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Smith v. Campbell County, Kentucky

United States District Court, E.D. Kentucky, Northern Division, Covington

March 25, 2019



          David L. Bunning, United States District Judge.

         On February 2, 2015, David Smith was arrested for drug crimes in Campbell County, Kentucky, and transported to the Campbell County Detention Center (“CCDC”). During his time at the CCDC, Plaintiff suffered from epidural abscesses and osteomyelitis of the spine, resulting in sepsis and acute paraplegia of the lower part of his body. Plaintiff filed suit against Campbell County, Campbell County Jailer James Daley, Southern Health Partners, Inc. (“SHP”), Dr. Mina Kalfas, nurses Anna Nash, Marissa Sparks, Amanda Clarkson, Leslie Doremus, and Krista Slayback, and various John and Jane Does. In his Complaint, Plaintiff alleges that Defendants exhibited deliberate indifference to his serious medical needs in violation of the Eighth and Fourteenth Amendments to the federal Constitution. (Doc. # 1 at 8-9). He also brings numerous pendant state-law claims, including negligence, outrage, intentional infliction of emotional distress, and violation of Kentucky Administrative Regulation (“KAR”) 501 3:090. Id. at 9-10.

         There are currently two Motions for Summary Judgment before the Court, both of which are fully briefed and ripe for review. (Docs. # 89, 91, 98, 99, 100, and 101).

         Defendants Campbell County and James Daley (collectively “County Defendants”) seek summary judgment on the deliberate-indifference and state-law claims against them. (Doc. # 91). They also argue that the claims against the John Doe defendants should be dismissed. Id. SHP, Kalfas, Nash, Sparks, Clarkson, Doremus, and Slayback (collectively “SHP Defendants”) also filed a Motion for Summary Judgment, requesting dismissal of all claims against them. (Doc. # 89). For the reasons set forth below, the County Defendants' Motion for Summary Judgment is granted. The SHP Defendants' Motion for Summary Judgment is granted in part and denied in part.


         Plaintiff David Smith was arrested February 2, 2015 on a warrant in Campbell County, Kentucky, for several drug-related crimes. (Doc. # 89-1). Smith was taken to the Campbell County Detention Center (“CCDC”) where he remained incarcerated until March 5, 2015. At the time of his incarceration, Campbell County contracted with Southern Health Partners, Inc. (“SHP”) to provide medical care to inmates at CCDC. (Doc. # 89-2). In turn, SHP contracted with Dr. Mina Kalfas to oversee the administration of medical care at CCDC. (Doc. # 89-3).

         Upon admission to the CCDC on February 2nd, Smith advised prison staff of a number of health problems, including withdrawal from heroin, depression, anxiety, leg pain, and a history of pain and bone fractures in his back. (Doc. # 98-3). Later on the same day, Smith reported to SHP nurse Marissa Sparks-a named defendant in this case-that he suffered from high blood pressure, depression, bipolar disorder, and hepatitis B and C and that he was taking blood pressure medications. (Docs. # 98-4 and 89-5). Smith also told the SHP nursing staff that he had overdosed on heroin in January 2014 and had attempted suicide “over a year ago.” (Doc. # 89-5). That same day, the SHP physician on staff at the CCDC, Dr. Mina Kalfas (also a named defendant), gave orders for detox and blood pressure monitoring. (Doc. # 89-6). Smith's medication reconciliation from CVS Pharmacy showed that his current medications were Lisinopril, HCTZ, Zantac, Cymbalta, Elavil, and Lithium, which all had been filled on January 2, 2015. (Doc. # 89-7). On February 3, 2015, Smith refused to allow SHP head nurse[1]Krista Slayback (a named defendant) to evaluate him for his antidepressant medications, Elavil and Cymbalta. Id. Smith also declined further detox monitoring on February 4th. Id.

