Court Opinions: 10th Circuit Court of Appeals Opinion from May 25

The 10th Circuit Court of Appeals

Editor’s Note: Law Week Colorado edits court opinion summaries for style and, when necessary, length.

Estate of Tomas Beauford, et al. v. Correct Care Solutions, et al. 

After midnight on April 16, 2014, Tomas Beauford suffered a fatal epileptic seizure in his cell while in pretrial custody at the Mesa County Detention Facility. The administrator of Beauford’s estate sued various Mesa County and medical defendants in federal district court in Colorado alleging they were deliberately indifferent to Beauford’s serious medical needs in violation of the 14th Amendment. 

Beauford was a 24-year-old Black male who suffered from epilepsy. He also had a severe intellectual disability and several mental health disorders, according to the 10th Circuit Court of Appeals opinion. Beauford’s IQ was 52, and he functioned at the level of a five- or six-year-old child, the court document states.

Beauford was prescribed many medications, including anti-seizure medicine, which he had a history of refusing, according to the 10th Circuit opinion. Beauford also had an implanted Vagus Nerve Stimulator to control his epilepsy. A VNS is a “bodily implant that interferes with a seizure by sending a shock through the nervous system” every few minutes and can be activated by a magnetic bracelet. It’s undisputed that, at the time he was arrested, Beauford had a VNS bracelet, but it wasn’t with him when he died.

On March 1, 2014, Beauford was arrested on charges of assault and unlawful sexual contact and booked into MCDF. He was housed alone in a single cell.

Mesa County contracted with a private company — defendant CHC — to provide medical services to inmates at MCDF. Defendant Dr. Kurt Holmes oversaw CHC’s medical care services and defendant Michael LeFebre was the mental health supervisor at MCDF. CHC also employed defendant nurses Velda Havens, Audra Keenan, Jeanne Schans and Renee Workman. Each of these defendants cared for Beauford in some capacity while he was detained at MCDF.

During his detention, Beauford refused medications about half the time, according to the court opinion. The nurses encouraged him to take his medicine by offering his favorite snacks. Holmes and LeFebre knew Beauford at times refused medication, including his anti-seizure medicine. But they took no action other than to advise the nurses they should continue to offer medication and entice Beauford to take it. 

Beauford’s physical and mental condition deteriorated at MCDF. He sometimes refused to eat and struggled to get dressed, sit up, stand or use the restroom on his own. During his approximately six-week detention, Beauford suffered documented seizures on March 1, 3 and 18 and April 15. 

By the evening of April 15, Beauford had been refusing all medications, including his anti-seizure medicine, for the past three days, the court opinion notes. That evening and through the early morning of April 16, deputies Peter Dalrymple and Richard Perkinson were on duty along with Workman. During two security checks the evening of April 15, Perkinson thought Beauford “seemed normal.”

Around 8:40 p.m., Perkinson and Workman were on medication rounds when they came to Beauford’s cell and observed him “on the bed, and completely covered by a blanket.” “[D]ue to how he was shaking” and knowing that Beauford was an epileptic, Perkinson “had a second thought that Mr. Beauford may be seizing.” Perkinson and Workman entered the cell and discovered he was having a seizure, which lasted five more minutes after Workman turned Beauford on his side. 

Perkinson and Workman then left Beauford’s cell at 8:49 p.m. to finish medication rounds. At 9:01 p.m., Dalrymple performed another security check. He looked into Beauford’s cell and saw him lying on his bed shaking with his eyes open. Dalrymple said nothing to Beauford and continued on to complete his check of other inmates. When interviewed by an MCDF officer a few hours after Beauford died, Dalrymple said he reported the shaking to Perkinson, who had assured him that, according to Workman, Beauford would be “fine.” At his deposition, Dalrymple likewise testified he had reported the shaking to someone but was uncertain whether he told Perkinson or Workman. 

Perkinson and Workman returned to Beauford’s cell at 9:21 p.m. Beauford refused to let Workman take his vitals and asked them to leave. Workman assured Perkinson that Beauford would be fine and she didn’t instruct the deputies to conduct extra monitoring of Beauford.

The deputies completed more security checks about every half-hour over the next several hours, and each time, observed Beauford laying on his bed, reading or sleeping. After doing a security round at 10:15 p.m., Perkinson moved on to other duties, leaving Dalrymple as the only officer assigned to the cell area.

During his security check at 11:55 p.m., Dalrymple saw Beauford laying on the floor of his cell, facedown, with his head under his desk. Dalrymple used his flashlight to illuminate Beauford and watched him for a few moments. He knew Beauford often slept in unusual positions in his cell and believed Beauford was breathing because he saw Beauford’s covers rising and falling. Dalrymple finished his security check.

On his next security round at around 12:15 a.m., Dalrymple observed Beauford lying motionless in the same position on the floor of his cell. This time, however, Dalrymple “could not tell for sure” if Beauford was breathing. After first completing his security check, Deputy Dalrymple alerted medical personnel he had observed Beauford lying on the floor of his cell. “About ten minutes passed between Deputy Dalrymple’s observation and his call to the [MCDF] medical staff.”

Around 12:25 a.m., Dalrymple and Workman entered Beauford’s cell and found him unresponsive. Workman retrieved a medical kit while Dalrymple started CPR and other staff called 911. Beauford was pronounced dead at approximately 2:45 a.m. on April 16, 2014. An autopsy concluded Beauford suffered “[s]udden unexpected death in epilepsy.” Toxicology tests showed low blood concentrations of four anti-seizure medications.

The district court granted summary judgment to all defendants finding the deputies were entitled to qualified immunity and the medical defendants couldn’t be found liable under Monell v. Department of Social Services of New York. 

The 10th Circuit reversed the district court’s grant of summary judgment to Dalrymple and reversed the grant of summary judgment to the Mesa County Defendants on the Estate’s entity liability claim under Monell. 

It found the estate carried its burden to show Dalrymple should have been denied qualified immunity and could be found indifferent because of the 10-minute delay to call for medical assistance even though he was unsure Beauford was breathing. “The district court’s failure to account for this fact and view it in the light most favorable to the nonmovant, the Estate argues, is reversible error. We agree,” the opinion states. “When the facts in the summary judgment record, and all reasonable inferences to be drawn from those facts, are viewed in the Estate’s favor, a reasonable jury could believe Deputy Dalrymple acted with deliberate indifference by waiting ten minutes to call for medical help even though he knew Mr. Beauford might not be breathing”

The district court’s order was otherwise affirmed.

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