8 (citing , 285 Ga.

App. 902, 904 (2007), , 284 Ga. 696 (2008))).

Under Georgia law, the tort of false imprisonment is “the unlawful

detention of the person of another, for any length of time, whereby such person

is deprived of his personal liberty.” O.C.G.A. § 51-7-20. The essential elements

of a false imprisonment claim under O.C.G.A. § 51-7-20 are a detention and its

unlawfulness. , 353 Ga. App. 656, 660 (2020)

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(citation omitted). The Georgia Court of Appeals has established the following

regarding a claim for false imprisonment under Georgia law: “Any restraint,

however slight upon another’s liberty to come and go as he pleases, constitutes

an arrest. There is an illegal arrest and false imprisonment of another where

he is detained for any length of time against his will.” ,

166 Ga. App. 284, 287 (1983) (citation omitted).

The Court finds that Hill has failed to plead any facts showing that the

Medical Defendants detained baby D.H. unlawfully. Baby D.H. cannot

plausibly have been detained against his will because, as a newborn baby, he

had no awareness of his alleged detention.2 In addition, Hill’s Corrected

Amended Complaint fails to allege any facts suggesting how the Medical

Defendants detained baby D.H. ( Corrected Am. Compl. ¶¶ 197–

205). Hill alleges that the Medical Defendants “did not immediately send baby

D.H. to a hospital for medical care,” ( ¶ 202), but she does not allege how

their failure to do so was unlawful. The Medical Defendants decision against

immediately sending baby D.H. to the hospital for medical care is an issue

sounding in negligence and thus will be more appropriately assessed under

2 The Court notes that the common law claim for false imprisonment

requires an awareness on the part of the falsely imprisoned person.

, 846 F.3d 1320, 1329 (11th Cir. 2017). The Court finds that

Georgia case law examining the legal standard to establish a state law claim

for false imprisonment under O.C.G.A. § 51-7-20 also implies an awareness

element—detention against a person’s will requires an awareness of the

detention in the first place. , 166 Ga. App. at 287.

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Count VI of Hill’s Corrected Amended Complaint, which alleges medical

malpractice. ( ¶¶ 173–96). Accordingly, the Court concludes that Hill fails

to state a claim for false imprisonment of baby D.H., and thus, the claim should

be dismissed as to the Medical Defendants.

C. Hill’s Claims Against the Clayton County Board of Commissioners

The County Defendants argue that the Board is not an entity that is

capable of being sued and that, therefore, Hill’s claims against it should be

dismissed. (Br. in Supp. of Cnty. Defs.’ Mot. to Dismiss, at 4–5). In response,

Hill argues that the Board is capable of being sued under

, 436 U.S. 658, 690 (1978). (Pl.’s Resp. Br. in Opp’n to Cnty.

Defs.’ Mot. to Dismiss, at 8). The County Defendants rely on

, 261 Ga. App. 667, 669 (2003), in support of their position

that Hill cannot sustain her claim against the Board. (Br. in Supp. of Cnty.

Defs.’ Mot. to Dismiss, at 5; Reply Br. in Supp. of Cnty. Defs.’ Mot. to Dismiss,

at 2). In , a woman was driving her car when she was struck and killed

by an ambulance. , 261 Ga. App. at 667. The ambulance was driven by a

county employee, and the woman’s parents brought a wrongful death action

against the county, the county board of commissioners, and the ambulance

driver. The Georgia Court of Appeals affirmed the trial court’s grant of

summary judgment to the board, finding no independent basis for liability of

the board under a theory of respondeat superior. at 667, 669;

, 261 Ga. 841 (1992) (“In a long line of cases, we,

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and the Court of Appeals, have held that a county board of education, unlike

the school district which it manages, is not a body corporate and does not have

the capacity to sue or be sued.”). The Plaintiff fails to address . The

Plaintiff has also sued the County which is the proper Defendant here if there

is respondeat superior ( ) liability. Accordingly, the County Defendants’

Motion to Dismiss should be granted as to the Board.

D. Hill’s Claims Against Clayton County

The County Defendants next argue that Hill’s federal claims against the

County should be dismissed for failure to state a claim under and that

her state law claims against the County are barred by sovereign immunity.

(Br. in Supp. of Cnty. Defs.’ Mot. to Dismiss, at 3, 5–12). The Court addresses

each of these arguments and Hill’s responses in turn.

1. Federal Claims Against the County

Regarding Hill’s federal claims, the County Defendants argue that the

claims should be dismissed (1) because she fails to allege a constitutional

violation by any County employee and (2) because she fails to allege facts

sufficient to establish liability. ( at 5–6). The County Defendants cite

to two Eleventh Circuit cases in support of their proposition that the complaint

must allege that a County employee committed the underlying constitutional

violation to state a claim under § 1983. ( (citing , 555 F.3d

1317, 1327 (11th Cir. 2009), and , 495 F.3d 1260, 1264 n.7

(11th Cir. 2007)). The Court does not, however, read these cases as establishing

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that “[a]bsent an underlying constitutional violation by one of its employees,

the County cannot be held liable under Section 1983.” ( ). Rather, both cases

stand for the proposition that absent allegations establishing a constitutional

violation itself, a plaintiff cannot state a claim for relief under § 1983. ,

555 F.3d at 1237 (“If no constitutional right would have been violated were the

[complaint’s] allegations established, there is no necessity for further inquiries

concerning qualified immunity.”); , 495 F.3d at 1264 n.7 (“We need not

address the Appellant’s claims of municipal or supervisory liability since we

conclude no constitutional violation occurred.”). Accordingly, the Court

concludes that the County Defendants are not entitled to dismissal of Hill’s

federal claims against the County on this ground.

