Tiffany Wingo v. Major Branson Harris

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FOR PUBLICATION

In the

United States Court of Appeals

For the Eleventh Circuit

____________________

No. 24-10933

____________________

TIFFANY WINGO,

as Administrator of the Estate of Kevil Wingo, Sr.,

KIEARA WINGO,

as surviving child of Kevil Wingo, Sr.,

ERIKA WINGO,

as Surviving Child of Kevin Wingo, Sr.,

ESQ. TERI FIELDS,

Conservator of Kevil Wingo, Jr., Surviving

Minor Child of Kevil Wingo, Sr.,

Plaintiffs-Appellants,

ANGEL CALLOWAY,

as mother and next friend of Erika Wingo,

surviving minor child of Kevil Wingo, Sr., et al.,

Plaintiffs,

versus

WELLSTAR HEALTH SYSTEM, INC., et al.,

Defendants,

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2 Opinion of the Court 24-10933

MAJOR BRANSON HARRIS,

individually,

LIEUTENANT CHARLES GORDON,

individually,

DEPUTY PAUL WILKERSON,

individually,

DEPUTY LYNDA MARSHALL,

individually,

JOHN DOES 1 - 10,

individually and in their capacity as employees of

Cobb County Sheriff's Office, et al.,

Defendants-Appellees.

____________________

Appeal from the United States District Court

for the Northern District of Georgia

D.C. Docket No. 1:20-cv-03662-VMC

____________________

Before ROSENBAUM, GRANT, and BRASHER, Circuit Judges.

BRASHER, Circuit Judge:

The main question in this appeal is whether nonmedical jail

officers were deliberately indifferent to a detainee’s serious medical

condition when they followed the advice of the jail’s medical staff.

Kevil Wingo was a pretrial detainee in the Cobb County Adult De-

tention Center when he died from a perforated ulcer. He was un-

der the care of nurses at the center when he died, and those nurses

had misdiagnosed him as suffering from drug withdrawal or “de-

tox.” His estate sued the Center’s sheriff’s deputies for deliberate

indifference. We hold that a nonmedical jail officer cannot be

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24-10933 Opinion of the Court 3

found liable for deliberate indifference when he or she reasonably

relies on the advice or opinion of a medical professional. Because

the sheriff’s deputies reasonably relied on the nurses’ diagnosis, we

conclude that they were not deliberately indifferent. The district

court also correctly granted summary judgment to Deputy Wilker-

son because the plaintiff’s medical expert could not say with any

degree of medical certainty that he caused Wingo’s death. As a re-

sult, we affirm.

I.

In September 2019, Kevil Wingo was arrested in Cobb

County for possessing 0.2 grams of cocaine. After his arrest, he was

booked as a pretrial detainee at the Cobb County Adult Detention

Center.

A few days after entering detention, Wingo began to com-

plain of abdominal pain and sweating. In response to these com-

plaints, Deputy Quinton Appleby took Wingo to the detention cen-

ter’s infirmary. En route to the infirmary, Wingo told Deputy Ap-

pleby that he had an ulcer, which Appleby relayed to the nursing

staff.

Nurse Yvette Burton admitted Wingo to the infirmary at

12:35 a.m. that night. In the infirmary, medical staff hired through

WellStar Health Systems, Inc., including Nurse Burton, were re-

sponsible for overseeing operations. Sheriff’s deputies, however,

were responsible for security. Those deputies were trained not to

make medical decisions but instead to defer to the medical staff.

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4 Opinion of the Court 24-10933

When Wingo was admitted, he was complaining of nausea,

vomiting, and abdominal discomfort. He was also heard pleading

with God, saying that he would never touch drugs again should he

survive.

Based on these signs and symptoms, Nurse Burton believed

Wingo to be detoxing or suffering from withdrawals. Indeed, at the

time, Wingo was in the middle of a mandatory 5-day period of re-

ceiving “withdrawal checks” for opiates, which further confirmed

her suspicion that his symptoms were a result of detoxing. Her ex-

perience as a nurse only strengthened this belief. After all, detoxing

afflicts as many as 40 percent of the inmates in the infirmary. Ac-

cording to Nurse Shanna Griffith, another nurse on the night shift,

the medical staff took Wingo’s vitals and then admitted him “so he

could stay overnight . . . [and] see the doctor in the morning.” Doc.

