Brown

IN THE UNITED STATES DISTRICT COURT

EASTERN DISTRICT OF ARKANSAS

CENTRAL DIVISION

TIEQUAIL BROWN PLAINTIFF

ADC #185015

v. No: 4:24-cv-00355-JM-PSH

KIM PARSONS, et al. DEFENDANTS

PROPOSED FINDINGS AND RECOMMENDATION

INSTRUCTIONS

The following 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 this Recommendation. By not objecting, you may

waive the right to appeal questions of fact.

DISPOSITION

I. Introduction

Plaintiff Tiequail Brown filed a pro se complaint pursuant to 42 U.S.C. § 1983

on April 23, 2024 (Doc. No. 1). Brown sues Turnkey Health (“TK Health”) Nurses

Kim Parsons and Kellie Echols (the “TK Defendants”) and Saline County Captain

Wade Gilliam and Sheriff Rodney Wright (the “County Defendants”) in both their

official and individual capacities. Doc. No. 1 at 1-2. He alleges that the defendants

were deliberately indifferent to his serious medical needs (a broken tooth) while he

was incarcerated as a pre-trial detainee at the Saline County Detention Center in

2023-2024.1 Id. at 4.

Before the Court is a motion for summary judgment, brief in support, and

statement of undisputed facts filed by the TK Defendants (Doc. Nos. 30-32) and a

motion for summary judgment, brief in support, and statement of undisputed facts

filed by the County Defendants (Doc. Nos. 33-35). Brown was notified of his

opportunity to file a response to the motions for summary judgment and separate

statements of disputed facts (Doc. No. 36). He filed a one-page response to the TK

Defendants’ motion (Doc. No. 37),2 and they filed a reply (Doc. No. 40). He filed

no response to the County Defendants’ motion or their statement of undisputed facts.

Because Brown failed to controvert the facts set forth in the defendants’ statements

of facts, Doc. Nos. 31 & 35, those facts are deemed admitted. See Local Rule

1 Brown is currently incarcerated in the Arkansas Division of Correction’s East

Arkansas Regional Unit. See Doc. No. 8.

2 Brown’s response references document number 30, which is the TK Defendant’s

motion for summary judgment. Doc. No. 37. However, to the extent Brown intended

this document to be a response to the TK Defendants’ statement of undisputed facts (Doc.

No. 31), he does not specifically refute any of their undisputed facts; rather, he generally

alleges that it is not true he was seen every time he submitted a sick call. Additionally, he

adds a new allegation – that the ibuprofen and Tylenol he was given for pain may have

damaged his internal organs. He makes no such claim in his complaint in this case. See

Doc. No. 1 at 4.

56.1(c). The defendants’ statement of facts, and the other pleadings and exhibits in

the record, establish that the material facts are not in dispute, and they are entitled to

judgment as a matter of law.

II. Legal Standard

Under Rule 56 of the Federal Rules of Civil Procedure, summary judgment is

proper if “the movant shows that there is no genuine dispute as to any material fact

and that the moving party is entitled to a judgment as a matter of law.” Fed. R. Civ.

P. 56(a); Celotex v. Catrett, 477 U.S. 317, 321 (1986). When ruling on a motion for

summary judgment, the court must view the evidence in a light most favorable to

the nonmoving party. Naucke v. City of Park Hills, 284 F.3d 923, 927 (8th Cir.

2002). The nonmoving party may not rely on allegations or denials, but must

demonstrate the existence of specific facts that create a genuine issue for trial. Mann

v. Yarnell, 497 F.3d 822, 825 (8th Cir. 2007). The nonmoving party’s allegations

must be supported by sufficient probative evidence that would permit a finding in

his favor on more than mere speculation, conjecture, or fantasy. Id. (citations

omitted). An assertion that a fact cannot be disputed or is genuinely disputed must

be supported by materials in the record such as “depositions, documents,

electronically stored information, affidavits or declarations, stipulations (including

those made for purposes of the motion only), admissions, interrogatory answers, or

other materials . . .”. Fed. R. Civ. P. 56(c)(1)(A). A party may also show that a fact

is disputed or undisputed by “showing that the materials cited do not establish the

absence or presence of a genuine dispute, or that an adverse party cannot produce

admissible evidence to support the fact.” Fed. R. Civ. P. 56(c)(1)(B). A dispute is

genuine if the evidence is such that it could cause a reasonable jury to return a verdict

for either party; a fact is material if its resolution affects the outcome of the case.

