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Caiozzo v. Koreman

September 22, 2009



Appeal from a judgment of the United States District Court for the Northern District of New York (Gary L. Sharpe, Judge). We reaffirm our position, stated in Arroyo v. Schaefer, 548 F.2d 47, 50 (2d Cir. 1977), that the standard for analyzing a claim of deliberate indifference to the health or safety of a convicted prison inmate held in state custody as a violation of the right of the inmate to be free from cruel and unusual punishment under the Eighth Amendment is also applicable to claims brought by pretrial state detainees under the Due Process Clause of the Fourteenth Amendment. In light of the Supreme Court's subsequent holding that a subjective standard is to be applied in the Eighth Amendment context, under which a defendant is liable only if he disregards a risk of harm of which he is aware, Farmer v. Brennan, The opinion of the court was delivered by: Sack, Circuit Judge

Argued: October 24, 2008

Before: SACK, KATZMANN and KELLY*fn1, Circuit Judges.

In Farmer v. Brennan, 511 U.S. 825, 837 (1994), the Supreme Court held that a subjective test adapted from the criminal law applies to suits against federal prison officials for violating a convicted inmate's right to be free from cruel or unusual punishment under the Eighth Amendment. In the wake of Farmer, such a defendant is liable to an injured prisoner only if he "disregards a risk of harm of which he is aware," id. at 837, and that causes the injury. Prior to Farmer, we had held that deliberate indifference claims brought by pretrial detainees in state facilities under the Due Process Clause of the Fourteenth Amendment were to be analyzed under the same test as Eighth Amendment claims by inmates who stood convicted. See, e.g., Arroyo v. Schaefer, 548 F.2d 47, 50 (2d Cir. 1977). In the pre-Farmer cases, however, the test we employed was objective, that is, it could be met without proof as to the state of mind of the defendant. We asked whether there were "circumstances indicating an evil intent, or recklessness, or at least deliberate indifference to the consequences of his conduct for those under his control or dependent upon him." Id. at 49 (internal quotation marks omitted).

In light of Farmer, we must decide which of two lines of our case law to follow -- our prior Fourteenth Amendment Due Process Clause jurisprudence, which permitted liability for abuse of pretrial state detainees if the more easily met objective test alone was met, or our prior decisions concluding that Fourteenth Amendment due process cases brought by state pretrial detainees should employ the same standards as Eighth Amendment cruel and unusual punishment cases brought by convicts, now clearly a subjective standard. We adhere to the latter line of authority.*fn2 Following the lead of our sister circuits that have addressed this question, we conclude that in Fourteenth Amendment deliberate indifference claims brought by pretrial detainees in state custody, the subjective standard is to be applied. Applying it, we affirm the district court's grant of summary judgment to the defendant.


Because summary judgment was granted against the appellant, the administrator of the estate of Phillip Caiozzo ("Caiozzo"), we consider the evidence in the light most favorable to him. See, e.g., Konikoff v. Prudential Ins. Co. of Am., 234 F.3d 92, 94 (2d Cir. 2000). At approximately 9:49 a.m. on July 11, 2001, Caiozzo was arrested by an Albany police officer and charged with first degree harassment.*fn3 Following his arraignment in Albany City Court, he was committed to the custody of the Albany County Sheriff, who transferred him to the Albany County Correctional Facility ("ACCF") at around 6:45 p.m. Caiozzo had previously been incarcerated at the ACCF on at least twenty-seven separate occasions, and had been treated for chronic alcoholism by the facility's medical staff. On this occasion, the ACCF booking officer recommended that Caiozzo be placed under intensive observation because he appeared intoxicated. Caiozzo was then sent to the medical department, where the nurse on duty, Defendant-Appellee Linda Cummins, R.N., performed an intake medical assessment at around 7:30 p.m. Vinay B. Das, M.D., was the doctor on call at that time.

The ACCF intake assessment consists of obtaining information from the detainee by asking a standardized list of questions. The nurse is required to make several specific observations, including whether the detainee is conscious, shows signs of injury or illness, or has visible signs of fever. The nurse is also required to assess any signs that the detainee is at risk of suicide, assault, or abnormal behavior.

In her intake assessment of Caiozzo, Cummins took his vital signs, which were within normal limits. Caiozzo was able to answer her questions and to sign the intake form. Cummins noted that Caiozzo exhibited abnormal behavior and smelled of alcohol, and that he stated that he was "possessed." Caiozzo also told Cummins that he wanted to go to sleep because he was tired. He reported that he had been hospitalized during the preceding year. Caiozzo had a history of psychiatric treatment and mental problems that the appellant asserts were related to alcohol abuse.

Caiozzo told Cummins that he consumed alcohol daily. Cummins then asked when he had had his last drink. Cummins' notes indicate her understanding, based on Caiozzo's response, that his last drink had been in the early evening of that very day, July 11. It now appears that this was not the case, and that Caiozzo meant to refer to the previous evening. Cummins' understanding corresponded with the booking officer's observation, of which Cummins was aware, that Caiozzo appeared intoxicated when he was booked at 6:45 p.m.; it also corresponded with her own observation that his breath smelled of alcohol. The appellant argues that Cummins should have realized that it was not possible for Caiozzo to have consumed alcohol earlier that same evening, since he had been arrested that morning and had been in custody ever since. While the appellant acknowledges that Cummins was unaware of this chronology, he asserts that with proper diligence, Cummins would have uncovered this information. The timing of a detainee's last drink is important in assessing the need for and timing of alcohol withdrawal treatment.

At the end of her assessment, Cummins concluded --erroneously, as it turns out -- that Caiozzo was under the influence of alcohol. She placed him under continual observation, which was consistent with the booking officer's recommendation.

That evening, two corrections officers were assigned to monitor five inmates, including Caiozzo. The officers kept the inmates under continual observation and recorded their observations in a log book at approximately 15 minute intervals. At about 10:15 p.m., Cummins received a call from the officer monitoring Caiozzo, who stated that Caiozzo was yelling and acting irrationally. Cummins came to his cell, where Caiozzo told her that he was going to go through alcohol withdrawal. Cummins noted in her medical chart: "[S]tates will be having withdrawal from alcohol." Cummins did not enter the cell, examine the decedent, or ask him any questions, any or all of which might have led her to observe alcohol withdrawal signs and symptoms such as incoherence, tremors, or sweating.

Cummins called Dr. Das and reported Caiozzo's signs and symptoms as she had observed them. Based on her earlier misinterpretation of Caiozzo's statement, she told Das that Caiozzo's most recent drink had been earlier that evening. She also told Das that Caiozzo was intoxicated, noting that he was speaking irrationally to himself, and was behaving erratically and apparently had mental health problems. Das indicated that Caiozzo should be kept under constant observation, that Das would follow up first thing in the morning, and that Das would start an alcohol withdrawal protocol at that time, if necessary.

Cummins did not receive any further calls from the observing officer between 10:15 p.m. and 2:45 a.m. During that time period, the officer assigned to monitor Caiozzo, defendant Koreman, did not notice Caiozzo shaking, trembling or sweating. Neither did he observe any unusual behavior by Caiozzo, who appeared to be awake on and off. Caiozzo vomited ...

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