         On February 5, 2015, Smith requested medical assistance by submitting a “Sick Call Slip, ” complaining of “Chronic Pain Due to Back” and indicated that it had been going on for the past two weeks. (Doc. # 98-5). SHP nurse Amanda Clarkson (who is also a named defendant) responded to the Sick Call Slip on February 7th and recorded the results on a “Clinical Pathways/Patient Clinical Data Form.” (Doc. # 89-11). Smith described his pain as “aches” and stated that his pain level was 8 out of 10 on the pain scale. Id. He also reported that his pain was greater with activity. Id. When asked if he had had this pain before, his answer was “no.” Id. Despite Smith being “very verbal” about his pain and his statement that his pain level was 8 out of 10 on the pain scale, Nurse Clarkson perceived Smith to be in only “slight pain” because he did not manifest physical symptoms of extreme pain, including sweating or difficulty breathing. (Doc. # 98-6 at 59). Nevertheless, Nurse Clarkson observed that Smith's vital signs were “slightly elevated, ” so she recommended a three-day regimen of ibuprofen 400 mg, which Dr. Kalfas prescribed. (Docs. # 89-6 and 98-6).

         Smith filled out his second Sick Call Slip on February 8, 2015, writing “Back Pain Severe.” (Doc. # 98-7). Nurse Julia Schlake (not a named defendant) responded to Smith's Sick Call Slip on February 9, 2015. (Doc. # 98-8). Again, Smith complained of constant pain that was 8 out of 10 on the pain scale and that had started two weeks ago. Id. Smith also stated that the increased pain began when he “sneezed and felt like he [had] pulled a muscle.” (Doc. # 89-13). Nurse Schlake determined that Smith's vital signs were “elevated, ” but did not prescribe any additional treatment, as Smith was still taking ibuprofen. (Doc. # 98-9 at 47). Later on February 9th, Smith was seen by SHP Nurse David Watkins (not a named defendant), although no written record of this visit exists. (Doc. # 98-10 at 46).

         On February 10th, Nurse Leslie Doremus (also a named Defendant) attempted to conduct a “History and Physical Assessment” for Smith, but he declined, stating “Don't need one.” (Doc. # 89-14). On February 11th, Smith submitted a third Sick Call Slip, on which he wrote “Upper back Disc . . . as well as breathing due to Spinal Compression!! Please Help!!” (Doc. # 98-11). He also wrote that had experienced the problem for “years but last two weeks.” Id. Nurse Schlake responded on February 12th and noted that Smith was experiencing pain in the middle of his back that was a 10 on the pain scale. (Doc. # 98-12). Smith once again told the nurse that the onset of back pain corresponded with a sneeze two weeks prior to entering CCDC. Id. Nurse Schlake recommended Tylenol, which Dr. Kalfas prescribed that same day. (Docs. # 89-6 and 98-12).

         Smith filed his fourth Sick Call Slip on February 13, 2015, which stated “Need to See Doctor ASAP Back.” (Doc. # 98-13). Smith was seen by Nurse Clarkson on February 14th. (Doc. # 98-14). In her evaluation, Nurse Clarkson noted that Smith described his back pain as “sharp, aches, ” and that his pain was at ¶ 10 on the pain scale. Id. She also noted “prior back injury” and that his vital signs were normal. Id. Nurse Clarkson did not recommend new treatment. Id.

         On February 15, 2015, Smith sent in his fifth Sick Call Slip, complaining of “Back Pain Numbness and Tingling Extra Strength Tylenol and See The Doctor!!” (Doc. # 98-15). Smith was seen by Nurse Doremus on February 16th. (Doc. # 89-20). During this visit, Smith stated that his back pain started in 2007 when he was “hit by a tractor” in an accident. Id. Smith further reported that his pain was constant and a 5 out of 10 on the pain scale. Id. Despite mentioning numbness and tingling in his Sick Call Slip, the Clinical Pathways form that Nurse Doremus filled out did not mention numbness or tingling. Smith was prescribed Naproxen 500 mg for his pain. (Docs. # 89-6 and 89-20).