Othman v. City of Country Club Hills, 671 F.3d 672, 675 (8th Cir. 2012). Disputes

that are not genuine or that are about facts that are not material will not preclude

summary judgment. Sitzes v. City of West Memphis, Ark., 606 F.3d 461, 465 (8th

Cir. 2010).

III. Undisputed Facts3

Brown was booked into the Saline County Detention Center (the “Facility”)

on January 27, 2023, and released to the Arkansas Department of Corrections on

June 28, 2024. Doc. No. 35-1 at 4.

3 The undisputed facts were submitted by the defendants and are supported by the

following documents attached to their motions for summary judgment: Brown’s TK Health

medical records and medical requests (Doc. No. 30-1); Brown’s medical records from East

Arkansas Regional Unit (Doc. No. 30-2); Brown’s Saline County Detention Center records

(Doc. No. 30-3); a sworn declaration from Kimberly Parsons, LPN (Doc. No. 30-8); a

sworn declaration from Kellie Echols, LPN (Doc. No. 30- 9); a transcript of Brown’s

Deposition (Doc. No. 35-3); Gilliam’s affidavit with records attached (Doc. No. 35-1); and

Wright’s affidavit (Doc. No. 35-2). Opinions, legal conclusions, and immaterial facts are

omitted.

County Defendants’ Involvement with Brown

at the Facility & Relevant Policies

Captain Wade Gilliam was the Jail Administrator at the Saline County

Sheriff’s Department in Benton, Arkansas from January 2021 through July 2024.

Doc. No. 35-1 at 1, ¶ 1. He held the position during Brown’s period of alleged

deficient care for broken teeth as described in his complaint. Id. As the Jail

Administrator, Gilliam generally managed the operations of the detention center. Id.

at 1, ¶ 2. In 2016, the County entered into a contract with TurnKey Medical (also

referred to as “TK Health”) to manage jail medical care. Id. Brown was under TK

Health’s care during the period of the alleged deficient care for broken teeth. Id.

Rodney Wright is the Sheriff of Saline County and held the same position

during Brown’s period of alleged deficient medical care for broken teeth as

described in his complaint. Doc. No. 35-2 at 1, ¶ 1. Wright delegates responsibility

for most day-to-day jail management activities to subordinate officers through a

chain of command in each division. Id. at 1, ¶ 2. Those officers are expected to

perform those day-to-day tasks pursuant to policies he has implemented for the

department. Id. TK Health coordinated and provided all care for detainees in the

Facility, including Brown. Id. at 1, ¶ 3. TK Health staff saw him and the other

detainees with health problems as needed, during regular “sick calls,” prescribed and

distributed necessary medications during “pill call,” answered all detainee medical

requests, and would alert Detention Center staff of an inmate’s need for an outside

medical visit (such as a dental visit). Id. at 1-2, ¶ 4. Wright explained that it is the

policy of the Saline County Detention Center to rely on the medical judgment of TK

Health, but that staff is also charged with monitoring the health needs of inmates and

alerting TK Health if they think an inmate needs medical attention (either through a

grievance or personal interaction). Id. at 2, ¶ 5; Doc. No. 35-1 at 2, ¶ 4.

Gilliam and Wright did not have any personal interaction with Brown (either

through conversation, letter, or grievance elevated to their level through the

grievance process during the period of the alleged improper treatment. Doc. No. 35-

1 at 2, ¶ 5; Doc. No. 35-2 at 2, ¶ 6. Brown testified in his deposition that Gilliam

did not personally fail to prescribe any medicine or treat his teeth, and that he sued

Gilliam because he is in charge of the Facility. Doc. No. 35-3 at 17: 17-21. Brown

testified in his deposition that Wright had no personal involvement in his medical

care, that he directed no correspondence to the Sheriff, and that he never met Wright.

Id. at 18:1-15. Brown testified that he sued Wright because he implemented a policy

requiring detainees to submit three sick calls before they could be seen by a dentist.

