Salinas v. Ramos

UNITED STATES DISTRICT COURT March 06, 2023

SOUTHERN DISTRICT OF TEXAS Nathan Ochsner, Clerk

LAREDO DIVISION

ALFONSO SALINAS, §

§

Plaintiff, §

§

VS. § CIVIL ACTION NO. 5:19-CV-150

§

SGT. LUIS M. RAMOS et al., §

§

Defendants. §

MEMORANDUM OPINION AND ORDER

In this prisoner civil rights action, Plaintiff Alfonso Salinas has sued four

individuals: (1) Sergeant Luis M. Ramos, (2) Jose L. Macias, Jr., (3) Commander Jose

A. Aguilera, Jr., and (4) Dr. Homero Sanchez. All four have moved to dismiss

Plaintiff’s lawsuit (Dkt. Nos. 52, 54). For the reasons below, Sergeant Ramos, Mr.

Macias, and Commander Aguilera’s motion (Dkt. No. 52) is GRANTED IN PART

and DENIED IN PART. Dr. Sanchez’s motion (Dkt. No. 54) is DENIED.

I. BACKGROUND

A. Defendant’s Confinement in First-Floor Cells

At this stage, the Court must accept all well-pleaded facts in the complaint as

true. Sewell v. Monroe City Sch. Bd., 974 F.3d 577, 582 (5th Cir. 2020). Plaintiff’s first

amended complaint alleges the following:

At all relevant times, Jose L. Macias was a mental health specialist employed

by Webb County Jail (Dkt. No. 40 ¶ 10). Sergeant Luis M. Ramos was a classification

officer at the Jail (id. ¶ 8). Commander Jose A. Aguilera, Jr. was commander of the

Jail’s classification unit, which controls inmate housing (id. ¶ 9).

On or around July 9, 2019, Plaintiff arrived at the Jail as a pretrial detainee

(id. ¶ 16). Plaintiff was initially housed in the Jail’s third-floor residential cells (id.

¶ 17). Shortly after Plaintiff’s arrival, Mr. Macias evaluated his mental health (id.).

Following the evaluation, Mr. Macias directed Sergeant Ramos to place Plaintiff in a

first-floor “holding cell” for observation (id. ¶¶ 18–19).

For at least two days, Plaintiff was held in first-floor Cell 110 (id. ¶ 26). Urine

and feces “filled and coated” the cell’s toilet and sink (id. ¶ 21). The cell’s floor “was

covered in excrement,” and its walls “were smeared with a sludge of urine and feces”

(id.). Because the toilet was clogged and inoperable, Plaintiff could not relieve himself

(id. ¶ 24). The cell had no bed, so Plaintiff was forced to sleep on the excrement-

covered floor (id. ¶ 23). The cell’s “nauseating” smell prevented Plaintiff from eating,

induced vomiting, and caused “debilitating headaches” (id. ¶ 25). Plaintiff

immediately notified jailers of these conditions and frequently requested grievance

forms and cleaning supplies (id. ¶ 22). Over the next three to four days, he was moved

to three other first-floor cells (id. ¶ 27). Each was just as unsanitary as Cell 110 (id.).

While the above events occurred in 2019, affidavits from two other detainees

show the first-floor cells remained filthy in 2021 (Dkt. Nos. 35-1, 35-2). Both detainees

reported prolonged stays in cells smeared with human blood and feces in 2021 (id.).

B. Withholding of Defendant’s Psychiatric Medications

In 2002—about 17 years before Plaintiff’s detention—Plaintiff was diagnosed

with bipolar disorder, depression, and post-traumatic stress disorder (id. ¶ 33). Since

then, he has taken psychiatric medication to manage his symptoms (id.).

Dr. Sanchez is a psychiatrist who treats detainees at the Jail (id. ¶¶ 11, 33).

After Plaintiff arrived at the Jail, Dr. Sanchez obtained Plaintiff’s medical records

and authorized the administration of his psychiatric medication (id. ¶ 33). Around

September 15, 2019, Plaintiff was accused of giving this medication to another

detainee (id. ¶¶ 35–36). Consequently, Dr. Sanchez orally ordered that Plaintiff not

be given his psychiatric medication (id.). Plaintiff received neither a written incident

report nor a disciplinary hearing (id. ¶ 35).

Over the next two months, Plaintiff submitted several grievance forms (id.