         Dr. Kalfas examined Smith for the first time on February 17, 2015. During the examination, Smith complained of “back pain, neck mid back pain.” (Doc. # 98-17). Dr. Kalfas recorded that Smith had seen a chiropractor at age fifteen and was hit by a forklift in 2007, resulting in a “crushed” L5-S1 in his back. Id. Dr. Kalfas noted that Smith received treatment for his back from Dr. Hanson, who performed “epidurals and dye.” Id. In addition, Smith reported problems with his left ankle, knee, and with heartburn. Id. Dr. Kalfas also observed that Smith had been on heroin, that he had not had any recent Lithium labs, and that he had no upper extremity or lower extremity symptoms at the time. (Docs. # 98-17 and 49-7 at 107). Based on his examination and review of Smith's health history, Dr. Kalfas diagnosed Smith with degenerative disc disease that caused chronic back and neck pain. (Doc. # 49-7 at 107). As treatment, he prescribed Voltaren (an anti- inflammatory gel) and Baclofen (a muscle relaxant). (Doc. # 98-17). Dr. Kalfas also prescribed Prilosec for Smith's heartburn and ordered labs for Lithium. (Docs. # 89-6, 98-17, and 49-7 at 107).

         On February 22, 2015, Smith complained of pain in his lower back, along with tingling and numbness in his lower extremities. (Doc. # 98-22). He also indicated that the pain interfered with walking. (Doc. # 98-22). Nurse Doremus completed an examination, during which she noted Smith had facial grimacing. (Doc. # 98-22). Nurse Doremus did not record Smith's pain level, nor did she complete a Clinical Pathways form. (Doc. # 98-16 at 44, 47). She reported Smith's symptoms to Dr. Kalfas, who prescribed a higher dose of Baclofen. (Docs. # 89-6 and 98-19).

         In the early morning of February 25, 2015, Smith approached Deputy Rickey Pemberton, who noticed that Smith was “breathing heavy and was in pain.” (Doc. # 98-20 at 2). Smith told Deputy Pemberton that if he wasn't sent to the hospital to treat his pain, he would swallow a razor blade. Id. Noticing what appeared to be metal in his mouth, Deputy Pemberton contacted SHP Nurse Marissa Sparks, who was unable to contact her supervisor. (Doc. # 98-21 at 4-5). After some time, Smith revealed that the “razor blade” was in fact a metal washer and that he was just trying to get some help because he was in so much pain. Id. at 3. Later on February 25th, Smith was evaluated by a social worker at NorthKey mental health clinic, who noted that Smith reported back pain and had threatened to swallow a razor blade if not treated. (Doc. # 98-23). The social worker also noted that Smith apologized and stated that he wanted treatment for his pain. Id. Smith reported to the social worker that he had attempted suicide in 2002 and 2011. Id. As a result of this incident, Smith was assessed as a high risk for suicide, placed in an anti-suicide smock, and relocated to an observation cell. (Doc. # 98-22). Smith was taken off suicide watch that same afternoon. Id.

         On February 26, 2015, Smith submitted his sixth Sick Call Slip, complaining of “Back Pain, Possible Bulging Discs Need to See Doctor Need X Rays Immediately.” (Doc. # 98-24). He wrote on the Sick Call Slip that he had had the problem for 25 days. Id. Smith was tended to by Nurse Doremus, who took Smith's vitals and referred him to Dr. Kalfas. (Doc. # 98-22). There is no indication in the record that Doremus completed a Clinical Pathways form for this visit.

         Later that day, Smith was examined by Dr. Kalfas for the second time. Id. Smith complained to Dr. Kalfas of increased pain in his back and right buttock. Id. Dr. Kalfas acknowledged that he would have reviewed the progress note from February 22nd, which indicated that Smith had complained of numbness and tingling in his legs as well as difficulty walking. (Doc. # 49-7 at 92). Smith also claims to have told Dr. Kalfas during this visit that he was experiencing “sporadic paralysis.” (Doc. # 98-45 at 5). In his evaluation, Dr. Kalfas noted that Smith had sustained injuries in multiple motor vehicle accidents, including a forklift injury in 2007. (Doc. # 98-22). Dr. Kalfas performed a straight-leg-raise test, which revealed radiating pain. Id. Smith also reported pain when bending axially and cried out when Dr. Kalfas put pressure on several para-spinal areas. Id. Despite this, Dr. Kalfas diagnosed Smith with malingering, observing that Smith exaggerated his pain and his gait. (Docs. # 49-7 at 96 and 98-22). In addition to his exaggerated gait, Dr. Kalfas recorded that Smith “cried out excessively, ” (Doc. # 98-22), in one instance shouting “oh, oh” as Dr. Kalfas pressed lightly on his head. (Doc. # 49-7 at 98). Dr. Kalfas also stated in his deposition that he suspected Smith to be malingering “[b]ecause he wanted to go to the hospital.” Id. at 93. In response to Smith's complaint of sporadic paralysis in his legs, Dr. Kalfas advised that he could still walk because he was capable of moving his toes. (Doc. # 98-45 at 5). Also during this evaluation, Smith requested an X-ray, which Dr. Kalfas declined, citing “no recent trauma.” (Docs. # 49-7 at 99 and 98-22). Dr. Kalfas also noted that Smith had no swelling or inflammation and no motor or sensory deficits. (Doc. # 98-22). Notably, Dr. Kalfas did not order any treatment as a result of this second examination. (Doc. # 49-7 at 100).

