# Antonio v. Board of County Commissioners for the County of Cibola

> District Court, D. New Mexico · September 2, 2020

URL: https://www.frixlaw.com/law-library/cases/10280594

## Case

- **Court:** District Court, D. New Mexico
- **Decided:** September 2, 2020
- **Opinion:** 100trialcourt
- **Cited by:** 0 later opinions in the Frix Law Library

## Citator (automated)

- No negative treatment found by the automated citator. That is not the same as a confirmation that the case is good law; read the citing cases.
- Full citator and citing cases: https://www.frixlaw.com/law-library/cases/10280594

## How later opinions describe it (automated extraction)

- noting that “[n]ormally, a single recent case from one circuit is not sufficient to make the law clearly established in another circuit”
- observing that “if an official is aware of the potential for harm but takes reasonable efforts to avoid or alleviate that harm, he bears no liability”
- recognizing that “there is little doubt that deliberate indifference to an inmate’s serious medical need is a clearly established constitutional right”

## Opinion text

IN THE UNITED STATES DISTRICT COURT

FOR THE DISTRICT OF NEW MEXICO

NATALIA ANTONIO, a Personal Representative
To the Estate of RUBEN TOLEDO, deceased,

Plaintiff,

vs. Civ. No. 19-572 KG/JFR

BOARD OF COUNTY COMMISSIONERS FOR
THE COUNTY OF CIBOLA, ADRIANNE JARAMILLO,
LISA BURNSIDE, MICHAEL HILDENBRANT,
AND MICHELLE LUCERO,

Defendants.

MEMORANDUM OPINION AND ORDER

On July 1, 2017, Ruben Toledo died at the University of New Mexico Hospital. He had
been transferred there from the Cibola General Hospital, where he had undergone emergency
medical attention due to a loss of consciousness and severe seizure episodes while a pre-trial
detainee at the Cibola County Detention Center (CCDC). Toledo’s personal representative filed
this lawsuit against Defendants, including CCDC and certain staff members, claiming inter alia
violation of Federal Civil Rights Act and the Constitution of the United States. (Doc. 3,
Amended Complaint).
Defendants Michelle Lucero and Michael Hildenbrant filed the instant motion under Fed.
R. Civ. P. to dismiss Count 1 of the complaint as it applies to them, asserting qualified immunity.
(Doc. 27). The matter now is fully and timely briefed. See (Doc. 37, Response and Doc. 38,
Reply). This Court notes jurisdiction under 28 U.S.C. § 1331 and 42 U.S.C. §§ 1983 and 1988.
Having considered the briefing, the Amended Complaint for the Recovery of Damages Caused
by the Deprivation of Civil Rights and Wrongful Death (Amended Complaint) (Doc. 3), the
controlling law, and for the following reasons, the Court now grants the Motion to Dismiss.
I. Summary of the Amended Complaint1
On June 20, 2017, a United States Park Ranger arrested Ruben Toledo at the Petroglyph
National Park “for suspicion of operating a motor vehicle while intoxicated.” (Doc. 3) at ¶¶ 18-

21. The Park Ranger transported Toledo to the Sandoval County Detention Center and Toledo
was transferred to the Cibola County Detention Center (CCDC) the next day. Id. at ¶ 22.
Upon his arrival Toledo allegedly told CCDC staff that “he suffered from depression and
anxiety, and staff noted he was chemically impaired.” Id. at ¶ 24. Toledo also allegedly reported
“prior to being booked” that he used alcohol daily. Id. at ¶ 34. According to Plaintiff, Toledo’s
vitals were abnormal at the time of booking. Id. at ¶ 26. Nonetheless, Plaintiff claims “staff
cleared [Toledo] for housing in general population.” Id. at ¶ 28.
Plaintiff alleges that Toledo asked to be removed from the “general population because
he feared he was in danger of bodily harm by other inmates if he remained.” Id. at ¶ 31.

