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

Plaintiff Trenton Gartman brought this lawsuit

based on an alleged incident in which he suffered heart

problems and was shocked by his implantable

cardioverter defibrillator (ICD) more than 20 times

during a roughly one-day stay in custody at a county

jail. Gartman brings 42 U.S.C. § 1983 claims against

defendants Patrick Cheatham and Jabari Agee, who were

employed as correctional officers at the jail, and

defendant Lisa Brady, a registered nurse who worked at

the jail as an employee of the company that contracted

to provide healthcare services to inmates. All

defendants are sued in their individual capacities.

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

(federal question) and 1343 (civil rights).

This case is now before the court on the

defendants’ motions for summary judgment.1 For the

reasons that follow, the motions will be denied.

I. Summary-Judgment Standard

“A party may move for summary judgment, identifying

each claim or defense--or the part of each claim or

defense--on which summary judgment is sought. The

court shall grant summary judgment if the movant shows

that there is no genuine dispute as to any material

fact and the movant is entitled to judgment as a matter

of law.” Fed. R. Civ. P. 56(a). The court’s role at

this stage is “not to weigh the evidence or to

1. Although Cheatham and Agee previously moved to

dismiss on the basis of qualified immunity, see Gartman

v. Cheatham, No. 2:18cv534-MHT, 2021 WL 96467, at *8

(M.D. Ala. Jan. 11, 2021) (Thompson, J.), they do not

raise this issue in their motion for summary judgment.

Brady also does not assert the defense of qualified

immunity in her motion for summary judgment.

2

determine the truth of the matter, but rather to

determine only whether a genuine [dispute] exists for

trial.” Dunn v. Dunn, 219 F. Supp. 3d 1100, 1109 (M.D.

Ala. 2016) (Thompson, J.). Accordingly, the court must

view the admissible evidence in the light most

favorable to the non-moving party and draw all

reasonable inferences in favor of that party. See

Matsushita Elec. Indus. Co. v. Zenith Radio Corp., 475

U.S. 574, 587 (1986). Summary judgment is appropriate

“[w]here the record taken as a whole could not lead a

rational trier of fact to find for the non-moving

party.” Id.

II. Background

Viewing the evidence in the light most favorable to

Gartman, the facts are as follows. On May 25, 2016,

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

3

County Jail, where he was booked and processed as a new

inmate by Sergeant Cheatham. According to the jail

administrator, Gartman was required to be held in

custody for 24 hours absent an order from a judge or

magistrate. See Nixon Deposition (Doc. 175-11) at 19.

According to Dr. Clifton Vance, a cardiologist who

has treated Gartman for roughly a decade, Gartman has a

heart condition associated with a weakened heart muscle

and a prior heart attack. See Vance Deposition (Doc.

175-13) at 5. To control this condition, Gartman takes

several regular medications and has an ICD, a

battery-operated device that was surgically implanted

in his chest. The ICD detects “lethal heart rhythms”

and responds by either pacing out of the fast rhythm

or, when necessary, “shock[ing] the heart back to

normal rhythm.” Id.

During his booking, Gartman told Cheatham that he

had heart problems, including a prior heart attack, and

chronic obstructive pulmonary disease, a respiratory

4

problem. He also listed all of the medications he took

and stated that he had an ICD. See Gartman Deposition

(Doc. 175-14) at 8; Cheatham Deposition (Doc. 175-10)

at 19.

After he was processed, Gartman was placed in a

“holding tank” with several other inmates. Gartman

Deposition (Doc. 175-14) at 18. According to Gartman,

around 10:00 or 11:00 p.m. he reported to a

correctional officer that he was having chest pains and

that he felt dizzy and lightheaded. See id. at 19-20.

He also felt a painful tingling in his arm that he had

previously experienced when he had a heart attack. See

id. at 20. In response to Gartman’s complaint, the

correctional officer informed Gartman that he called

the nurse and that she would see Gartman at 5:00 a.m.

when she came in. See id. After this, Gartman’s

symptoms gradually subsided, and he and several other

inmates were moved to a separate pod.

A recording of an outgoing call placed around 12:30

5

a.m. on May 26 reflects that a correctional officer

left a message for Nurse Brady informing her that an

inmate later identified as Gartman was “saying he’s

having pains, his heartbeat’s out of rhythm, he’s got a

heart problem and different things going on, [and] he’s

dizzy and whatnot.” Pl.’s Ex. 2. According to the

correctional officer who placed this call, Gartman

complained of these symptoms during the booking

process, although she could not recall whether Cheatham

was present to hear these complaints. See McAllister

Deposition (Doc. 175-8) at 6.

