Gartman v. Cheatham

IN THE DISTRICT COURT OF THE UNITED STATES FOR THE

MIDDLE DISTRICT OF ALABAMA, NORTHERN DIVISION

TRENTON GARTMAN, )

)

Plaintiff, )

) CIVIL ACTION NO.

v. ) 2:18cv534-MHT

) (WO)

PATRICK CHEATHAM, an )

Individual, et al., )

)

Defendants. )

OPINION AND ORDER

Pursuant to 42 U.S.C. § 1983, plaintiff Trenton

Gartman brings this lawsuit seeking damages from, among

others, defendants Jabari Agee and Patrick Cheatham for

violation of his Fourteenth Amendment right to medical

care while he was in pretrial custody at the Autauga

County Jail. Agee and Cheatham were employed as officers

in the jail and are sued in their individual capacities.

Jurisdiction is proper pursuant to 28 U.S.C. §§ 1331

(federal question) and 1343 (civil rights).

Agee and Cheatham have moved to dismiss the federal

claim against them on the basis of failure to state a

claim and qualified immunity. For the reasons that

follow, the motion will be denied.

I. MOTION-TO-DISMISS STANDARD

In considering a defendant’s motion to dismiss, the

court accepts the plaintiff's allegations as true, see

Hishon v. King & Spalding, 467 U.S. 69, 73 (1984), and

construes the complaint in the plaintiff's favor, see

Duke v. Cleland, 5 F.3d 1399, 1402 (11th Cir. 1993).

“The issue is not whether a plaintiff will ultimately

prevail but whether the claimant is entitled to offer

evidence to support the claims.” Scheuer v. Rhodes, 416

U.S. 232, 236 (1974).

To survive a motion to dismiss, a complaint need not

contain “detailed factual allegations,” Bell Atl. Corp.

v. Twombly, 550 U.S. 544, 545 (2007), “only enough facts

to state a claim to relief that is plausible on its

face.” Id. at 570. “A claim has facial plausibility

when the plaintiff pleads factual content that allows the

court to draw the reasonable inference that the defendant

is liable for the misconduct alleged.” Ashcroft v.

Iqbal, 556 U.S. 662, 678 (2009). “The plausibility

standard is not akin to a ‘probability requirement,’ but

it asks for more than a sheer possibility that a

defendant has acted unlawfully.” Id. (quoting Twombly,

550 U.S. at 556).

II. FACTS

The allegations in the third amended complaint are as

follows.

On May 25, 2016, plaintiff Gartman was arrested by

the Prattville, Alabama Police Department on a

misdemeanor charge for domestic abuse in the third

degree. He was taken to the Autauga County Jail, booked,

and processed as a new inmate.

Gartman suffers from a heart condition that requires

regular medication, and he has an implantable

cardioverter defibrillator (ICD), a battery-operated

device that was surgically implanted in his chest to

control his heart rate. During processing, he informed

defendant Officer Cheatham of his condition and his need

to take his heart medications. However, when his parents

brought his heart medications to the jail, they were

informed by jail personnel that Gartman could not have

them unless his doctor verified them. His parents were

not allowed to leave his medications with jail personnel.

After he was processed, Gartman was placed in the

‘drunk tank’ along with several other inmates. Sometime

between 11:00 p.m. and 12:00 a.m. that night, Gartman

began to sweat and to experience shortness of breath and

problems with his heart. He communicated these symptoms

and his history of heart problems to an officer at the

jail who is not a defendant in the lawsuit, who called

the on-call nurse and reported Gartman’s symptoms. The

nurse told the officer to do nothing further regarding

Gartman and said that she would check on Gartman once she

arrived at the jail in the morning. However, after she

arrived at work, the nurse failed to make any attempt to

check in on Gartman.

Due to excessive heat in the drunk tank, Gartman and

the other inmates were moved to another cell at around

3:00 or 4:00 a.m. While he was being moved, Gartman

repeatedly informed jail officers that he was

experiencing chest pains, shortness of breath, and

dizziness. He also reported that the symptoms were

getting worse. In the hours after he was moved, Gartman

repeatedly pushed the call button in his cell and told

the jail officers that his symptoms were continuing and

his condition was deteriorating. At around 12:00 p.m.,

another inmate noticed Gartman’s poor condition and

advised jail officers that Gartman was obviously dealing

with a serious medical issue and needed to see a nurse.

Between 2:00 and 3:00 p.m., more than 14 hours after

Gartman began experiencing symptoms, defendant Officer

Agee took Gartman to the jail medical unit. There,

Gartman was seen for the first time by a nurse. With

Agee present, Gartman described his health history and

symptoms to the nurse. He explained that he had a heart

condition and an ICD, that he had not been able to take

his needed heart medications, and that he was

experiencing ongoing chest pain and shortness of breath.