Plaintiff also alleges Toledo “began seeing things in his cell….” Id. at ¶ 32.
On June 23, 2017, Defendant Lucero, a physician’s assistant, examined Toledo. Id. at ¶
33. Defendant Lucero purportedly noted that Toledo’s “blood pressure and pulse were still
elevated….” Id. at ¶ 35. According to Plaintiff, “Defendant Lucero noted that Mr. Toledo was a
‘difficult historian’ with a ‘poor memory’ and that he had a knowledge deficit.” Id. at ¶ 36.
Plaintiff contends that Defendant Lucero prescribed “Lisinopril, a blood pressure medication,

1 The Court summarizes only those portions of the Amended Complaint that are relevant to the
Motion to Dismiss.
and Metformin, a medication used to treat diabetes.” Id. at ¶ 38. Plaintiff alleges that Toledo
then went “back to his cell with no further care or monitoring ordered.” Id. at ¶ 39.
Plaintiff further alleges that later that day Toledo began “screaming to be let out of his
cell” and hallucinating. Id. at ¶¶ 40-41. Plaintiff asserts that when jail officers went to check on
Toledo, he ran to get out of his cell, causing jail officers to mace and handcuff him. Id. at ¶¶ 42-

43. Plaintiff maintains that jail officers then decided to have Toledo medically cleared in order
to house him in segregation. Id. at ¶ 44.
Plaintiff contends that Toledo “told medical staff that he was experiencing alcohol
withdrawal and was hallucinating.” Id. at ¶ 46. Plaintiff also contends that Toledo’s “vitals were
still abnormal.” Id. at ¶ 52. According to Plaintiff, medical staff contacted Defendant
Hildenbrant, a nurse without prescribing authority, for instructions. Id. at ¶¶ 47 and 49.
“Defendant Hildenbrant was not at the facility.” Id. at ¶ 48. Plaintiff alleges that “Defendant
Hildenbrant directed staff to place [Toledo] on alcohol withdrawal protocol, including
prescription medication, over the phone.” Id. at ¶ 50.

Plaintiff maintains that Toledo went back to segregation where he “was observed
periodically by jail guards,” but “not monitored by medical staff.” Id. at ¶¶ 56-57. According to
Plaintiff, beginning the night Toledo returned to segregation, he began acting erratically and
could not stand on his own. Id. at ¶¶ 58-67. The next morning, Plaintiff claims Toledo suffered
a seizure and injured his head. Id. at ¶¶ 72-78. Plaintiff alleges that Toledo finally became
unresponsive and was transported to Cibola General Hospital and then to the University of New
Mexico Hospital. Id. at ¶¶ 84-96. Toledo never regained consciousness and was removed from
life support on July 1, 2017, and, consequently, died. Id. at ¶¶ 97-99. This lawsuit follows.
In Count I of the Amended Complaint, Plaintiff brings a 42 U.S.C. § 1983 claim against
Defendants Lucero and Hildenbrant, in their individual capacities, for violating Toledo’s
Fourteenth Amendment right to adequate medical care.2 Plaintiff alleges that Defendant Lucero
knew that Toledo was “chemically impaired” but failed to adequately monitor Toledo for alcohol
withdrawal. Id. at ¶¶ 105, 124-25. Plaintiff also alleges that when Defendant Hildenbrant

learned that Toledo was hallucinating Defendant Hildenbrant should have transferred Toledo to a
hospital rather than prescribe alcohol withdrawal medications (Librium and Clonidine), without
the prescribing authority to do so, over the phone. Id. at ¶¶ 116-20. Furthermore, Plaintiff
asserts that Defendant Hildenbrant failed to monitor Toledo’s condition. Id. at ¶¶ 124-25.
II. The Motion to Dismiss
Defendants Lucero and Hildenbrant move under Fed. R. Civ. P. 12(b)(6) to dismiss
Count I, as it applies to them, on the basis of qualified immunity. First, Defendants Lucero and
Hildenbrant argue that Plaintiff fails to state plausible Fourteenth Amendment claims against
them for failure to provide adequate medical care. Second, Defendants Lucero and Hildenbrant

argue that they “were unable to locate a case which would establish that the Defendants’ alleged
conduct violated clearly established law.” (Doc. 27) at 10. Plaintiff opposes the Motion to
Dismiss in its entirety.
III. Standard of Review
“To survive a motion to dismiss, a complaint must contain sufficient factual matter,