Brady slept through this call and responded shortly

after 4:00 a.m. The correctional officer informed her

that the inmate had “calmed down” and was “not

complaining right now.” Pl.’s Ex. 5. Brady called

again about an hour later to get the inmate’s name and

check whether he was alright. The correctional officer

reiterated that the inmate had calmed down. She also

explained that she had told the inmate that if he could

6

not breathe, then he would be on the floor. Brady

responded, “Yeah, good for you.” Pl.’s Ex. 6. Brady

mentioned that she would be arriving at the jail early

that morning and asked where the inmate was.

Brady did not see Gartman in the morning. Shortly

after 8:30 a.m., however, she received Gartman’s

medications from his family. She made no effort to

verify the medications and provide them to Gartman or

to inquire whether he had been able to take them the

previous night as prescribed. See Brady Deposition

(Doc. 175-5) at 54. Gartman had not, in fact, been

permitted to take his medications, see Gartman

Deposition (Doc. 175-14) at 20, although Dr. Vance was

unable to conclude whether this caused any of Gartman’s

symptoms while in custody, see Vance Deposition (Doc.

175-13) at 8-9.

According to Gartman, around 1:00 p.m. he again

began to feel chest pain as if someone was sitting on

his chest, as well as the tingling in his arm. See

7

Gartman Deposition (Doc. 175-14) at 23. He asked

another inmate to call a nurse while he lay down.

Officer Agee escorted Gartman to see Brady at the

nurse’s station around 2:00 p.m. See id. at 24-25;

Pls. Ex. 10 (Doc. 175-1) at 5.

At the nurse’s station, with Agee present, Gartman

told Brady that he was experiencing “chest pain,

shortness of breath, and dizziness,” and that these

symptoms had worsened since lunch. Gartman Declaration

(Doc. 175-15) at 2. He informed Brady about his heart

condition and history, his ICD, and his heart

medications and the fact that he had not been able to

take them. See id. Brady measured Gartman’s

respiration rate and found it to be elevated above a

normal range. See Brady Deposition (Doc. 175-5) at 19.

According to Brady, she attributed this elevated rate

to anxiety and declined to take any additional vital

signs. See id. at 20. Other witnesses, however,

testified that Brady performed additional tests, which

8

she did not document. Gartman testified that Brady

placed her hand on his wrist and looked at her watch,

in a manner that appeared consistent with measuring his

heart rate. See Gartman Deposition (Doc. 175-14) at

25. Agee went even further and testified that Brady

measured Gartman’s blood pressure and temperature and

connected wired nodes to his chest as if to take an

electrocardiogram (EKG). See Agee Deposition (Doc.

175-9) at 31-33; see also Cheatham Deposition (Doc.

175-10) at 19-20 (stating that he saw Brady pulling out

the EKG machine).

Brady then asked Gartman to provide a urine sample,

and Agee accompanied him to the restroom. When Gartman

tried to pee, his ICD shocked him, causing him to

scream and fall to the floor. See Gartman Declaration

(Doc. 175-15) at 2; Gartman Deposition (Doc. 175-14) at

25. Agee was next to him and needed to assist him to

sit on a foot stool. See Gartman Deposition (Doc.

175-14) at 27. Gartman told Brady that something was

9

wrong and that his ICD had fired. See Gartman

Declaration (Doc. 175-15) at 2-3. When Brady told him

he was fine, Gartman insisted that he was not fine.

See id. at 3. Around 3:00 p.m., Brady called to

request that an officer come to the medical station

because she had “Gartman on the floor.” Pl.’s Ex. 8;

see also Cheatham Deposition (Doc. 175-10) at 20.

Cheatham (who arrived in response) and Agee helped

Gartman to stand up and walked him out of the nurse’s

station. See Gartman Declaration (Doc. 175-15) at 3.

The officers escorted Gartman to his most recent

cell to retrieve his belongings before returning him to

the holding cell. On their way to the holding cell,

Gartman’s ICD shocked him again, causing him to fall to

the floor and defecate on himself. See Gartman

Declaration (Doc. 175-15) at 3; Gartman Deposition

(Doc. 175-14) at 28. Gartman told Cheatham and Agee

that his ICD had fired, that he had defecated on

himself, and that he needed to go to the hospital. See

10

Gartman Declaration (Doc. 175-15) at 3. Cheatham and

Agee forced him to get up and continued to escort him

to the holding cell. After about ten steps, Gartman’s

ICD fired again, and Gartman again fell. Gartman

reiterated that his ICD had fired and that he needed to

go to a hospital. See id. at 3-4. The officers pulled

Gartman up from the ground and told him to walk to the

cell. See Gartman Deposition (Doc. 175-14) at 31.