         On February 27, 2015, Officer Alexander Fead wrote in an incident report that he had heard Smith moaning while “slowly attempting to sit in a chair.” (Doc. # 98-26). Smith told Officer Fead that he was experiencing back pain. Id. Officer Fead notified Nurse Schlake, who said that she “would contact the doctor to see if anything could be done. Id. Also on February 27th, Smith submitted a Campbell County Inmate Grievance Form, on which he wrote

Issues I have is medical refuses to find solution by looking into cause by x -Ray. They think trying to mask the pain external with medication. But without knowing cause. How can you treat the problem and letting problem get works and cause more damage. Back problems can lead to paralysys or death!!I cause issues within the dorm by excess painful out crys through out the night!! If you heard any details ask any night officers who have seen me in degress of health!!Please I just want to find out problem before any more damage encures. P.S. medical staff as well as Dr. Calvis. I believe E.R. would be only option! Thank you.

(Doc. # 98-27).

         On March 1, 2015, Smith sent in his seventh Sick Call Slip, stating “No Improvement In Back!! Getting Worse and Causing Breathing Problems and Sore Ribs!! Also Need Treatments for Heels Cracked Bad!!” (Doc. # 98-28). While on an observation round at 7:30 a.m. on March 2nd, Officer Tyler Holzschuh heard Smith making “audible ‘grunting' sounds as if he was in pain.” (Doc. # 98-31). Officer Holzschuh wrote in his report that “Smith was observed laying in his bunk, out of breath and stated ‘my legs are numb, I can't feel my legs all the way up to my waist.'” Id. After reporting the incident to his supervisor, Officer Holzschuh called Nurse Slayback, who advised Officer Holzschuh that Smith was “faking” and that he was already on the sick call list for later that morning. Id. According to Officer Holzschuh, Nurse Slayback told him that Smith “had ready seen the doctor twice in the past month for the same issue.” Id. Nurse Slayback also stated that “for the numerous times he has been evaluated for the same issue by the medical department, Inmate D. Smith needed to be placed into medical isolation for observation.” Id. Officer Holzschuh testified that at the time of his report, Smith was being housed in “DS-3 203 A, ” an isolation cell used for inmates who have medical issues or disciplinary problems. (Doc. # 98-32 at 6). Holzschuh indicated that Smith had been moved into isolation because he was disturbing other inmates by crying out in pain during the night. Id. at 7.

         Smith was seen by Nurse Slayback twice on March 2nd. At 11:20 a.m., Nurse Slayback noted that Smith complained of back pain and numbness in both legs. (Doc. # 98-29). She observed that Smith was not answering her questions and continually moaned. Id. Nurse Slayback ordered that Smith be held in isolation for “abuse of medical services.” Id. Later at 1:56 p.m., Nurse Slayback observed that Smith was able to bear weight and move all of his extremities. Id. He continued to moan, yell, and scream. Id. Nurse Slayback recommended that Smith get an X-ray, which Dr. Kalfas approved. (Doc. # 49-5 at 48-49). Smith received an X-ray on March 2, 2015, which showed degenerative disc disease in the thoracic and lumbar spine. (Doc. # 89-26).