2 Plaintiff also brings Count I against Defendant Lisa Burnside, a CCDC sergeant. In addition to
Count I, Plaintiff brings Counts II and III, negligence claims, against Defendants Board of
County Commissioners for the County of Cibola, Lucero, Hildenbrant, and Burnside. Finally,
Plaintiff brings Count IV against Defendant Adrianne Jaramillo, the CCDC administrator,
alleging that “Defendant Jaramillo practiced a custom and policy of providing inadequate
medical care to inmates at CCDC.” (Doc. 3) at ¶ 184.
accepted as true, to state a claim to relief that is plausible on its face.” Emps.’ Ret. Sys. of R.I. v.
Williams Cos., Inc., 889 F.3d 1153, 1161 (10th Cir. 2018) (citation omitted). “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.” Free Speech v. Fed. Election
Comm'n, 720 F.3d 788, 792 (10th Cir. 2013) (citation omitted). In making this plausibility

assessment, courts “accept as true ‘all well-pleaded factual allegations in a complaint and view
these allegations in the light most favorable to the plaintiff.’” Schrock v. Wyeth, Inc., 727 F.3d
1273, 1280 (10th Cir. 2013) (citation omitted).
In evaluating a qualified immunity defense in the context of a Rule 12(b)(6) motion to
dismiss, courts “must determine whether the plaintiff pled facts indicating: (1) the defendant
violated a statutory or constitutional right and (2) that right was ‘clearly established’ at the time
of the challenged conduct.” Crall v. Wilson, 769 Fed. Appx. 573, 575 (10th Cir. 2019) (quoting
Ashcroft v. al-Kidd, 563 U.S. 731, 735 (2011)). “The burden of making this two-part showing
lies with the plaintiff….” Carabajal v. City of Cheyenne, Wyoming, 847 F.3d 1203, 1208 (10th

Cir. 2017). “This is a heavy burden.” Id. Moreover, courts “may address the two prongs of the
qualified immunity analysis in either order: ‘[I]f the plaintiff fails to establish either prong of the
two-pronged qualified-immunity standard, the defendant prevails on the defense.’” Cummings v.
Dean, 913 F.3d 1227, 1239 (10th Cir.), cert. denied sub nom. Cummings v. Bussey, __ U.S. __,
140 S.Ct. 81 (2019) (citation omitted).
With respect to the second qualified immunity prong, “[t]he relevant, dispositive inquiry
in determining whether a right is clearly established is whether it would be clear to a reasonable
officer that his conduct was unlawful in the situation he confronted.” Thomas v. Durastanti, 607
F.3d 655, 669 (10th Cir. 2010) (quotation omitted). Importantly, “the federal right allegedly
violated must have been ‘clearly established at the time of the defendant’s unlawful conduct.’”
Cummings, 913 F.3d at 1240 (citation omitted).
“To be clearly established, a legal principle must have a sufficiently clear foundation in
then-existing precedent.” District of Columbia v. Wesby, ––– U.S. ––––, 138 S.Ct. 577, 589

(2018). The determinative “question is ‘whether the violative nature of the particular conduct is
clearly established.’” Mullenix v. Luna, ––– U.S. ––––, 136 S.Ct. 305, 308 (2015) (per curiam)
(citation omitted). Hence, the Supreme Court has repeatedly instructed circuit courts “not to
define clearly established law at a high level of generality.” Kisela v. Hughes, ___ U.S. ___, 138
S.Ct. 1148, 1152 (2018). Although “a case directly on point” is not required, “existing precedent
must have placed the constitutional question regarding the illegality of the defendant’s conduct
beyond debate.” Cummings, 913 F.3d at 1239.
Ordinarily, “a preexisting Supreme Court or Tenth Circuit decision, or the weight of
authority from other circuits, must make it apparent to a reasonable officer that the nature of his

