Kettner v. Castleberry

IN THE UNITED STATES DISTRICT COURT

EASTERN DISTRICT OF ARKANSAS

CENTRAL DIVISION

BURTON JAMES KETTNER PLAINTIFF

V. Case No. 4:23-CV-00734-JM-BBM

SHARRON CASTLEBERRY, Jail

Administrator, Prairie County

Detention Facility; RICK PARSONS,

Sheriff, Prairie County, Prairie County

Detention Facility; RICK HICKMAN,

Former Sheriff, Prairie County, Prairie

County Detention Facility; and

BRAD GRADY, Former Administrator,

Prairie County Detention Facility DEFENDANTS

RECOMMENDED DISPOSITION

The following Recommended Disposition (“Recommendation”) has been sent to

United States District Judge James M. Moody Jr. You may file written objections to all or

part of this Recommendation. If you do so, those objections must (1) specifically explain

the factual and/or legal basis for your objection; and (2) be received by the Clerk of this

Court within fourteen (14) days of the date of this Recommendation. If you do not file

objections, Judge Moody may adopt this Recommendation without independently

reviewing all of the evidence in the record. By not objecting, you may waive the right to

appeal questions of fact.

I. INTRODUCTION

On August 7, 2023, Plaintiff Burton James Kettner (“Kettner”), a pretrial detainee

then housed at the Prairie County Detention Facility (“PCDF”), filed a pro se § 1983

Complaint, alleging that Defendants violated his constitutional rights. (Doc. 2). An

Amended Complaint and Second Amended Complaint followed. (Docs. 6, 8).

After the Court screened the Amended Complaint and Second Amended Complaint1

in accordance with the Prison Litigation Reform Act, Kettner was allowed to proceed with

deliberate-indifference claims against Defendants—PCDF Administrator Sharron

Castleberry (“Castleberry”), Prairie County Sheriff Rick Parsons (“Sheriff Parsons”),

former Prairie County Sheriff Rick Hickman (“Sheriff Hickman”), and former PCDF

Administrator Brad Grady (“Grady”)—for allegedly denying him medical care for his

stage-four colon cancer, heart condition, and dental needs, among other issues. (Doc. 12 at

2). Kettner sues Defendants in their individual and official capacities, (Doc. 6 at 3).

On November 5, 2024, Defendants filed a Motion for Summary Judgment, a Brief

in Support, and a Statement of Undisputed Facts, arguing that Kettner’s claims fail on the

merits. (Docs. 49–51). Kettner filed a Response, (Doc. 53), and Defendants filed a Reply

and an Addendum, (Docs. 54–55). The Addendum appeared to be a single page of

Kettner’s deposition and new evidence that was not attached to Defendants’ summary

judgment filings. (Doc. 55 at 2). Thus, on December 12, 2024, the Court ordered

Defendants to produce Kettner’s entire deposition transcript and gave Kettner the

opportunity to file a sur-reply. (Doc. 56). Defendants complied with the Order and filed an

Addendum containing the entire deposition transcript, (Doc. 57), and Kettner filed a sur-

1 Both the Amended Complaint, (Doc. 6), and the Second Amended Complaint, (Doc. 8), were

served on the Defendants and were construed together as constituting Kettner’s claims. See (Doc. 12)

(screening Kettner’s claims considering both documents).

reply. (Doc. 58). Thus, the issues are joined and ready for disposition. For the reasons set

forth below, the Court recommends Defendants’ Motion for Summary Judgment be

granted.2

II. FACTUAL BACKGROUND3

Kettner was diagnosed with stage IV colorectal cancer in April 2017. (Doc. 42 at

221, 246; Doc. 57 at 30, 28:15–16). He underwent radiation therapy and chemotherapy,

which required he have a heart port installed. (Doc. 42 at 167, 206, 231; Doc. 57 at 31,

29:2–3). He also used a colostomy bag. (Doc. 42 at 203; Doc. 57 at 16, 14:24–25).

In June 2017, Kettner developed a blood clot in his left arm and was prescribed a

blood thinner, Eliquis. (Doc. 42 at 231–232). Kettner underwent surgery in August 2017,

which successfully removed the cancer. (Doc. 42 at 167, 221; Doc. 57 at 18, 16:3–7). And

in June 2018, he had his colostomy bag removed. (Doc. 42 at 160, 167; Doc. 57 at 16,

14:24–25). Even so, Kettner continued to suffer from stomach aches, pain, and problems

controlling his bowel movements. (Doc. 42 at 140; Doc. 57 at 16–17, 14:25–15:2). And

2 Summary judgment is appropriate when the record demonstrates that there is no genuine dispute

as to any material fact, and the moving party is entitled to judgment as a matter of law. See FED. R. CIV. P.

56(a); Celotex Corp. v. Catrett, 477 U.S. 317, 322–23 (1986); Anderson v. Liberty Lobby Inc., 477 U.S.

242, 249–50 (1986). The moving party bears the initial burden of demonstrating the absence of a genuine

dispute of material fact. Celotex, 477 U.S. at 323. Thereafter, the nonmoving party must present specific

facts demonstrating that there is a material dispute for trial. See FED. R. CIV. P. 56(c); Torgerson v. City of

Rochester, 643 F.3d 1031, 1042 (8th Cir. 2011) (en banc). “Courts must construe the evidence in the light

most favorable to the nonmoving party and draw all reasonable inferences in favor of that party.” Brand v.

Nat’l Union Fire Ins. Co. of Pittsburgh, PA, 934 F.3d 799, 802 (8th Cir. 2019) (citing Young v. United

Parcel Serv., Inc., 575 U.S. 206, 216 (2015)).

