United States District Court, D. Utah, Central Division
ORDER AND MEMORANDUM DECISION
CAMPBELL U.S. DISTRICT COURT JUDGE
an inmate at the Washington County Purgatory Correctional
Facility, Plaintiff Martin Crowson began suffering from
symptoms of toxic metabolic encephalopathy, a degenerative
neurologic disorder caused by exposure to toxic substances.
Rather give him medical care, medical staff wrongly assumed
that he was withdrawing from drugs or alcohol and placed him
in an observation cell for seven days without treatment. Mr.
Crowson brings claims under 42 U.S.C. § 1983, alleging
that the lack of medical care violated the Eight
Amendment's ban on cruel and unusual punishment, as
applied to him as a pre-hearing detainee by the Fourteenth
Amendment. The remaining Defendants in the case-Michael
Johnson (a nurse), Dr. Judd LaRowe, and Washington
County-have moved for summary judgment. For the reasons
below, the court denies their motions in most respects.
case arises from Mr. Crowson's stay in the Washington
County Purgatory Correctional Facility (the Jail) from June
11, 2014, when he was booked for a parole violation, until
July 1, 2014, when he was taken to the hospital for what
would be diagnosed as metabolic encephalopathy.
17, 2014, Mr. Crowson was placed in solitary confinement,
known as the “A Block, ” because of a
disciplinary charge. On the morning of June 25, while still
in solitary confinement, Jail Deputy Brett Lyman noticed that
Mr. Crowson was acting slow and lethargic. The deputy alerted
Defendant Michael Johnson. As a registered nurse, Nurse
Johnson could not formally diagnose and treat Mr. Crowson.
His role was to assess inmates and communicate with medical
staff who could make diagnoses-in this case, Jon Worlton, a
physician assistant (PA), and Judd LaRowe, the Jail's
Johnson evaluated Mr. Crowson that morning. He noted normal
vital signs, but also memory loss: Mr. Crowson could not
remember the kind of work he did before his arrest. Nurse
Johnson instructed jail deputies to move Mr. Crowson to a
medical observation cell, and entered a request in the
medical recordkeeping system for PA Worlton to conduct a
being moved to the medical observation cell, another deputy,
Fred Keil, noticed that Mr. Crowson appeared unusually
confused. Deputy Keil performed a body cavity search on Mr.
Crowson; when ordered to re-dress himself, Mr. Crowson first
put on his pants, then put his underwear on over his pants.
Johnson checked Mr. Crowson again that afternoon. He observed
that Mr. Crowson's pupils were dilated but reactive to
light, and that Mr. Crowson appeared alert and oriented. He
left the Jail at the end of his shift without conducting
further physical or mental assessments, and without
contacting Dr. LaRowe. PA Worlton never received Nurse
Johnson's request for a psychological examination and,
according to the Jail's medical recordkeeping system, no
medical personnel checked on Mr. Crowson for the next two
Johnson returned to work on June 28 and visited Mr. Crowson
in the early afternoon. Mr. Crowson seemed confused and
disoriented and had elevated blood pressure. He gave one-word
answers to Nurse Johnson's questions, and understood, but
could not follow, an instruction to take a deep breath. After
his visit, Nurse Johnson relayed his observations to Dr.
LaRowe by telephone. Dr. LaRowe ordered that Mr. Crowson
undergo a chest x-ray and a blood test. The blood test, known
as a complete blood count, could have detected an acid-base
imbalance in Mr. Crowson's blood, a symptom of
Crowson never received the x-ray or the blood test. Nurse
Johnson tried to draw Mr. Crowson's blood on June 28, but
couldn't because of scarring on Mr. Crowson's veins
and because Mr. Crowson would not hold still. Nurse Johnson
reported his unsuccessful attempt to Dr. LaRowe, who made no
further attempts to diagnose Mr. Crowson.
morning of June 29, Nurse Johnson again took Mr.
Crowson's vital signs and noted an elevated heart rate.
He also observed noted in the medical recordkeeping system
that Mr. Crowson was still acting dazed and confused, and was
experiencing delirium tremens, a symptom of alcohol
withdrawal. He again reported his observations to Dr. LaRowe,
who prescribed Librium and Ativan-medicines used to treat
substance withdrawal-and instructed Nurse Johnson to
administer a dose of Ativan. An hour later, Nurse Johnson
checked on Mr. Crowson, who was sleeping, and noted that his
vital signs had returned to normal.