He also told the nurse that the symptoms were getting

worse and that he needed medical care.

The nurse ordered Gartman to provide a urine sample.

Officer Agee escorted Gartman into the bathroom and

waited for him by the sinks. As Gartman stood in front

of the toilet, however, his ICD fired, sending an

electric shock into his heart and causing him to fall to

the floor. Agee witnessed both this fall and Gartman’s

cries of pain. When Agee told Gartman to get up, Gartman

explained that he could not get up because his ICD had

just fired. Agee helped Gartman stand and return to the

medical unit.

Once back in the medical unit, Gartman told the nurse

that his ICD had fired while he was in the bathroom,

causing him to fall and making it impossible for him to

provide a urine sample. The nurse checked his heart rate

and reassured him that he was fine. She told him that

she was going to send him back to his cell so she could

go do pill call. Gartman insisted that he was not fine,

that his ICD had fired, and that he needed urgent medical

help. The nurse told Gartman that she did not have time

to run any tests on him and, since he was due to be

released later that evening, he could get his medications

and any necessary medical help after he was released.

Once again, Agee was present and listened to the entire

exchange.

The nurse told Agee to move Gartman from his previous

cell back to the drunk tank, which was next to the

booking area. She explained that this move would make it

easier for jail officers to keep an eye on Gartman until

his release.

Officer Agee escorted Gartman out of the medical

unit. They encountered Officer Cheatham in the hallway,

and Agee updated him about Gartman’s condition. The two

officers decided that before they could take Gartman to

the drunk tank, they needed to escort him back to his

previous cell so he could collect his bedding.

Gartman collected his bedding without incident and

turned to walk with Agee and Cheatham to the drunk tank.

At that point, however, his ICD fired once again, causing

him to cry out in pain and fall to the floor. The shock

from the ICD also caused Gartman to lose control of his

bowels, and he defecated on himself as he lay on the

floor.

Agee and Cheatham saw Gartman fall to the floor and

told him to get up. Even after Gartman explained to them

that his ICD had fired again and that he was weakened and

in pain from the shock, the officers repeatedly ordered

him to stand. Eventually, Gartman was able to stand up

and begin walking again. After only a few more steps,

however, his ICD fired again, and he once again fell to

the floor. At this point, Agee and Cheatham began

yelling at and mocking Gartman. Another jail officer

drew his taser, pointed it at Gartman, and threatened to

use it on him if he did not stand up and walk.

Under the threat of being tased, and while still

being yelled at and mocked by Agee and Cheatham, Gartman

struggled back to his feet and began to walk slowly

toward the drunk tank. Gartman was sweating profusely

and was short of breath. He told Agee and Cheatham again

that he was experiencing significant chest pain and

needed medical help. Gartman’s ICD shocked him a total

of 17 times during the ten-minute walk to the drunk tank,

causing him several more falls. The shocks led Gartman

to lose control of his extremities and flail noticeably,

and during at least one fall he accidentally touched

Cheatham. Cheatham told Gartman that if he touched

Cheatham again, he would charge Gartman with assaulting

an officer.

After falling numerous times, Gartman finally reached

the drunk tank. At this point, he was on all fours and

exhausted by the shocks. Once in the cell, Gartman again

tried to alert Agee and Cheatham to the fact that he was

suffering chest pains, was being repeatedly shocked by

his ICD, and believed he was having a heart attack. Agee

and Cheatham merely left Gartman in the cell. They

failed to notify their superiors or a medical

professional that Gartman’s condition had gotten worse,

that his ICD had fired numerous times, that he had

defecated on himself, or that he could barely make it

through the walk to the drunk tank.

At approximately 4:00 p.m., Gartman was visited by

his attorney. The attorney immediately observed that

Gartman appeared to be in significant physical distress

and in need of urgent medical attention. During the

attorney’s visit, Gartman’s ICD shocked him yet again.

The attorney expressed concern to a jail officer about

Gartman’s obvious distress, and Gartman explained his

symptoms and underlying conditions to the officer.

However, Gartman received no additional care beyond being

taken by wheelchair to the showers to clean himself off

after having soiled himself. His ICD fired several more

times while he was in the shower.

Gartman was eventually released at approximately 5:12

p.m., and someone from the jail called Prattville

Fire/EMS to arrange for Gartman to be taken to the

hospital for his symptoms. After Gartman had already

been placed in the back of the ambulance, Cheatham

demanded that he sign a document entitled “Release and

Hold Harmless Agreement” before he could leave.

Gartman was transported from the jail directly to a

hospital, where he was admitted and treated for

arrhythmia and acute heart failure. Gartman remained

hospitalized for approximately three days and required

heart catheterization procedures to treat his condition.