conduct is unlawful.” Carabajal, 847 F.3d at 1210. Nonetheless, “when a public official’s
conduct is so egregious even a general precedent applies with ‘obvious clarity,’ the right can be
clearly established notwithstanding the absence of binding authority involving materially similar
facts.” Ullery v. Bradley, 949 F.3d 1282, 1291 (10th Cir. 2020) (citation omitted). Notably, “the
‘obvious clarity’ scenario, is a ‘narrow exception’ to the ‘normal rule that only case law and
specific factual scenarios can clearly establish a violation.’” J W by & through Tammy Williams
v. Birmingham Bd. of Educ., 904 F.3d 1248, 1260 (11th Cir. 2018) (citation omitted). In sum,
qualified immunity protects “all but the plainly incompetent or those who knowingly violate the
law.” Mullenix, 136 S.Ct. at 308.
IV. Discussion
A. Whether Plaintiff has Stated Plausible Fourteenth Amendment Claims Against
Defendants Lucero and Hildenbrant

“Under the Fourteenth Amendment’s due process clause, pretrial detainees … are entitled
to the same degree of protection regarding medical attention as that afforded convicted inmates
under the Eighth Amendment.” Barrie v. Grand County, Utah, 119 F.3d 862, 867 (10th Cir.
1997). The Eighth Amendment provides that a “claim for inadequate medical attention must be
judged against the ‘deliberate indifference to serious medical needs’ test….” Id. at 868 (citation
omitted). “The deliberate indifference standard has objective and subjective components,” both
of which a plaintiff must prove. Sawyers v. Norton, 962 F.3d 1270, 1283 (10th Cir. 2020)
(citation omitted).
“The objective component … is met if the harm suffered rises to a level sufficiently
serious to be cognizable under the Cruel and Unusual Punishment Clause.” Id. (citation
omitted). A medical need is “sufficiently serious … if the condition has been diagnosed by a
physician as mandating treatment or is so obvious that even a lay person would easily recognize
the necessity for a doctor’s attention.” Id. (citation omitted). Here, Defendants Lucero and
Hildenbrant do not contest that Toldeo suffered a sufficiently serious medical need. See
Martinez v. Beggs, 563 F.3d 1082, 1088-89 (10th Cir. 2009) (agreeing that death meets
sufficiently serious harm element of objective component of Eighth Amendment claim).
Plaintiff, therefore, has met the objective component of the deliberate indifference standard.

To meet “the subjective component, the plaintiff must show the official ‘knows of and
disregards an excessive risk to inmate health or safety.’” Sawyers, 962 F.3d at 1283. (citations
omitted). To make that showing, the plaintiff must demonstrate that the official was both
“aware of facts from which the inference could be drawn that a substantial risk of serious harm
exists, and he must also draw the inference.” Id. (citation omitted).
In the context of a medical professional’s alleged subjective state of mind, the Court
considers the medical professional’s “knowledge at the time he prescribed treatment for the
symptoms presented, not to the ultimate treatment necessary.” Self v. Crum, 439 F.3d 1227,

1233 (10th Cir. 2006). Moreover, “[d]eliberate indifference to [an excessive risk to inmate
health] requires more than a showing of negligence … or even malpractice….” Vasquez v.
Davis, 882 F.3d 1270, 1278 (10th Cir. 2018) (citations omitted). Put another way, “[s]o long as
a medical professional provides a level of care consistent with the symptoms presented by the
inmate, absent evidence of actual knowledge or recklessness, the requisite state of mind cannot
be met,” i.e., a “good faith effort to diagnose and treat” a medical condition does not amount to a
conscious disregard of a claimed harm. See Self, 439 F.3d at 1233, 1235 (determining that
reasonable jury could not infer conscious disregard of risk by doctor when nothing suggested
doctor “otherwise failed to provide a course of treatment consistent with the symptoms he