The County Defendants next argue that Hill’s federal claims against the

County should be dismissed because she fails to allege facts sufficient to

establish liability. (Br. in Supp. of Cnty. Defs.’ Mot. to Dismiss, at 6).

They argue that Hill fails to “demonstrate through specific factual allegations

that the County, through its ‘deliberate conduct,’ was the ‘“moving force”

behind the injury alleged.’” ( at 7 (quoting , 2012 WL

2131117, at *5–6 (M.D. Ga. May 10, 2012))).

Under , a local government body is liable under § 1983 when the

execution of its policy or custom constitutes the “moving force” that inflicts

injury upon an individual in violation of her constitutional rights. , 436

U.S. at 694. To state a claim for § 1983liability against a municipality or other

10

local government entity, a plaintiff must allege plausible facts showing (1) that

her constitutional rights were violated, (2) that the municipality had a custom

or policy that constituted deliberate indifference to her constitutional rights,

and (3) that the custom or policy caused her constitutional violation.

, 392 F.3d 1283, 1289 (11th Cir. 2004).

Hill relies primarily on the case of , 2005

WL 7861525 (N.D. Ga. Sept. 27, 2005), in support of her position that the

County had a policy of not funding or providing medical care to pregnant

detainees. (Pl.’s Resp. Br. in Opp’n to Cnty. Defs.’ Mot. to Dismiss, at 11–13).

The County Defendants argue that the court’s reasoning in supports

dismissal of Hill’s claims. (Br. in Supp. of Cnty. Defs.’ Mot. to Dismiss,

at 9–11; Reply Br. in Supp. of Cnty. Defs.’ Mot. to Dismiss, at 6–8). Before

addressing the three prongs required to establish liability as applied to

the present case, the Court proceeds with a summary of .

The case involved the tragic death of Kassandra Kimbell in late

January 2003, while she was in custody at the Clayton County jail. ,

2005 WL 7861525, at *1–7. Kimbell was pregnant at the time of her death, and

an autopsy determined her cause of death to be a “massive acute

intra-abdominal hemorrhage, due to a ruptured ectopic pregnancy.” at *6.

Kimbell was admitted to the jail in late December 2002, but the parties never

found a record of Kimbell’s initial health assessment upon admission to the

jail, which was required by the national standards for correctional health care.

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On the day before her death, Kimbell began presenting a number of

symptoms related to the ectopic pregnancy. at *1. Kimbell’s interactions

with the jail staff and medical staff in the time leading up to her death

ultimately gave rise to the claims in the underlying lawsuit. at *1–7.

Kimbell’s estate named Clayton County as a defendant in the lawsuit, arguing

that the county denied her statutorily mandated health care, which violated

her constitutional rights and ultimately caused her death. at *9. Kimbell’s

estate argued (1) that the county’s policy of under-staffing caused her lack of

medical care and death and (2) that the county was negligent per se in its

custom of providing inadequate medical care. at *10, *17.

Regarding the first argument, the court determined “that Kimbell’s

Eighth Amendment rights were violated by virtue of the delay in transporting

her to the Jail’s infirmary for treatment and diagnosis,” satisfying the first

prong of her estate’s § 1983 claim. at *11. And the court also assumed,

weighing evidence of under-funding and under-staffing, that the estate

produced sufficient evidence of a custom of under-staffing within the jail.

Nonetheless, the court ultimately granted summary judgment to the county,

concluding that the county’s policy of under-staffing was not the “moving force”

behind the violation of Kimbell’s constitutional rights regarding the delay in

her receiving medical care. at *15. Specifically, the court noted that

was “not a case where jail personnel recognized the seriousness of [her]

condition and attempted to obtain medical treatment, but were stymied in that

12

effort because of delays caused by under-funding or under-staffing,” nor was it

a case “where, because of a lack of staffing, jail personnel were too busy with

other inmates or duties to be aware of what was going on with an inmate.”

Rather, Kimbell’s “death resulted because a particular employee or employees

did not take appropriate action in response to [her] repeated pleas for medical

intervention.” Under those circumstances, the court found no genuine issue

of material fact as to the issue of causation and thus found in favor of the

county on the first argument.

Regarding the second argument, the court briefly considered whether

Kimbell’s estate showed that the county had a policy or custom of providing

inadequate medical care. at *17. The court ultimately concluded that

although Kimbell’s estate cited to “a couple of examples of inmates who had

trouble getting their medication in a timely fashion, [the] isolated incidents

[did] not suggest a pattern that would have put the County on notice that [the

third-party medical care vendor] was providing constitutionally inadequate

care.” For those reasons, the court found no genuine issues of material fact

as to the county’s liability and ultimately granted summary judgment

in favor of the county on all federal claims.