After his release from the hospital, Gartman’s

cardiologist generated a report on data downloaded from

Gartman’s ICD. The data showed that the ICD had fired 37

times between 2:11 p.m. and 5:25 p.m. on May 26, 2016,

while he was in custody at the Autauga County Jail.

III. DISCUSSION

A. Fourteenth Amendment

Officers Agee and Cheatham move to dismiss Gartman’s

Fourteenth Amendment claim against them, arguing that he

has failed to state a claim upon which relief can be

granted under Rule 12(b)(6) of the Federal Rules of Civil

Procedure.1

The Eighth Amendment prohibits “cruel and unusual

punishments,” U.S. Const. amend. VIII, including

deliberate indifference to the medical needs of inmates.

See Estelle v. Gamble, 429 U.S. 97, 104 (1976). While

claims involving the mistreatment of pretrial detainees

in custody are governed by the Due Process Clause of the

Fourteenth Amendment rather than by the Eighth Amendment,

the Eleventh Circuit Court of Appeals treats the standard

for deliberate indifference under the two amendments as

“identical.” Goebert v. Lee Cty., 510 F.3d 1312, 1326

(11th Cir. 2007).

To plead a claim for deliberate indifference to his

medical needs, a plaintiff must sufficiently allege

“(1) a serious medical need; (2) the defendants'

1. The motion to dismiss also cites to Rule 12(b)(1),

lack of subject-matter jurisdiction. However, neither

the motion nor the defendants’ brief offers any argument

or evidence in support of this ground, and the court

finds that it does have subject-matter jurisdiction

pursuant to 28 U.S.C. §§ 1331 (federal question) and 1343

(civil rights).

deliberate indifference to that need; and (3) causation

between that indifference and the plaintiff's injury.”

Mann v. Taser Int'l, Inc., 588 F.3d 1291, 1306–07 (11th

Cir. 2009). The first prong is objective, focusing on

the inmate’s actual medical condition. The second prong

is subjective, focusing on the official’s state of mind.

A serious medical need is “one that has been

diagnosed by a physician as mandating treatment or one

that is so obvious that even a lay person would easily

recognize the necessity for a doctor's attention.”

Farrow v. West, 320 F.3d 1235, 1243 (11th Cir. 2003).

Alternatively, whether a medical need is serious can be

determined by “whether a delay in treating the need

worsens the condition.” Mann, 588 F.3d at 1307. Under

either definition, “the medical need must be one that, if

left unattended, poses a substantial risk of serious

harm.” Id.

Deliberate indifference requires that the official

know of and disregard “an excessive risk to inmate health

or safety.” Farmer v. Brennan, 511 U.S. 825, 837 (1994).

Deliberate indifference is more than negligence; it

requires knowledge of the risk and disregard of the

inference that such a risk could harm an inmate or

prisoner. See Brown v. Johnson, 387 F.3d 1344, 1351

(11th Cir. 2004). An official “must both be aware of

facts from which the inference could be drawn that a

substantial risk of serious harm exists, and he must also

draw the inference.” Farmer, 511 U.S. at 837. While an

official’s failure to address a risk that he “should have

perceived but did not” is “no cause for commendation,” it

does not rise to the level of deliberate indifference.

Id. at 838.

A finding of deliberate indifference does not require

that an inmate have been denied medical care entirely.

Even if “medical care is ultimately provided, a prison

official may nonetheless act with deliberate indifference

by delaying the treatment of serious medical needs, even

for a period of hours.” McElligott v. Foley, 182 F.3d

1248, 1255 (11th Cir. 1999). However, whether officials

“should have employed additional diagnostic techniques or

forms of treatment is a classic example of a matter for

medical judgment and therefore not an appropriate basis

for grounding liability under the Eighth Amendment.”

Adams v. Poag, 61 F.3d 1537, 1545 (11th Cir. 1995)

(internal quotation marks and citation omitted).

1. Serious Medical Need

Because Gartman contends that Officers Agee and

Cheatham were deliberately indifferent to his

deteriorating medical condition after he was released

from the jail medical unit, the court will confine its

consideration of the seriousness of his medical needs to

that period.2 Even within that narrow time frame,

however, the gravity of Gartman’s condition was obvious.

