Gandara v. Kane County

IN THE UNITED STATES DISTRICT COURT

FOR THE NORTHERN DISTRICT OF ILLINOIS

EASTERN DIVISION

ANTONIO GANDARA, SR., as the )

legal guardian of Antonio Gandara, Jr., )

)

Plaintiff, )

) No. 21-cv-03819

v. )

) Judge Andrea R. Wood

KANE COUNTY, Kane County Sheriff )

RONALD HAIN, et al., )

)

Defendants. )

MEMORANDUM OPINION AND ORDER

Antonio Gandara, Jr. (“Gandara”) was remanded into custody at the Kane County Jail

(“Jail”) after being found mentally unfit to stand trial in Kane County Circuit Court. While at the

Jail, Gandara frustrated attempts to complete a medical evaluation by refusing to speak, staring

intently at the jail cell wall, and otherwise exhibiting psychotic behavior. After just over two

weeks, he refused food and recreational time and exhibited an unsteady gait. Soon after, he

collapsed in his cell and was diagnosed with hypernatremia, leading to a hypoxic brain injury

and rendering him disabled and reliant on a caregiver. Gandara’s father, Plaintiff Antonio

Gandara, Sr. (“Plaintiff”) has brought this lawsuit against Defendants Kane County, Ronald Hain

(in his official capacity as Kane County Sheriff), Wexford Health Sources, Inc. (“Wexford”), and

several Wexford employees for, among other things, deliberate indifference to Gandara’s health

and safety. Before the Court is Kane County and Hain’s (“County Defendants”) motion to

dismiss the claims against them pursuant to Federal Rule of Civil Procedure 12(b)(6). (Dkt. No.

22.) For the reasons stated below, the motion is granted.

BACKGROUND

For purposes of County Defendants’ motion to dismiss, the Court “accept[s] all well-

pleaded facts as true and draw[s] all reasonable inferences in favor of the non-moving party.”

Bell v. City of Country Club Hills, 841 F.3d 713, 716 (7th Cir. 2016). The Second Amended

Complaint (“SAC”) alleges as follows.

Following an arrest in July 2020, a judge of the Kane County Circuit Court found

Gandara “mentally unfit to stand trial” and sent him to the Jail “for the purpose of an immediate

medical evaluation and placement in a treatment facility to restore his mental fitness to stand

trial.” (SAC ¶ 23, Dkt. No. 51.) Wexford provides healthcare to inmates and prisoners held in

custody in the State of Illinois. (Id. ¶ 11.) Once Gandara was in custody, six different Wexford

employees attempted to evaluate him medically. (Id. ¶¶ 25–30.) But the evaluation was never

completed. Instead, during each attempt, Gandara refused to speak or participate and exhibited

“psychotic behavior.” (Id. ¶¶ 25–30.) Plaintiff also sent correspondence to a Wexford employee

outlining his son’s troubled psychological history. (Id. ¶ 27.)

After a few weeks in the Jail, Gandara’s behavior came to the attention of a Sheriff’s

deputy. Upon noticing that Gandara “did not eat breakfast, refused shower/rec. time, and

appeared to have [an] unsteady gait,” the deputy notified a Wexford employee and a food log

was started for Gandara. (Id. ¶ 32.) The next day, Gandara collapsed in his cell and he was

subsequently diagnosed with hypernatremia at Northwestern Medicine Delnor Hospital. (Id.

¶ 33.) Gandara’s hypernatremia caused a hypoxic brain injury, “leaving him wholly disabled and

dependent on a care giver.” (Id. ¶ 40.) During his weeks in the Jail, Wexford staff and the Jail did

not coordinate care. (Id. ¶ 39.)

Plaintiff has brought the present lawsuit on behalf of his son against Kane County; Hain,

in his official capacity as Kane County Sheriff; Wexford; and a number of Wexford employees

who provided health services to inmates at the Jail. The present motion addresses only the three

claims against County Defendants.1 Count I asserts a claim against Kane County pursuant to 42

U.S.C. § 1983 for the alleged violation of Gandara’s Fourteenth Amendment rights through the

deliberate indifference to his health and safety while at the Jail. Count II sets forth a § 1983

claim against Hain based on Monell v. Department of Social Services of the City of New York.,

436 U.S. 658 (1978), alleging that the Jail violated Gandara’s rights as a result of a practice,

policy, or custom authorized by Hain. And finally, Count VII sets forth an indemnification claim

under state law against Kane County.