Having summarized the case, the Court now turns to the first

prong of the test required to establish liability: whether Hill plausibly

alleges a violation of her constitutional rights. In her Corrected Amended

Complaint, Hill alleges that the County violated both her and baby D.H.’s

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Eighth and Fourteenth Amendment rights and also baby D.H.’s Fourth

Amendment rights.3 (Corrected Am. Compl. ¶¶ 62, 69, 157). As a preliminary

matter, the Corrected Amended Complaint alleges that Hill was incarcerated

“for a probation violation and for a pending criminal charge.” (Corrected Am.

Compl. ¶ 26). The Court agrees with Hill that her federal claims against the

County (and all Defendants) are therefore properly stated under both the

Eighth and Fourteenth Amendments. ( ); s , 2005 WL

7861525, at *10 (citing , 30 F.3d 1390, 1396 (11th

Cir. 1994)). Because the standard for violation of a convicted detainee’s rights

under the Eighth Amendment is the same as the standard for violation of a

pre-trial detainee’s rights under the Fourteenth Amendment, the Court

considers the claims collectively. , 30 F.3d at 1396.

The Eighth Amendment prohibition on cruel and unusual punishment

encompasses the right of incarcerated people to receive medical treatment, and

any “deliberate indifference to serious medical needs of prisoners constitutes”

3 The County Defendants do not specifically address Hill’s Fourth

Amendment claims on behalf of baby D.H. in either of their briefs, but they

argue that all of Hill’s federal claims against the County should be dismissed

for failure to allege facts supporting liability. (Br. in Supp. of Cnty.

Defs.’ Mot. to Dismiss, at 6). With regard to the Fourth Amendment claim, the

Court agrees. Hill alleges that the “denial of freedom to baby D.H. after his

birth was an unlawful seizure in violation of his [Fourth] Amendment rights,”

(Corrected Am. Compl. ¶ 69), but Hill does not allege that the County had a

policy or custom of unlawfully seizing newborns after their birth at the Jail in

violation of their constitutional rights. Thus, the Court concludes that Hill fails

to state a claim premised upon a violation of baby D.H.’s Fourth Amendment

rights against the County.

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a violation of that right. , 429 U.S. 97, 104 (1976). Such

deliberate indifference applies to the actions of both prison guards in denying

or delaying access to medical care and medical professionals in providing

health care to incarcerated individuals.

Construing the facts as pleaded in the Corrected Amended Complaint in

the light most favorable to Hill, the Court concludes that Hill has adequately

pleaded a violation of her constitutional rights under the Eighth and

Fourteenth Amendments. Specifically, the Court finds that Hill’s allegations

of her denied requests for prenatal care over a period of more than three

months and the thirteen-hour delay in her transfer to the hospital after being

admitted to the Jail infirmary before giving birth plausibly allege a deliberate

indifference to her serious medical needs. (Corrected Am. Compl. ¶ 4–7). Hill’s

allegations are analogous to the violation of Eighth Amendment rights at issue

in where the Northern District found a violation “by virtue of the delay

in transporting [Kimbell] to the Jail’s infirmary for treatment and diagnosis.”

, 2005 WL 7861525, at *11. Thus, Hill sufficiently pleads facts to

establish the first prong of her § 1983 claim under the Eighth and Fourteenth

Amendments against the County.

Turning to the second prong of Hill’s § 1983 claim under , the

Court considers whether the County had a custom or policy that constituted

deliberate indifference to Hill’s constitutional rights. Hill argues that the

County had a policy of not funding or providing medical care to pregnant

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detainees. (Pl.’s Resp. Br. in Opp’n to Cnty. Defs.’ Mot. to Dismiss, at 11). The

County Defendants contend that Hill’s argument is undercut by her claims

against the Medical Defendants, which contemplate the provision of medical

care to individuals who are detained at the Jail. (Br. in Supp. of Cnty. Defs.’

Mot. to Dismiss, at 7–8 (quoting Corrected Am. Compl. ¶¶ 16–17, 155, 175)).

The County Defendants allude specifically to Hill’s claims that the County

medical staff contacted Dr. Clopton when Hill arrived at the Jail’s infirmary,

that Dr. Clopton was given detailed information on Hill’s condition, and that

Hill’s medical screening records from her intake support those facts. (

(quoting Corrected Am. Compl. ¶¶ 122–123; Docs. 42-1, 42-7)). Taken together,

the County Defendants argue that Hill’s claims against the County amount to

implausible and conclusory allegations that are merely naked assertions

devoid of factual enhancement. ( at 8–9).

Having summarized the parties’ arguments regarding the second prong,

the Court notes that Hill’s allegations in her Corrected Amended Complaint

contemplate more than the sheer of funding or provision of medical

care to pregnant detainees. Rather, like the allegations at issue in ,

2005 WL 7861525, at *17, Hill’s allegations hinge on the of that

medical care, specifically in the prenatal context. ( , Corrected Am.

Compl. ¶ 156 (“Defendant Clayton County took no action to address the

of medical care[,] nor did [the County] correct the policy and custom

of as evidenced by the pain and suffering of

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Ms. Tiana Hill and death of baby D.H.” (emphasis added))). Construing the

allegations in the light most favorable to Hill, the Court concludes that Hill

has plausibly pleaded a custom of providing inadequate prenatal care to

pregnant detainees that constituted deliberate indifference to her

constitutional rights. Contrary to the County Defendants’ contention, Hill also

pleads facts that, if true, plausibly support a custom of inadequate prenatal

care to pregnant detainees, claiming for example that she “repeatedly

requested prenatal care but received no medical attention for her pregnancy.”