2. In his brief in opposition to the motion to

dismiss, Gartman raises as an additional ground for

Cheatham’s deliberate indifference his failure to advise

Gartman adequately on what he needed to do to receive his

heart medication while in the jail. However, Gartman

does not plead any facts that would indicate that

Cheatham knew or had any reason to know that a delay of

less than a day in receiving his medication would cause

Gartman to suffer adverse consequences. Nor does he

plead any facts that would indicate that Cheatham acted

with anything more than mere negligence in failing to

Agee and Cheatham dismiss symptoms like shortness of

breath, chest pain, and dizziness as insufficient to

establish a serious medical need. However, those are far

from the only symptoms Gartman alleges. In his

complaint, he says that he became sweaty, clutched his

chest, and cried out in pain as he was repeatedly and

visibly shocked by his ICD. These shocks caused him to

lose control of his bowels and defecate on himself.

Gartman’s condition also interfered with his ability to

walk, causing him to flail his extremities and fall to

the floor numerous times. He was so weakened by the end

of the journey to the drunk tank that he crawled into the

cell on his hands and knees and later required a

wheelchair to reach the showers. Even a layperson would

explain fully the jail’s medication policy. Therefore,

the court finds that Gartman has failed to state a claim

for deliberate indifference by Cheatham as to his actions

during the intake process and need not consider whether

his condition at that point was sufficiently serious.

See, e.g., Morrison v. Stephenson, No. 2:06cv283, 2008 WL

114890 (S.D. Ohio Jan. 9, 2008) (Frost, J.) (finding no

deliberate indifference where, among other things, jail

officials refused to provide plaintiff with her

medication because it was not in a prescription bottle).

certainly recognize that Gartman’s multitude of serious

symptoms warranted medical attention. See, e.g.,

Aldridge v. Montgomery, 753 F.2d 970, 972 (11th Cir.

1985) (finding that a layperson could recognize a serious

medical need where a detainee had a one-and-a-half-inch

cut over his eye that was allowed to bleed for two and a

half hours before it was sutured).

Indeed, a layperson allegedly did recognize the

seriousness of Gartman’s condition. The complaint

alleges that it was immediately obvious to Gartman’s

attorney that his client was severely ill and required

urgent medical attention. The attorney found Gartman’s

condition so alarming that he raised his concerns with a

jail officer. The fact that Gartman’s attorney allegedly

“easily recognize[d] the necessity for a doctor's

attention” and requested that Gartman receive such

attention highlights just how clearly serious his

condition was. Farrow v. West, 320 F.3d 1235, 1243 (11th

Cir. 2003); see also Patel v. Lanier Cty., 969 F.3d 1173,

1189 (11th Cir. 2020) (emphasizing the relevance of a

“layperson and eyewitness[‘s]” testimony that the

inmate’s physical distress was clear to a finding of

serious medical need).3

The seriousness of Gartman’s condition is made all

the more obvious by the fact that he had a history of

heart issues and an ICD in his chest, which he allegedly

reported to Cheatham during intake and repeatedly

mentioned throughout his incarceration. His condition

was not limited to minor dizziness and shortness of

breath, as the defendants characterize it: according to

the complaint, he also complained of acute chest pain,

turned pale, and became sweaty. In short, as Gartman

told Agee and Cheatham directly multiple times, he was

experiencing the symptoms of a heart attack. Any

reasonable layperson would be aware that such symptoms

3. At least one other layperson recognized the

seriousness of Gartman’s illness while he was in the

jail. At around noon on May 26, before Gartman was taken

to the medical unit, an inmate in a nearby cell observed

that Gartman was in poor condition and alerted jail

officers to Gartman’s need to see a nurse. While this

occurred outside the relevant timeframe, it is worth

noting that even before Gartman’s dramatic deterioration,

require immediate medical attention--and that the need

for medical attention is even more urgent when the

individual reporting such symptoms had a known heart

condition. Indeed, the fact that an inmate suffers from

a known underlying condition related to his symptoms

further heightens the seriousness and urgency of those

symptoms. See, e.g., Adams v. Poag, 61 F.3d 1537, 1543

(11th Cir. 1995) (finding that sweating, wheezing, and

shortness of breath constituted a serious medical need in

a patient with diagnosed asthma); Aldridge, 753 F.2d at

973 (finding that complaints of headaches and dizziness,

coupled with a history of head injuries, could be a

serious medical need); see also Gordon v. Frank, 454 F.3d

858, 863 (8th Cir. 2006) (“[A] reasonable officer would

consider chest pain and difficulty breathing to be

symptoms that require medical attention in anyone who

claims to have heart disease.”); Wright v. Hernandez, No.

2:10cv336, 2013 WL 4928439, at *5 (M.D. Fla. Sept. 12,

2013) (Steele, J.) (finding that a reasonable trier of

a layperson was able to recognize the seriousness of his

fact could find that “numerous complaints of dizziness,

shortness of breath, chest pains, and falling,” in

conjunction with “plaintiff’s known cardiac condition,”

constituted a serious medical need).