¶¶ 37, 42). Therein, he asked to speak with Dr. Sanchez, reported his deteriorating

mental health, and requested medical attention (id.). The requests were denied (id.).

In late November 2019, Plaintiff attempted suicide (id. ¶¶ 43–45). A few days later,

Dr. Sanchez ordered the restoration of Plaintiff’s psychiatric medicine (id. ¶ 46).

C. Procedural History

On August 5, 2022, Plaintiff filed his first amended complaint (Dkt. No. 40). Of

the pleading’s original four claims, only three remain pending: (1) a Fourteenth

Amendment conditions-of-confinement claim against Sergeant Ramos and Mr.

Macias; (2) a Fourteenth Amendment supervisory liability claim against Commander

Aguilera; and (3) a Fourteenth Amendment deprivation of medical care claim against

Dr. Sanchez.1 The defendants moved to dismiss these claims, and the Court heard

1 The first amended complaint originally asserted a Fifth Amendment due process claim against

Deputy Marshal John Doe (see Dkt. No. 40). The Court dismissed this claim with prejudice (Dkt. No.

45).

oral argument (Dkt. Nos. 52, 54, 58–61; Min. Ent. Feb. 9, 2023).

II. LEGAL STANDARD

A. Dismissal Under Rule 12(b)(6)

To survive a motion to dismiss, a complaint must allege sufficient facts that,

accepted as true, “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)). A claim is plausible when the alleged facts allow “the court to draw the

reasonable inference that the defendant is liable for the misconduct alleged.” Id.

“Threadbare recitals of the elements of a cause of action, supported by mere

conclusory statements, do not suffice.” Id. In reviewing a motion to dismiss, the court

must accept the complaint’s well-pleaded allegations as true and draw all reasonable

inferences in the plaintiff’s favor. Sewell, 974 F.3d at 582. “[A] well-pleaded complaint

may proceed even if it strikes a savvy judge that actual proof of those facts is

improbable . . . .” Twombly, 550 U.S. at 556.

B. Qualified Immunity

In their motion to dismiss, Sergeant Ramos, Mr. Macias, and Commander

Aguilera raise the affirmative defense of qualified immunity (see Dkt. No. 52).

“[Q]ualified immunity protects government officials ‘from liability for civil damages

insofar as their conduct does not violate clearly established statutory or constitutional

rights of which a reasonable person would have known.’” Pearson v. Callahan, 555

U.S. 223, 231 (2009) (quoting Harlow v. Fitzgerald, 457 U.S. 800, 818 (1982)). To

overcome qualified immunity, a plaintiff must show (1) “the defendant violated the

plaintiff's constitutional rights,” and (2) “the defendant’s actions were objectively

unreasonable in light of clearly established law at the time of the violation.” Porter v.

Epps, 659 F.3d 440, 445 (5th Cir. 2011).

With respect to the second prong, “[t]he constitutional right must be

sufficiently clear to put a reasonable officer on notice that certain conduct violates

that right.” Sanchez v. Swyden, 139 F.3d 464, 466 (5th Cir. 1998). The Court must

conduct its inquiry “in light of the specific context of the case.” Cope v. Cogdill, 3 F.4th

198, 204 (5th Cir. 2021) (quoting Mullenix v. Luna, 577 U.S. 7, 12 (2015) (per

curiam)). “[U]nless existing precedent ‘squarely governs’ the conduct at issue, an

official will be entitled to qualified immunity.” Id. (quoting Brosseau v. Haugen, 543

U.S. 194, 201 (2004) (per curiam)).

III. DISCUSSION

A. Conditions of Confinement Claims Against Sergeant Ramos

and Mr. Macias

Under the Fourteenth Amendment, pretrial detainees have a right to be free

from punishment and to be provided with basic human needs, such as medical care

and protection from harm. Hare v. City of Corinth, 74 F.3d 633, 639 (5th Cir. 1996)

(en banc). Pretrial detainees may bring constitutional challenges under two theories:

(1) conditions of confinement or (2) episodic acts or omissions. Est. of Henson v.

Wichita Cnty., 795 F.3d 456, 462 (5th Cir. 2015). A plaintiff may plead “both

alternative theories, and a court may properly evaluate each separately.” Id. at 464.