3 With few exceptions, these facts are sourced from Defendants’ summary judgment exhibits,

which include Castleberry’s affidavit and portions of Kettner’s PCDF intake paperwork, grievances, and

medical request forms, (Docs. 49-1 to 49-7); Kettner’s deposition, (Doc. 57); an additional grievance

attached to Kettner’s sur-reply, (Doc. 58 at 6); Kettner’s medical records, (Doc. 42); and, as necessary,

Kettner’s verified Complaints, (Docs. 6, 8).

the chemotherapy exacerbated Kettner’s pre-existing dental problems, causing his teeth to

rot and “hurt[] real bad.” (Doc. 42 at 169–170; Doc. 57 at 15, 13:7–21 & 35–36, 33:23–

34:1).

Kettner’s heart port remained installed, and he was required to attend regular follow-

up appointments with both his colorectal surgeon, Dr. William C. Mustain, and his

oncologist, Dr. Omer Khalil, to make sure his cancer did not return. (Doc. 42 at 58–59,

167, 221; Doc. 57 at 18, 16:15–19). The follow-up appointments consisted of periodic

PET/CT scans, colonoscopies, blood work, and port flushes. (Doc. 42 at 139–140, 160–

161, 168). Kettner also continued take his blood thinner. (Doc. 42 at 106, 154, 161). Kettner

generally maintained his follow-up appointments and took his medication as prescribed.4

See (Doc. 42 at 73–174); (Doc. 57 at 20, 18:9–12). That is, until he was twice incarcerated

in the PCDF. It is undisputed that Kettner did not receive any medical care during either of

his PCDF incarcerations. See (Doc. 8 at 4; Doc. 49-3; Doc. 57 at 53, 51:16–19).

According to Kettner, he was first incarcerated at PCDF sometime after April 1,

2022. (Doc. 57 at 41–42, 39:22–40:13). Although there is no evidence regarding Kettner’s

first date of incarceration, the parties appear to agree that he was booked in on September

2, 2022. (Doc. 53 at 4, 23; Doc. 54 at 3). During the 2022 incarceration, the jail

administrator was Grady, and the Prairie County Sheriff was Sheriff Hickman. (Doc. 57 at

42, 40:20–21 & 54, 52:21–25). There is not much record evidence of what occurred during

4 In June 2021, it was noted that Kettner was taking his blood thinner “sporadically,” and cancelled

a colonoscopy appointment. (Doc. 42 at 106).

Kettner’s first PCDF incarceration, but Kettner claims he filled out an “Inmate Medical

form” and “was asking them for medical help and [] explained to each one of them that

[he] needed to see [his] doctors” so he “could stay on top of everything.” (Doc. 53 at 4;

Doc. 57 at 54–55, 52:21–53:3).

Kettner bonded out in November 2022 and visited his oncologist, Dr. Khalil, on

November 8, 2022, with complaints of abdominal pain. (Doc. 42 at 69–72; Doc. 53 at 23;

Doc. 57 at 12, 10:6–13). Dr. Khalil noted that Kettner had been incarcerated, had not seen

Dr. Mustain, and had “missed CT scans [that] will need to be rescheduled.” (Doc. 42 at 69,

72). Blood work was conducted, which showed “mild and stable anemia.” (Doc. 42 at 72).

But there was “no clinical evidence of disease recurrence.” (Doc. 42 at 72). Kettner was

advised to schedule a consultation for pain management, “[c]ontinue regular follow up for

Colorectal cancer,” have a CT scan prior to his next visit, and return to the clinic in six

months for repeat assessment and blood work. (Doc. 42 at 72).

But, before Kettner could continue his follow-up appointments, he missed a court

date and was rebooked into PCDF on January 17, 2023. (Doc. 49-1 at 2; Doc. 49-6 at 2,

¶ 2; Doc. 57 at 11–12, 9:23–10:3). During the 2023 incarceration, the jail administrator

was Castleberry, and the Prairie County Sheriff was Sheriff Parsons. (Doc. 57 at 42, 40:24–

25 & 54, 52:1–3).

This time, Kettner filled out a medical intake questionnaire that is contained in the

record. (Doc. 49-1 at 1). On the intake form, Kettner wrote the name of his family doctors,

“Dr. Mustang and Dr. Kohkahaalil,” and that he had anxiety, major dental problems, a

meth addiction, colon cancer, and stomach problems. Id. Kettner answered “no” when

asked if he was taking medication or had any heart problems. Id. Kettner explained in his

deposition that he was not on his blood thinners at that time and understood the question

about “heart problems” to be asking about heart attacks and the like; thus, he did not

disclose his prescription for Eliquis or that he had a heart port that needed flushed. (Doc.

57 at 26, 24:5–18 & 33–34, 32:3–9).

Regardless, Kettner revealed his medical needs to PCDF staff in other ways. Shortly

after his January 2023 booking, Kettner began to submit paper medical requests and

verbally request help. (Doc. 57 at 49–50, 47:21–48:5). At some point, he told “them” that

he was having pains in his chest, similar to his previous blood clot, and needed his blood

thinner. (Doc. 57 at 33–34, 31:17–32:4). Another unspecified time, Kettner was having

bowel movements that he could not control, but no one would provide him an anti-

diarrheal. (Doc. 57 at 52, 50:3–10). But, despite Kettner’s verbal and written requests for

help, he never received any help or response. (Doc. 57 at 49, 47:21–25).

So, on July 29, 2023, Kettner submitted his first grievance on the digital kiosk. (Doc.

8 at 4; Doc. 57 at 37–38, 35:23–36:3 & 39, 37:7–9). Additional grievances followed on

August 3, 12, 15, 27, 31 and September 5, 17, 2023. (Doc. 51 at 2, ¶ 3). As the jail

administrator, Castleberry viewed and responded to the grievances. See (Doc. 49-2 at 2;

Doc. 49-3 at 2; Doc. 58 at 6).