         On March 3, 2015, Officer Patricia Dietz was notified that Smith had urinated on himself. Smith told her that he was unable to walk and could not move to get water or to use the restroom. (Doc. # 98-33). Officer Dietz spoke with Nurse Schlake, who said that Smith had received X-rays, which showed no broken bones. (Doc. # 98-33). Smith was given a jug of water and his pants were taken to be washed. (Doc. # 98-33). Also on March 3rd, Smith was seen by Dr. Kalfas for the third time, who reviewed the X-ray results and noted that Smith complained of increased pain. (Doc. # 98-29). Dr. Kalfas acknowledged that he would have seen the progress notes from the day before stating that Smith complained of bilateral leg numbness and was seen moaning, yelling, and screaming. (Doc. # 49-7 at 58). He also states in his notes that Smith had back issues and testified that Smith “appeared to be in some pain.” Id. at 69. Nevertheless, Dr. Kalfas concluded once again that Smith was malingering. (Doc. # 98-29). According to Dr. Kalfas's notes, a sensory examination of Smith's lower extremities was “inconsistent.” Id. He wrote that Smith would withdraw his feet in response to stimuli but act as if he didn't feel anything. Id. Dr. Kalfas also observed that Smith's deep tendon reflexes were 2 and symmetrical, the pulses were intact, and he had good strength and coordination of his lower extremities. Id. Finally, when Smith told Dr. Kalfas that he was unable to walk, Dr. Kalfas told Smith that he “need[ed] to get up and walk!” and explained in his deposition that this command “ha[d] a little bit of forcefulness behind it.” (Doc. # 49-7 at 63). Dr. Kalfas testified that after he ordered Smith to walk, Smith “got up slowly and he limped a little bit and seemed to, after a couple steps, move a little better.” (Doc. # 49-7 at 69). Dr. Kalfas ordered no new treatment or diagnostic tests as a result of this third exam.

         At 6:37 p.m. on March 3rd, Officer Dietz received a phone call from Smith's sister, Casey Simon, who requested that her brother be taken to the hospital because he could not feel his legs. (Doc. # 98-35). Smith's sister called again on March 4th at 1:57 p.m., this time speaking with Nurse Slayback. (Doc. # 98-37). Smith's sister told Nurse Slayback that Smith was not mentally stable and that she was concerned for his safety. Id. She also told Nurse Slayback that Smith was unable to move his legs and that he needed to be transferred to the emergency room. Id. Nurse Slayback told Smith's sister that Smith had been evaluated by the prison doctor and that “if any issues arise [Smith] will be treated.” Id. Later on March 4th, Smith was again placed on suicide watch after Nurse Slayback observed multiple scratch marks on Smith's left forearm. (Doc. # 98-37). According to Nurse Slayback's Progress Notes, Smith denied any suicidal ideations and claimed the scratches resulted from the wall. Id. While on suicide watch, Smith was observed yelling. (Docs. # 98-10 at 3 and 98-38).

         On March 5, 2015 at 5:00 a.m., Smith was observed laying on the floor of his cell yelling for help. (Doc. # 98-40). Sergeant Pemberton and three deputies responded to Smith's cell. Id. Smith told the officers that that he had fallen from his bunk and couldn't get up, but that he did not want assistance in returning to his bunk for fear of “hurting his back worse.” Id. Smith further stated that he did not want anyone but a “St. Elizabeth [Hospital] medical professional” to help him. Id. Sergeant Pemberton told Smith that “you have been checked by our medical staff, had xrays, and they the medical staff say that you can walk.” Id. Later at 8:30 a.m., Nurse Slayback observed Smith sleeping on his stomach on the floor. (Doc. # 98-37). Nurse Slayback examined Smith when we woke up less than two hours later. Id. Nurse Slayback noted that she witnessed Smith move his legs and wiggle his toes despite his claims to the contrary. (Doc. # 49-5 at 32). Nevertheless, Nurse Slayback decided to transport Smith to St. Elizabeth Hospital for evaluation of Smith's mental status and because of “psychosomatic complaints of lower extremity paralysis.” (Docs. # 49-7 at 45 and 98-37). She testified that Smith was able to bend his knees in the process of moving him into the wheelchair and did not appear to be in pain. (Doc. # 49-5 at 33). She also observed that he was able to stand and walk with the assistance of one person on each side. Id. at 34. Numerous officers who transported Smith to the hospital corroborated Nurse Slayback's account. For instance, Officer Joan Warfield noted that “[a]s deputies and medical personnel were helping [Smith] to the wheel chair he was moving his legs and at the same time stating he could not move them.” (Doc. # 98-41).