Here, Plaintiff asserts both a conditions-of-confinement claim and an episodic-acts-

or-omissions claim against Sergeant Ramos and Mr. Macias.2

1. Episodic Acts or Omissions

The Court begins with Plaintiff’s episodic-acts-or-omissions claim. An episodic-

acts-or-omissions claim “faults specific jail officials for their acts or omissions”

causing the complained-of harm. Shepherd v. Dallas Cnty., 591 F.3d 445, 452 (5th

Cir. 2009). To state an episodic-acts-or-omissions claim, the plaintiff must show the

defendant acted with subjective deliberate indifference. Hare, 74 F.3d at 647–48. A

defendant acts with subjective deliberate indifference when he “knows of and

disregards an excessive risk” of serious harm to a pretrial detainee. Kelson v. Clark,

1 F.4th 411, 417 (5th Cir. 2021) (quoting Garza v. City of Donna, 922 F.3d 626, 635

(5th Cir. 2019)). In other words, to establish deliberate indifference, a plaintiff must

show (1) the defendant was aware of facts from which he could infer a substantial

risk of serious harm existed, and (2) the defendant “actually drew that inference.” Id.

(quoting Dyer v. Houston, 964 F.3d 374, 380 (5th Cir. 2020)). “[K]nowledge of a

substantial risk of harm may be inferred if the risk was obvious.” Easter v. Powell,

467 F.3d 459, 463 (5th Cir. 2006).

Here, Plaintiff sufficiently alleges Sergeant Ramos and Mr. Macias acted with

deliberate indifference. First, Plaintiff plausibly alleges that both Sergeant Ramos

and Mr. Macias “were familiar with [the] first-floor cells and their conditions” (Dkt.

2 While Plaintiff labels Count One a “Conditions of Confinement” claim, he also alleges that Sergeant

Ramos and Mr. Macias acted with “deliberate indifferen[ce]” (Dkt. No. 40 ¶ 49). Deliberate indifference

is an element of an episodic-acts-or-omissions claim. Hare, 74 F.3d at 647–48. It is not an element of

a conditions-of-confinement claim. Id. at 645. Plaintiff’s response confirms his intent to assert both

theories of liability (Dkt. No. 58 at 4–5). The Court therefore construes Count One as asserting both

an episodic-acts-or-omissions claim and a conditions-of-confinement claim.

No. 40 ¶ 18). As to Sergeant Ramos, Plaintiff alleges he “knew of Cell 110’s terrible

condition” because a “nauseating smell emanat[ed] from the cell into the hallway” (id.

¶ 21). The cell’s windows also “allowed [Sergeant] Ramos and the corrections officers

to see into the cell while passing by” (id.). Because the Texas Commission on Jail

Standards (TCJS) requires face-to-face observation of all inmates at least once per

hour, Sergeant Ramos and the corrections officers reporting to him “must have been

aware” of Plaintiff’s filthy cell conditions if they “complied with their regulatory

obligations” (id.). Moreover, Plaintiff “immediately notified corrections officers that

the cell was unacceptable for habitation” and “renewed his requests every time a

corrections officer walked past” his cell (id. ¶ 22).

As to Mr. Macias, he was a mental health specialist who identified Plaintiff as

having a mental health risk (see id. ¶¶ 17–19). Mr. Macias consequently ordered

Plaintiff placed in the first-floor cells for observation (id.). While Mr. Macias himself

“never came into the cell to observe” Plaintiff, the Court can reasonably infer that Mr.

Macias was apprised of Plaintiff’s filthy living conditions during this “observation”

period (id. ¶ 19). If Mr. Macias had the authority to order at-risk detainees to the first

floor for observation, it is reasonable to infer that he was involved in their observation

and knew of their behavior, progress, and grievances. Based on these facts, Plaintiff

has plausibly alleged Sergeant Ramos and Mr. Macias knew of the cells’ conditions.

Plaintiff also adequately alleges his deplorable cell conditions posed a serious

risk of harm (Dkt. No. 40 ¶¶ 21–27). A “sludge” of human waste covered the floor and

walls, and excrement filled the sink and toilet (id. ¶ 21). Without a bed, Plaintiff was

forced to sleep on the excrement-covered floor (id. ¶ 23). Plaintiff could not relieve

himself, as doing so would “add to the film of excrement he had to sleep on” (id. ¶ 24).

Plainly, these alleged conditions posed a substantial risk of serious harm. See Taylor

v. Stevens, 946 F.3d 211, 221–22 (5th Cir. 2019), cert. granted, judgment vacated on

other grounds sub nom., Taylor v. Riojas, 141 S. Ct. 52 (2020) (finding “exposure to

bodily waste” from cells “covered in urine and feces” posed an “obvious” risk of serious

harm). Despite this obvious risk, Sergeant Ramos and Mr. Macias ordered Plaintiff’s

placement in the first-floor cells and took no action to ameliorate their conditions

(Dkt. No. 40 ¶ 50).