DISCUSSION

To survive a Rule 12(b)(6) motion, “a complaint must contain sufficient factual matter,

accepted as true, to ‘state a claim to relief that is plausible on its face.’” Ashcroft v. Iqbal, 556

U.S. 662, 678 (2009) (quoting Bell Atl. Corp. v. Twombly, 550 U.S. 544, 570 (2007)). This

pleading standard does not necessarily require a complaint to contain detailed factual

allegations. Twombly, 550 U.S. at 555. Rather, “[a] claim has facial plausibility when the

plaintiff pleads factual content that allows the court to draw the reasonable inference that the

defendant is liable for the misconduct alleged.” Adams v. City of Indianapolis, 742 F.3d 720, 728

(7th Cir. 2014) (quoting Iqbal, 556 U.S. at 678).

1 County Defendants initially filed the present motion to dismiss in response to the First Amended

Complaint. When Plaintiff was subsequently granted leave to file the Second Amended Complaint to add

an additional claim against the Wexford defendants, the parties agreed that the previously filed motion

and briefing would be considered as directed toward the Second Amended Complaint.

I. Section 1983 Claim against Kane County (Count I)

Kane County argues that it cannot be held liable under § 1983 for the harms allegedly

suffered by Gandara because the Sheriff, not the County, bears responsibility for the Jail, and the

County neither makes policy for nor employs the Sheriff.

Plaintiff mounts no rebuttal. In opposing County Defendants’ motion to dismiss, his

argument is limited to the § 1983 claim against Hain. But Count I of the SAC is directed against

only Kane County. (Compare First Am. Compl. ¶¶ 29–35, Dkt. No. 19, with SAC ¶¶ 52–58.)2 In

any case, Hain, not Kane County, controls the Jail. See Moy v. County of Cook, 640 N.E.2d 926,

928–31 (Ill. 1994); 55 ILCS 5/3-6017 (“[The sheriff] shall have the custody and care of the

courthouse and jail of his or her county, except as is otherwise provided.”). And “in Illinois, the

Sheriff is an independently elected officer who is accountable only to the people, rather than to

the County board.” Thomas v. Cook Cnty. Sheriff’s Dep’t, 604 F.3d 293, 305 n.4 (7th Cir. 2010);

see also Franklin v. Zaruba, 150 F.3d 682, 686 (7th Cir. 1998) (“[S]heriffs are agents of the

county, but they are separate from the county boards to such a degree that the county boards

cannot be held liable for their actions under respondeat superior.”). In other words, Kane County

bears no substantive liability for actions allegedly taken by Hain and the Wexford defendants.

See Bd. of Cnty. Comm’rs of Bryan Cnty. v. Brown, 520 U.S. 397, 403 (“We have consistently

refused to hold municipalities liable under a theory of respondeat superior.”); Thompson v.

Duke, 882 F.2d 1180, 1187 (7th Cir. 1989) (“Thompson cannot maintain a section 1983 action

2 At times, Plaintiff appears to make roundabout references to the County in his brief—for example, he

contends that “[t]hese allegations are sufficient to assert a deliberate indifference claim against Sheriff

Hain and put the Defendants on notice as to Plaintiff’s claims that all Defendants were aware of

[Gandara’s] serious medical needs and displayed deliberate indifference to those needs . . . .” (Defs.’ Mot.

to Dismiss at 3.) But even if such references address the claim against Kane County, rather than just the

claim against Hain, they fail to respond effectively to the arguments with respect to Kane County in

County Defendants’ motion.

against Cook County for ‘practices, policies, or actions’ which are unrelated to that entity. We

therefore affirm the district court’s grant of summary judgment in favor of Cook County under

Monell.”). For these reasons, Count I is dismissed.

II. Monell Claim against Sheriff Hain (Count II)

Even though Hain, in his role as Kane County Sheriff, is responsible for the Jail, he can

be held liable under § 1983—absent his personal involvement in the alleged constitutional

violation—only if “the action that is alleged to be unconstitutional implements or executes a

policy statement, ordinance, regulation, or decision officially adopted and promulgated by [the

Sheriff’s] officers.” Monell, 436 U.S. at 690. The Seventh Circuit recognizes three ways in

which a government unit can responsible for constitutional violations under § 1983:

(1) through an express policy that, when enforced, causes a

constitutional deprivation; (2) through a wide-spread practice that

although not authorized by written law and express policy, is so

permanent and well-settled as to constitute a custom or usage with

the force of law; or (3) through an allegation that the constitutional

injury was caused by a person with final decision policymaking

authority.