Id. at 18:17-19:7.

Saline County had a dental service policy in place to govern the provision of

dental care for detainees in the Detention Center in 2023-2024. Doc. No. 35-1 at

246 (D8.4 Detainee Dental Services). The policy provides that detainees “shall

receive emergency dental treatment and other dental treatment as deemed necessary

by a contract dentist.” Id. It further provides that the severity of a detainee’s pain

or infection will determine if the dental problem is an emergency, and that detainee

requests for dental care are to be documented on a request/grievance form provided

by the detention officer and then forwarded to nursing staff. Id.

Brown’s Dental Treatment at the Saline County Detention Center

Brown consented to receive treatment from TK Health at the Facility. Doc.

No. 30-1 at 25. A nonparty nurse performed Brown’s initial medical screening. Doc.

No. 30-1 at 3-7; Doc. No. 30-8 at ¶ 4; Doc. No. 30-8 at ¶ 4. According to the intake

form, Brown told the TK Health nurse that he had no major dental conditions.4 Id.

On March 21, 2023, Brown placed a sick call request regarding tooth pain,

stating that “the whole right side of my face is swelling and i have abscesses and an

ear infection something wrong with my teeth and a messed up arm that i was

supposed to see the doctor for im really going to report this jail for malpractice.”

Doc. No. 30-1 at 24. On March 22, Parsons notified Brown that he would be seen

in clinic. Id.; Doc. No. 30-8 at ¶ 7.

4 According to Brown’s deposition testimony and past medical records, he was a

heavy smoker, had some prior dental problems, and had multiple teeth removed prior to

his incarceration at the Facility. See Doc. No. 35-3 at 31:11-32:18. See also Doc. No.

30-4 (Brown’s health records from Colorado Coalition for the Homeless); Doc. No. 30-5

(Brown’s medical records from Denver Health); Doc. No. 30-6 (Brown’s medical records

from Mental Health Center of Denver); Doc. No. 30-7 (Brown’s medical records from

Chesterfield Mental Health).

In May or June 2023, a nonparty nurse told Brown that he would not see a

dentist; she then offered to treat at least six of Brown’s teeth with a “film” or

“coating” to prevent dental decay, but Brown declined this treatment. Doc. No. 35-

3 at 48:11-50:25, 55:9-12.

On June 5, 2023, Brown placed a sick call request, stating “I have a broken

tooth on the left side and its starting to get infected it is causing alot of pain and

discomfort and is starting to make my gums swell.” Doc. No. 30-1 at 22. A nonparty

nurse examined Brown’s “top right middle” tooth in response to his complaint of

“tooth throbbing.” Doc. No. 30-1 at 45-46. The nurse noted that there was no

evidence of dental decay, no swelling, no redness, no pus, no sign of infection, teeth

were not positive to percussion, and Brown appeared to be in only “mild distress.”

Id. The nonparty nurse administered ibuprofen and orajel topical treatment for seven

days to treat Brown’s pain. Id.

On June 13, 2023, Brown placed a sick call request regarding tooth pain,

stating “I’m starting to get a toothache from this broken tooth and an ear infection

with it it’s getting very bad.” Doc. No. 30-1 at 21. Parsons examined Brown’s “top

right 2nd molar” the following day. Id. at 43-44. She noted the “tooth is broken

off,” but that there was no evidence of dental decay, no swelling, no redness, no pus,

no sign of infection, teeth were not positive to percussion, and Brown appeared to

be in “mild distress.” Id. Parsons administered 325mg acetaminophen for seven

days to treat Brown’s pain complaint. Id.

On June 23, 2023, Brown placed a sick call request regarding tooth pain,

stating “My tooth it still in pain and my ear is hurting also its becoming loose and

sensitive to the touch.” Doc. No. 30-1 at 27. A nonparty nurse examined Brown’s

fourth tooth (small molar in upper right jaw) on June 25, 2023. Id. at 40, 42. The

nonparty nurse noted that there was evidence of dental decay, but that “overall teeth

are well,” there was no swelling, no redness, no pus, no sign of infection, teeth were

not positive to percussion, and Brown appeared to be in “no distress.” Id. The

nonparty nurse administered 200 mg ibuprofen for seven days to treat Brown’s pain.