Taken together, these facts plausibly allege Sergeant Ramos and Mr. Macias

were deliberately indifferent to the excessive risk posed by the first-floor cell

conditions. See Hope v. Harris, 861 F. App’x 571, 585 (5th Cir. 2021) (finding

deliberate indifference plausible where plaintiff alleged defendant knew of

unsanitary conditions—“which ha[d] an obvious risk of harm”—yet continued to

subject plaintiff to those conditions). At this stage, Plaintiff has adequately pled an

episodic-acts-or-omissions claim against Sergeant Ramos and Mr. Macias.

2. Conditions of Confinement

Plaintiff also asserts a conditions-of-confinement claim against Sergeant

Ramos and Mr. Macias. To state a conditions-of-confinement claim, a plaintiff must

show (1) a rule, restriction, intended condition or practice, or sufficiently extended or

pervasive act or omission, (2) “which was not reasonably related to a legitimate

government objective,” (3) caused the constitutional violation. Duvall v. Dallas Cnty.,

631 F.3d 203, 207 (5th Cir. 2011) (quoting Hare, 74 F.3d at 645). A condition may

reflect a de facto policy when “evidenced by a pattern of acts or omissions ‘sufficiently

extended or pervasive . . . to prove an intended condition or practice.’” Id. (quoting

Shepherd, 591 F.3d at 452). The violation must be more than de minimis—the

plaintiff must show “a pervasive pattern of serious deficiencies.” Id. at 208 (quoting

Shepherd, 591 F.3d at 454). Proving such a pattern does not require providing

“specific examples of other instances of detainees who suffered [a similar] fate.”

Montano v. Orange Cnty., 842 F.3d 865, 876 (5th Cir. 2016). However, “isolated

examples of illness, injury, or even death, standing alone, cannot prove that

conditions of confinement are constitutionally inadequate.” Shepherd, 591 F.3d at

454. Plaintiffs face “a heavy burden” when attempting to prove a pattern. Id. at 452.

Here, Plaintiff has not plausibly alleged the existence of a condition or practice.

Plaintiff bases his conditions-of-confinement claim on the defendants’ “general or de

facto” practice of placing at-risk inmates in the “uninhabitable first-floor cells” (Dkt.

No. 58 at 11). To support this claim, Plaintiff alleges he resided in four equally squalid

cells over the course of six days (see Dkt. No. 40 ¶¶ 21, 27). And based on two

affidavits, these conditions persisted until June 2021 (see Dkt. Nos. 35-1, 35-2).

Because Plaintiff has not shown an extended or pervasive pattern of violations,

he has failed to prove the existence of a de facto policy. First, the Court declines to

consider the 2021 affidavits. To be sure, they are deeply troubling. Nonetheless,

Plaintiff has provided no case law allowing courts to consider post-incident events to

find a de facto policy, and the Court has located none. Where a court has considered

similar incidents to conclude a de facto policy existed, the plaintiff pointed to prior

events. See, e.g., Duvall, 631 F.3d at 208 (holding a de facto policy existed where the

record showed “the County’s awareness of the situation preceded [the detainee’s]

confinement, and that there had been serious outbreaks of MRSA in the [j]ail for at

least three years before [the detainee’s] arrival” (emphasis added)); Cleveland v.

Gautreaux, 198 F. Supp. 3d 717, 738–39 (M.D. La. 2016) (finding claim plausible in

part because plaintiffs pointed three prior detainee deaths). Because the law is

unsettled on this matter, the Court will not consider the 2021 events.

Second, considered alone, Plaintiff’s six-day stay in four unhabitable cells does

not plausibly establish a pervasive pattern. Cf. Dotson v. Bexar Cnty. Hosp. Dist., No.

5:19-cv-83, 2019 WL 6311375, at *5 (W.D. Tex. Nov. 25, 2019) (finding claim plausible

where plaintiffs alleged detainee received grossly inadequate medical care “over five

months and through dozens of personnel members”); Cleveland, 198 F. Supp. 3d at

739 (same, in part because complaint detailed jail’s inadequate treatment over a

period of several weeks). Moreover, while a plaintiff may point to government reports

or testimony from staff to establish a de facto policy, Plaintiff has not done so here.

