The opinion
United States Court of Appeals
For the Eighth Circuit
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No. 25-1963
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Jessica Ann McKee,
lllllllllllllllllllllPlaintiff - Appellee,
v.
Jessica J. Brady, in her individual as well as her official capacity as a nurse at the
Steele County Detention Center,
lllllllllllllllllllllDefendant - Appellant,
Steele County,
lllllllllllllllllllllDefendant.
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Appeal from United States District Court
for the District of Minnesota
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Submitted: February 11, 2026
Filed: August 17, 2026
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Before COLLOTON, Chief Judge, BENTON and KELLY, Circuit Judges.
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COLLOTON, Chief Judge.
Jessica McKee is a former pretrial detainee at the Steele County Detention
Center in Minnesota. McKee sued Jessica Brady, a Registered Nurse and former
employee of the jail, under 42 U.S.C. § 1983. McKee alleged that Brady deprived her
of adequate medical care in violation of the Fourteenth Amendment. The district
court denied Brady’s motion for summary judgment. Brady appeals based on
qualified immunity, and we reverse.
I.
McKee was diagnosed with Crohn’s disease in 1994, but she characterizes her
condition as “in remission until she became a pretrial detainee.” In a pre-booking
questionnaire on September 12, 2019, McKee circled “Yes” in response to whether
she was currently feeling well, and wrote “None” when asked to list all of her
medications. She also denied having seizures, a handicap, or any other medical
problems.
Each housing unit at the detention center was equipped with a “kiosk” for
detainees to contact jail personnel. Detainees could use the kiosk to send messages
to jail administrators, order hygiene products, and request a medical visit or “sick
call.” The jail billed detainees for medical services, but the medical unit treated
detainees regardless of their ability to pay.
On November 20, McKee sent a kiosk message to the jail medical unit
requesting a low bunk. She reported that she was experiencing seizures “caused by
malnutrition due to my chrones - which tends to act up in here as the diet leaves
something to be desired.” Nurse Brady denied the request. She explained that
McKee’s medical records contained “no note of a seizure disorder, medications for
seizures, or being treated for a seizure disorder.”
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McKee sent another message on December 10. She stated that her Crohn’s
disease “has gotten significantly worse the last couple weeks” and that “[t]he blood
loss is starting to make me feel light headed especially during my cycle.” McKee
requested a vegetarian diet in hope that “removal of processed meats may calm it
down.” Brady authorized the change in diet.
McKee followed up on December 16. She wrote that “[t]he change in diet
seems to have made the bleeding worse” and requested to return to a regular diet.
McKee also asked: “[C]an you tell me if you can get my prescription in here for my
chrones? It is sulfasalazine.” Brady authorized the change in diet and asked McKee
for her outside care provider’s information. Later that afternoon, Brady sent a fax to
McKee’s provider requesting all records related to McKee’s treatment for Crohn’s
disease.
On December 18, McKee sought to “resubmit” her November 20 bunk request.
She explained that her Crohn’s disease required her to enter and exit the upper bunk
frequently to access the restroom, and that a hip condition made the climb painful.
Brady replied the next day that “[s]ick call is available if you would like to be
evaluated to see if you meet criteria for a low bunk.” McKee did not request a sick
call.
McKee’s outside care provider transmitted the relevant medical records to the
jail that same afternoon. McKee’s sulfasalazine prescription allowed for no
remaining refills. Brady’s nursing license did not authorize her to prescribe
medication. Brady forwarded McKee’s records to the jail’s prescribing physician.
After 5:00 p.m. on January 9, 2020, McKee wrote that her Crohn’s disease was
“getting worse.” She asked if the medical team had “any suggestions for staying
hydrated.” Brady saw the message when she arrived at the jail the following
morning. She called McKee to the medical unit for an in-person evaluation, and
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ultimately referred McKee to the emergency room. McKee received a blood
transfusion and developed sepsis. She remained in the hospital until January 20 and
alleges that she suffered permanent injuries.
McKee filed this action under 42 U.S.C. § 1983, alleging that Nurse Brady was
deliberately indifferent to her medical needs and violated her rights as a pretrial
detainee under the Due Process Clause of the Fourteenth Amendment. Brady moved
for summary judgment based on qualified immunity. The district court denied the
motion as to McKee’s Fourteenth Amendment claim against Brady. “On appeal from
the denial of summary judgment based on qualified immunity, we accept as true the
facts that the district court found were adequately supported, as well as the facts that
the district court likely assumed, to the extent they are not blatantly contradicted by
the record.” Barton v. Taber, 908 F.3d 1119, 1123 (8th Cir. 2018) (internal quotation
omitted). We review issues of law de novo. Id.