recognized”); Mata v. Saiz, 427 F.3d 745, 761 (10th Cir. 2005) (determining that district court
correctly concluded nurse was entitled to qualified immunity when record showed she “made a
good faith effort to diagnose and treat Ms. Mata’s medical condition”); see also Silverstein v.
Fed. Bureau of Prisons, 559 Fed. Appx. 739, 754 (10th Cir. 2014) (observing that “if an official
is aware of the potential for harm but takes reasonable efforts to avoid or alleviate that harm, he
bears no liability”).
Plaintiff argues, however, that the United States Supreme Court’s ruling in Kingsley v.
Hendrickson eliminates the subjective component of the deliberate indifference standard. 576
U.S. 389 (2015). In Kingsley, a pretrial detainee alleged that jail officers used excessive force on
him in violation of the Fourteenth Amendment’s Due Process Clause. Id. at 393. The Court held
that “courts must use an objective standard” instead of “a subjective standard that takes into
account a defendant’s state of mind” to decide “whether the force deliberately used is,
constitutionally speaking, ‘excessive[]’….” Id. at 396. The Court concluded “that a pretrial
detainee must show only that the force purposely or knowingly used against him was objectively

unreasonable.” Id. at 396–97.
Plaintiff observes that “various circuits have interpreted Kingsley to apply to conditions
of confinement and/or inadequate medical care claims under the Fourteenth Amendment rather
than just excessive force claims.” (Doc. 37) at 6 (citing Second, Seventh and Ninth Circuit
cases). 3 Plaintiff relies on Colbruno v. Kessler to project that the Tenth Circuit will join those
circuits in applying Kingsley to conditions of confinement claims, including inadequate medical
care claims. 928 F.3d 1155 (10th Cir. 2019) (applying Kingsley to case involving pretrial
detainee taken to hospital without clothing).
After Colbruno was decided, the Tenth Circuit “noted ‘the circuits are split on whether

Kingsley alters the standard for conditions of confinement and inadequate medical care claims
brought by pretrial detainees.’” Sawyers, 962 F.3d at 1282 n. 11 (citation omitted). Even so, and
given existing Tenth Circuit precedent, this Court will apply the subjective standard to conditions
of confinement claims, including inadequate medical care claims. Id. (holding that “we need not
resolve this question for our circuit because we can affirm under the Eighth Amendment
deliberate indifference standard, which is more favorable to the three officers”). See, e.g., Parks
v. Taylor, 2020 WL 1271587, *3-4 (W.D. Okla.) (citations omitted) (stating “[A]bsent a Tenth

3 Plaintiff acknowledges that the Fifth and Eighth Circuits confine the holding in Kingsley to
excessive force cases. (Doc. 37) at 7.
Circuit decision [applying Kingsley to inadequate medical care claims], this Court should
continue to apply existing precedent”).
1. The Subjective Component: Defendant Lucero
Viewing the allegations in the Amended Complaint as true and viewing any reasonable
inferences therefrom in the light most favorable to Plaintiff, Plaintiff has alleged that Defendant

Lucero was aware of the following facts when she examined Toledo on June 23, 2017, three days
after Toledo’s arrest. First, Defendant Lucero observed that Toledo was a “difficult historian,”
had a “poor memory,” and “had a knowledge deficit.” (Doc. 3) at ¶ 36. Second, Defendant
Lucero knew that Toledo had a chemical impairment and suffered from alcohol withdrawal. See
id. at ¶ 105. Finally, Defendant Lucero observed that Toledo’s blood pressure and pulse were
elevated, symptoms associated with alcohol withdrawal. Notably, Plaintiff does not specifically
allege that Defendant Lucero knew that Toledo was “seeing things in his cell” or had “asked to
be moved out of general population because he feared he was in danger of bodily harm by other
inmates if he remained.” See id. at ¶¶ 34, 31, and 32. Consequently, the allegations in the

Amended Complaint indicate that Defendant Lucero knew at the time she examined Toledo that
he was experiencing alcohol withdrawal, which caused an elevated blood pressure and pulse.
Furthermore, the allegations in the Amended Complaint show that Defendant Lucero
provided a level of care consistent with the medical issues she was aware of, i.e., she prescribed
blood pressure and diabetes medications to treat Toledo’s elevated blood pressure and pulse. In
other words, the allegations, as presently pled, indicate that Defendant Lucero made a “good
faith effort to diagnose and treat” Toledo’s elevated blood pressure and pulse apparently caused
by a chemical impairment or alcohol withdrawal. See Mata, 427 F.3d at 761.
Even if Defendant Lucero also should have required monitoring or even hospitalization,
as Plaintiff alleges, those allegations amount, at most, to allegations of negligence or medical
malpractice, especially when one considers Defendant Lucero’s medically consistent and good
faith effort to treat Toledo’s elevated blood pressure and pulse. See Estate of Hunter by Hunter
v. Uintah Cty., 807 Fed. Appx. 868, 872 (10th Cir. 2020) (holding that “although the defendants