See Feliz v. El Paso Cnty., 441 F. Supp. 3d 488, 498–99 (W.D. Tex. 2020) (finding

claim plausible where plaintiff cited a TCJS report noting inadequate jail conditions);

Shepherd, 591 F.3d at 453 (holding plaintiff “demonstrate[d] the existence of an

unlawful condition” where he “presented extensive independent evidence” of the jail's

violations, including two government-authored reports and affidavits from jail

employees).

Because Plaintiff has not adequately alleged an unconstitutional condition

existed as of July 2019, his claim against Sergeant Ramos and Mr. Macias cannot

move forward on this theory. Sergeant Ramos and Mr. Macias’s motion to dismiss

(Dkt. No. 52) is therefore GRANTED as to Plaintiff’s conditions-of-confinement

claim.

B. Supervisory Liability Claim Against Commander Aguilera

“[L]iability under the doctrine of respondeat superior is not cognizable in

§ 1983 actions.” Cozzo v. Tangipahoa Par. Council, 279 F.3d 273, 286 (5th Cir. 2002).

However, a supervisor may be held liable for a constitutional violation where (1) he

failed to train or supervise officers, (2) the failure to train or supervise had a causal

connection to the constitutional violation, and (3) the failure to train or supervise

constitutes deliberate indifference to constitutional rights. Id. To state a failure-to-

train claim, “a plaintiff must allege with specificity how a particular training program

is defective.” Goodman v. Harris Cnty., 571 F.3d 388, 395 (5th Cir. 2009) (quoting

Roberts v. City of Shreveport, 397 F.3d 287, 293 (5th Cir.2005)).

To be deliberately indifferent, the supervisor must have known a substantial

risk of serious harm existed and disregarded that risk. Est. of Davis ex rel. McCully

v. City of N. Richland Hills, 406 F.3d 375, 381 (5th Cir. 2005). Failure to train

constitutes deliberate indifference where the inadequacy of training was so obvious,

and a violation of constitutional rights was so likely, that the supervisor was

deliberately indifferent to the need for more training. Cozzo, 279 F.3d. at 287. A

showing of deliberate indifference typically requires a pattern of similar violations.

Id. at 286–87. To establish a pattern, a plaintiff must point to “prior acts” that are

“fairly similar to what ultimately transpired.” Davis, 406 F.3d at 383.

Here, Plaintiff alleges the following: As commander of the housing unit,

Commander Aguilera oversaw inmates’ housing and their confinement conditions

(Dkt. 40 ¶ 54). Commander Aguilera “was aware or should have been aware” of the

first-floor cell conditions (id. ¶ 55). He also supervised Sergeant Ramos, a

classifications officer (id. ¶ 54). Commander Aguilera failed to train or supervise

Sergeant Ramos and other Jail staff “on the proper minimal standards necessary to

house detainees” (id. ¶ 56). As a result of this failure, “there has been a pattern of

similar constitutional violations” (id. ¶ 57). Finally, because Commander Aguilera

failed to train or supervise Sergeant Ramos, “Plaintiff was housed in unconstitutional

conditions” (id. ¶ 58).

Plaintiff has not plausibly shown Commander Aguilera acted with deliberate

indifference. First, alleging Commander Aguilera “should have been aware” of the

first-floor cell conditions cannot show deliberate indifference (id. ¶ 55). To plausibly

allege deliberate indifference, Plaintiff must allege Commander Aguilera had actual

knowledge of the cells’ conditions and the risk they posed. See Davis, 406 F.3d at 381.

He has not done so.

Second, Plaintiff has not adequately alleged a pattern of constitutional

violations from which Commander Aguilera’s deliberate indifference could be

inferred. Plaintiff states a “pattern of similar constitutional violations” existed

because detainees endured similar conditions in 2021—two years after Plaintiff

endured such conditions (see Dkt. Nos. 35-1, 35-2, 40, 58). But to show a “pattern of

similar violations,” Plaintiff must point to prior similar acts. Davis, 406 F.3d at 383;

cf. Connick v. Thompson, 563 U.S. 51, 63 n.7 (2011) (stating that, in a municipality

failure-to-train claim, “contemporaneous or subsequent conduct cannot establish a

pattern of violations”). Again, Plaintiff has not done so.