2. Deliberate Indifference

Officers Agee and Cheatham argue that their actions

do not constitute deliberate indifference because they

were simply relying on the professional medical judgment

of the nurses, neither of whom indicated that Gartman’s

condition was serious or required immediate treatment.

Gartman responds that Agee and Cheatham were on notice

that they should be monitoring his condition because the

nurse who examined him recommended that he be placed in

the drunk tank so that the officers could keep an eye on

him.

Gartman alleges sufficient facts to indicate that the

officers were told directly that they needed to monitor

his condition to ensure that his symptoms did not worsen.

condition and his need for medical treatment.

Even if this were not the case, however, it is clear that

his alleged deterioration was so conspicuous that Agee

and Cheatham could not have missed it and had a

responsibility to respond to it.

It is true that “when a prison inmate has received

medical care, courts hesitate to find an Eighth Amendment

violation.” Waldrop v. Evans, 871 F.2d 1030, 1035 (11th

Cir. 1989). However, it “misstates the controlling law”

to say that the “provision of medical care ... precludes

an Eighth Amendment claim.” McElligott v. Foley, 182

F.3d 1248, 1259 (11th Cir. 1999). An assessment by a

medical professional does not relieve jail officials from

their obligation to monitor inmates and provide care when

needed. The Eleventh Circuit has made clear that “[t]he

fact that [an inmate] had been seen by [a medical

professional] does not mean that a layman could not tell

that [the inmate] had a serious medical need” at a later

time. Goebert v. Lee Cty., 510 F.3d 1312, 1327 (11th

Cir. 2007). If an officer realizes that an inmate is

still in need of care, even if he had previously been

seen by a medical professional, he has a duty to, at the

very least, “look into the matter.” Id. at 1328; see

also Fikes v. Abernathy, 793 F. App’x 913, 924 (11th Cir.

2019) (finding that “when an inmate’s medical condition

is so obviously dire that a nonmedical official must know

that the inmate requires additional medical attention,”

that official is deliberately indifferent if he chooses

instead to do nothing (emphasis omitted)).4

The defendants err in characterizing Gartman’s claim

as a dispute over the adequacy of the treatment he

received. In fact, Gartman’s allegations against Agee

and Cheatham are based on the deterioration in his

condition that occurred after he was released from the

medical unit. As his brief in opposition to the motion

to dismiss points out, Gartman’s condition allegedly

deteriorated rapidly and dramatically after he was seen

by the nurse, in ways that were visible and obvious.

4. While unpublished opinions are not controlling

authority, they may be cited as persuasive authority to

the extent that their legal analysis warrants. See

Bonilla v. Baker Concrete Constr., Inc., 487 F.3d 1340,

1345 n.7 (11th Cir. 2007).

Agee and Cheatham were allegedly present as Gartman fell

over and over again, defecated on himself, and complained

of chest pain and shortness of breath. The fact that

they allegedly yelled at him to get up and mocked him for

his symptoms indicates that they saw his struggles and

were aware of his worsening condition.5 Gartman’s

serious medical need was obvious, particularly in light

of his underlying heart condition, and Agee and Cheatham

allegedly simply chose to ignore it.

The allegation that, upon noting Gartman’s

deterioration, neither Agee nor Cheatham offered him any

assistance, provided him with additional medical care, or

even reported his condition to the nurse or their

supervisors is enough to state a claim of deliberate

indifference. See McElligot, 182 F.3d at 1259 (there was

enough to find deliberate indifference where “the

defendant was aware that plaintiff’s condition was, in

fact, deteriorating and still did nothing to treat this

5. Indeed, Agee and Cheatham’s allegedly aggressive

and callous behavior could be viewed as evidence of their

deteriorating state”); Carswell v. Bay Cty., 854 F.2d

454, 457 (11th Cir. 1988) (a jail administrator who saw

an inmate’s deteriorating condition and was asked to get

the inmate to a doctor could have been found deliberately

indifferent for doing nothing to ensure that the inmate

received medical attention). Instead, Agee and Cheatham

allegedly chose to mock Gartman for his illness. Indeed,

the allegation that Cheatham demanded that Gartman sign a

release before he was allowed to go to the hospital

supports the conclusion that Cheatham was aware he had

violated Gartman’s rights and was trying to protect

himself, his colleagues, and his employer from liability.

Agee and Cheatham are incorrect that Gartman’s

condition was not severe or evident enough to warrant

their intervention. Gartman’s symptoms, as alleged in

the complaint, were dramatic and easily noticeable. Any

reasonable observer would be able to recognize that an

inmate with preexisting heart problems who cried out

because of severe chest pain and trouble breathing; could

active intent to harm Gartman or as taking pleasure in

not walk without being shocked, flailing, and falling;

and defecated on himself required immediate medical

attention.