Only portions of the grievances are contained in the record, (Doc. 58 at 6; Doc. 49-

2 at 2; 49-3 at 2), but Kettner testified as to the content of each grievance during his

deposition. (Doc. 57 at 39–48, 37:1–46:6). Kettner grieved that, despite telling “staff,”

“medical,” and “everyone” that he had colon cancer and needed his port flushed once a

month, a PET scan once a year, and blood work done, he had not been receiving medical

care for his colon cancer and dental issues. (Doc. 49-2 at 2, Doc. 58 at 6). He lamented that

his requests to see a dentist had been ignored and that he had to pull several of his own

teeth. (Doc. 58 at 6). He also wrote that he was “in constant pain and worried about [his]

health.” Id. Castleberry generally responded that she would put Kettner on the list to be

seen by the doctor but explained that Kettner would need to fill out a medical release form

to receive medical treatment. (Doc. 49-2 at 2; Doc. 49-3 at 2; Doc. 49-6 at 3, ¶¶ 5, 9; Doc.

57 at 40, 38:11–15 & 41, 39:1–24 & 44, 42:12–21 & 46–47, 44:15–45:15; Doc. 58 at 6).

Kettner testified that he repeatedly asked for the medical release form “from day

one,” so he could receive treatment, and that it is usually the jail administrator’s

responsibility to get the form to the inmates. (Doc. 57 at 44–45, 42:17–43:5). In fact, when

he asked for the form, several PCDF guards told Kettner that “they had to ask Ms.

Castleberry.” (Doc. 57 at 45–46, 43:12–44:7). But he did not receive the form until “Mrs.

Taylor” brought it to him on September 6, 2023, when he immediately signed it. (Doc. 53

at 6, 28; Doc. 57 at 38, 36:11–13). But Defendants argue that Castleberry and the previous

PCDF jail administrator, Grady, are not “responsible for making an inmate sign the medical

release form.” (Doc. 50 at 6). Castleberry also states in her affidavit that Kettner’s access

to medical care was only delayed because of Kettner’s “failure to sign the medical release

form” until September 20, 2023. (Doc. 49-6 at 3, ¶¶ 8–9).

On September 19, 2023, Kettner was sentenced to the ADC. (Doc. 8 at 4). On

September 26 & 28, 2023, Castleberry filled out a medical evaluation request to the PCDF

medical care provider and tried to “fast-track” Kettner to the ADC to receive care. (Doc.

49-4 at 2–3; Doc. 49-5 at 2; Doc. 57 at 50, 48:20–24). Kettner was transferred to the ADC

on October 5, 2023. (Doc. 49-6 at 3–4, ¶ 10). The ADC began flushing Kettner’s port, and,

on October 10, 2023, took him to see Dr. Khalil. (Doc. 57 at 58, 46:22–25; Doc. 42 at 65–

68).

At the October 10, 2023 appointment, Dr. Kahlil noted that Kettner was

incarcerated, had been “lost to follow up” since November 2022, had not received the

repeat CT scans as advised, and had not had a colonoscopy since January 2022. (Doc. 42

at 68). Kettner complained of stomach discomfort, but reported a good appetite, weighed

15 pounds more than his last visit, and his immediately reviewable blood work showed

“normal counts.” (Doc. 42 at 65, 68). Dr. Kahlil noted there was “no clinical evidence of

disease recurrence” and recommended that Kettner receive CT scans, continue regular

follow-up care, and return in six weeks for additional blood work. (Doc. 42 at 68).

Kettner received CT scans on November 14, 2023, and followed up with Dr. Kahlil

on November 21, 2023. (Doc. 42 at 63). Dr. Kahlil noted that Kettner’s CT scans also

showed “no evidence of regional or recurrent disease.” (Doc. 42 at 63). Dr. Kahlil

instructed Kettner to continue with regular follow-up appointments and to return to the

clinic every eight weeks to have his port flushed and repeat blood work. (Doc. 42 at 63).

Kettner had at least one more visit with Dr. Khalil while incarcerated—again

showing “no clinical evidence of disease recurrence”—and, in June 2024, Kettner was

released from ADC custody. (Doc. 42 at 51–55; Doc. 39). As of his September 30, 2024

deposition, Kettner still had not seen a dentist but planned on getting dentures because it

was “too late” to get any other work done. (Doc. 57 at 15, 13:10–14 & 16, 14:4–14).

III. DISCUSSION

Defendants argue that they are entitled to qualified immunity. (Doc. 50 at 12–14).

According to Defendants, Kettner cannot establish any Defendant deprived him of his

constitutional rights because “the acts about which [Kettner] complains show that none of

them demonstrate a deprivation of a constitutional right.” (Doc. 50 at 14). Similarly,

Defendants argue that the record does not contain a supervisory constitutional violation.

Id. at 10–12.

A. Individual-Capacity Claims: Qualified Immunity

Qualified immunity protects a government official from liability when his or her

conduct does not violate “clearly established statutory or constitutional rights of which a

reasonable person would have known.” Harlow v. Fitzgerald, 457 U.S. 800, 818 (1982).

To determine if Defendants are entitled to qualified immunity, the Court must conduct a

two-pronged inquiry into whether Kettner has demonstrated: “(1) a deprivation of a

constitutional right, [that was] (2) … clearly established at the time of the deprivation.”

Robbins v. City of Des Moines, 984 F.3d 673, 678 (8th Cir. 2021). Defendants are entitled

to qualified immunity should either prong be decided in their favor. Watson v. Boyd, 2 F.4th

1106, 1112 (8th Cir. 2021) (citations omitted). The Court has discretion on which prong to

address first. Pearson v. Callahan, 555 U.S. 223, 236 (2009). Because this case turns on

whether a constitutional violation occurred, the Court’s analysis begins and ends with that

prong.