200-6 at 28.

Over the course of that night, Deputy Britton McPhee, a

Sheriff’s Deputy serving in the infirmary, watched Wingo. Deputy

McPhee observed Wingo being “very loud” from the time he en-

tered the infirmary. This disruption continued throughout the

night, causing his cell mates to protest that they could not sleep.

Continuing to complain of his symptoms, Wingo repeatedly asked

Deputy McPhee to send him to the hospital. In accordance with his

training, Deputy McPhee replied that this decision would be up to

the medical staff. Displeased with this response, Wingo replied:

“just shut . . . up and do what I’m telling you to do.” Doc 191-3 at

174.

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At 6:00 a.m., Deputy Lynda Marshall relieved Deputy

McPhee. Deputy McPhee informed Deputy Marshall that Wingo

had been generally disruptive, “hollering,” and demanding to go to

the hospital. He also told her that, according to the nurses, Wingo

was detoxing. Deputy Marshall, who had served in the Sheriff’s Of-

fice for over 27 years, had frequently seen individuals detoxing dur-

ing pretrial detention. Based on this experience, and judging from

Wingo’s symptoms, Deputy Marshall agreed with the nurses’ as-

sessment.

Nurse Annaleen Visser, who took over from Nurse Burton

during the day shift, also believed that Wingo was detoxing.

Wingo’s frequent demands to go to the hospital did nothing to

change her mind. In her experience, detoxing inmates always wish

to go to the hospital in hopes of a better bed, better meals, more

privacy, and opiates. In Nurse Visser’s mind, inmates will “do any-

thing to go to the ER.” Doc. 200-5 at 88. Because she was so sure

that Wingo was detoxing, she declined to do a physical assessment

of him, preferring to wait—in accordance with detoxing proto-

cols—for him to be “calm.”

Throughout the early morning, Deputy Marshall observed

Wingo continuing to yell that he needed to go to the hospital.

Wingo also told Deputy Marshall that he could not breathe. In re-

sponse, she told him that “if you are talking to me, you are breath-

ing,” but she also asked him for more details. Doc. 191-4 at 138. He

reiterated that he could not breathe and that he needed to go to the

hospital. Deputy Marshall relayed these complaints to the nurses,

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who told her that Wingo was “just trying to go to the hospital, he

was detoxing, drug seeking, [and] that he was okay.” Id.

By this time, Wingo’s repeated yelling and disruption had

become a source of frustration to Wingo’s fellow inmates. The

frustration eventually reached a breaking point, and Deputy Mar-

shall heard that Wingo’s inmates were planning to fight him in his

cell. She went to retrieve him. But when she opened the door,

Wingo fell to the floor and again asked to go to the hospital. She

informed the nurses, who did nothing in response. Then, fearing

that Wingo would suffer physical harm if she put him back in his

cell, she called her supervisor, Lieutenant Charles Gordon, for ad-

vice.

When Lieutenant Gordon arrived at the infirmary at

7:30 a.m., he observed Wingo on the ground. Deputy Marshall in-

formed him that Wingo had been “causing some type [of] issue

with other inmates in the cell.” Doc. 191-6 at 80. Lieutenant Gor-

don then asked Nurse Visser whether Wingo was “okay,” to which

she replied that he was “medically fine.” Id. at 65, 87-90, 96. He also

asked Deputy Marshall to call his superior, Major Branson Harris,

to assess the situation.

Upon Major Harris’s arrival, Nurse Visser told him—as she

had told Lieutenant Gordon—that Wingo was simply detoxing and

drug seeking. She further told him that, in her opinion, Wingo

needed to be isolated in a cell by himself. Unfortunately, the only

individual cell in the infirmary was already occupied. As a result,

Nurse Visser recommended, and Major Harris agreed, that Wingo

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should be transferred to a padded, isolated cell in the infirmary ex-

tension. There, he would be kept under close observation.

Before transferring Wingo to the extension, Major Harris

asked Nurse Visser again if it would be medically appropriate to do

so. She assured him that it was.

Accordingly, at 7:45 a.m., Major Harris and Lieutenant Gor-

don escorted Wingo to the extension. As they walked him there,

they determined that he was too unstable to walk on his own and

placed him in a wheelchair. Lieutenant Gordon asked the nursing

staff why Wingo was so unbalanced. The nurses said it was simply

a symptom of detoxing. Shortly after 7:45, Major Harris and Lieu-

tenant Gordon left Wingo in a padded cell.