(Corrected Am. Compl. ¶ 5). If Hill, in fact, requested prenatal care for more

than three months but received no such care, such allegations state a plausible

claim for a violation of her Eighth and Fourteenth Amendment rights. If the

County, during discovery, produces health records showing that Hill received

prenatal care while detained, however, such evidence would likely be sufficient

to refute Hill’s allegations. Nonetheless, at the motion to dismiss stage, the

allegations themselves are sufficient.

In addition, Hill alludes to two other sources to support her contention

that the County had a custom of providing inadequate prenatal care to

pregnant detainees at the Jail. (Corrected Am. Compl. ¶¶ 80–83). First, Hill

provides the sworn affidavit of Ms. Lauren Law, who claims that while she was

detained at the Jail in 2017, she “personally witnessed a lady who appeared to

be 7 to 8 months pregnant repeatedly ask for food and medication” and

“witnessed the jail staff repeatedly deny her food, medication, and medical

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attention.” ( ¶ 82; Doc. 42-5, at 1). Second, Hill provides the sworn affidavit

of Ms. Christine Richardson, a licensed practical nurse who worked at the Jail

in 2018 and who claimed that the Jail had (1) a lack of adequate health

assessments of women during their jail intake, (2) a lack of health services for

pregnant women, (3) a lack of access for women to obstetrical-gynecological

services, and (4) a lack of nursing staff. (Corrected Am. Compl. ¶ 83; Doc. 42-6,

at 1). Richardson also claims that she “personally spoke with Sheriff Victor Hill

on numerous occasions concerning” the deficiencies in prenatal health services

for pregnant women at the Jail, stressing “the seriousness of the perilous [J]ail

conditions and the need for [an] immediate remedy.” (Doc. 42-6, at 1). But

Richardson claims that, to her knowledge, “Sheriff Hill took no action to correct

the deficiencies.” ( at 2).

Taking Hill’s factual allegations concerning her personal experience at

the Jail and the experiences of Law and Richardson at the Jail and construing

those allegations in the light most favorable to Hill, the Court cannot conclude

as a matter of law that Hill fails to plead a custom of inadequate prenatal care

to pregnant detainees at the Jail. As the litigation progresses, these allegations

and the evidence underlying them may ultimately prove insufficient, but they

are more than just a “threadbare recital” of the elements to establish

liability and are therefore sufficient here at the motion to dismiss stage. ,

556 U.S. at 678. Thus, Hill sufficiently pleads facts to establish the second

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prong of her § 1983 claim.4

Finally, regarding the third prong of Hill’s § 1983 claim under ,

the Court considers whether the County’s custom of providing inadequate

prenatal care to pregnant detainees (or was the “moving force” behind)

her constitutional violation—the County’s deliberate indifference to her

serious medical needs. The court in found that the county’s custom of

under-staffing did not cause Kimbell’s constitutional violation because “the

delay in Kimbell’s access to medical care at the infirmary was caused, not by a

lack of staff, but by arguably poor decisions made by the members of this staff.”

, 2005 WL 7861525, at *15. The Court finds that Hill’s allegations here

4 The County Defendants argue that Hill’s § 1983 claims under

against the County should be dismissed because she fails to identify any

instances, other than the case, of widespread abuse. (Br. in Supp. of

Cnty. Defs.’ Mot. to Dismiss, at 9–10 (citing , 522 F. App’x

733, 735 (11th Cir. 2013), , 133 F.3d

797, 802 (11th Cir. 1998), and , 787 F.2d 1496,

1499 (11th Cir. 1986))). Notably, none of the cases that the County Defendants

cite in support of their contention occurred at the motion to dismiss stage, and

two of the cases involved the issue of supervisory liability, not liability,

in the § 1983 context, which is inapplicable here. Further, the Eleventh Circuit

in stated that “[t]o establish a policy or custom, it is necessary

to show a persistent and wide-spread practice.” , 787 F.2d at 1499

(emphasis added). But the court concluded that the plaintiff presented

sufficient evidence to support the jury’s finding of a custom or policy of

improper police misconduct. Here, whether the County in fact had a custom

(or widespread practice) of providing inadequate prenatal care to pregnant

detainees is a question properly resolved at a later stage in this case. And in

addition, Hill cites to the affidavits of Law and Richardson in her Corrected

Amended Complaint, which support her allegations of a practice of inadequate

prenatal care for pregnant detainees at the Jail. Thus, the Court finds the

County Defendants’ argument on widespread abuse unpersuasive.

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are distinguishable from the allegations in . Importantly, allegations

of inadequate prenatal care for pregnant detainees, at the very least, could

have plausibly caused the harm that Hill and baby D.H. suffered. Thus, the

Court concludes that Hill sufficiently pleads facts to establish the third prong

of her § 1983 claim against the County, and accordingly, both Hill and baby

D.H. plausibly state a § 1983 claim under the Eighth and Fourteenth

Amendments against the County.5

2. State Law Claims Against the County

The County Defendants next argue that sovereign immunity bars Hill’s

state law claims against the County, including her claim for false

imprisonment of baby D.H. and her claim for liability for negligence of a

contractor.6 (Br. in Supp. of Cnty. Defs.’ Mot. to Dismiss, at 11–12; Corrected

Am. Compl. ¶¶ 204, 211). Hill does not address the County Defendants’

arguments in her response brief. ( Pl.’s Resp. Br. in Opp’n to Cnty. Defs.’