Although Kettner was a pretrial detainee for most of his time at PCDF, the Court

nevertheless analyzes his claims under the Eighth Amendment “deliberate-indifference

standard.” See Jackson v. Buckman, 756 F.3d 1060, 1065 (8th Cir. 2014) (applying the

deliberate-indifference standard to a pretrial detainee’s claim of failure to provide medical

care in violation of the due process clause of the Fourteenth Amendment). To prevail on

his medical-deliberate-indifference claims, Kettner must establish that (1) he had “an

objectively serious medical need,” and (2) Defendants “knew of and disregarded that

need.” Redmond v. Kosinski, 999 F.3d 1116, 1119 (8th Cir. 2021) (quoting Coleman v.

Rahija, 114 F.3d 778, 784 (8th Cir. 1997)). “To constitute an objectively serious medical

need or a deprivation of that need, the need or the deprivation alleged must be either

obvious to the layperson or supported by medical evidence, like a physician’s diagnosis.”

Cannon v. Dehner, 112 F.4th 580, 586 (8th Cir. 2024) (cleaned up), cert. denied, 145 S.

Ct. 1149 (2025). Moreover, Kettner must show “not only that his condition is serious, but

also urgent—one that ‘may produce death, degeneration, or extreme pain.’” Dalen v.

Harpstead, 123 F.4th 900, 904 (8th Cir. 2024) (quoting Carney v. Hess, 2007 WL 9752816

(E.D. Mo. Jan. 24, 2007), aff’d, 271 F. Appx. 543 (8th Cir. 2008)).

To establish deliberate indifference, there must be evidence suggesting Defendants

“recognized that a substantial risk of harm existed and knew that their conduct was

inappropriate in light of that risk.” Shipp v. Murphy, 9 F.4th 694, 703 (8th Cir. 2021)

(quoting Letterman v. Does, 789 F.3d 856, 862 (8th Cir. 2015)). As the Eighth Circuit has

held:

The subjective prong of deliberate indifference is an extremely high standard

that requires a mental state of more . . . than gross negligence. It requires a

mental state akin to criminal recklessness. Even medical malpractice does

not automatically constitute deliberate indifference.

Saylor v. Nebraska, 812 F.3d 637, 644 (8th Cir. 2016) (cleaned up). Relatedly, “inmates

have no constitutional right to receive a particular or requested course of treatment, and

prison doctors remain free to exercise their independent medical judgment[.]” Meuir v.

Greene Cty. Jail Emps., 487 F.3d 1115, 1118 (8th Cir. 2007) (quoting Dulany v. Carnahan,

132 F.3d 1234, 1239 (8th Cir. 1997)). Thus, a “mere disagreement with treatment decisions

does not rise to the level of a constitutional violation.” Jolly v. Knudsen, 205 F.3d 1094,

1096 (8th Cir. 2000) (quoting Estate of Rosenberg v. Crandell, 56 F.3d 35, 37 (8th Cir.

1995)). In sum, Kettner may prove deliberate indifference by “showing grossly

incompetent or inadequate care, showing a defendant’s decision to take an easier and less

efficacious course of treatment, or showing a defendant intentionally delayed or denied

access to medical care.” Allard v. Baldwin, 779 F.3d 768, 772 (8th Cir. 2015) (cleaned up).

Because Kettner alleges that he has multiple serious medical needs, the Court will first

analyze each need before discussing whether Defendants were deliberately indifferent.

Defendants may be held liable if they were personally involved in deliberately

disregarding Kettner’s serious medical needs, see Wever v. Lincoln Cnty., Nebraska, 388

F.3d 601, 606 (8th Cir. 2004), i.e. they may be held liable if they, themselves, denied

Kettner adequate medical care. However, as the Eighth Circuit has held, “[a] supervisor

may be liable under section 1983 if their failure to properly supervise and train the

offending employee caused a deprivation of constitutional rights.” Davis v. Buchanan

Cnty., Missouri, 11 F.4th 604, 624 (8th Cir. 2021) (cleaned up).

To prove a supervisory-liability claim, Kettner “must demonstrate that the

supervisor was deliberately indifferent to or tacitly authorized the offending acts. This

requires a showing that the supervisor had notice that the training procedures and

supervision were inadequate and likely to result in a constitutional violation.” Wever, 388

F.3d at 606 (quoting Andrews v. Fowler, 98 F.3d 1069, 1078 (8th Cir. 1996); see also

Davis, 11 F.4th at 624 (“When a ‘supervising official who had no direct participation in an

alleged constitutional violation is sued for failure to train or supervise the offending actor,

the supervisor is entitled to qualified immunity unless plaintiff proves that the supervisor

(1) received notice of a pattern of unconstitutional acts committed by a subordinate, and

(2) was deliberately indifferent to or authorized those acts.’”) (quoting S.M. v. Krigbaum,

808 F.3d 335, 340 (8th Cir. 2015)). “This ‘rigorous standard’ requires proof that the

‘supervisor had notice of a pattern of conduct by the subordinate that violated a clearly

established constitutional right.’” Id. (quoting Krigbaum, 808 F.3d at 340). Put differently,

a supervisor is deliberately indifferent if he facilitates, condones, or turns a blind eye to the

violative conduct of his subordinates. Boyd v. Knox, 47 F.3d 966, 968 (8th Cir. 1995).