Deputy Paul Wilkerson, who worked in the infirmary, took

over responsibility for observing Wingo. Because Wingo was sup-

posed to be under close observation in the infirmary extension, it

was part of Deputy Wilkerson’s duties to check in on him during

security rounds every 12 minutes. In part, this was to ensure that

Wingo was still alive. During these security rounds, Deputy

Wilkerson was required to look in each cell rather than just rely on

the cell’s camera feed.

Deputy Wilkerson admits that he did not look in Wingo’s

cell during each security round as required. But because he saw

Wingo change positions a few times through the camera feed, he

believed Wingo to be alive and well. And when Major Harris and

Deputy Wilkerson did a security check together at 8:22 a.m., both

believed that they saw Wingo’s chest rising and falling.

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8 Opinion of the Court 24-10933

In the hour after Wingo arrived in the extension, neither Ma-

jor Harris nor Deputy Wilkerson saw any cause for alarm. But,

once Deputy Wilkerson opened the door at 8:49 a.m., it became

clear that Wingo was in serious trouble. Wingo was so motionless

that, initially, Deputy Wilkerson was concerned that Wingo was

“possibly in the corner playing a game and possibly could jump up

at any moment.” Doc. 191-7 at 201. He was quickly disabused of

this notion as he determined that Wingo was unresponsive, at

which point he summoned the medical team on an emergency ba-

sis.

Shortly thereafter, Wingo was declared dead. An autopsy by

the Cobb County Medical Examiner later found that Wingo died

from complications of a perforated gastric ulcer with peritonitis.

Later, Wingo’s daughter, Tiffany Wingo, acting on behalf of

his estate, along with other members of Wingo’s family, filed the

complaint underlying this appeal. She initially named and served

WellStar, several WellStar nurses, Major Harris, Lieutenant (now-

Sergeant) Gordon, and Deputy Wilkerson as defendants. Later, she

named and served Deputy Marshall. WellStar and the WellStar

nurses eventually reached a settlement with Wingo and were dis-

missed. This settlement left the sheriff’s deputies as the only de-

fendants.

As relevant to this appeal, Tiffany Wingo brought claims

against (1) all defendants under 42 U.S.C. § 1983, alleging that they

were deliberately indifferent to her father’s serious medical needs,

and (2) Deputy Wilkerson under state tort law, alleging that he was

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negligent in failing to properly conduct security rounds according

to official policy.

At the close of discovery, the defendants filed a motion for

summary judgment as to all claims. They also moved to exclude

the testimony of Tiffany Wingo’s causation expert, Dr. Brian My-

ers. Dr. Myers had testified that the defendants’ inaction caused

Wingo’s death. But in his deposition, Dr. Myers admitted that he

could not say, “with any degree of medical certainty” whether

Wingo could have been saved at 7:45 a.m. when he first entered

the extension and came under Deputy Wilkerson’s watch. Doc.

200-1 at 107. Dr. Myers explained that his causation opinion

“doesn’t bring into the issue of time;” to “opine on whether or not

at 7:45 . . . if he would have survived at that point, I can’t say . . . .”

Id.

The district court (1) granted summary judgment on the sec-

tion 1983 claims, concluding the defendants were protected by

qualified immunity, and (2) granted summary judgment to Deputy

Wilkerson on a state tort claim because Dr. Myers could not say

with any degree of medical certainty whether Wingo would have

survived if he had been treated differently at 7:45 a.m.

Tiffany Wingo appealed.

II.

We review a grant of summary judgment de novo. Boigris v.

EWC P&T, LLC, 7 F.4th 1079, 1084 (11th Cir. 2021). Summary judg-

ment is appropriate when “there is no genuine dispute as to any

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10 Opinion of the Court 24-10933

material fact and the movant is entitled to judgment as a matter of

law.” Fed R. Civ. P. 56(a). A dispute as to a material fact “is genuine

if the evidence is such that a reasonable jury could return a verdict

for the nonmoving party.” Furcron v. Mail Centers Plus, LLC, 843 F.3d

1295, 1303 (11th Cir. 2016) (internal quotation marks and citation

omitted).

III.