Mot. to Dismiss, at 9–13). The County Defendants argue that Hill’s failure to

address the arguments constitutes abandonment of the claims. (Reply Br. in

Supp. of Cnty. Defs.’ Mot. to Dismiss, at 9).

5 The County Defendants provide no authority suggesting that baby

D.H. cannot state a claim for violation of his Eighth and/or Fourteenth

Amendment rights against the County under . Thus, the Court

concludes that these claims proceed absent authority to the contrary.

6 The Court notes that Hill’s claim for false imprisonment and her claim

for liability for negligence of a contractor are both labeled as “Count VII” in the

Corrected Amended Complaint. (Corrected Am. Compl., at 39–40).

20

The Constitution of the State of Georgia extends sovereign immunity to

“the state and all of its departments and agencies,” including sheriffs and

counties. Ga. Const. art. I, § II, ¶ IX(e); , 264 Ga. 744, 747

(1994). In addition, “[a] county is not liable to suit for any cause of action unless

made so by statute.” O.C.G.A. § 36-1-4. The Court agrees with the County

Defendants that Hill’s state law claims against the County are barred by

sovereign immunity. Thus, Hill fails to state a claim for false imprisonment

and for liability for negligence of a contractor against the County.

E. Hill’s Claims Against Sheriff Hill in His Official Capacity

The County Defendants move to dismiss the claims against Sheriff Hill

in his official capacity, arguing that the federal claims are barred by Eleventh

Amendment immunity and that the state law claims are barred by sovereign

immunity. (Br. in Supp. of Cnty. Defs.’ Mot. to Dismiss, at 12–15). Regarding

the former, the County Defendants argue that the Eleventh Amendment bars

all of Hill’s claims against Sheriff Hill in his official capacity because he was

acting as an “arm of the State,” and regarding the latter, they argue that

sovereign immunity bars Hill’s state law claims against Sheriff Hill for the

same reasons as her state law claims against the County. ( (citing

, 338 F.3d 1304, 1308 (11th Cir. 2003), and , 270 Ga.

64, 65 (1998))). In response, Hill argues that Sheriff Hill’s operation of “an

unsanctioned paramilitary jail” falls outside the control of the State of Georgia,

that Sheriff Hill is liable for the misconduct of his jail staff, and that Sheriff

21

Hill had a duty to feed and care for all persons charged with violating county

ordinances. (Pl.’s Resp. Br. in Opp’n to Cnty. Defs.’ Mot. to Dismiss, at 13–14

(citing , 226

F.3d 1226, 1231–34 (11th Cir. 2000), and O.C.G.A. §§ 15-16-24, 15-16-10)).

The Eleventh Amendment bars suits against government officials when

they act as “arms of the State.” , 338 F.3d at 1308 (citation omitted).

And the Eleventh Circuit Court of Appeals has set forth four factors to

determine whether an official constitutes an “arm of the State” when carrying

out a particular government function: “(1) how state law defines the entity;

(2) what degree of control the State maintains over the entity; (3) where the

entity derives its funds; and (4) who is responsible for judgments against the

entity.” at 1309. Applying the four factors, the Eleventh Circuit in

determined that the Clinch County sheriff acted as an arm of the State in

establishing a use-of-force policy at the jail and in training and disciplining his

deputies under the policy. at 1328. Under the test, the first three factors

weighed in favor of immunity because the sheriff’s authority to use force was

derived from and controlled by the State and because the sheriff’s office was

partially funded by the state. at 1319–24. And the fourth factor “d[id] not

defeat immunity” because both state and county funds would be implicated by

an adverse judgment against the sheriff in his official capacity. at 1324–29.

Therefore, the Georgia sheriff in was entitled to Eleventh

Amendment immunity. at 1328.

22

The brevity of the parties’ briefing on the issue of Eleventh Amendment

immunity as applied to Georgia county sheriffs posed at present does not

reflect the mountain of existing Eleventh Circuit case law on the issue.

, (finding a Georgia sheriff acted as an arm of the State in establishing

and maintaining a use-of-force policy and thus was entitled to immunity);

, 840 F.3d 1334, 1344 (11th Cir. 2016) (finding a Georgia

deputy sheriff acted as an arm of the State in failing to accommodate a

vegetarian dietary request from a detainee and thus was entitled to immunity);

, 871 F.3d 1340, 1344 (11th Cir. 2017) (en banc)

(denying rehearing of the Eleventh Circuit’s 2016 panel opinion in ).

Most relevantly, in , the Eleventh Circuit revisited its decision in

, applying the four-factor test to determine that a Cobb County deputy

sheriff acted as an arm of the State in providing food to jail detainees and was

therefore entitled to Eleventh Amendment immunity. , 840 F.3d at

1339–44. Notably, though the Eleventh Circuit in indicated that the

sheriff’s provision of food to detainees would not constitute acting as an arm of

the State, the majority panel in nonetheless found that such activity

indeed constituted action as an arm of the State. , 338 F.3d at 1319,

1323 n.43; , 840 F.3d at 1344; ,

393 F. Supp. 3d 1147, 1159 (M.D. Ga. 2019) (summarizing the Eleventh

Circuit’s application of the four factors in ).