1. Serious Medical Needs

Heart Port and Blood Thinners. Kettner testified that (1) his heart port, placed by

Dr. Mustain, needed to be flushed once a month for blood clots, and (2) before his

incarceration, Dr. Khalil had prescribed him a blood thinner to prevent any blood clots

related to the port. (Doc. 57 at 36, 34:13–18). The Court assumes that the flushing of

Kettner’s heart port is part of a doctor’s treatment plan. And, according to Kettner, the

blood thinner was prescribed by Dr. Khalil to prevent any further blood clots. Thus, the

Court finds that both issues constitute serious medical needs, i.e., treatments following

from a doctor’s diagnosis.

Colon Cancer. To be clear, the record contains no evidence that Kettner suffered a

recurrence of colon cancer during his time at the PCDF. Indeed, Kettner testified that a

surgery in 2017 successfully removed his colon cancer. (Doc. 57 at 18, 16:3–10). However,

Kettner did testify that he should have a PET scan or colonoscopy every six months,

presumably to monitor any recurrence. (Doc. 57 at 35, 33:16–17). To extent that the

possibility of a recurrence of cancer could constitute a serious medical need, the Court will

proceed under this assumption when analyzing Kettner’s claims related to the lack of PET

scans and colonoscopies during his first incarceration (September 2, 2022–November

2022) and his second incarceration (January 17, 2023–October 5, 2023).

Dental Needs. The Court finds that Kettner’s three “rotting” and painful teeth

constituted a serious medical need. See e.g., Boyd, 47 F.3d at 969 (concluding that a three-

week delay in dental care, coupled with knowledge that an inmate is suffering, can support

a finding of an Eighth Amendment violation); Patterson v. Pearson, 19 F.3d 439, 440 (8th

Cir. 1994) (per curiam) (reversing grant of summary judgment where there was evidence

that dentist learned of plaintiff’s tooth-related swelling, headache, and severe pain in March

but did not remove tooth until April); Moore v. Jackson, 123 F.3d 1082, 1086–87 (8th Cir.

1997) (per curiam) (denying summary judgment to defendants who delayed adequate

treatment for a toothache for eight months that became infected and ultimately required

extraction); Hartsfield v. Colburn, 371 F.3d 454, 457 (8th Cir. 2004) (finding plaintiff’s

extreme dental pain, bleeding gums, swelling, and difficulty sleeping or eating constituted

a serious medical need). The Court notes that Kettner provides no dates associated with

this serious medical need.

Anti-diarrheal. Although it is not mentioned in his Amended Complaints, Kettner

testified that—on unspecified dates—he had bowel movements that he could not control,

and no one would provide him an anti-diarrheal. (Doc. 57 at 52, 50:3–10, 16–18, 20). The

Court finds that it is obvious to a layperson that out-of-control bowel movements require

medical attention. Thus, the Court finds that—to the extent Kettner experienced accidents

related to his bowel movements—this constituted a serious medical need.

2. Deliberate Indifference

Before analyzing whether each Defendant was deliberately indifferent, a recitation

of Kettner’s “group” assertions is necessary. All in all, Kettner ascribes the following

actions to a vague “group,” which may or may not consist of the Defendants.

In both of his operative Complaints, Kettner vaguely alleges that the

“administration” has been aware of his medical needs from the first day he was booked in.

(Doc. 6 at 5; Doc. 8 at 3). In his First Amended Complaint, Kettner adds that he told “them”

about his teeth falling out. (Doc. 6 at 5). Kettner also testified that he had diarrhea and

accidents, but no one would provide an anti-diarrheal. (Doc. 57 at 52, 50:3–10, 16–18, 20).

Additionally, Kettner testified that he asked “them” for the medical release forms from the

moment he was booked in, but no one would give him the forms. (Doc. 57 at 38, 36:6–7).

The analysis below incorporates these “group” allegations, as well as the individual

allegations against certain Defendants.

Former Sheriff Rick Hickman. A thorough review of the record reveals that there is

no evidence (aside from vague and blanket assertions of fact) that former Prairie County

Sheriff Hickman knew about Kettner’s serious medical condition. In fact, there is little to

no record evidence at all regarding Kettner’s three-month incarceration at PCDF in 2022

when Sheriff Hickman and Administrator Grady were there.

In his Second Amended Complaint, as to Sheriff Hickman, Kettner alleges that he

was Jail Administrator Grady’s boss and, “I feel he know[s] what was going on in his jail

and did not help me! I put in medical requests and never got any help or answers[.]” (Doc.

8 at 5). In his deposition, Kettner testified about Sheriff Hickman:

Q: Do you believe that Rick Hickman intentionally ignored you and your

medical condition?

A: Yes, ma’am, I do.

Q: And do you believe that he was responsible for your medical conditions

while at Prairie County?

A: Yes.

Q: And was he responsible for making you sign a medical release form?

A: Yes, ma’am.

Q: Rick Hickman, at that time he was the former Sheriff of Prairie County.

Now, was that your time in April?

A: Yes, ma’am. And I was asking them back when Brad Grady was the

Administrator and everything, I was asking them for medical help and I

explained to each one of them that I needed to see my doctors, that way I

could stay on top of everything.5

5 Throughout this Recommendation, the deposition excerpts are copied word for word without

removing grammatical errors.

(Doc. 57 at 54, 52:12–53:3). In combination, for the following reasons, these vague

statements do not amount to evidence that Sheriff Hickman (1) knew of Kettner’s serious

medical needs, and (2) was deliberately indifferent towards them.