Calhoun v. Ramsey, 408 F.3d 375, 379 (7th Cir. 2005) (internal quotation marks omitted). The

SAC identifies four specific practices at the Jail that allegedly “put pretrial detainees . . . at

serious risk”: (1) insufficient staffing that prevented adequate cell checks; (2) not requiring

“correctional officers to perform regular cell checks;” (3) not “maintain[ing] food logs to ensure

pretrial detainees with known psychological disabilities were adequately fed and hydrated;” and

(4) “[f]ailing to promulgate standards, policies, and procedures for medical evaluation, treatment

and care.” (SAC ¶ 63.)

County Defendants argue that Plaintiff has failed to plead widespread abuse or any other

occurrences to support a Monell claim.3 In response, Plaintiff asserts that he need not present

multiple occurrences but instead can overcome a Rule 12(b)(6) motion by pleading based on

Gandara’s own experience.

Notably, while the FAC was limited to Gandara’s own situation, the SAC now includes

allegations regarding four other instances between 2013 and 2019 in which the Jail was sued by

inmates for issues involving deficient medical treatment. (SAC ¶¶ 47–51.) Still, the four

instances alleged in the SAC—which span a six-year period and are presented without an

explanation as to how they support an inference of a widespread practice—are insufficient

plausibly to suggest a “specific pattern or series of incidents that support the general allegations

of a custom or policy.” Hollins v. City of Milwaukee, 574 F.3d 822, 827 (7th Cir. 2009). Indeed,

outside of the fact that each incident involved a bad medical outcome, it is difficult to glean from

the SAC how the various incidents are at all similar to Gandara’s situation. According to the

SAC, one of the instances involved a pretrial detainee who was injured falling from a bunk bed.

(SAC ¶ 50.) Another consists of a medical malpractice suit alleging failure to provide an inmate

with necessary medication. (Id. ¶ 47.) A third involved medical personnel allegedly ignoring

complaints of pain. (Id. ¶ 49.) And the final one concerned allegedly improper psychiatric care

leading to a suicide attempt. (Id. ¶ 48.) But the SAC does not allege, or support a plausible

inference, that cell checks or food logs (i.e., the practices that Plaintiff alleges to have been

deficient with respect to Gandara’s care) would have prevented any of the other instances of

alleged deliberate indifferent or even have reduced the risk of them occurring.

3 The SAC also alleges that Hain had final policymaking authority (SAC ¶ 66), which is one of the

Seventh Circuit’s recognized Monell prongs. But Plaintiff has clarified in his brief that he “is solely

alleging a Monell violation under the second prong.” (Pl’s Opp’n to Mot. to Dismiss at 8–9, Dkt. No. 17.)

The four other isolated incidents of alleged deliberate indifference occurring over a span

of six years share little in common with Gandara’s situation. At most, the incidents might be read

as supporting Plaintiff’s fourth allegation of an improper policy: “[f]ailing to promulgate

standards, policies, and procedures for medical evaluation, treatment and care.” (Id. ¶ 63.) But

nothing in the SAC otherwise indicates that the Jail lacks such standards. To the contrary, the

SAC alleges that multiple Wexford employees attempted to evaluate Gandara and there is no

indication that they raised any concerns with Hain or his employees. The SAC also does not

allege that Hain was aware of the letter Plaintiff sent to a Wexford employee detailing his son’s

psychological history. The four disparate instances of prior alleged deliberate indifference to

health and safety, combined with the allegations regarding the alleged indifference to Gandara’s

health and safety, are not enough to support a plausible inference of a broad failure to

promulgate adequate standards, policies, and procedures for medical evaluation, treatment, and

care. In short, Plaintiff has failed to plead sufficient facts to establish an inference that there is a

widespread practice “so permanent and well-settled as to constitute a custom or usage with the

force of law.” Calhoun, 408 at 379 (internal quotation marks omitted).

Plaintiff cites White v. City of Chicago, 829 F.3d 837, 844 (7th Cir. 2016), for the

proposition that he need not identify “even one other individual” affected by the alleged policy

or practice to state a claim. But in White, the finding of a widespread policy from a single

instance was based on a standard-issue warrant form used by the Chicago Police Department.