Id.

On September 22, 2023, Brown placed a sick call request regarding tooth pain,

stating “I have two broken teeth beside each other im going to need dental treatment

for them please and thank you.” Doc. No. 30-1 at 23. The following day, Parsons

notified Brown that he would be seen in clinic, and he was later examined by Echols.

Id. at 23, 38-39. Echols examined Brown’s “upper right 1st and 2nd molar” and

noted that there was evidence of dental decay, but there was no redness around the

teeth, no swelling, no trauma, no pus, no sign of infection, teeth were not positive to

percussion, and Brown appeared to be in “mild distress.” Id. Echols administered

325mg acetaminophen and orajel topical treatment for seven days to treat Brown’s

pain. Id.

On September 30, 2023, Brown placed a sick call request regarding tooth pain,

stating “my Tylenol has been stopped but im still having pain in my mouth from my

two broken teeth and they are still chipping away as I eat I would like to see a dentist

or have some work done on my teeth.” Doc. No. 30-1 at 26. On October 1, Parsons

responded to this sick call request, stating “I will continue the tylenol for 7 days and

get you on the list for the dentist.” Id.

On October 3, 2023, Brown placed a sick call request complaining of

toothache. Doc. No. 30-1 at 16. The following day, Echols notified Brown that he

would be seen in clinic. Id. On October 5, 2023, a nonparty nurse examined

Brown’s “two upper r[ight] teeth” in response to his complaint of “toothache.” Doc.

No. 30-1 at 36-37. The nonparty nurse noted that there was evidence of dental decay

which she described as “black in center of teeth.” Id. at 36. She also noted “some

redness” and “cracked teeth,” but that there was no swelling, no pus, no sign of

infection, teeth were not positive to percussion, and Brown appeared to be in “no

distress.” Id. The nonparty nurse administered ibuprofen and orajel topical

treatment for seven days to treat Brown’s pain complaint. Id.

On October 10, 2023, Brown placed a sick call request regarding tooth pain,

stating “my teeth are getting worse and im starting to bleed from under them.” Doc.

No. 30-1 at 20. Parsons notified Brown that he was scheduled to be seen in clinic.

Id. On October 11, 2023, Echols examined Brown’s “right first premolar, second

premolar, and first molar.” Id. at 34-35. She noted that there was evidence of dental

decay, but there was no redness around the teeth, no swelling, no trauma, no pus, no

sign of infection, teeth were not positive to percussion, and Brown appeared to be in

“mild distress.” Id. Echols administered Brown 325mg acetaminophen and orajel

topical treatment for seven days. Id.

On November 2, 2023, Brown submitted a grievance, stating “I was supposed

to see a dentist for my broken teeth but I haven’t and they stopped my pain meds

now my gums are starting to swell and I’m in more pain I would like something to

be done about this treatment from the nurses. . . . I would like to see a dentist and be

put on pain meds for the pain.” Doc. No. 30-3 at 1-2.

Echols no longer worked at the Facility after January 2024. Doc. No. 30-9

(Declaration of Kellie Echols, LPN) at ¶ 2. Parsons no longer worked at the Facility

after February 2024. Doc. No. 30-9 (Affidavit of Kimberly Parsons, LPN) at ¶ 2.

On March 11, 2024, Brown placed a medical call regarding his teeth, stating

“ive been having problems with two of my teeth im in alot of pain and I need to be

seen by a dentist to possibly have them pulled.” Doc. No. 30-1 at 15. The next day,

a nonparty nurse examined Brown’s top right second and third molars. Id. at 32-33.

She noted that there was evidence of dental decay described as “visible decay, rotted,

small hole on inner second molar.” Id. at 32. She also noted “slight swelling” around

the affected teeth, but noted no redness around the teeth, no external swelling, no

trauma, no pus, no sign of infection, teeth were not positive to percussion, and that

Brown appeared to be in “moderate distress.” Id. at 32-33. The nurse administered

orajel topical treatment and saltwater rinse for seven days. Id. at 33.