Cheatham added that he would charge Gartman with

assaulting an officer if Gartman touched him, to which

Gartman replied that he could not control what he did

when he was shocked. See id.

Gartman again started to walk with the officers,

slowly and with “labored breathing.” Gartman

Declaration (Doc. 175-15) at 4. Near the nurse’s

station, Gartman’s ICD shocked him again, and Gartman

fell down. See Gartman Deposition (Doc. 175-14) at 31;

Agee Deposition (Doc. 175-9) at 36 (estimating that the

nurse’s station was “[m]aybe forty feet” away).

11

Gartman loudly insisted that he could not get up, that

his ICD had shocked him, that he was having a heart

attack, and that he needed to go to the hospital. See

Gartman Declaration (Doc. 175-15) at 4. While Cheatham

and Agee again yelled at Gartman to get up, a third

officer in the area drew his taser and threatened to

tase Gartman if he did not stand up. See id.; Agee

Deposition (Doc. 175-9) at 38; Cheatham Deposition

(Doc. 175-10) at 21; Slater Deposition (Doc. 175-12) at

6. According to Brady, she saw Gartman as he passed

the nurse’s station, although she denies that she saw

him fall or heard the officers yelling about a taser.

See Brady Deposition (Doc. 175-5) at 29-30.

After numerous falls, Gartman reached the holding

cell. As Cheatham removed Gartman’s handcuffs,

Gartman’s ICD shocked him again. Cheatham again

threatened to charge Gartman with assaulting an officer

if Gartman hit him. See Gartman Declaration (Doc.

175-15) at 5. At that point, Gartman lay on his back

12

on the floor until he received a visit from his

attorney around 4:00 p.m. Cheatham brought Gartman to

this visit by wheelchair. While Gartman was with his

attorney, Gartman’s ICD shocked him again, and Cheatham

returned Gartman to his cell. See id.; see also Pls.

Ex. 10 (Doc. 175-1) at 20 (indicating that this visit

ended at 4:05 p.m.). Cheatham let Gartman out of his

cell once more prior to his release, again in a

wheelchair, in order to take a shower. While Gartman

was in the shower, his ICD shocked him multiple times

until he asked to be returned to his cell. See Gartman

Deposition (Doc. 175-14) at 34; Gartman Declaration

(Doc. 175-15) at 5. According to Cheatham, he twice

informed Brady of Gartman’s ongoing symptoms. See

Cheatham Deposition (Doc. 175-10) at 28-29. Agee

similarly testified that he told Brady that Gartman had

fallen. See Agee Deposition (Doc. 175-9) at 43. Brady

disputed that either officer told her about additional

shocks or updated her on Gartman’s condition. See

13

Brady Declaration (172-2) at 20-21.

After Gartman’s attorney told correctional staff

that Gartman needed medical attention, Cheatham called

Prattville Emergency Medical Services at 5:12 p.m. See

Pls. Ex. 26 (Doc. 175-17); Cheatham Deposition (Doc.

175-10) at 16, 30; Nixon Deposition (Doc. 175-11) at

11. Around 5:30 p.m., Gartman was released from the

jail on a gurney and transported directly to the

hospital by ambulance. See id. In the ambulance,

Gartman received an intravenous (IV) injection. See

id.; Gartman Deposition (Doc. 175-14) at 35-36; see

also Vance Deposition (Doc. 175-13) at 8 (noting

generally that IV medications may be provided “to try

to get the heart to stay in rhythm”).

According to reports downloaded from Gartman’s ICD,

between 2:00 p.m. and 5:30 p.m. on May 26, 2016,2 the

2. Two different episode summaries downloaded from

Gartman’s ICD list firing times that are 12 minutes

apart. Compare Defs.’ Ex. S (Doc. 172-2) at 137-138

(indicating that Gartman’s ICD fired between 2:23 p.m.

and 5:12 p.m.), with Defs.’ Ex. T (Doc. 172-2) at 145

14

device recorded 37 episodes of ventricular

fibrillation--a condition involving potentially “lethal

heart rhythms,” Vance Deposition (Doc. 175-13) at

5--and delivered 27 shocks to his heart. See Pl.’s Ex.