See White, 829 F.3d at 844. The use of such a standard-issue warrant form for a large police

department plausibly suggests a widespread practice. It is true that single-individual allegations

may be sufficient “where . . . the complaint charges the municipality or other governmental

entity with having engaged in improper conduct directly.” Jackson v. Marion County, 66 F.3d

151, 152–53 (7th Cir. 1995). But Plaintiff here alleges that it was Wexford staff, not Hain or Jail

officials, who “engaged in improper conduct directly” as to Gandara.

While it is possible to clear the plausibility hurdle by pleading one’s own experience, “it

is necessarily more difficult . . . because what is needed is evidence that there is a true municipal

policy at issue, not a random event.” Grieverson v. Anderson, 538 F.3d 763, 774 (7th Cir. 2008).

And the individualized experience of Gandara was of Jail officials allegedly reporting medical

events and delegating medical questions to Wexford medical staff. The Seventh Circuit has made

clear that when jail officials “reasonably relied on the judgment of medical personnel,” they did

not act with deliberate indifference. Miranda v. Cnty. of Lake, 900 F.3d 335, 343 (7th Cir. 2018).

The inadequate treatment of Gandara that Plaintiff alleges came entirely at the hands of Wexford

employees. (See SAC ¶¶ 25–31.) The SAC specifically alleges that a Sheriff’s deputy informing

Wexford personnel that Gandara “did not eat breakfast, refused shower/rec. time, and appeared

to have unsteady gait.” (Id. ¶ 32.) At that point, a food log was started. (Id.) In other words, the

deputy noted a potential medical issue and reported it to medical personnel, who subsequently

acted on the report. What the SAC does not allege is that the Sheriff, or any of his employees,

“ha[d] a reason to believe (or actual knowledge) that prison doctors or their assistants are

mistreating (or not treating) a prisoner.” Arnett v. Webster, 658 F.3d 742, 755 (7th Cir. 2011).

Medical personnel repeatedly evaluated Gandara and declined to take more drastic steps, such as

admitting him to a mental health facility or ordering closer observation. There is no indication

that Jail officials should have gleaned that Gandara was being mistreated.

County Defendants also contend that Plaintiff fails to allege that any widespread policy

was the moving force behind Gandara’s injury. Plaintiff responds by arguing that it was the

failure to provide treatment in response to Gandara’s actions that constituted the moving force

leading to his injury. But again, all that Plaintiff alleges is a generalized complaint regarding the

sufficiency of medical treatment in the Jail; he does not adequately allege a specific Jail policy

that led to Gandara’s injury. See Thomas, 604 F.3d at 307 (“The relevant question for the

causation requirement is whether the Sheriff's policy of understaffing was the reason the CMTs

could not access the forms on those days that Smith and the other inmates claimed to have

submitted their requests.” (emphasis in original)).

Under Plaintiff’s view, any bad medical outcome would be enough to establish a Monell

claim if some different action may have been taken somewhere along the line that might have

avoided that outcome. But such a tangential relationship between the alleged municipal action

and the alleged constitutional violation is not enough to plead that the action was a moving force

behind the violation. See Brown, 520 U.S. at 404 (“[A] plaintiff must show that the municipal

action was taken with the requisite degree of culpability and must demonstrate a direct causal

link between the municipal action and the deprivation of federal rights.”); City of Oklahoma City

v. Tuttle, 471 U.S. 808, 823 (1985) (“At the very least there must be an affirmative link between

the policy and the particular constitutional violation alleged.”). Thus, Plaintiff has not adequately

that the Sheriff’s “policies [were] the moving force behind the constitutional violation.” Thomas,

604 F.3d at 306 (emphasis in original).

For these reasons, Count II is dismissed.

III. Indemnification (Count VII)

Lastly, County Defendants seek dismissal of Count VII, which seeks indemnification by

Kane County “for any judgments in this case arising from the Defendants’ actions.” (SAC ¶ 97.)

The Court has dismissed both claims implicating the County and the Sheriff. Because those

claims have been dismissed, there is nothing for the County potentially to indemnify. See Askew

v. Sheriff of Cook Cnty., Ill., 568 F.3d 632, 637 (7th Cir. 2009). For that reason, Claim VII

seeking indemnification is dismissed as to Kane County.

CONCLUSION

Accordingly, for the reasons stated above, County Defendants’ motion to dismiss Counts

I, II, and VII (Dkt. No. 22) is granted. Counts I, II, and VII are dismissed as to the County

Defendants.

ENTERED:

Dated: November 1, 2022 aaaechw

Andrea R. Wood

United States District Judge

10