First, as to Kettner’s allegation that the “administration” has been aware of his

medical needs from his first day at PCDF, this assertion is far too vague to provide evidence

for his claim against Sheriff Hickman. (Doc. 6 at 5; Doc. 8 at 3). As the Court noted in its

initial screening order:

Kettner does make allegations against the “Administration.” But this general

term is not specific enough for the Court to understand which Defendant

knew of, but ignored, his serious medical needs. Without specific allegations

against a Defendant, the Court cannot determine if a Defendant’s actions may

have been unlawful. See Iqbal, 556 U.S. at 676 (explaining that, to state a

viable § 1983 claim, a prisoner “must plead that each Government-official

defendant, through the official’s own individual actions, has violated the

Constitution”). As such, Kettner’s Complaint as currently pled fails to state

a claim on which relief may be granted.

(Doc. 6 at 5; Doc. 8 at 3). When this Court granted Kettner the opportunity to amend, the

Court expressly reminded Kettner that any amended pleading should (1) provide a

description of each Defendant’s individual actions that allegedly violated his constitutional

rights, and (2) explain how the Defendants knew about Kettner’s serious medical needs.

(Doc. 4 at 4). Kettner’s general assertions against the “administration” are insufficient.

Second, while Kettner asserts that he told “them” about his teeth falling out, (Doc.

6 at 5), this assertion is also far too vague. The same goes for Kettner’s assertions regarding

the anti-diarrheal. (Doc. 57 at 52, 50:3–10, 16–18, 20). In fact, at basic level, Kettner failed

to tie the dental and bowel movement allegations to any dates or any party. Kettner’s

statement that “they” never brought him the medical release forms suffers the same fate—

no dates or named parties are implicated.6 (Doc. 57 at 38, 36:6–10).

Kettner’s specific assertions against Sheriff Hickman fare no better. Kettner’s claim

that Sheriff Hickman was Administrator Grady’s boss, and his feeling that Sheriff Hickman

knew what was going on “in his jail” and did not help, again, are far too vague.

Consequently, Kettner fails to identify any individual actions taken by Sheriff Hickman

that violated Kettner’s constitutional rights. Finally, while Kettner testified that he

“explained to each one of them [presumably, Sheriff Hickman and Grady] that I needed to

see my doctors, that way I could stay on top of everything,” this statement fails to identify

when Kettner told them, what doctors he requested to see, and in reference to what medical

need.7

These few assertions in his Complaints and deposition represent the entirety of

Kettner’s “direct deliberate-indifference” evidence against Hickman. Unfortunately, both

Kettner’s allegations and his testimony lack the factual enhancement necessary to prove a

constitutional violation. Even drawing all inferences in Kettner’s favor, on this record,

Sheriff Hickman is entitled to qualified immunity. Kettner’s direct deliberate-indifference

claims against Sheriff Hickman should be dismissed.

To be sure, Kettner could be proceeding on a supervisory-liability deliberate-

indifference claim separate from his direct deliberate-indifference claim. Specifically,

6 To the extent Kettner asked Castleberry for the medical release forms and she did not provide

them, this allegation will be addressed alongside Kettner’s other specific allegations against Castleberry.

7 Given the context of this testimony, the Court assumes that “each one of them” refers to both

Sheriff Hickman and Grady. (Doc. 57 at 54–55, 52:24-53:3).

Kettner asserts that he feels “[Sheriff Hickman] know[s] what was going on in his jail and

did not help me!” (Doc. 8 at 5). However, in this case, without more information regarding

(1) how Sheriff Hickman knew about Kettner’s medical needs, (2) when Sheriff Hickman

learned about his medical needs, or (3) what medical needs Sheriff Hickman knew about,

Kettner cannot prove that Sheriff Hickman facilitated, condoned, or turned a blind eye to

Kettner’s serious medical needs. Without evidence of a supervisory constitutional

violation, Sheriff Hickman is entitled to qualified immunity. Kettner’s claims against

Sheriff Hickman should be dismissed.

Former Jail Administrator Brad Grady. As with Sheriff Hickman, a careful review

of the record reveals that there is no evidence (aside from vague and blanket assertions of

fact) that former Jail Administrator Brad Grady knew about Kettner’s serious medical

condition. In his Second Amended Complaint, Kettner asserts that Grady “was aware of

my medical need, and [he] did not get me any help, or did not take me to see any of my

cancer [doctors] or get me any help, for medical, or dental!” (errors in original). (Doc. 8 at

5). Kettner further asserts that he put in medical requests and never got any help or answers.

Id. Kettner testified about Grady as follows:

Q: And do you believe Brad Grady intentionally ignored you and your

medical needs?

A: Yes, I do.

Q: And was he responsible for your medical needs during Prairie County?

A: Yes, ma’am. He was the Administrator and he knew that I had—had it

and he didn’t pay it no attention.

(Doc. 57 at 55, 53:4–10). In combination, these conclusory statements do not amount to

evidence that Brad Grady (1) actually knew of Kettner’s serious medical needs, and (2)

was deliberately indifferent towards them.

As the Court found above, Kettner’s general allegations against the “administration”

cannot support his claims against Grady. Similarly, Kettner’s specific assertions against

Grady are also lacking. Although Kettner says he submitted multiple grievances and never

got any help or answers, (Doc. 8 at 5), Kettner fails to identify or produce any grievance

putting Grady on notice of Kettner’s medical needs. Without more, Kettner cannot prove

what Grady knew and when. Kettner also testified that he “explained to each one of them

[presumably, Sheriff Hickman and Grady] that I needed to see my doctors, that way I could

stay on top of everything,” but again, this statement fails to identify when Kettner told

them, what doctors he requested to see, and in reference to what medical need. For these

reasons, Grady is entitled to qualified immunity as to Kettner’s direct deliberate-

indifference claim.