         Upon admission to St. Elizabeth Hospital in Edgewood, Kentucky, Dr. Laroy Kendall noted that Smith complained of back pain, difficulty walking, and abdominal pain. (Doc. # 98-43). Dr. Kendall also observed that Smith “reports that he cannot move his lower extremities but has been witnessed to move them on several occasions and did move them for me.” Id. Doctors at St. Elizabeth later determined that Smith had a spinal abscess and osteomyelitis of the spine. (Doc. # 98-39). Doctors performed an emergency L7-10 laminectomy on the afternoon of March 5, 2015. Id. Also on March 5th, Nurse Schlake wrote that Deputy O'Brien had received reports from inmates that Smith was giving away his commissary and food trays in exchange for getting assaulted so that he could go to the hospital. Id. Smith was discharged on April 30, 2015, at which point he was determined to be paraplegic with “trace” movements of his legs. (Doc. # 89-1 at 8). Smith was then transported to Gateway Rehabilitation Hospital. Id. Upon discharge from Gateway on May 27, 2015, Smith was diagnosed with the “effects of spinal epidural abscess with MRSA with paraplegia.” Id. At the time of discharge from Gateway, Smith was unable to move or ambulate. Id.

         On January 29, 2016, Smith sued Campbell County, Jailer James Daley, SHP, Dr. Kalfas, and nurses Anna Nash, Marissa Sparks, Amanda Clarkson, Leslie Doremus, and Krista Slayback, and ten John and Jane Does. (Doc. # 1). Plaintiff alleged that defendants exhibited deliberate indifference to his serious medical needs in violation of the Eighth and Fourteenth Amendments to the U.S. Constitution. (Doc. # 1 at 8-9). Plaintiff also brought pendant state claims, including negligence, outrage, intentional infliction of emotional distress, and violation of Kentucky Administrative Regulation (“KAR”) 501 3:090. (Doc. # 1 at 9-10). On April 30, 2018, both the SHP and County Defendants filed Motions for Summary Judgment on all claims. (Docs. # 89 and 91). Plaintiff filed Responses (Docs. # 98 and 99), to which both sets of Defendants replied. (Docs. # 100 and 101).

         II. ANALYSIS

         A. Standard of Review

         Summary judgment is appropriate when the record reveals “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). A genuine issue of material fact exists where “the evidence is such that a reasonable jury could return a verdict for the nonmoving party.” Anderson v. Liberty Lobby, Inc., 477 U.S. 242, 248 (1986). The “moving party bears the burden of showing the absence of any genuine issues of material fact.” Sigler v. Am. Honda Motor Co., 532 F.3d 469, 483 (6th Cir. 2008). Once a party files a properly-supported motion for summary judgment, by either affirmatively negating an essential element of the non-moving party's claim or establishing an affirmative defense, “the adverse party must set forth specific facts showing that there is a genuine issue for trial.” Anderson, 477 U.S. at 250. However, “the mere existence of a scintilla of evidence in support of the [non-moving party's] position will be insufficient.” Id. at 252.

         The Court must “accept Plaintiff's evidence as true and draw all reasonable inferences in his favor.” Laster v. City of Kalamazoo, 746 F.3d 714, 726 (6th Cir. 2014) (citing Anderson, 477 U.S. at 255). The Court may not “make credibility determinations” or “weigh the evidence when determining whether an issue of fact remains for trial.” Id. (citing Logan v. Denny's, Inc., 259 F.3d 558, 566 (6th Cir. 2001)). “The ultimate question is ‘whether the evidence presents a sufficient disagreement to require submission to a jury or whether it is so one-sided that one party must prevail as a matter of law.'” Back v. Nestle USA, Inc., 694 F.3d 571, 575 (6th Cir. 2012) (quoting Anderson, 477 U.S. at 251-52). If there is a dispute over facts that might affect the outcome of the case under governing law, the entry of summary judgment is precluded. Anderson, 477 U.S. at 248.