23

The Eleventh Circuit’s opinions in and have garnered a

considerable amount of scrutiny in their approach to the four factors

and their ultimate effect on plaintiffs’ § 1983 claims. , , 338

F.3d at 1347 (Barkett, J., dissenting) (“By inventing a previously unknown

function as the purported focus of its analysis, the majority [in ] trades

the clarity to be found in the Georgia law of county jails for a blur of inference

and speculation. The upshot is a substantial blow to established law assuring

citizens’ ability to hold local governments accountable for violations of the

United States Constitution.”); , 840 F.3d at 1345 (Parker, J., dissenting)

(“The majority [in ] . . . los[es] sight of the principal purpose behind the

Eleventh Amendment—not implicated here—of protecting the State’s purse

from federal-court judgments absent consent to suit. The result is a decision

that significantly expands the reach of sovereign immunity and will leave

Georgia counties unanswerable for constitutional violations predicated on

their failure to provide food or any of the other necessities required by

[O.C.G.A.] § 42-5-2.”); , 871 F.3d at 1344 (Martin, J., dissenting from

denial of rehearing en banc) (“[T]he panel opinion is a dramatic

expansion of what had until now been a narrow reach of sovereign immunity

into the administration of Georgia county jails. For the 50,000 people detained

in county jails across the state of Georgia, the consequences of the panel’s

holding are large.”). Such scrutiny, however, has not been so considerable as to

result in a revisiting of and departure from the Eleventh Circuit’s approach in

24

and .

In the wake of and several federal district courts in

Georgia have found that the cases operate to bar a plaintiff’s § 1983 claim

against a Georgia county sheriff accused of failing to provide constitutionally

mandated medical care to a detainee. ,

, 291 F. Supp. 3d 1357, 1360 (M.D. Ga. 2017); , 393 F. Supp. 3d at

1160; , 2020 WL 5608637, at *4–6 (S.D. Ga. Sept.

18, 2020). , 428 F. Supp. 2d 1298, 1318–22

(N.D. Ga. 2006) (finding, in a case predating , that a Georgia sheriff was

not acting as an arm of the State when providing medical care to detainees in

county jail), , 212 F. App’x 916 (11th Cir. 2006). In , the plaintiff

suffered injuries due to inadequate medical care for his sickle cell disease while

detained at the Muscogee County jail, and he brought a § 1983 claim against

the Muscogee County sheriff in his official capacity, among other claims

against other defendants. The sheriff sought dismissal of the claims against

him in his official capacity on Eleventh Amendment grounds under

and .

With reservations as to whether its analysis reached the proper

constitutional result but without hesitation as to whether the result was

required under binding precedent, the U.S. District Court for the Middle

District of Georgia in found “no distinction for Eleventh Amendment

purposes between a county sheriff feeding county detainees in a county jail and

25

a county sheriff taking care of the medical needs of those same county

detainees in that same county jail.” at 1362. The Middle District in

proceeded to address each of the four factors “for the sake of

thoroughness” but reiterated its key holding that the Muscogee County sheriff

was entitled to immunity because the provision of medical care at issue in the

case was indistinguishable from the provision of food at issue in for

Eleventh Amendment purposes.

Here, the Court agrees with the Middle District in and in

that it was likely unnecessary for the court to conduct its own

analysis in light of . ; , 393 F. Supp. 3d at 1160 (“[I]n an effort

to avoid reinventing the wheel (particularly a wheel as well made as ),

the Court will rest its decision on the proposition that ‘because the provision of

medical care cannot be distinguished from the provision of food for Eleventh

Amendment purposes, requires a finding of immunity in this case.’”

(quoting , 291 F. Supp. 3d at 1362)). Therefore, the Court concludes that

a Georgia county sheriff acts as an arm of the State in providing medical care

to detainees and thus is entitled to Eleventh Amendment immunity. 7

Accordingly, Sheriff Hill is entitled to Eleventh Amendment immunity in this

case, and Hill fails to state a claim against Sheriff Hill in his official capacity.

7 Because Sheriff Hill is entitled to Eleventh Amendment immunity

under and for all claims asserted against him in his official

capacity, the Court declines to address whether he is entitled to state sovereign

immunity for Hill’s state law claims against him in his official capacity.

26

F. Hill’s Claims Against Sheriff Hill in His Individual Capacity

The County Defendants next move to dismiss the claims against Sheriff

Hill in his individual capacity, arguing that the federal claims are barred by

qualified immunity and that the state law claims are barred by official

immunity. (Br. in Supp. of Cnty. Defs.’ Mot. to Dismiss, at 15–23). Hill argues,

in response, that Sheriff Hill is not entitled to qualified immunity because he

acted in violation of her constitutional rights and because those actions caused

her injuries. (Pl.’s Resp. Br. in Opp’n to Cnty. Defs.’ Mot. to Dismiss, at 15–22).

The Court addresses each of these arguments and Hill’s responses in turn.