Though Agee and Cheatham allegedly flatly ignored

Gartman’s deterioration, offering him no additional care

after he left the medical unit, they argue that their

actions could constitute merely a few hours’ delay in

treatment since Gartman went to the hospital as soon as

he was released. However, Agee and Cheatham err in

concluding that a medical emergency, and the delay in

treating it, must last for days or even months in order

to be obvious and serious. It is well-established in the

Eleventh Circuit that “an unexplained delay of hours in

treating a serious injury states a prima facie case of

deliberate indifference.” Brown v. Hughes, 894 F.2d

1533, 1538 (11th Cir. 1990). This is particularly true

in the context of “emergency needs”--broken bones,

bleeding cuts, and, much more seriously, heart attacks.

Farrow v. West, 320 F.3d 1235, 1247 (11th Cir. 2003).

his suffering.

Whenever “the medical need involves life-threatening

conditions or situations where it is apparent that delay

would detrimentally exacerbate the medical problem,” even

a delay of a few hours is enough to constitute deliberate

indifference. Id. at 1245 (internal quotation marks,

brackets, and citation omitted).

A heart attack is self-evidently the type of grave

and urgent condition that requires immediate treatment.

See, e.g., Williams v. Limestone Cty., 198 F. App’x 893,

896 (11th Cir. 2006). Other federal courts of appeals

have held that a delay of mere minutes in treating a

heart attack victim may constitute deliberate

indifference. See Tlamka v. Serrell, 244 F.3d 628, 635

(8th Cir. 2001) (finding a delay of ten minutes enough to

constitute deliberate indifference); Bass ex rel. Lewis

v. Wallenstein, 769 F.2d 1173, 1183 (7th Cir. 1985) (a

delay of ten to 15 minutes could constitute deliberate

indifference). And, based on the facts alleged in the

complaint, there was no reason for this delay--the

officers could have gotten medical assistance for Gartman

immediately, but chose to mock and then ignore him

instead. The allegation that Agee and Cheatham failed to

provide Gartman with any care in the two to three hours

after his release from the medical unit, as his condition

deteriorated significantly in front of them, is enough to

state a claim of deliberate indifference.

Agee and Cheatham further argue that Gartman fails to

plead that each of them individually had subjective

knowledge of his serious medical need. However, at the

motion-to-dismiss stage, all that is required is that

Gartman allege “sufficient facts ... to make it plausible

that the defendants had knowledge of the substantial risk

of serious harm he faced,” not that he include

allegations about each defendant’s mental state. Lane v.

Philbin, 835 F.3d 1302, 1307 (11th Cir. 2016). An

allegation that a plaintiff informed a defendant of the

substantial risk of harm the plaintiff faced is enough to

satisfy this standard. See id. at 1309. And “the very

fact that the risk was obvious” is also enough to

establish that a jail official knew of it. Farmer v.

Brennan, 511 U.S. 825, 842 (1994).

Based on the facts alleged in the complaint, there is

no way that either Agee or Cheatham could have been

unaware of the fact that Gartman was gravely ill, in

serious pain, and in need of immediate medical treatment.

Both officers were allegedly fully aware of his heart

condition and ICD: Gartman explained his medical history

to Cheatham during intake, and Agee was present when

Gartman recounted the same history to the nurse. On the

walk to the drunk tank, Gartman reiterated the fact that

he had an ICD and told both officers directly that he

believed he was having a heart attack and needed

immediate medical help. He repeated his pleas once again

when they reached the cell. The fact that Gartman

allegedly communicated the danger of his condition to the

officers is enough to establish that they did, in fact,

know of the risk.

Moreover, both officers were allegedly present for

Gartman’s alarming and unmistakable deterioration on the

walk to the drunk tank, during which he repeatedly fell,

defecated on himself, clutched his chest, and grew weak

and sweaty. Gartman need not plead what the officers

were actually thinking in order to establish that his

condition was so obvious and severe that they knew about

it and the risk it posed to his health and ignored it

anyway. Harper v. Lawrence Cty., 592 F.3d 1227, 1234

(11th Cir. 2010) (finding that defendants met the

subjective-knowledge test where they were aware of the

plaintiff’s “symptoms and behavior at the jail”). Thus,

the allegations in the complaint are more than enough to

state a plausible claim that Agee and Cheatham met the

subjective-knowledge requirement.

The court finds that Gartman’s allegations are

sufficient to state a claim for deliberate indifference.

The court turns next to determining whether Agee and

Cheatham are nevertheless protected from suit by

qualified immunity.