To the extent that Kettner proceeds on supervisory-liability deliberate-indifference

claims against Grady, those claims also fail. Kettner testified that Grady “was the

Administrator and he knew that I had—had it and he didn’t pay it no attention.” (Doc. 57

at 55, 53:9–10). However, in this case, without more information regarding (1) how Grady

knew about Kettner’s medical needs, (2) when Grady learned about his medical needs, or

(3) what exact medical needs Grady knew about, Kettner cannot prove that Grady

facilitated, condoned, or turned a blind eye to Kettner’s serious medical needs. As such,

Grady is entitled to qualified immunity on any supervisory liability claims, as well.

Sheriff Rick Parsons. Kettner’s claims against Sheriff Rick Parsons arose during his

second incarceration in PCDF in 2023. In his Second Amended Complaint, Kettner asserts

that “Rick Parsons is the new Sheriff of [PCDF]. I have put in medical requests and

grievances. Have not received any answers or help! And when I asked to speak with the

Sheriff, Mrs. Castleberry said he does not talk to the inmates!” (Doc. 8 at 5). Kettner further

asserts that he sent three grievances with attention to the Sheriff: one on July 29, 2023,

another on August 3, 2023, and a final grievance on August 7, 2023. Id. at 4. Kettner further

testified:

Q: And so at the time Rick Parsons, he was the sheriff of Prairie County?

A: Yes, ma’am.

Q: And so was the sheriff responsible for making you sign the medical

release form?

A: Well, they should see to it that I get it, at least where I could sign it. He

should know what’s going on in his jail, I would think.

(Doc. 57 at 54, 52:1–8). Upon review in a light most favorable to Kettner, these general

claims do not amount to evidence that Sheriff Parsons (1) knew of Kettner’s serious

medical needs, and (2) was deliberately indifferent towards them.

Although Kettner says he submitted multiple medical requests alongside three

grievances directed at Sheriff Parsons, (Doc. 8 at 5), the record is devoid of any grievance

or medical request putting Sheriff Parsons on notice of Kettner’s medical needs. In fact,

Kettner testified that when he asked to speak with Sheriff Parsons, Castleberry said he does

not talk to the inmates. (Doc. 8 at 5). Castleberry’s statements, as alleged by Kettner, would

seem to confirm Sheriff Parsons’s lack of knowledge of, or deliberate indifference to,

Kettner’s serious medical needs. Based on the record before the Court, Sheriff Parsons is

entitled to qualified immunity as to Kettner’s direct deliberate-indifference claim.

Regarding Kettner’s supervisory liability deliberate-indifference claims against

Sheriff Parsons, Kettner testified that, with respect to the medical release form, “they

[presumably, Sheriff Parsons] should see to it that I get it, at least where I could sign it. He

should know what’s going on in his jail, I would think.” (Doc. 57 at 54, 52:6–8). But again,

although Kettner alleges that he sent grievances to Sheriff Parsons on certain dates, Kettner

does not detail the content of those medical grievances. (Doc. 8 at 4). Without more

information regarding Sheriff Parsons’s knowledge, Kettner cannot prove that Sheriff

Parsons facilitated, condoned, or turned a blind eye to Kettner’s serious medical needs.

Boyd, 47 F.3d at 968. And, without evidence of a constitutional violation, Sheriff Parsons

is entitled to qualified immunity. Kettner’s claims against Sheriff Parsons should be

dismissed.

Jail Administrator Sharron Castleberry. Unlike the other Defendants, evidence in

the record shows that Castleberry was at least somewhat involved in Kettner’s care during

his 2023 incarceration at PCDF. But whether proceeding directly against Castleberry on a

medical-deliberate-indifference claim or against her in her supervisory capacity, the

evidence must show some sort of awareness—either that Castleberry “knew of” Kettner’s

serious medical needs or “had notice” that her subordinates were being deliberately

indifferent to Kettner’s serious medical needs. Davis, 11 F.4th at 624.

It is undisputed that Kettner interacted with Castleberry through the grievance

process from July 2023 until his transfer in October 2023. See e.g., (Doc. 49-2–49-3; Doc.

57; Doc. 58 at 6). There is no evidence, however, of any involvement by Castleberry in

Kettner’s medical care prior to Kettner’s July 29, 2023 grievance; accordingly, the Court

focuses on Castleberry’s actions from July 29, 2023 to the time Kettner was transferred to

the ADC on October 5, 2023. Fact questions abound.

First, because neither party attached the full grievance history, it is difficult to

determine exactly what information was conveyed to Castleberry and when. But, perhaps

more important is the dispute regarding the medical release form. Defendants argue that

any delay in Kettner receiving medical services was Kettner’s own fault. According to

Defendants, PCDF inmates “must sign a medical release form” in order to receive medical

care, and a “failure to sign such medical release will result in the prolonging of medical

services.” (Doc. 50 at 6). They point out that Castleberry told Kettner of this requirement

on several occasions, yet Kettner failed to follow the “proper practice” and “failed to sign

a medical release form until September 20, 2023.” Id. at 8. Without explaining how a PCDF

inmate is supposed to obtain the medical release form, or including any supporting

evidence, Defendants assert that Castleberry was not “responsible for making an inmate

sign the medical release form.” (Doc. 50 at 6; Doc. 54 at 4). After Kettner “finally” signed

the form, Castleberry “[a]ttentively” submitted a medical request form to the PCDF

medical provider and the ADC on September 26, 2023. (Doc. 50 at 8; Doc. 49-6 at 3, ¶¶

9–10).

But Kettner testified that he repeatedly asked for the medical release form “from

day one,” and that it is usually the jail administrator’s responsibility to get that form to the

inmates. (Doc. 57 at 44–45, 42:17–43:5). He also testified that he asked several PCDF

guards for the form, but they told Kettner that “they had to ask Ms. Castleberry.” (Doc. 57

at 45–46, 43:12–44:7). Ultimately, Kettner received the form from “Mrs. Taylor” on

September 6, 2023, and he signed it that day.8 (Doc. 53 at 6, 28; Doc. 57 at 38, 36:11–13).