II.
Brady asserts that she is entitled to qualified immunity because her actions do
not constitute deliberate indifference. “Government officials performing
discretionary functions are entitled to qualified immunity unless they violate clearly
established statutory or constitutional rights of which a reasonable person would have
known.” Whisman ex rel. Whisman v. Rinehart, 119 F.3d 1303, 1309 (8th Cir. 1997).
To establish a constitutional violation based on deliberate indifference, McKee must
show that she suffered from an objectively serious medical need of which Brady had
actual knowledge and that Brady deliberately disregarded. Barton, 908 F.3d at 1124.
The district court concluded that “Nurse Brady has not met her burden for
qualified immunity,” because a reasonable jury could find she was deliberately
indifferent to McKee’s serious medical needs. Brady, however, does not bear the
burden of proof. To defeat a motion for summary judgment, plaintiff McKee must
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show that “it was clearly established that [Brady’s] conduct constituted deliberate
indifference to [McKee’s] serious medical needs.” Givens v. Jones, 900 F.2d 1229,
1232 (8th Cir. 1990). We conclude McKee has not made this showing.
Brady responded to each of McKee’s requests. She initiated an in-person
evaluation when she saw McKee’s message about hydration. She granted McKee’s
requests to change diet. She reasonably denied McKee’s bunk requests because
McKee lacked supporting documentation. Brady also reminded McKee that she
could request a sick call in order to request a change in bunk. McKee could have
requested a sick call from the same kiosk that she used to send the messages, but she
did not.
When McKee requested prescription medication, her last prescription did not
allow for another refill, and Brady was not authorized to prescribe medication. Brady
forwarded McKee’s records to the jail’s physician with authority to prescribe
medication, and there was no clearly established right to have Brady do more. See
Blank v. Bell, 634 F. App’x 445, 449 (5th Cir. 2016) (jail nurse’s failure to provide
medication did not violate a clearly established right when the medical officer did not
write a prescription); Figueroa v. Vose, No. 94-2062, 1995 WL 564496, at *1 (1st
Cir. Sept. 22, 1995) (nurse was not deliberately indifferent where she declined to
provide medication that was not prescribed, and did not unreasonably delay in having
staff doctor evaluate prisoner’s request for prescription). The district court assumed
that Brady “could have gone to the Jail Administrator for a disagreement with [the
prescribing physician’s] decision-making.” But Brady had no clearly established
constitutional obligation to monitor a physician’s treatment decisions or to report any
disagreement with a physician’s decision on medication that was outside the scope
of the nurse’s authority.
McKee argues that Brady should have proactively provided care that McKee
did not request. McKee described concerning symptoms, including blood loss that
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made her feel light-headed. The district court concluded that Brady “admitted that
a bleeding issue would require immediate medical attention.” Brady’s actual
testimony was that if a detainee were passing blood, then she would want more
information about the reason for the bleeding, so she could relay that information to
the provider. Brady said she figured that if the detainee’s symptoms were acting up
to the point that the detainee wanted medical attention, then sick call was available
for the detainee to schedule an evaluation.
Brady did respond to all of McKee’s requests, and McKee has not presented
evidence that Brady’s mental state was “akin to criminal recklessness.” Saylor v.
Nebraska, 812 F.3d 637, 644 (8th Cir. 2016) (internal quotation omitted). Brady may
have been negligent in relying on McKee’s self-assessment of what steps were
appropriate to address her condition. But even if Brady “could be second-guessed for
not acting more aggressively,” negligence or even gross negligence is insufficient to
establish deliberate indifference. Morris v. Cradduck, 954 F.3d 1055, 1059 (8th Cir.
2020); see Green v. Shaw, 827 F. App’x 95, 97 (2d Cir. 2020) (jail nurse entitled to
qualified immunity even though she misdiagnosed inmate’s rectal bleeding as
hemorrhoids, performed no visual exam, did not refer inmate to doctor, and told
inmate to return in three or four days). We therefore conclude that Brady is entitled
to qualified immunity.
For the foregoing reasons, the district court’s order denying summary judgment
is reversed.
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