On March 22, 2024, Brown placed a medical call regarding his teeth, stating

“I put in a sick call for my mental health and my teeth and I haven’t been seen I need

to be seen.” Doc. No. 30-1 at 13. On March 23, 2024, a nonparty nurse examined

Brown’s “upper right.” Doc. No. 30-1 at 30-31. The nonparty nurse noted that there

was evidence of dental decay as one of the two teeth was “broken off,” but there was

no redness around the teeth, no swelling, no trauma, no pus, no sign of infection,

teeth were not positive to percussion, and Brown appeared to be in “mild distress.”

Id. The nurse administered 200 mg ibuprofen, 325 mg acetaminophen, and orajel

topical treatment for seven days. Id.

On April 3, 2024, Brown placed a grievance with Facility staff, stating “I’ve

put in several grievances and sick calls in about my teeth and I’ve been refused

treatment I am in constant pain and my jaw is starting to ache from my broken teeth

. . . I would like to talk to the captain or the sheriff about my options for treatment.”

Doc. No. 30-3 at 3. On April 5, detention staff stated they would notify “medical

administration.” Id.

On April 11, 2024, Brown placed a grievance with Facility staff, stating “I’ve

been waiting to see a dentist about my teeth and my sick calls have been ignored.”

Doc. No. 30-3 at 5.

On April 13, 2024, Brown placed a medical call regarding his teeth, stating

“I’ve been having intense pain in my teeth and gums.” Doc. No. 30-1 at 17. On

April 14, 2024, a nonparty nurse examined Brown’s teeth in response to his

complaint of dental pain. Doc. No. 30-1 at 28-29. The nonparty nurse noted that

there was evidence of dental decay, but there was no redness around the tooth, no

swelling, no trauma, no pus, no sign of infection, tooth was not positive to

percussion, and Brown appeared to be in “mild distress.” Id. The nurse administered

ibuprofen, acetaminophen, and orajel topical treatment for seven days. Id.

On April 23, 2024, Brown filed this lawsuit. Doc. No. 1.

On April 29, 2024, Brown placed a grievance with Facility staff, stating “I

was charged for 2 sick calls for the same problem and one of them doesn’t even have

a date and y’all have been blocking my sick calls and not giving me proper treatment

. . . Give me my money back and send me to the dentist . . . .” Doc. No. 30-3 at 7.

On May 7, 2024, Brown placed a sick call request regarding his teeth, stating

“my teeth still hurts I need to do a follow up on them.” Doc. No. 30-1 at 14. A non-

party nurse responded to this sick call request, stating “You will be seen in clinic.”

Id. The nurse also noted that she “renewed [Brown’s] meds until dental

appointment.” Id.

On June 11, 2024, Brown placed a grievance with Facility staff, stating “I’ve

been putting in sick calls about my tooth and I have an infection in my jaw I need to

be seen and I haven’t been seen. . . . Please do something about the infirmary staff

they are not doing their job.” Doc. No. 30-3 at 9. Detention Officer Silva responded,

“I’m giving this to medical.” Id.

Brown’s Dental Treatment at the Arkansas Division of Correction (ADC)

In late June 2024, Brown was transferred from the Facility to the ADC’s

Ouachita River Correction Unit (“ORCU”). Doc. No. 30-2 at 8 (intake assessment).

On July 1, 2024, Brown was examined by Larry Davis, DDS (a dentist

unaffiliated with TK Health), as part of his dental intake at ORCU. Doc. No. 30-2

at 2. Dr. Davis examined Brown and took a panoramic x-ray. Id. He noted that

Brown’s oral hygiene was “moderate,” and recommended three fillings and the

extraction of teeth 4 and 5. Id. However, Dr. Davis determined that there was no

“emergent dental need” nor was there an “emergent need for dental hygiene services

at [that] time.” Id. Dr. Davis prescribed Brown to take acetaminophen for two

weeks. Id. Dr. Davis did not schedule the extractions. Id.

On July 3, 2024, Brown was examined by a nurse not employed by TK Health,

who noted that Brown’s teeth merely needed “routine treatment,” and his mouth

appeared “normal.” Doc. No. 30-2 at 9-10.