took steps to ameliorate Mr. Hunter’s condition, they were wrong about the risk that Mr. Hunter
faced, which does not satisfy the subjective component of the deliberate indifference test”);
Sparks v. Singh, 690 Fed. Appx. 598, 604 (10th Cir. 2017) (observing that “the ‘inadvertent
failure to provide adequate medical care’ tantamount to negligence does not satisfy the deliberate
indifference standard” (citation omitted)). Such negligence or malpractice does not meet the
subjective component required for a Fourteenth Amendment inadequate medical care claim.
Furthermore, Plaintiff’s mere disagreement “with a diagnosis or a prescribed course of treatment
does not state a constitutional violation.” Perkins v. Kan. Dep't of Corrs., 165 F.3d 803, 811
(10th Cir. 1999); see also Gee v. Pacheco, 627 F.3d 1178, 1192 (10th Cir. 2010) (noting that

“[d]isagreement with a doctor's particular method of treatment, without more, does not rise to the
level of an Eighth Amendment violation”).
The allegations in the Amended Complaint simply do not demonstrate that Defendant
Lucero knew of an excessive risk to Toledo’s health that she completely disregarded. Hence,
Plaintiff has not pled facts that show she meets the subjective component of the deliberate
indifference standard as to Defendant Lucero. Plaintiff, therefore, has not alleged sufficient facts
to show that Defendant Lucero was deliberately indifferent to Toledo’s medical needs.
Consequently, Plaintiff has not stated a plausible Fourteenth Amendment inadequate medical
care claim against Defendant Lucero.
2. The Subjective Component: Defendant Hildenbrant
Viewing the allegations in the Amended Complaint as true and viewing any reasonable
inferences therefrom in the light most favorable to Plaintiff, Plaintiff has alleged that Defendant
Hildenbrant was aware of the following facts when he examined Toledo. First, Defendant
Hildenbrant knew from medical staff that Toledo was experiencing alcohol withdrawal and

hallucinations. Finally, Defendant Hildenbrant knew that Toledo’s blood pressure and pulse
were abnormal, symptoms associated with alcohol withdrawal.
The allegations in the Amended Complaint also indicate that Defendant Hildenbrant did
not disregard Toledo’s alcohol withdrawal. Instead, Defendant Hildenbrant provided Toledo a
level of care consistent with alcohol withdrawal by prescribing alcohol withdrawal medication.
This provision of care demonstrates a good faith effort to diagnose and treat Toledo’s alcohol
withdrawal. See Mata, 427 F.3d at 761.
In addition, considering Defendant Hildenbrant ordered appropriate medication for
Toledo’s alcohol withdrawal, the allegations against him sound more in negligence or medical

malpractice and not deliberate indifference; specifically, failure to physically examine Toledo;
provision of an unauthorized prescription; failure to order medical staff to monitor Toledo; and
failure to hospitalize. Again, Plaintiff’s mere disagreement “with … a prescribed course of
treatment does not state a constitutional violation.” Perkins, 165 F.3d at 811.
The allegations in the Amended Complaint do not demonstrate that Defendant
Hildenbrant completely disregarded an excessive risk to Toledo’s health. Plaintiff, therefore, has
not pled facts that show she satisfies the subjective component of the deliberate indifference
standard as to Defendant Hildenbrant. The Court concludes that Plaintiff has not alleged
sufficient facts to state a plausible Fourteenth Amendment inadequate medical care claim against
Defendant Hildenbrant.
In sum, Plaintiff has failed to plead facts that plausibly demonstrate that Defendants
Lucero and Hildenbrant violated Toledo’s Fourteenth Amendment rights, the first qualified
immunity prong. Although this determination ends the qualified immunity analysis in favor of