11 (Doc. 175-18) at 1-3. During these episodes,

Gartman’s heart rate was between 222 and 272 beats per

minute. See id. According to Dr. Vance, Gartman’s

heart was repeatedly going out of rhythm and being

shocked back into rhythm by the ICD. See Vance

Deposition (Doc. 175-18) at 8. In the aftermath of

this incident, Gartman’s ICD was replaced and several

additional procedures were performed; Vance opined that

these medical procedures likely would have been

required “at some point” regardless of Gartman’s

experience in the jail. Id. at 9-11; see also Wilensky

Report (Doc. 172-3) at 11.

(indicating that Gartman’s ICD fired between 2:11 p.m.

and 5:00 p.m.). The parties do not contend that this

discrepancy affects their arguments at the

summary-judgment stage.

15

III. Motions for Summary Judgment

A. Fourteenth Amendment

The Eighth Amendment prohibits “cruel and unusual

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

“deliberate indifference to serious medical needs of

prisoners,” Estelle v. Gamble, 429 U.S. 97, 104 (1976).

“A core principle of Eighth Amendment jurisprudence in

the area of medical care is that prison officials with

knowledge of the need for care may not, by failing to

provide care, delaying care, or providing grossly

inadequate care, cause a prisoner to needlessly suffer

the pain resulting from his or her illness.”

McElligott v. Foley, 182 F.3d 1248, 1257 (11th Cir.

1999). While claims involving the mistreatment of

pretrial detainees are governed by the Due Process

Clause of the Fourteenth Amendment rather than the

Eighth Amendment, the Eleventh Circuit Court of Appeals

has treated the standards under the two amendments as

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

16

(11th Cir. 2007). Although the Eleventh Circuit

declined to decide whether this remains true following

the Supreme Court’s decision in Kingsley v.

Hendrickson, 576 U.S. 389, 400-02 (2015) (holding that

an objective standard applies to excessive force claims

brought by pretrial detainees under the Fourteenth

Amendment because “pretrial detainees (unlike convicted

prisoners) cannot be punished at all”), see Dang ex

rel. Dang v. Sheriff, Seminole Cty., Fla., 871 F.3d

1272, 1279 n.2 (11th Cir. 2017) (declining to reach

question of whether “a pretrial detainee alleging

constitutionally deficient medical care need not show

deliberate indifference”), the appellate court has

continued to require proof of deliberate indifference

with respect to pretrial detainees’ claims of

inadequate medical care. See, e.g., Swain v. Junior,

961 F.3d 1276, 1285 (11th Cir. 2020); Bryant v. Buck,

793 F. App’x 979, 983 n.3 (11th Cir. 2019) (per

curiam). This court will do the same.

17

Accordingly, to prevail on his § 1983 claims for

deliberate indifference to his medical needs, Gartman

must show “(1) a serious medical need; (2) the

defendants’ deliberate indifference to that need; and

(3) causation between that indifference and [his]

injury.” Mann v. Taser Int’l, Inc., 588 F.3d 1291,

1306-07 (11th Cir. 2009).

Whether a medical need is serious is an objective

inquiry. 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)

(quoting Hill v. Dekalb Reg’l Youth Det. Ctr., 40 F.3d

1176, 1187 (11th Cir. 1994)). Alternatively, a serious

medical need may 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

18

substantial risk of serious harm.” Id. (quoting

Farrow, 320 F.3d at 1243).

Deliberate indifference is a subjective

requirement. Deliberate indifference requires proof of

a defendant’s “(1) subjective knowledge of a risk of

serious harm; and (2) disregard of that risk (3) by

conduct that is more than mere [or gross] negligence.”

Dang, 871 F.3d at 1280.3 “Whether a particular

defendant has subjective knowledge of the risk of

serious harm is a question of fact ‘subject to

demonstration in the usual ways, including inference

from circumstantial evidence, and a factfinder may

conclude that a prison official knew of a substantial

risk from the very fact that the risk was obvious.’”

Goebert, 510 F.3d at 1327 (quoting Farmer v. Brennan,

3. The Eleventh Circuit has alternately

characterized the third prong as requiring conduct

exceeding “gross” negligence or conduct exceeding

“mere” negligence. See Smith v. Wood, No. 20-12918,

2021 WL 4452526, at *3 & n.2 (11th Cir. 2021) (per

curiam) (collecting cases). The court’s analysis holds

under either framing of the standard.