On July 25, 2024, Brown placed a sick call stating: “My jaw is still in a lot of

pain from my broken teeth and its getting worse can I please get more pain med I

ran out and I’m in a lot of pain.” Doc. No. 30-2 at 6-7. A nurse not employed by

TK Health examined Brown, who told the nurse that “he has a few broken teeth top

right of mouth, they have been broken for about a year. Dr. Davis gave [him] OPM

Tylenol when he first came in.” Id. The nurse noted “no sign of distress,” “broken

teeth noted to right side upper part mouth,” and there was nothing remarkable about

the appearance of his gum and jaw near the toothache. Id. The nurse provided

Brown with ibuprofen for three days. Id.

On July 26, 2024, Brown was transferred from ORCU to East Arkansas

Regional Unit (“EARU”). Doc. No. 30-2 at 5-6. On July 27, 2024, Brown was

examined by a nurse not employed by TK Health who noted that there was “a hole

in center of tooth on top R side of mouth, no redness or swelling noted to gumline,

no external swelling noted.” Doc. No. 30-2 at 5. The nurse then notified a dentist

unaffiliated with TK Health, who gave a verbal order to prescribe Brown with

ibuprofen for seven days. Id. Brown was then placed on a dental list. Id.

On August 1, 2024, Brown was examined by Yee Yang, DDS (a dentist

unaffiliated with TK Health), as part of a dental sick call. Doc. No. 30-2 at 1. Dr.

Yang did not note any concerns in Brown’s medical history, recommended that teeth

4 and 5 be extracted as they were “non restorable,” and then extracted teeth 4 and 5.

Id. Dr. Yang then prescribed Brown ibuprofen for two weeks. Id.

IV. Analysis

A. Legal Standard – Pretrial Detainee’s Medical Treatment Claims

Brown was a pretrial detainee when he was treated by defendants Parsons and

Echols between June and September of 2023. Pretrial detainees’ claims are

evaluated under the Fourteenth Amendment’s Due Process Clause rather than the

Eighth Amendment. See Hartsfield v. Colburn, 371 F.3d 454, 457 (8th Cir. 2004).

Pretrial detainees are entitled to at least as much protection under the Fourteenth

Amendment as under the Eighth Amendment. See id. (citing Spencer v. Knapheide

Truck Equip. Co., 183 F.3d 902, 906 (8th Cir. 1999)); see also Davis v. Hall, 992

F.2d 151, 152–53 (8th Cir. 1993) (per curiam) (applying deliberate indifference

standard to pretrial detainee’s claims of inadequate medical care).5 To succeed with

5 In Spencer, the Eighth Circuit explained that it had never articulated an exact

standard for evaluating medical treatment claims brought by pretrial detainees. 183 F.3d

at 905. The Court acknowledged that pretrial detainees’ claims may be subject to an

objective reasonable test rather than the subjective deliberate indifference standard. Id.

The Eighth Circuit addressed this issue again in Bailey v. Feltmann, 810 F.3d 589, 593

(8th Cir. 2016), where it declined to address the proper constitutional standard

unnecessarily, but noted that when that case was decided it was not clearly established

an Eighth Amendment inadequate medical care claim, a plaintiff must allege and

prove that: (1) he had objectively serious medical needs; and (2) prison officials

subjectively knew of, but deliberately disregarded, those serious medical needs.

Dulany v. Carnahan, 132 F.3d 1234, 1239 (8th Cir. 1997). Additionally, the Eighth

Circuit has held that a “prisoner must show more than negligence, more even than

gross negligence, and mere disagreement with treatment decisions does not rise to

the level of a constitutional violation.” Estate of Rosenberg by Rosenberg v.

Crandell, 56 F.3d 35, 37 (8th Cir. 1995).

B. Saline County Defendants

1. Individual Capacity Claims.

The Saline County Defendants argue that they are entitled to qualified

immunity with respect to Brown’s claims against them in their individual capacities

because he cannot establish that they were deliberately indifferent to his serious

medical needs.6 Doc. No. 34 at 3-6. Brown acknowledged in his deposition that

Gilliam and Wright were not involved in his medical care, and he sued them based

that a pre-trial detainee was entitled to more protection than that provided by the Eighth

Amendment.