1. Federal Claims Against Sheriff Hill Individually

Regarding Hill’s federal claims, the County Defendants first argue that

the claims against Sheriff Hill in his individual capacity should be dismissed

because Hill fails to allege a constitutional violation by Sheriff Hill and fails to

allege a causal connection between Sheriff Hill’s actions and any violation of

her constitutional rights. (Br. in Supp. of Cnty. Defs.’ Mot. to Dismiss, at 17).8

The Eleventh Circuit has established that supervisors can be held liable for

the constitutional violations of their subordinates under § 1983 “when the

supervisor personally participates in the alleged constitutional violation or

8 The County Defendants also argue here that the claims should be

dismissed because Hill fails to allege a constitutional violation by any County

employee. (Br. in Supp. of Cnty. Defs.’ Mot. to Dismiss, at 16). For the same

reasons discussed in Section III.D.1 above in the context of Hill’s federal claims

against the County, the Court finds this argument unpersuasive.

27

when there is a causal connection between the actions of the supervising

official and the alleged constitutional deprivation.” , 480

F.3d 1265, 1270 (11th Cir. 2007) (citation omitted). Hill does not appear to

allege that Sheriff Hill personally participated in her alleged constitutional

violation; thus, the question here is whether she sufficiently alleges a causal

connection between Sheriff Hill’s actions and her constitutional deprivation.

A causal connection may be established when: 1) a “history of

widespread abuse” puts the responsible supervisor on notice of

the need to correct the alleged deprivation, and he or she fails to

do so; 2) a supervisor’s custom or policy results in deliberate

indifference to constitutional rights; or 3) facts support an

inference that the supervisor directed subordinates to act

unlawfully or knew that subordinates would act unlawfully and

failed to stop them from doing so.

Only the first two showings of causal connection are at issue here.

The County Defendants argue that Hill fails to allege facts plausibly

supporting a claim under either of the two showings of causal connection. (Br.

in Supp. of Cnty. Defs.’ Mot. to Dismiss, at 18).9 They first contend that Hill

fails to allege facts showing a “history of widespread abuse” that put Sheriff

Hill on notice of the need to correct Hill’s alleged deficiency at the Jail or a

“pattern of similar constitutional violations.” ( (quoting ,

9 The County Defendants do not specifically address Hill’s Fourth

Amendment claim on behalf of baby D.H. against Sheriff Hill in his individual

capacity. The Court concludes that Hill fails to plausibly allege a causal

connection sufficient to establish Fourth Amendment liability against Sheriff

Hill. Thus, Hill’s claims against Sheriff Hill in his individual capacity premised

upon a violation of baby D.H.’s Fourth Amendment rights are dismissed.

28

824 F. App’x 938, 941 (11th Cir. 2020))). The County Defendants also contend

that Hill fails to allege facts showing that a custom or policy of Sheriff Hill

resulted in deliberate indifference to Hill’s constitutional rights. (Br. in Supp.

of Cnty. Defs.’ Mot. to Dismiss, at 18).

As discussed above in Section III.D.1 regarding liability, the

Court concludes that Hill has indeed plausibly alleged facts indicating a

custom of providing inadequate prenatal care to pregnant detainees at the Jail.

Further, Hill also alleged facts indicating that Sheriff Hill was on notice of the

deficiency in prenatal care for pregnant detainees but failed to take corrective

action, such that the custom is attributable to his inaction. (Corrected Am.

Compl. ¶ 80–84). Such allegations support a plausible claim that Sheriff Hill

had a custom of providing inadequate prenatal care to pregnant detainees at

the Jail and that Sheriff Hill’s custom violated Hill’s constitutional right to

receive medical treatment while being detained. , 429 U.S. at 104.

Accordingly, the Court concludes that Hill has adequately pleaded causal

connection, and thus, Sheriff Hill is not entitled to dismissal of Hill’s § 1983

claim against him on that ground.

The County Defendants next argue that even if Hill sufficiently alleges

a constitutional violation attributable to Sheriff Hill, her federal claims against

Sheriff Hill in his individual capacity should be dismissed because he did not

violate any clearly established law and is therefore entitled to qualified

immunity. “Qualified immunity protects government officials performing

29

discretionary functions from suits in their individual capacities unless their

conduct violates clearly established statutory or constitutional rights of which

a reasonable person would have known.” , 884 F.3d 1290,

1296 (11th Cir. 2018) (quotation marks omitted). “Although the defense of

qualified immunity is typically addressed at the summary judgment stage of a

case, it may be raised and considered on a motion to dismiss.”

, 929 F.3d 1304, 1311 (11th Cir. 2019) (quotation marks, alteration, and

citation omitted). “Generally speaking, it is proper to grant a motion to dismiss

on qualified immunity grounds when the complaint fails to allege the violation

of a clearly established constitutional right.” (quotation marks and citation

omitted). As with any other motion to dismiss, the alleged facts are accepted

as true, and all inferences are drawn in the plaintiff’s favor.

, 285 F.3d 1334, 1337 (11th Cir. 2002). However, “[o]nce an

officer has raised the defense of qualified immunity, the burden of persuasion

on that issue is on the plaintiff.” Indeed, “the driving force behind creation

of the qualified immunity doctrine was a desire to ensure that insubstantial

claims against government officials will be resolved prior to discovery.”