19

511 U.S. 825, 842 (1994)). “Disregard of the risk is

also a question of fact that can be shown by standard

methods.” Id.

B. Serious Medical Need

The court previously found that Gartman pleaded a

serious medical need. See Gartman, 2021 WL 96467, at

*4-5. The court now finds that the evidence, at a

minimum, creates a genuine dispute as to whether

Gartman suffered a serious medical need. The

defendants do not meaningfully argue otherwise.

The records from Gartman’s ICD reflect that Gartman

repeatedly experienced a heart rate in excess of 220

beats per minute. Dr. Vance identified these rates as

“potentially lethal heart rhythms.” Vance Deposition

(Doc. 175-13) at 6. He elaborated that the number of

defibrillator shocks that Gartman experienced was

“consistent with” a ventricular tachycardia storm,

which is associated with a risk of death, stroke, or

20

brain damage. Id. at 10. Dr. Vance opined that this

number of defibrillator shocks indicated a medical

emergency, for which a patient needs to go to the

emergency room. See id. at 7-8.

During the period in which his heart was going out

of rhythm and the ICD was shocking it back into rhythm,

Gartman stated that he experienced chest pain,

shortness of breath, and dizziness and that these

symptoms worsened over time. By his account, he was

pale, weak, and profusely sweating. The pain of the

shocks caused him to flail his extremities and fall to

the floor multiple times. On one occasion, it caused

him to lose control of his bowels and defecate on

himself.

A rational jury could find from this evidence that

Gartman’s condition in the Autauga County Jail was both

painful and dangerous. Likewise, a jury reasonably

could find that Gartman’s visible symptoms, combined

with the chest pain, dizziness, and shortness of breath

21

that he repeatedly reported, would cause even a lay

person to recognize as obvious Gartman’s need for

immediate medical attention. Indeed, the urgency and

seriousness of Gartman’s symptoms were made all the

more obvious by the fact that Gartman told Cheatham and

Brady, and a jury could permissibly infer that Agee

overheard, see infra Section IV.C.2, that Gartman had a

history of serious heart issues, including a previous

heart attack, that he took heart medications to control

these issues, and that he had an ICD in his chest. A

reasonable lay person would understand that Gartman’s

symptoms required immediate medical attention in any

event but would be especially sensitive to this need in

light of Gartman’s underlying condition, which made him

particularly vulnerable. See, e.g., Adams v. Poag, 61

F.3d 1537, 1543 (11th Cir. 1995) (holding that

sweating, wheezing, and shortness of breath constituted

a serious medical need in a patient with diagnosed

asthma); Aldridge v. Montgomery, 753 F.2d 970, 973-74

22

(11th Cir. 1985) (per curiam) (holding that a patient’s

complaints of headaches and dizziness, coupled with a

history of traumatic head injuries, could constitute a

serious medical need); 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. 2:10-cv-336-FtM-29DNF, 2013 WL 4928439, at *5 (M.D.

Fla. Sept. 12, 2013) (Steele, J.) (finding that a

reasonable trier of fact could find that “numerous

complaints of dizziness, shortness of breath, chest

pains, and falling,” together with “plaintiff’s known

cardiac condition,” constituted a serious medical

need).

C. Deliberate Indifference

Defendants Cheatham, Agee, and Brady each argue

that the evidence fails to create any genuine dispute

23

as to whether their conduct constituted deliberate

indifference. As they note, Gartman’s declaration

contains several speculative statements regarding the

mental states of Cheatham, Agee, and Brady at various

times during his detention. The court does not rely on

these statements in its analysis. However, the record

contains sufficient evidence in the form of

nonconclusory statements by Gartman, the defendants,

and other witnesses, as well as the reasonable

inferences that could be drawn from that evidence, to

create a genuine dispute as to whether each defendant

exhibited deliberate indifference to a serious medical

need.

1. Defendant Brady

The evidence presents a genuine dispute as to

whether Brady was deliberately indifferent to Gartman’s

serious cardiac issues.

A reasonable jury could find that Brady had

24

subjective knowledge of a risk of serious harm to

Gartman. According to Gartman, he told Brady of the

painful symptoms he was experiencing, including

worsening chest pain, dizziness, and shortness of

breath, together with the cardiac history that

contextualized the seriousness of those symptoms. See

Gartman Declaration (Doc. 175-15) at 2. Then, although

Brady did not see Gartman fall when his ICD fired, she

heard him yell and turned around to find him on the

floor. See Brady Deposition (Doc. 175-5) at 32.