B. Qualified Immunity

Officers Agee and Cheatham argue that qualified

immunity bars Gartman from bringing a claim against

them.6 “Qualified immunity offers complete protection

for government officials sued in their individual

capacities if their conduct does not violate clearly

established statutory or constitutional rights of which a

reasonable person would have known.” Vinyard v. Wilson,

311 F.3d 1340, 1346 (11th Cir. 2002) (internal quotation

marks and citation omitted). The Eleventh Circuit

follows a two-step analysis to determine whether a public

official is entitled to qualified immunity. See Sims v.

Metro. Dade Cty., 972 F.2d 1230, 1236 (11th Cir. 1992).

First, the defendant must prove that he was acting within

the scope of his ‘discretionary authority’ at the time of

the allegedly illegal conduct. See id. Once this is

shown, the burden shifts to the plaintiff to prove that

6. Agee and Cheatham also claim that they are

protected from any state claims by both absolute and

state-agent immunity. Because Gartman has not brought

any state claims against either Agee or Cheatham, the

court need not reach this issue.

the defendant's actions violated clearly established

statutory or constitutional law. See id. Here, both

parties agree that Agee and Cheatham were acting within

the scope of their discretionary authority during the

time period at issue. Thus, the sole question is whether

their actions violated clearly established law.

“For a constitutional right to be clearly

established, its contours must be sufficiently clear that

a reasonable official would understand” that his conduct

violates that right, thereby giving fair and clear

warning to a government official who may engage in such

behavior. Hope v. Pelzer, 536 U.S. 730, 739 (2002)

(internal quotation marks and citation omitted). “This

is not to say that an official action is protected by

qualified immunity unless the very action in question has

previously been held unlawful ...; but it is to say that

in the light of pre-existing law the unlawfulness must be

apparent.” Id.

A plaintiff may show the violation of a clearly

established right in three ways. “First, and most

commonly, a plaintiff can point to a case with materially

similar facts decided by the Supreme Court, the Court of

Appeals, or the highest court of the relevant state.”

Sebastian v. Ortiz, 918 F.3d 1301, 1310 (11th Cir. 2019)

(internal quotation marks and citation omitted). A

plaintiff may also show “that a broader, clearly

established principle should control the novel facts in

this situation. The final, and often most difficult

option is to demonstrate that the official’s conduct was

so far beyond the hazy border between [unlawful] and

acceptable [conduct] that the official had to know he was

violating the Constitution even without caselaw on

point.” Id. (internal quotation marks, brackets, and

citations omitted). The Eleventh Circuit has also stated

in dicta that “[a] finding of deliberate indifference

necessarily precludes a finding of qualified immunity;

prison officials who deliberately ignore the serious

medical needs of inmates cannot claim that it was not

apparent to a reasonable person that such actions

violated the law.” Hill v. DeKalb Reg’l Youth Det. Ctr.,

40 F.3d 1176, 1186 (11th Cir. 1994), overruled in part on

other grounds by Hope v. Pelzer, 536 U.S. 730 (2002).

As discussed in detail in the previous section,

Gartman alleges sufficient facts to state a claim that

Officers Agee and Cheatham were deliberately indifferent

in violation of his Fourteenth Amendment right to medical

care. Since materially similar cases clearly established

this right prior to the time that Agee and Cheatham

acted, they are not protected from the claim by qualified

immunity.

First, the law was clearly established that Gartman’s

symptoms demonstrated a substantial risk of serious

harm.7 Far before the events at issue here, the Eleventh

7. The Eleventh Circuit has reserved the question of

whether prior precedent must clearly establish that the

specific medical issue in the case constitutes a serious

medical need. See Patel v. Lanier Cty., 969 F.3d 1173,

1191 n.11 (11th Cir. 2020). However, the court in Patel

found it “unlikely that an officer will be able to avail

himself of qualified immunity where ... the evidence

allows the inference that he was aware of and flatly

ignored a serious risk of harm requiring medical

attention just because our prior case law didn’t put him

on notice of that risk.” Id. The court explained that,

“[b]ecause a serious medical need is, by definition, one

that ... would be obvious to lay people, no officer can

Circuit held that an inmate presenting with shortness of

breath, dizziness, and sweating can have a serious

medical need--particularly when he has an underlying

condition related to those symptoms. See Adams v. Poag,

61 F.3d 1537, 1543 (11th Cir. 1995); Aldridge v.

Montgomery, 753 F.2d 970, 973 (11th Cir. 1985). Agee and

Cheatham had plenty of notice that Gartman’s symptoms

were dangerous and that they were obligated to respond to

them.

It was also clearly established that it is

unreasonable for an official to ignore an inmate whose

condition is deteriorating, even if that inmate had

previously received some medical care. In Carswell v.