Defendants Lucero and Hildenbrant, the Court also will examine whether Plaintiff meets the
second qualified immunity prong, the “clearly established” right requirement.
B. Whether Toledo’s Right to More Medical Treatment than Provided by Defendants
Lucero and Hildenbrant was Clearly Established

Plaintiff argues first that it has been clearly established for decades that a pretrial detainee
has a constitutional right to adequate medical care. See Mata, 427 F.3d at 749 (recognizing that
“there is little doubt that deliberate indifference to an inmate’s serious medical need is a clearly
established constitutional right”). However, a simple recitation of this general legal principle
does not satisfy Plaintiff’s burden of demonstrating that a clearly established right existed in June
2017 sufficient to overcome the qualified immunity defense. The Tenth Circuit in Cox v. Glanz
rejected similar argument and “found this ‘anemic attempt ... did virtually nothing to define the
contours of the clearly-established-law question….’” 800 F.3d 1231, 1246 (10th Cir. 2015).
Indeed, the Tenth Circuit noted that the plaintiff could not
discharge her burden by relying upon authorities that do no more than establish general
legal principles—even if those principles are apposite in the Eighth Amendment
deliberate-indifference context—such as the legal truism that medical professionals in
certain circumstances can be held liable for handling their gatekeeper role with deliberate
indifference.

Id. at 1247 n.8. The Court concluded the plaintiff’s “arguments seeking ‘to define clearly
established law at a high level of generality’ are unavailing.” Id. (citation omitted).
Next, Plaintiff cites Garcia v. Salt Lake County, a case that clearly establishes a pretrial
detainee’s right to adequate medical care “in the context of an alcoholic detainee who had
overdosed on barbiturates.” (Doc. 37) at 15; 768 F.2d 303 (10th Cir. 1985). In Garcia, the
plaintiff sued the County that administered the jail and had admitted an intoxicated unconscious
pretrial detainee. Garcia, 768 F.2d at 305-06. The jail failed to adequately monitor the pretrial

detainee and provide medical personnel. Id. As a result, the pretrial detainee died while in the
jail’s custody. Id. at 306. The Tenth Circuit “conclude[d] that the jury's finding against the
County is supported by sufficient evidence of gross deficiencies and deliberate indifference in
staffing and procedures to monitor persons admitted to the jail in an unconscious condition who
are suspected of being intoxicated.” Id. at 308. The Court further found that “[t]he record
supports the conclusion that the County's policy of admitting to jail unconscious persons
suspected of being intoxicated, carried out with the described deficiences and indifference,
caused a violation of Garcia's constitutional rights.” Id.
The Tenth Circuit, however, has “distinguished Garcia in cases involving detainees who

are inebriated but conscious and responsive.” Estate of Duke by & through Duke v. Gunnison
Cty. Sheriff's Office, 752 Fed. Appx. 669, 673 (10th Cir. 2018).
Although defendants in Garcia were aware that Garcia was unconscious for many hours,
they took no action to attend to his obvious medical needs. By comparison, [the detainee
in this case] was conscious, on his feet, argumentative, and cognizant that he was being
arrested. [He] exhibited characteristics that are common to many intoxicated individuals.

Id. at 674 (quoting Martinez v. Beggs, 563 F.3d 1082, 1091 (10th Cir. 2009)). The Tenth Circuit
in Estate of Duke by & through Duke then noted that “to defeat a qualified immunity defense
‘existing law must have placed the constitutionality of the officer’s conduct beyond debate.’”
752 Fed. Appx. at 674 (citation omitted). The Court found that “Duke, like the detainee in
Martinez, exhibited many common characteristics of intoxicated individuals but was responsive
and functioning.” Id. Hence, the Tenth Circuit concluded “it is at least reasonably debatable that
Martinez rather than Garcia provides the controlling precedent, and thus affirm[ed] the grant of
qualified immunity to the individual defendants.” Id.
Similar to the pretrial detainees in Estate of Duke by & through Duke and Martinez,
Toledo “was responsive and functioning” when Defendants Lucero and Hildenbrant examined