According to Gartman, he explained to Brady that his

ICD had just fired because his heart rate exceeded 220

beats per minute and that he needed to go to the

hospital. See Gartman Declaration (Doc. 175-15) at

2-3. A jury reasonably could find from this evidence

that Brady was on notice of the seriousness and

dangerousness of Gartman’s medical condition at the

time that he was in the nurse’s station.

Brady argues otherwise, relying principally on the

25

deposition testimony of Gartman’s cardiologist that “if

the patient has one shock and they’re feeling totally

fine, they have no symptoms at all,” then the patient

likely does not need to go to the hospital emergency

room. Vance Deposition (Doc. 175-13) at 7; see also

id. at 13 (“If the patient is stable, they’re not

having chest pain ... or they don’t feel their heart

racing over and over, then we would have them come to

the clinic the next day. ... One shock symptom free,

yeah, very reasonable to wait to the next day.”);

Wilensky Report (Doc. 172-3) at 12 (stating defense

expert’s agreement “that one firing does not

necessarily result in a referral to the ED”). She

contends that, because Gartman experienced only one ICD

firing when he visited the nurse’s station, she lacked

subjective knowledge that Gartman’s medical condition

was serious enough to warrant immediate,

emergency-level medical care.

Even setting aside evidence that Brady became aware

26

of additional firings after Gartman had left the

nurse’s station, see Cheatham Deposition (Doc. 175-10)

at 28-29 (testifying that Cheatham informed Brady that

Gartman continued to state that he was being shocked),

Brady’s argument simultaneously overstates Dr. Vance’s

testimony and understates the symptoms that Gartman

claims to have reported to her. By its terms, Dr.

Vance’s testimony as to when one ICD shock would not

warrant emergency-level care applies to patients

presenting as “symptom free.” Brady attempts to extend

this testimony to include patients whose only symptom

is chest pain, based on Dr. Vance’s testimony that his

office receives “phone calls all the time about chest

pain at night, so it’s not always something that has to

go to the emergency room.” Vance Deposition (Doc.

175-13) at 13. However, this testimony does not

unambiguously address a patient who reports chest pain

and whose ICD has fired, particularly in light of

Vance’s earlier testimony specifically identifying

27

chest pain as one symptom that would undermine a

determination that a patient whose ICD had fired once

was “stable” enough not to go to the emergency room.

Id.

Moreover, chest pain was not the only symptom that

Gartman reported. According to Gartman, he told Brady

not only that his ICD had fired and that he was

experiencing chest pain, but also that he was

experiencing dizziness and shortness of breath and that

his symptoms were worsening. Outwardly, he was pale

and sweaty and had difficulty getting up from the

ground. While Brady testified that Gartman said

nothing about why he was coming to see her and that she

perceived him as “stable,” Brady Deposition (Doc.

175-5) at 57, 59, the conflicting evidence creates a

genuine dispute that is appropriately resolved by a

jury weighing credibility, rather than a court acting

on a motion for summary judgment.

The evidence also creates a genuine dispute as to

28

whether Brady disregarded this substantial risk of

serious harm to Gartman. “[W]hen the need for medical

treatment is obvious, medical care that is so cursory

as to amount to no treatment at all may constitute

deliberate indifference.” Adams, 61 F.3d at 1544.

Brady concededly made no effort to provide or obtain

medical care for Gartman. She did not call for

paramedics or send Gartman to the hospital, nor did she

initiate a process to take either step. She did not

contact the on-call doctor. And she testified that she

did not even take Gartman’s vitals to investigate his

condition further, except to the extent that she

assessed and recorded Gartman’s respiration rate, which

was elevated above normal levels. A jury reasonably

could find that Brady’s failure to take any of these

actions disregarded a known risk of serious harm to

Gartman and amounted to more than negligence.

29

2. Defendants Cheatham and Agee

Although similar evidence bears on the questions of

whether Cheatham or Agee exhibited deliberate

indifference, the court emphasizes that “[e]ach

individual Defendant must be judged separately and on

the basis of what that person knows.” Burnette v.

Taylor, 533 F.3d 1325, 1331 (11th Cir. 2008). Even

considering the different information available to

Cheatham and Agee, the evidence presents a genuine

dispute as to whether each officer was deliberately

indifferent to Gartman’s heart issues after he left the

nurse’s station.

A reasonable jury could find that Cheatham and Agee

were each individually aware of Gartman’s underlying

heart condition, his history of heart issues, and the

ICD implanted in his chest. Gartman shared this

information directly with Cheatham during the booking

process. And a reasonable jury permissibly could infer

that Agee overheard this information as he stood in the

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nurse’s station while Gartman explained his history of

heart issues and his present symptoms to Brady.