, 555 U.S. 223, 231 (2009) (quotation marks, alteration,

and citation omitted). To overcome the qualified immunity defense, Hill must

make two showings in her Corrected Amended Complaint: (1) that Sheriff Hill

violated a constitutional right, and (2) that the right in question was clearly

established at the time of its violation. , 929 F.3d at 1311.

30

As established above in this Section regarding Sheriff Hill’s supervisory

liability, the Court concludes that Hill has adequately alleged facts supporting

a plausible claim that Sheriff Hill violated her constitutional right to receive

medical treatment under the Eighth and Fourteenth Amendments, and those

rights were indeed clearly established at the time of the alleged violation.

, 429 U.S. at 104. Accordingly, the Court concludes that Sheriff Hill is

not entitled to dismissal of Hill’s federal claims against him in his individual

capacity on the ground of qualified immunity.

2. State Law Claims Against Sheriff Hill Individually

Regarding Hill’s state law claims against Sheriff Hill in his individual

capacity, the County Defendants argue that the claims should be dismissed

because they are barred by official immunity. (Br. in Supp. of Cnty. Defs.’ Mot.

to Dismiss, at 21). The County Defendants also argue that the claims should

be treated as abandoned and therefore subject to dismissal because Hill offered

no opposition to Sheriff Hill’s claim of official immunity in her response brief.

(Reply Br. in Supp. of Cnty. Defs.’ Mot. to Dismiss, at 14).

Under Georgia’s official immunity doctrine, state officials may be held

liable for their ministerial acts performed negligently but are immune from

liability for their discretionary acts unless they acted “with actual malice or

with actual intent to cause injury in the performance of their official functions.”

Ga. Const. art. I, § 2, ¶ IX(d). The County Defendants claim that Hill’s

allegations implicate Sheriff Hill’s discretionary functions, in that they are

31

premised on his responsibility for supervising the Jail. (Br. in Supp. of Cnty.

Defs.’ Mot. to Dismiss, at 22 (citing , 260 Ga. App. 187, 191

(2003), , 301

Ga. 257 (2017))). The Court agrees. Sheriff Hill’s failure to ensure the provision

of adequate prenatal care to pregnant detainees was more so an “exercise of

personal deliberation and [lack of] judgment,” as opposed to a simple, absolute,

or definite task. , 211 Ga. App. 156, 157 (1993). Therefore,

Sheriff Hill is entitled to official immunity on Hill’s state law claims against in

him in his individual capacity unless he acted with actual malice.

Under Georgia law, the actual malice standard is a demanding one that

“requires an officer to act with a deliberate intention to do a wrongful act”;

unreasonable or even recklessly illegal conduct does not support such an

inference. , 811 F.3d 1259, 1266 (11th Cir. 2016) (quotation

marks and citation omitted). Importantly, “the actual malice necessary to

overcome official immunity must be the intent to cause the harm suffered by

the plaintiff.” , 304 Ga. App. 47, 49 (2010). The Court agrees

with the County Defendants that Hill fails to allege facts showing that Sheriff

Hill intended to cause the harm that Hill suffered. (Br. in Supp. of Cnty. Defs.’

Mot. to Dismiss, at 23). Accordingly, Sheriff Hill is entitled to official immunity

on Hill’s state law claims against him in his individual capacity.

32

G. Hill’s Claims for Punitive Damages and Attorney’s Fees

Finally, the County Defendants move to dismiss Hill’s claims for

punitive damages and attorney’s fees. (Br. in Supp. of Cnty. Defs.’ Mot. to

Dismiss, at 24–25). As to the former, the Court agrees. ,

363 Ga. App. 466, 473 (2022) (“Georgia law does not permit punitive damages

against a governmental entity.”);

, 580 F. Supp. 3d 1314, 1350 (N.D. Ga. 2021). Thus, to the extent Hill

seeks to recover punitive damages from government entities—the County, the

Board, and Sheriff Hill in his official capacity—those claims are dismissed. As

to the latter, the Court disagrees. 42 U.S.C. § 1988(b) (“In any action or

proceeding to enforce a provision of [42 U.S.C. § 1983], the court, in its

discretion, may allow the prevailing party, other than the United States, a

reasonable attorney’s fee as part of the costs . . . .”). Thus, Hill’s claim for

attorney’s fees may proceed.

IV. Conclusion

For the reasons set forth above, the Medical Defendants’ Motion to

Dismiss [Doc. 48] is GRANTED, and the County Defendants’ Motion to Dismiss

[Doc. 49] is GRANTED in part and DENIED in part. The County Defendants’

Motion to Dismiss is GRANTED as to: the claims against the John Doe

Defendants; all claims against the Board; the Fourth Amendment and state

law claims against the County; all claims against Sheriff Hill in his official

capacity; the Fourth Amendment and state law claims against Sheriff Hill in

33

his individual capacity; and the claims for punitive damages against the

County and Sheriff Hill in his official capacity. The County Defendants’ Motion

to Dismiss is DENIED as to: the Eighth and Fourteenth Amendment claims

against the County and Sheriff Hill in his individual capacity; the claim for

punitive damages against Sheriff Hill in his individual capacity; and the claim

for attorney’s fees.

SO ORDERED, this 9th day of December, 2022.

A torres Wo Tpiroe 4

THOMAS W. THRASH, JR.

United States District Judge

34