6 To determine whether a defendant is entitled to qualified immunity, the Court must

consider two questions: (1) do the facts alleged by plaintiff establish a violation of a

constitutional or statutory right; and (2) if so, was that right clearly established at the time

of the defendant’s alleged misconduct. Wright v. United States, 813 F.3d 689, 695 (8th

Cir. 2015). Qualified immunity is a question of law, not fact, for the court to decide.

Kelsay v. Ernest, 933 F.3d 975, 981 (8th Cir. 2019).

on their respective roles with the Facility. And the record also demonstrates that

neither Gilliam nor Wright were involved in Brown’s dental treatment. The lack of

involvement by the County Defendants precludes liability on their parts. See

Mayorga v. Missouri, 442 F.3d 1128, 1132 (8th Cir. 2006) (“Liability under section

1983 requires a causal link to, and direct responsibility for, the deprivation of

rights.”) (internal quotations and citations omitted). Gilliam and Wright are

therefore entitled to summary judgment.

2. Official Capacity Claims.

The County Defendants are also entitled to judgment in their official

capacities. Official capacity claims are “functionally equivalent to a suit against the

employing governmental entity.” Veach v. Bartels Lutheran Home, 627 F.3d 1254,

1257 (8th Cir. 2010). Thus, a suit against a defendant in his official capacity is in

essence a suit against the County or city itself. See Murray v. Lene, 595 F.3d 868

(8th Cir. 2010); Liebe v. Norton, 157 F.3d 574 (8th Cir. 1998). A municipality

cannot be held liable on the basis of respondeat superior, or simply by virtue of

being the employer of a tortfeasor. Atkinson v. City of Mountain View, Mo., 709

F.3d 1201 (8th Cir. 2013). Accordingly, Gilliam and Wright, as county employees,

can only be held liable in their official capacity in this case if Brown can establish

that a constitutional violation was committed pursuant to “an official custom, policy,

or practice of the governmental entity.” Moyle v. Anderson, 571 F.3d 814, 817 (8th

Cir. 2009). Brown did not allege in his complaint that his failure to receive dental

treatment at the Facility was caused by an unconstitutional policy or custom of

Saline County.7 Gilliam and Wright are therefore entitled to judgment as a matter

of law in their official capacities.

C. TK Defendants

Viewing the evidence in the light most favorable to Brown, the Court finds

that the undisputed material evidence in the record does not establish that either

Parsons or Echols was deliberately indifferent to Brown’s serious medical needs for

the reasons explained below.

First, the evidence in the record does not show that Brown’s broken and

decayed tooth constituted an objectively serious medical need in need of immediate

treatment. The TK Defendants summarized the applicable law relating to dental

issues in their brief:

“A serious medical need is one that has been diagnosed by a physician

as requiring treatment, or one that is so obvious that even a layperson

would easily recognize the necessity for a doctor’s attention.” Holden

7 In his complaint, Brown alleged, “I’ve also wrote grievances and appeals to the

staff of Saline County Detention Center and asked to see the Captain/Gilliam and the

Sheriff/Rodney Wright for help but I’ve not been helped.” Doc. No. 1 at 4. In his

deposition, Brown explains that he sued Gilliam because he was in charge of the Facility

and Wright because he promulgated a policy dictating that he submit three sick calls

before seeing a dentist. Doc. No. 35-3 at 17:17-21, 18:17-19:7. The record shows,

however, that Saline County’s dental treatment policy did not require three sick calls

before being sent to a dentist. See Doc. No. 35-1 at 246. The record also shows that

Brown submitted more than three sick calls and was seen by TK Health staff but not

referred to a dentist. See Undisputed Facts, supra.

v. Hirner, 663 F.3d 336, 342 (8th Cir. 2011) (holding that plaintiff’s

tooth pain was not a serious medical need because he did not show an

“outward sign of injury, such as bleeding and swelling, that a layperson

would recognize or established a medical professional diagnosed the

dental pain as needing treatment”). But see Hartsfield v. Colburn, 371

F.3d 454, 457 (8th Cir. 2004) (concluding a plaintiff who had severe

pain “from loose and infected teeth, which caused blood to seep from

his gums, swelling, and difficulty sleeping and eating” had alleged an

objectively serious medical need for dental care in a § 1983 action);