Although Agee testified that he “tr[ies] not to

overhear” anything that is said between inmates and

nurses, Agee Deposition (Doc. 175-9) at 32, a jury need

not credit this testimony, particularly in light of

Agee’s testimony that he did, in fact, observe and

overhear some interactions between Gartman and Brady

during the visit, see id. at 31-34.

In light of this context, the evidence presents a

genuine factual issue as to whether Cheatham and Agee

each had subjective knowledge of a substantial risk of

serious harm to Gartman. Gartman’s condition

unmistakably deteriorated as Gartman’s ICD repeatedly

shocked him in the presence of both officers. Agee was

standing next to Gartman the first time that Gartman’s

ICD shocked him. Both Cheatham and Agee were present

with Gartman as they escorted him out of the nurse’s

station and as Gartman’s ICD proceeded to shock him at

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least three additional times. And Cheatham was present

when Gartman’s ICD shocked him again when he arrived at

the holding cell.

Each shock caused Gartman to scream, flail, and

fall to the ground. Gartman grew weak, pale, and

sweaty, clutched his chest, and, on one occasion,

defecated on himself. After each shock, Gartman

explained that his ICD had shocked him and that he

needed to go to the hospital. If Gartman’s account is

credited, a lay person in Cheatham or Agee’s shoes

would recognize an obvious need for immediate medical

attention.

Rather than providing or requesting immediate

medical attention for Gartman, a reasonable jury could

find that Cheatham and Agee flatly ignored Gartman’s

pleas for help. According to Gartman, each time he

fell to the floor in response to a shock from his ICD

while walking back to the holding cell, the officers

forced him to stand up and continue walking over his

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protestations that his ICD was firing and that he

needed hospital-level care. Twice, Cheatham threatened

to charge Gartman with assault for flailing as he fell.

Although both officers claimed that they kept Brady

apprised of Gartman’s condition, see Cheatham

Deposition (Doc. 175-10) at 28-29; Agee Deposition

(Doc. 175-9) at 43, a reasonable jury could discredit

this testimony in light of Brady’s conflicting account,

see Brady Declaration (Doc. 172-2) at 20-21. To the

extent Cheatham and Agee argue that there is no

inconsistency between their testimony that they

informed Brady of Gartman’s involuntary defecation,

falling over, and additional shocks and Brady’s

statement that she was not “made aware that Mr.

Gartman’s condition had deteriorated,” Cheatham and

Agee fail to view Brady’s statement in the light most

favorable to Gartman as required by the

summary-judgment standard. A reasonable jury could

find that, for over an hour between when Cheatham and

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Agee began to escort Gartman from the nurse’s station

and when paramedics were finally requested, Cheatham

and Agee made no attempt to obtain medical treatment or

attention for Gartman, in the face of visible symptoms

and behaviors coupled with Gartman’s reports of pain.

Given the obvious seriousness of Gartman’s symptoms,

the evidence creates a genuine dispute as to whether

this decision by both officers not to take any actions

to secure medical treatment--either by Brady and jail

medical staff or by paramedics--disregarded a known

risk of serious harm and amounted to more than

negligence. See Carswell v. Bay Cty., 854 F.2d 454,

457 (11th Cir. 1988) (holding that a jail administrator

who observed an inmate’s “deteriorating condition” and

received a request for medical attention from the

inmate could be found deliberately indifferent for

doing nothing to ensure that the inmate received

medical attention).

Cheatham and Agee argue, as they did in their

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earlier motion to dismiss, that their inaction does not

constitute deliberate indifference because they merely

relied on Brady’s medical judgment. As the court

previously noted, however, “it ‘misstates the

controlling law’ to say that the ‘provision of medical

care ... precludes an Eighth Amendment claim.’”

Gartman, 2021 WL 96467, at *6 (quoting McElligott, 182

F.3d at 1259). “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.