Tiffany Wingo argues that the district court erred in two re-

spects. First, she says that, viewing the facts in the light most favor-

able to her, the defendants were deliberately indifferent to Wingo’s

medical needs and, as a result, violated his constitutional rights.

This is so, she argues, even though it is undisputed that Deputy

Marshall, Lieutenant Gordon, and Major Harris relied on the

nurses’ advice in their treatment of Wingo. Second, she says that

the district court erred in its treatment of Dr. Myers’s testimony.

Tiffany Wingo says that her claims against Deputy Wilkerson sur-

vive summary judgment because Dr. Myers’s testimony establishes

that Deputy Wilkerson could have saved her father’s life if he had

called for emergency medical care between 7:45 and 8:45 a.m. We

discuss each argument in turn below.

A.

We will start with Tiffany Wingo’s argument about deliber-

ate indifference. Because the state has a “constitutional obligation

to provide minimally adequate medical care to those whom they

are punishing by incarceration,” Harris v. Thigpen, 941 F.2d 1495,

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1504 (11th Cir. 1991), the Fourteenth Amendment prohibits

“[d]eliberate indifference to a prisoner’s serious medical needs.”

Goebert v. Lee County, 510 F.3d 1312, 1326 (11th Cir. 2007).

To establish liability on a deliberate indifference claim, a

plaintiff must demonstrate that: (1) the injured party suffered a dep-

rivation that was objectively “sufficiently serious,” and (2) the de-

fendant acted with “subjective recklessness as used in the criminal

law.” Wade v. McDade, 106 F.4th 1251, 1262 (11th Cir. 2024) (en

banc) (citing Farmer v. Brennan, 511 U.S. 825, 834 (1994)). To meet

the second step, the plaintiff must show that the “defendant was

actually, subjectively aware that his own conduct caused a substan-

tial risk of serious harm to the plaintiff.” Id.

Taking the undisputed facts in Tiffany Wingo’s favor, we

cannot say that Deputy Marshall, Lieutenant Gordon, or Major

Harris were deliberately indifferent to Wingo’s serious medical

needs. Over the course of the night, the jail’s medical staff assured

each of these guards that Wingo’s symptoms were consistent with

drug withdrawal and that he was medically fine. Our caselaw rec-

ognizes that a nonmedical officer cannot be held liable for deliber-

ate indifference if he reasonably relies on the opinion of a medical

officer in his treatment of a detainee or inmate. For instance, in

Townsend v. Jefferson County, we determined that correctional offic-

ers were not deliberately indifferent when they reasonably relied

on a nurse’s professional judgment that the situation was “not an

emergency.” 601 F.3d 1152, 1158–59 (11th Cir. 2010).

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Our decision in Townsend is consistent with the law of other

circuits. The Eighth Circuit, for example, has noted that “a prison

official may rely on a medical professional’s opinion if reliance on

that opinion is reasonable.” Smith v. Lisenbe, 73 F.4th 596, 601 (8th

Cir. 2023) (internal quotation marks omitted). The Tenth Circuit

has similarly made clear that “[p]rison officials generally may rely

on the advice and course of treatment prescribed by medical per-

sonnel.” Est. of Beauford v. Mesa County, 35 F.4th 1248, 1265 (10th

Cir. 2022). The Seventh Circuit, too, has “long recognized” that

“non-medical officials may reasonably defer to the judgment of

medical professionals regarding inmate treatment.” Giles v.

Godinez, 914 F.3d 1040, 1049 (7th Cir. 2019). The Sixth and Third

Circuits also take this approach. See Winkler v. Madison County, 893

F.3d 877, 901 (6th Cir. 2018); Spruill v. Gillis, 372 F.3d 218, 236 (3d

Cir. 2004).

Applying that approach here, the guards were not deliber-

ately indifferent to Wingo’s serious medical condition. The record

establishes that the medical staff assured security personnel that

Wingo was medically stable and exhibiting symptoms consistent

with detox. The nurses told Deputy Marshall, for instance, that

Wingo was detoxing and that his requests for hospitalization were

about seeking attention and drugs. Likewise, Nurse Visser told

Lieutenant Gordon that Wingo was “fine medically,” and the nurs-

ing staff told Lieutenant Gordon that Wingo was simply unbal-

anced due to detoxing. Finally, Nurse Visser told Major Harris that

Wingo was detoxing and drug seeking. On this record, we can’t say

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the deputies’ reliance on the nursing professionals was unreasona-

ble.