Boyd v. Knox, 47 F.3d 966, 969 (8th Cir. 1995) (evidence that plaintiff

had an impacted and infected wisdom tooth, his mouth was so swollen

he could barely open it, and pus regularly oozed from the infection

sufficient to show serious medical need); Fields v. Gander, 734 F.2d

1313, 1315 (8th Cir. 1984) (dental pain from an infected tooth coupled

with swelling in plaintiff’s face sufficient to put sheriff on notice that

plaintiff had a serious medical need); Avery v. Turn Key Health Clinics,

LLC, 839 F. App’x, 26, 26 (8th Cir. 2021) (per curiam) (Kelly, J.,

concurring in part and dissenting in part) (opining that the plaintiff

suffered from a serious medical need when the nurses noted that he

showed symptoms of a tooth abscess, including visible signs of tooth

decay, infection, redness and swelling of the gums, positivity to

percussion tests, and pus surrounding the affected tooth).

Doc. No. 32 at 4-5. Although Brown complained of pain, each provider that

examined him noted there was no sign of infection, no pus, no redness, no swelling,8

and no positivity to percussion tests. See Undisputed Facts, supra. Each provider

also noted that Brown was in moderate, mild, or no distress. Id. Furthermore, when

he was transferred to the ADC’s ORCU and examined by Dr. Davis on July 1, 2024

(more than eight months after he was last treated by either TK Defendant), Dr. Davis

8 One entry references “slight swelling” on March 12, 2024, months after Parsons

and Echols left employment at the Facility. Doc. No. 30-1 at 32-33. All other

examinations of Brown’s gums, including those by Parsons and Echols, showed no

swelling.

did not diagnose Brown with any emergent dental need; he merely stated that teeth

4 and 5 could be extracted and gave Brown a prescription for Tylenol for two weeks.

See Doc. No. 30-2 at 2. When Brown was transferred to the EARU a few weeks

later, a nurse documented “no redness or swelling to gumline, no external swelling

noted.” Id. at 5. And while Brown eventually had his teeth extracted by another

dentist, the dentist’s only note on Brown’s dental condition was that teeth 4 and 5

were “non restorable.” Id. at 1.

Second, even if Brown’s broken or decayed tooth constituted a serious

medical need, there is no evidence that either Parsons or Echols were deliberately

indifferent to that need on the few occasions they treated him. Parsons examined

Brown only once and Echols twice. Specifically, on June 14, 2023, Parsons

examined Brown’s teeth and noted he had a broken tooth but no sign of infection,

pus, redness, swelling, or positivity to percussion. Doc. No. 30-1 at 43-44. Brown

did not complain about his teeth again until three months later, in September. On

September 22, 2023, Echols examined Brown and noted some decay but no sign of

infection, pus, redness, swelling, or positivity to percussion. Id. at 38-39. And on

October 11, 2023, Echols examined Brown and noted the same again. Id. at 34-35.

Several other non-party providers noted the same. See Undisputed Facts, supra. On

each occasion, Brown received prescriptions for pain medication to treat his

complaints of pain. Brown may have disagreed with this course of treatment and

believed he should have been referred to a dentist or received more care than that

provided at the Facility. However, a mere disagreement regarding treatment does

not equate a constitutional violation. See Estate of Rosenberg by Rosenberg, 56 F.3d

at 37.

Because the evidence in this record does not establish that Parsons or Echols

were deliberately indifferent to Brown’s serious medical needs, his claims against

them in both their individual and official capacities’ should be dismissed with

prejudice.

V. Conclusion

The undisputed facts establish as a matter of law that the defendants were not

deliberately indifferent to Brown’s serious medical needs. The undersigned therefore

recommends that the defendants’ motions for summary judgment (Doc. Nos. 30 &

33) be granted. Brown’s claims should be dismissed with prejudice.

DATED this 5th day of February, 2026.

vmremenwrttee Crocus

? See Brockinton v. City of Sherwood, 503 F.3d 667, 674 (8th Cir. 2007) (official

capacity claim fails if plaintiff cannot establish a constitutional violation).