Without pointing to prior instances, Plaintiff has not alleged “specific facts that

rise above the speculative level.”3 Parker v. Blackwell, 23 F.4th 517, 525 (5th Cir.

2022); see Goodman, 571 F.3d at 396; Skinner v. Ard, No. 3:19-cv-66, 2020 WL

699740, at *4, *9 (M.D. La. Feb. 11, 2020). Plaintiff’s pleadings therefore fail to show

Commander Aguilera acted with deliberate indifference.

Because Plaintiff’s claim fails on the deliberate indifference prong,

Commander Aguilera’s motion to dismiss (Dkt. No. 52) is GRANTED as to Plaintiff’s

supervisory liability claim against him.

C. Qualified Immunity as to Sergeant Ramos and Mr. Macias

Because Plaintiff has plausibly alleged an episodic-acts-or-omissions claim

against Sergeant Ramos and Mr. Macias, see supra Section III.A.1., the Court must

assess whether they enjoy qualified immunity.

Qualified immunity protects officers if their alleged act did not violate a clearly

established constitutional right. Sanchez, 139 F.3d at 466. In July 2019, it was clearly

established that housing detainees in cells covered in human waste violated the

3 Under the narrow “single incident exception,” some plaintiffs may establish a failure-to-train-or-

supervise claim without pointing to prior instances. Cozzo, 279 F.3d. at 287. Because Plaintiff does not

argue this exception should apply, the Court does not address it (see Dkt. No. 58 at 12–15).

Constitution. See Taylor, 141 S. Ct. at 53–54. In Taylor v. Riojas, the Supreme Court

vacated a finding of qualified immunity where the plaintiff, Mr. Trent Taylor, was

held in unsanitary conditions for six days. Id. There, feces covered the floor, ceilings,

walls, and water faucet. Id. at 53. Mr. Taylor did not eat or drink for four days because

he feared contamination. Id. The cell lacked a bunk, so he slept naked in sewage. Id.

On this record, the Supreme Court held “any reasonable officer should have realized

that [these] conditions of confinement offended the Constitution.” Id. at 54.

Taylor is squarely on point. Plaintiff was kept in similarly inhumane

conditions for roughly the same amount of time as Mr. Taylor (see Dkt. No. 40 ¶¶ 21–

27). Plaintiff and Mr. Taylor suffered nearly identical harm: they could not eat, they

could not relieve themselves, and they slept in filth (see id. ¶¶ 23–25). Crucially, the

facts underlying Taylor occurred in 2013. Taylor, 141 S. Ct. at 53. Thus, the right not

to be held in such conditions was clearly established as of 2013—well before Plaintiff’s

2019 confinement. As in Taylor, “any reasonable officer should have realized” that

holding Plaintiff in these conditions violated the constitution. Id. at 54.

In sum, Plaintiff has sufficiently stated an episodic-acts-or-omissions claim

against Sergeant Ramos and Mr. Macias. See supra Section III.A.1. The right at issue

was clearly established at the time of Plaintiff’s confinement. Therefore, Sergeant

Ramos and Mr. Macias are not entitled to qualified immunity at this time. Their

motion to dismiss (Dkt. No. 52) is DENIED as to Plaintiff’s episodic-acts-or-omissions

claim.

D. Deprivation of Medical Care Claim Against Dr. Sanchez

Under the Fourteenth Amendment, pretrial detainees have a constitutional

right “not to have their serious medical needs met with deliberate indifference.”

Kelson, 1 F.4th at 417 (quoting Thompson v. Upshur Cnty., 245 F.3d 447, 457 (5th

Cir. 2001)). An episodic act or omission does not violate a detainee’s right to medical

care unless the official acted with subjective deliberate indifference. Hare, 74 F.3d at

647–48. “[M]ere disagreement with the treatment provided” does not constitute

deliberate indifference. Easter, 467 F.3d at 464. Rather, a defendant acts with

deliberate indifference if he “knows of and disregards an excessive risk” to a pretrial

detainee’s safety. Kelson, 1 F.4th at 417 (quoting Garza, 922 F.3d at 635). A plaintiff

can establish deliberate indifference by showing the defendant “refused to treat him,

ignored his complaints, intentionally treated him incorrectly” or otherwise “clearly

evince[d] a wanton disregard for any serious medical needs.” Gobert v. Caldwell, 463

F.3d 339, 346 (5th Cir. 2006) (internal quotations omitted). “[A] serious medical need

is one for which treatment has been recommended or for which the need is so

apparent that even laymen would recognize that care is required.” Id. at 345 n.12.