Tiffany Wingo makes two arguments in response to this rea-

soning. But neither works.

First, she argues that nonmedical officers cannot rely on

medical opinions when those opinions are obviously wrong even

to a layman. We will assume without deciding that her statement

of the law is correct. Cf. Townsend, 601 F.3d at 1159 (“Townsend

has not presented evidence that her situation was so obviously dire

that two lay deputies must have known that a medical professional

had grossly misjudged Townsend’s condition.”). Even so, we can-

not say that the facts support her assertion that the nurses’ diagno-

sis here would be obviously wrong to a layman. A perforated ulcer

is hidden in the body and presents diffuse symptoms like nausea,

vomiting, and abdominal discomfort. It is not the kind of ailment

that a layman can easily diagnose.

Second, Tiffany Wingo argues that the guards could not rea-

sonably rely on the nurses’ opinions because the guards did not

have the nurses reexamine Wingo after he began to stumble. We

disagree. When Wingo was admitted to the infirmary, the nurses

took his vitals and diagnosed him as detoxing. He was then set for

observation overnight. Over the course of that night and into the

morning, as Wingo began to show signs of distress, the guards

alerted the nurses to his symptoms. Each time, the nurses assured

the guards that Wingo was okay. The nurses concluded that Wingo

was experiencing drug withdrawal, a condition they viewed as

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14 Opinion of the Court 24-10933

uncomfortable but not life-threatening. That medical judgment

later proved incorrect. Still, the record does not show that a rea-

sonable nonmedical officer would have had a clear basis to ques-

tion that assessment at the time.

B.

We turn now to the grant of summary judgment in favor of

Deputy Wilkerson. Dr. Myers’s testimony formed the only basis

for Tiffany Wingo’s causation argument against Deputy Wilker-

son. The district court entered judgment on the claims against Dep-

uty Wilkerson because Dr. Myers was unwilling to say with any

degree of medical certainty that Deputy Wilkerson’s inaction

caused Wingo’s death. The district court concluded that, even if

Dr. Myers’s testimony were admissible, his testimony would be in-

sufficient to survive summary judgment on causation.

We agree that Dr. Myers’s testimony, even if admissible,

does not create an issue of fact on causation with respect to Deputy

Wilkerson’s liability. Dr. Myers testified that, as a general matter,

the chances of survivability of a ruptured ulcer decrease over time.

When asked about Wingo’s chances of survival when he first came

under Deputy Wilkerson’s watch at 7:45 a.m., Dr. Myers admitted

that he could not say “with any degree of medical certainty”

whether Wingo could have been saved. Doc. 200-1 at 107. Instead,

Dr. Myers explained that his causation opinion “doesn’t bring into

the issue of time” and he could not “opine on whether or not at

7:45 . . . [Wingo] would have survived . . . .” Id.

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The lack of meaningful causation evidence is fatal to Tiffany

Wingo’s state and federal claims against Deputy Wilkerson. Both

the deliberate indifference and state tort law claims against Deputy

Wilkerson require that a plaintiff demonstrate causation. Marbury

v. Warden, 936 F.3d 1227, 1233 (11th Cir. 2019) (noting that a suc-

cessful deliberate indifference claim requires that the plaintiff show

causation); Collins v. Athens Orthopedic Clinic, P.A., 837 S.E.2d 310,

312 (Ga. 2019) (explaining that a negligence claim under Georgia

law contains four elements: a duty, a breach of that duty, causation,

and damages). When the issue of causation presents a medical

question beyond a layperson’s ordinary experience, expert testi-

mony is necessary for both kind of claims as well. See Alberson v.

Norris, 458 F.3d 762, 765–66 (8th Cir. 2006) (section 1983 claim);

Barnes v. Anderson, 202 F.3d 150, 159 (2d Cir. 1999) (same); Cowart

v. Widener, 697 S.E.2d 779 (2010) (state law claim); Fed. R. Evid.

702.

Although Dr. Myers’s testimony may have allowed a rea-

sonable jury to find the nurses or other guards liable for their con-

duct earlier in the night, no reasonable jury could find Deputy

Wilkerson liable based on this testimony. The district court did not

err in granting Deputy Wilkerson summary judgment.

IV.

The district court’s grant of summary judgment is

AFFIRMED.