Bay County, the Eleventh Circuit held that there was

sufficient evidence to find that a jail administrator had

been deliberately indifferent to an inmate’s medical

be unfairly surprised to learn that he violated the

Constitution by flatly ignoring it.” Id. Since Agee and

Cheatham are alleged to have flatly ignore Cheatham’s

condition, that reasoning would apply with equal force

here. Regardless, circuit precedent had clearly

established that Gartman’s symptoms did constitute a

needs even though he had received some medical care. 854

F.2d 454, 457 (11th Cir. 1988). The court concluded that

the nonmedical official “had knowledge of Carswell’s need

for medical care” beyond what he had already received

because he “saw Carswell’s deteriorating condition during

rounds at the jail” and “received a request specifically

addressed to him from Carswell for medical attention.”

Id. The fact that he nevertheless “did nothing

significant” to ensure that Carswell received the medical

attention he obviously needed was enough, the court

found, to constitute deliberate indifference, despite the

fact that Carswell had received some medical attention

and the relevant official was not a medical professional.

Id.

The Eleventh Circuit reiterated this standard in

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

There, the court held that the facility commander of a

jail was not entitled to qualified immunity from an

inmate’s deliberate indifference claim because he had

serious medical need, so there is no basis for qualified

“abundant reason to believe that her medical need was

serious,” despite the fact that she was under the care of

prison medical staff. Id. at 1327. The court

specifically noted that Carswell had put the facility

commander on notice “that his actions or inaction

violated [the inmate’s] constitutional right to timely

treatment of her serious medical needs” because it

established that when an inmate’s condition has

deteriorated to the point where it is obvious to a lay

observer, a jail official is not excused from acting

simply because a doctor had previously treated the

inmate. Id. at 1331.

Both Carswell and Goebert underscore that “when an

inmate’s medical condition is so obviously dire that a

nonmedical official must know that the inmate requires

additional medical attention, that official can be held

liable for deliberate indifference if he does nothing.”

Fikes v. Abernathy, 793 F. App’x 913, 924 (11th Cir.

2019). By the time of the incident at issue here, it was

immunity under any test.

thus a clearly established principle that “a nonmedical

official does not fulfill his obligations to an inmate

whose condition is clearly deteriorating merely by

obtaining some medical attention for the inmate, if it is

plain and obvious to a person without medical expertise

that the care is inadequate and insufficient.” Id.

It had further been established that Agee and

Cheatham’s failure to act for even the short period until

Gartman was released was impermissible. The Eleventh

Circuit has repeatedly held that delay in the “treatment

of serious and painful injuries [is] clearly recognized

as rising to the level of a constitutional claim.”

Harris v. Coweta Cty., 21 F.3d 388, 393 (11th Cir. 1994).

A delay of mere hours in the treatment of emergency

medical needs--those with a “degree of immediacy” equal

to or greater than “broken bones and bleeding cuts”--has

been established to constitute deliberate indifference.

Id. at 394; see also Youmans v. Gagnon, 626 F.3d 557, 564

(11th Cir. 2010) (finding it established law that short

delays in responding to a serious medical need may

“constitute a constitutional violation if injuries are

sufficiently serious”). It is beyond question that

symptoms of a heart attack, especially in a patient with

a preexisting heart condition, present an emergency

situation requiring immediate care. Agee and Cheatham

had plenty of notice that even a short delay in providing

care was unacceptable under established law.

Moreover, even if there had been no materially

similar cases, the circumstances here would still be

governed by the “broader, clearly established principle”

that an official’s knowledge of an inmate’s need for

medical care and intentional refusal to provide that care

constitutes deliberate indifference. Patel v. Lanier

Cty., 969 F.3d 1173, 1190 (11th Cir. 2020). The Eleventh

Circuit has held that nothing more is required to put an

officer on notice that “complete abdication in the face

of a known serious need is unconstitutional.” Id. at

1191. If an officer actually knows about a condition

that poses a substantial risk of serious harm and yet

does nothing to address it, as Agee and Cheatham

allegedly did here, “the preexisting decisional language

obviously and clearly applies” and the officer is not

entitled to qualified immunity. Id. (brackets, ellipses,

and citation omitted).

Agee and Cheatham were on notice that they were

obligated to obtain additional care for Gartman based on

his symptoms and deteriorating condition and that failure

to do so would violate his Fourteenth Amendment rights.

Instead of obtaining such care, they allegedly mocked and

ignored him. They are not protected by qualified

immunity from his resulting claim.

* * *

Accordingly, it is the ORDER, JUDGMENT, and DECREE of

the court that defendants Jabari Agee and Patrick

Cheatham’s motion to dismiss (doc. no. 96) is denied.

DONE, this the 11th day of January, 2021.

/s/ Myron H. Thompson

UNITED STATES DISTRICT JUDGE