him. See Estate of Duke by & through Duke, 752 Fed. Appx. at 674. Accordingly, as in Estate
of Duke by & through Duke, it is at least reasonably debatable that Garcia, which concerned an
unconscious intoxicated pretrial detainee, does not provide controlling precedent in this case,
which concerns a conscious pretrial detainee undergoing alcohol withdrawal. Garcia, therefore,
does not provide clearly established law pertinent to Toledo’s Fourteenth Amendment right to
adequate medical care.
Plaintiff also seems to argue that Toledo’s rights are clearly established based on the
obvious clarity doctrine. Plaintiff contends that the objective component of the deliberate
indifference standard, which requires a sufficiently serious and obvious medical risk, “if proved

by a plaintiff will actually support the notion the law was clearly established in the first place”
since that component provides fair notice of what conduct is unconstitutional. (Doc. 37) at 16.
Plaintiff, however, does not cite any case law to support that contention. Moreover, such a
contention would obviate the clearly established right requirement to defeat qualified immunity
in inadequate medical care cases. Indeed, Plaintiff’s contention is contrary to the principle that
“the ‘obvious clarity’ scenario, is a ‘narrow exception’ to the ‘normal rule that only case law and
specific factual scenarios can clearly establish a violation.’” J W by & through Tammy Williams,
904 F.3d at 1260 (citation omitted). This Court rejects Plaintiff’s obvious clarity argument.
Finally, Plaintiff cites Harper v. Lawrence Cty., Ala, in which the Eleventh Circuit stated
its prior cases “established that a jail official who is aware of but ignores the dangers of acute
alcohol withdrawal and waits for a manifest emergency before obtaining medical care is
deliberately indifferent to the inmate’s constitutional rights.” Harper, 592 F.3d 1227, 1235 (11th
Cir. 2010). As stated above, a right is clearly established when “a preexisting Supreme Court or

Tenth Circuit decision, or the weight of authority from other circuits, … make it apparent to a
reasonable officer that the nature of his conduct is unlawful.” Carabajal, 847 F.3d at 1210.
Harper is neither a preexisting Supreme Court decision nor a Tenth Circuit decision. Moreover,
Plaintiff does not suggest, nor does she provide legal authority to assert, that a clearly established
right in one outside circuit constitutes “the weight of authority from other circuits.” Cf.
Woodward v. City of Worland, 977 F.2d 1392, 1397 (10th Cir. 1992) (noting that “[n]ormally, a
single recent case from one circuit is not sufficient to make the law clearly established in another
circuit”) (quoting Martin A. Schwartz & John E. Kirklin, Section 1983 Litigation: Claims,
Defenses, and Fees § 9.20, at 537 (2d ed. 1991)). Moreover, unlike the Eleventh Circuit’s

clearly established law, in this case neither Defendant Lucero nor Defendant Hildenbrant ignored
Toledo’s alcohol withdrawal symptoms and both provided Toledo with appropriate medications.
Plaintiff has not convinced the Court that Harper clearly establishes a constitutional right with
respect to pretrial detainees suffering from alcohol withdrawal who receive, at a minimum,
appropriate medications.
For the above reasons, the Court determines that Plaintiff has not demonstrated that she
meets the clearly established right requirement, the second qualified immunity prong, necessary
to defeat qualified immunity. The Court concludes that Plaintiff has not carried her heavy
burden of pleading sufficient facts to defeat qualified immunity as to Defendants Lucero and
Hildenbrant. Accordingly, Defendants Lucero and Hildenbrant are entitled to qualified
immunity with respect to Count I and the Court will dismiss Count I without prejudice as to
Defendants Lucero and Hildenbrant.
IT IS ORDERED that
1. “Defendant[s] Lucero’s and Hildenbrant’s Motion to Dismiss Plaintiff’s Claims
Brought Under 42 U.S.C. § 1983 and for Qualified Immunity” (Doc. 27) is granted; and
2. Count I of the Amended Complaint is dismissed without prejudice as to Defendants
Lucero and Hildenbrant.
loans:
UNITED STATES DISTRICT GE

17

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Source: Frix Law Library, https://www.frixlaw.com/law-library/cases/10280594. Public record. Not legal advice.