Johnson visited Mr. Crowson again that afternoon. He noted
that Mr. Crowson was better able to verbalize his thoughts
and that his vital signs remained stable. But Mr. Crowson
again reported memory loss, telling Nurse Johnson that he
could not remember the last five days. Nurse Johnson, who
still assumed that that Mr. Crowson was suffering from
substance withdrawal, told Mr. Crowson that he was in a
medical observation cell, and that he would begin taking
medication to help his condition.
following day, Nurse Ryan Borrowman was assigned to the
medical holding area. Nurse Borrowman first saw Mr. Crowson
on July 1 and noted that his physical movements were delayed
and that he struggled to focus and would lose his train of
thought. As Nurse Borrowman recounted in his declaration,
“[d]ue to the severity of [Mr. Crowson's] symptoms
and the length of time he had been in a medical holding cell,
I immediately called Dr. LaRowe for immediate medical
care.” (Decl. of Ryan Borrowman ¶ 9 (ECF No. 67).)
Dr. LaRowe ordered Nurse Borrowman to send Mr. Crowson to the
hospital, and Mr. Crowson was transported to the Dixie
Regional Medical Center.
parties' summary judgment briefs allude to, but do not
explain, Mr. Crowson's circumstances before and after his
incarceration at the Jail. The amended complaint refers to a
hospitalization at Dixie Regional Medical Center “a few
weeks before being arrested and detained” at the Jail,
and states cryptically that medical history “would have
revealed to Facility staff that Crowson should not have been
given any drug categorized as a benzodiazepine” (such
as Librium). (Am. Compl. ¶ 37 (ECF No. 7).) The
hospitalization appears to have been the result of a heroin
overdose. (Dep. of Martin Crowson at 5:15-6:19, 49:19-22 (ECF
No. 66-2) [hereinafter “Crowson Dep.”].)
parties also do not discuss the after-effects of Mr.
Crowson's encephalopathy. According to the amended
complaint, Mr. Crowson remained in the hospital until July 7,
2014, and continued to suffer from “residual effects of
encephalopathy, liver disease, and other problems.”
(Am. Compl. ¶ 43.) He testified in his deposition that
he spent months recovering at his mother's house in
Hooper, Utah before returning to the Jail on September 7,
And then I really don't have a memory for like the next
two-and-a-half months until my brain-it's like my brain
checked out sometime. Because I guess-I guess I was still
eating food and I was still doing stuff because-and my mom
and my girl was changing my diaper, and my little brother.
They were changing my diaper the whole time I was in Hooper
until like-I don't even-I don't even-I can't even
say necessarily a certain time that I checked back in to my
(Crowson Dep. at 19:7-15.)
Crowson filed this case against Washington County, the Jail
and Jail personnel (including Sheriff Pulsipher in his
individual and official capacities), alleging negligence
under state law, violations of the Utah Constitution, and
violations of the Eighth and Fourteenth Amendments. A number
of parties and claims have already been dismissed, both by
court order and stipulation of the parties. Most recently,
the court, at the December 19, 2019 hearing on the present
motions, dismissed PA Worlton from the case because of Mr.
Crowson's failure to serve him. Mr. Crowson's only
remaining claims are his § 1983 claims against
Washington County (including Sheriff Pulsipher in his
official capacity), Nurse Johnson, and Dr. LaRowe.
remaining Defendants have moved for summary judgment. Nurse
Johnson and Dr. LaRowe argue that their care did not violate
constitutional standards, and that they are, consequently,
entitled to qualified immunity. Washington
County seeks summary judgment on the grounds that
none of its employees committed an underlying constitutional
violation, and that Mr. Crowson cannot show that a County
policy or custom caused Mr. Crowson's injuries.
Defendants also argue that Mr. Crowson's claims should be
dismissed because he failed to comply with the Prison
Litigation Reform Act, 42 U.S.C. § 1997e(a), which
requires that prisoners exhaust all available administrative
remedies before filing suit under § 1983.
motion for summary judgment should be granted “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). “Judgment as a
matter of law is appropriate when the nonmoving party has
failed to make a sufficient showing on an essential element
of his or her case with respect to which he or she has the
burden of proof.” Koch v. City of Del City,
660 F.3d 1228, 1238 (10th Cir. 2011) (quoting Shero v.
City of Grove, Okl., 510 F.3d 1196, 1200 ...