If Kettner signed the medical release form on September 6, 2023, Castleberry’s submission

of medical evaluation forms on September 26, 2023, was perhaps not so “attentive.”

Moreover, on these murky facts, a jury might find that Castleberry should have (or at least

could have) gotten the medical release form to Kettner sooner and curbed the alleged delay

in medical care.

It could also be inferred from the record that Kettner’s access to medical care was

being delayed for non-medical reasons, such as Kettner’s imminent transfer to the ADC.

See Dantzler v. Baldwin, 133 F.4th 833, 847 (8th Cir. 2025) (“We have recognized that a

prison official delaying medical treatment for nonmedical reasons may amount to

deliberate indifference.”) (cleaned up). Indeed, Kettner testified: “Once I was finally going

to the ADC, then they finally wanted to go ahead and let me sign the papers.” (Doc. 57 at

38, 36:16–18). He believes he was finally provided the medical release form approximately

8 In support of his assertion that he signed the form on September 6, 2023, Kettner submits a

handwritten document that states: “Today i signed my medicial Release forms for my cancer Doctors

Release September 6th.” (Doc. 53 at 6) (errors in original). The document appears to be signed by a “D.

Taylor.” Id. Kettner also testified that he signed the form on September 6. (Doc. 57 at 38, 36:11–14). But,

during a series of leading questions, Kettner also testified that he did not sign the form until September 20,

2023. Id. at 48, 46:7–13.

two days before he was sentenced. Id. at 36:11–14. And Castleberry states that she “fast-

tracked” Kettner to the ADC to receive medical care. (Doc. 49-6 at 3–4, ¶ 10; Doc. 54 at

5); see also (Doc. 49-4 at 3; Doc. 49-5 at 2).

Despite these fact questions and the dispute between the parties regarding who or

what caused Kettner’s delay in medical care, Castleberry is still entitled to qualified

immunity. That is because, in order to establish a constitutional violation based on a delay

in medical care, Kettner “must place verifying medical evidence in the record to establish

the detrimental effect of delay in medical treatment.” Dantzler, 133 F.4th at 843 (citations

omitted). In other words, Kettner must show, with medical records, that the delay in

medical treatment adversely affected his cancer prognosis, exacerbated his conditions, or

otherwise caused him harm. Id. Kettner placed medical evidence in the record, (Doc. 42),

but the records do not reveal any detrimental effect based on the alleged delay in medical

care. To the contrary, once Kettner was finally able to get his bloodwork done and receive

a CT scan, Dr. Khalil found “no clinical evidence of disease recurrence.” (Doc. 42 at 54,

63, 68).

There is also no medical evidence showing that a delay in Kettner having his port

flushed caused any detrimental effect. Kettner testified that, when he was in PCDF, he

“was having real bad chest pains where [his] port was…[that] felt like when [he] had [his]

blood clot.” (Doc. 57 at 51, 49:13–15). He also testified that, after he eventually had his

port removed post-incarceration, his blood pressure got higher. (Doc. 57 at 22, 20:17–20).

And when asked specifically about whether the delay in receiving a PET scan worsened

his condition, Kettner testified, “I think it could have helped with my port and everything,

you know.” (Doc. 57 at 53, 51:1–2). But “self-reported assertions of pain” must be

supported by corroborating medical or expert evidence, Hancock v. Arnott, 39 F.4th 482,

487 (8th Cir. 2022), and none of the medical records provided by Kettner show any

evidence of a second blood clot.

As for the lack of dental care, Kettner claims that he had to pull three teeth with his

fingers while in PCDF, and he was willing to send those teeth to the Court as evidence.

(Doc. 6 at 5; Doc. 33). But even after he was released from ADC custody, Kettner had not

yet seen a dentist. (Doc. 57 at 16, 14:4–14). And he provides no medical evidence in

support of his dental claims. Moreover, by the time Kettner filed a grievance to Castleberry

asking to see a dentist on August 15, 2023, the teeth had already been pulled. (Doc. 58 at

6). Given Castleberry’s lack of awareness of Kettner’s dental complaint, her actions (or

lack thereof) cannot be correlated to Kettner’s loss of teeth.

In sum, Kettner has not shown that Sheriff Parsons, Sheriff Hickman, or Grady were

directly involved in denying him medical care or even aware of his serious medical needs.

Although Castleberry became aware of Kettner’s medical needs in late July 2023, Kettner

has not shown that any subsequent delay in receiving medical treatment was detrimental to

his health. Accordingly, Kettner has failed to show Defendants violated his constitutional

rights, and Defendants are entitled to qualified immunity in their individual capacity.

B. Official-Capacity Deliberate-Indifference Claims

To the extent Kettner proceeds against Defendants in their official capacities, those

claims are the equivalent of claims against their employer, Prairie County. Veatch v.

Bartels Lutheran Home, 627 F.3d 1254, 1257 (8th Cir. 2010). But, because there is no

evidence of an underlying constitutional violation, the official-capacity claims fail as a

matter of law. Whitney v. City of St. Louis, Missouri, 887 F.3d 857, 860 (8th Cir. 2018).

IV. CONCLUSION

IT IS THEREFORE RECOMMENDED THAT:

l. Defendants’ Motion for Summary Judgment, (Doc. 49), be GRANTED.

2. Kettner’s First Amended Complaint and Second Amended Complaint be

DISMISSED with prejudice.

3. Judgment be entered accordingly.

DATED this 19th day of August, 2025.

Bunce a Uoove-

UNITED STATES MAGISTRATE JUDGE

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