(quoting Goebert, 510 F.3d at 1328). Thus, Gartman’s

visit with Brady did not relieve Cheatham and Agee of

all obligations to monitor Gartman’s condition and take

action; to the contrary, Cheatham and Agee both

testified that Brady, or another medical staff,

specifically told them to place Gartman on

“observation,” Agee Deposition (Doc. 175-9) at 30;

Cheatham Deposition (Doc. 175-10) at 21-22, which Agee

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understood at least to mean that he was responsible to

check that Gartman was “still breathing,” Agee

Deposition (Doc. 175-9) at 30. A reasonable jury could

find that Cheatham and Agee, on notice that Gartman’s

medical condition warranted monitoring, instead chose

to ignore and disregard obvious symptoms that Gartman’s

condition was serious and worsening. See, e.g., Fikes

v. Abernathy, 793 F. App’x 913, 921 (11th Cir. 2019)

(per curiam) (holding that, even after medical visits,

correctional staff “were required ... to notice that

[an inmate’s] condition was very serious and getting

worse and intervene to get him the medical attention he

obviously needed”).

D. Causation

Brady, Agee, and Cheatham argue that there was no

causal connection between any deliberate indifference

attributable to them and any injuries suffered by

Gartman. The court need not reach any questions as to

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long-term consequences for Gartman because the evidence

creates a genuine dispute as to whether deliberate

indifference by Cheatham, Agee, and Brady caused

Gartman to experience needless pain while he waited

over an hour to receive medical treatment for his heart

condition.

An inmate’s experience of unnecessary pain may

constitute a cognizable injury for a claim of

deliberate indifference. See McElligott, 182 F.3d at

1257 (recognizing that “prison officials may violate

the Eighth Amendment’s commands by failing to treat an

inmate’s pain”). “Deliberately inflicted pain, as with

an electric cattle prod, does not become unimportant

and unactionable under the [E]ighth [A]mendment simply

because the pain produced is only momentary.” Brown v.

Hughes, 894 F.2d 1533, 1538 (11th Cir. 1990) (per

curiam). The Eleventh Circuit has recognized that

hourlong delays before inmates were provided medical

treatment may constitute an injury that supports a

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constitutional claim. See, e.g., id. (holding that “a

deliberate delay on the order of hours in providing

care for a ... broken foot is sufficient to state a

constitutional claim”); Aldridge, 753 F.2d at 972-73

(holding that ignoring a bleeding cut for two and a

half hours before it was sutured was actionable).

To the extent that Cheatham and Agee argue that

they were prohibited by jail policy from calling

paramedics, a reasonable jury could find that both

officers made no attempt to notify either jail medical

staff or superior officers of Gartman’s serious medical

need, delaying Gartman’s receipt of treatment for his

heart issues. And insofar as Brady argues that no

delay in treatment was attributable to her inaction

because any processes that she could have followed to

obtain emergency medical care for Gartman would have

taken more time than it actually took for Gartman to be

released, the evidence does not justify summary

judgment on this basis. The evidence does not clearly

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reflect when the process to approve Gartman for release

started. Although Cheatham testified that the jail

administrator began speaking with Gartman’s attorney

about the release process as early as 4:05 p.m., see

Cheatham Deposition (Doc. 175-10) at 27, the jail

administrator denied that he spoke with Gartman’s

attorney and testified that another correctional

officer under Cheatham had contacted the city for

approval of Gartman’s release, see Nixon Deposition

(Doc. 175-11) at 11, 13-14; see also Pls. Ex. 9 (4:57

p.m. call inquiring whether Gartman could “go a few

minutes early”). Even if the court were to assume that

the release process actually began immediately at 4:05

p.m. and would not have proceeded any faster if Brady

had made any effort to obtain an order to send Gartman

to the hospital, a reasonable jury still could find

that Brady’s deliberate indifference caused a roughly

one-hour delay in treatment of Gartman’s medical

condition from the time that Brady called for another

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correctional officer after Gartman’s ICD shocked him in

the nurse’s station.

IV. Conclusion

Based on the evidence presented at this stage, a

reasonable jury could find that Brady, Cheatham, and

Agee, or some combination of the three, chose to wait

out Gartman’s time in the custody of the Autauga County

Jail and that, for over an hour, they did so with

deliberate indifference to the serious, painful, and

dangerous cardiac condition that Gartman was

experiencing and had directly reported to each of them.

The evidence creates genuine disputes of material fact

as to whether each defendant violated Gartman’s

Fourteenth Amendment rights.

***

Accordingly, it is ORDERED that:

(1) Defendants Patrick Cheatham and Jabari Agee’s

motion for summary judgment (Doc. 163) and defendant

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Lisa Brady’s motion for summary judgment (Doc. 168) are

denied.

(2) This case will proceed to trial on the claims

discussed in this opinion and order.

DONE, this the 9th day of March, 2022.

/s/ Myron H. Thompson

UNITED STATES DISTRICT JUDGE

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