Psychological or psychiatric treatment can constitute a serious medical need. Hare,

74 F.3d at 642.

Here, Plaintiff has plausibly pled a deprivation of medical care claim.4

4 Dr. Sanchez also challenges the Court’s subject matter jurisdiction (see Dkt. No. 54 at 5–6). Because

this claim arises under the Fourteenth Amendment and federal law, the Court has jurisdiction to hear

this lawsuit. See 28 U.S.C. § 1331; Belcher v. Judd, No. 3:07-cv-348, 2007 WL 2375081, at *1 (N.D.

Tex. Aug. 20, 2007) (denying a Rule 12(b)(1) motion to dismiss because plaintiff plausibly stated a

§ 1983 claim by alleging jail personnel withheld necessary psychiatric medication).

Accepting Plaintiff’s allegations as true—as the Court must at this stage—Dr.

Sanchez had access to Plaintiff’s medical records and initially authorized the

administration of Plaintiff’s medication (Dkt. No. 40 ¶¶ 33, 41). Later, as a

disciplinary measure, Dr. Sanchez discontinued the treatment (id. ¶¶ 35–36). He did

not implement an alternative, supervised means of administering the medication (id.

¶ 42). Dr. Sanchez also received Plaintiff’s multiple grievance forms, which reported

Plaintiff’s declining mental health (id.). Given Dr. Sanchez’s professional training,

the grievance forms notified him that Plaintiff faced a substantial risk of mental

health deterioration and suicide (id.). Despite knowing this substantial risk existed,

Dr. Sanchez ignored it until it was almost too late—when Plaintiff attempted suicide

(id. ¶¶ 44–46).

In sum, Plaintiff alleges Dr. Sanchez denied him psychiatric medication

despite knowing (1) Plaintiff needed his medication, (2) Plaintiff repeatedly requested

his medication, and (3) he faced a substantial risk of serious harm without this care

(see id. ¶¶ 35, 41–42). As alleged, Plaintiff has plausibly pled an inadequate medical

care claim against Dr. Sanchez. See Converse v. City of Kemah, 961 F.3d 771, 775 (5th

Cir. 2020) (finding a plausible constitutional violation where plaintiffs alleged

defendants “had subjective awareness that [a detainee] was at substantial risk of

suicide” and were “deliberately indifferent to this risk”); Belcher v. Judd, No. 3:07-cv-

348, 2007 WL 2375081, at *1 (N.D. Tex. Aug. 20, 2007) (same, where plaintiff alleged

“he was denied the medication necessary to treat his bipolar disorder”).

Notwithstanding Plaintiff’s allegations, Dr. Sanchez urges dismissal. He

believes Plaintiff failed to precisely state how Dr. Sanchez knew of Plaintiff’s

grievances (see Dkt. No. 54 at 10). Without this precise set of facts, Dr. Sanchez

argues Plaintiff has not alleged deliberate indifference (see id.). But at this stage,

Plaintiff need not plead facts particularly within the defendant’s knowledge. Eachus

v. Steelman, No. 4:20-cv-324, 2021 WL 857988, at *18 (E.D. Tex. Mar. 8, 2021).

Consequently, Dr. Sanchez’s motion to dismiss (Dkt No. 54) is DENIED.

IV. CONCLUSION

For the foregoing reasons, Sergeant Ramos, Mr. Macias, and Commander

Aguilera’s motion (Dkt. No. 52) is GRANTED IN PART and DENIED IN PART.

Dr. Sanchez’s motion (Dkt. No. 54) is DENIED. Plaintiff’s conditions-of-confinement

claim against Sergeant Ramos and Mr. Macias is DISMISSED WITH

PREJUDICE. Likewise, Plaintiff’s supervisory liability claim against Commander

Aguilera is DISMISSED WITH PREJUDICE. The Clerk is DIRECTED to

terminate Jose A. Aguilera, Jr. from this action.

The following claims remain pending: (1) Plaintiff’s episodic-acts-or-omissions

claim against Sergeant Ramos and Mr. Macias and (2) Plaintiff’s deprivation of

medical care claim against Dr. Sanchez. For these remaining claims, the Magistrate

Judge is ORDERED to convene a Rule 16 management conference as soon as

possible.

It is so ORDERED.

SIGNED March 6, 2023.

Le Garcia Cafe :

United States District Judge

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