         As the moving parties, the Defendants must shoulder the burden of showing the absence of a genuine dispute of material fact as to at least one essential element of each of Plaintiff's claims. Fed.R.Civ.P. 56(c); see also Laster, 746 F.3d at 726 (citing Celotex Corp. v. Catrett, 477 U.S. 317, 324 (1986)). Assuming Defendants satisfy their burden, the Plaintiff “must-by deposition, answers to interrogatories, affidavits, and admissions on file-show specific facts that reveal a genuine issue for trial.” Laster, 746 F.3d at 726 (citing Celotex Corp., 477 U.S. at 324). Furthermore, “the trial court no longer has a duty to search the entire record to establish that it is bereft of a genuine issue of material fact.” Street v. J.C. Bradford & Co., 886 F.2d 1472, 1479-80 (6th Cir. 1989).

         B. Pseudonymous Defendants

         As an preliminary matter, the Defendants identified in Plaintiff's Complaint as “John and Jane Does 1-10” must be dismissed under Federal Rule of Civil Procedure 4(m), which states that “[i]f service . . . is not made upon a defendant within 120 days after the filing of the complaint, the court . . . shall dismiss the action without prejudice as to that defendant . . . .” As Plaintiff provides no evidence that these pseudonymous defendants have been served, all claims against those defendants must be dismissed without prejudice.[2] Fed. R. Civ. P 4(m); see Petty v. Cty. of Franklin, 478 F.3d 341, 345 (6th Cir. 2007).

         C. Defendants Anna Nash and Marissa Sparks

         In his Response to the SHP Defendants' Motion for Summary Judgment, Plaintiff concedes that the facts do not support any of his claims against Defendant nurses Anna Nash and Marissa Sparks. (Doc. # 98 at 22). After reviewing the record, the Court agrees. Accordingly, all of Plaintiff's claims against Anna Nash and Marissa Sparks are dismissed with prejudice.

         D. Section 1983 Deliberate Indifference Claim

         Both the County and SHP Defendants seek summary judgment on Plaintiff's § 1983 claim. To prevail on a claim under 42 U.S.C. § 1983, a plaintiff “must establish that he was [1] denied a constitutional right, and [2] that the deprivation was caused by a defendant acting under color of state law.” Carl v. Muskegon Cty., 763 F.3d 592, 595 (6th Cir. 2014). The Court will address the second element first.

         1. Under color of state law

         With the exception of Dr. Kalfas, none of the Defendants dispute that the second element is met in this case. Counties are suable “persons” under § 1983. Alkire v. Irving, 330 F.3d 802, 814 (6th Cir. 2003) (citing Monell v. Dep't of Soc. Servs., 436 U.S. 658 (1978)); see also Jones v. Muskegon Cty., 625 F.3d 935, 946 (6th Cir. 2010). Furthermore, county correctional institutions and their employees are routinely regarded as acting under color of state law. See, e.g., Blosser v. Gilbert, 422 Fed.Appx. 453, 456 (6th Cir. 2011); Jones, 625 F.3d at 944-46. Therefore, Campbell County and Campbell County Jailer James Daley may both be sued under § 1983.

         Likewise, SHP and its employees, including the nurse defendants in this case, are subject to suit under § 1983 because they acted under color of state law. “It is well settled that private parties that perform fundamentally public functions, or who jointly participate with a state to engage in concerted activity, are regarded as acting ‘under color of state law' for the purposes of § 1983.” Bartell v. Lohiser, 215 F.3d 550, 556 (6th Cir. 2000). “Contracting out prison medical care does not relieve” the Commonwealth or its counties of the “constitutional duty to provide adequate medical treatment to those in its custody, and does not deprive . . . prisoners of the means to vindicate their” constitutional rights. West v. Atkins, 487 U.S. 42, 56 (1988); see also Hicks v. Frey, 992 F.2d 1450, 1458 (6th Cir. 1993). Thus, SHP and its employees are suable persons under § 1983.

         Meanwhile, Dr. Kalfas contends-without citation to case law-that he did not act under color of state law because he is an independent contractor of SHP and not a direct employee. (Doc. # 89-1 at 14-15). In essence, Dr. Kalfas argues that while a private contractor of a county jail is suable under § 1983, a private subcontractor is not. Plaintiff argues to the contrary, citing Carl v. Muskegon County, 763 F.3d 592 (6th Cir. 2014) for the proposition that “the employment arrangement of an individual does not affect the authority under which they act.” (Doc. # 98-19). The Court agrees with Plaintiff on this point.

         In Carl, a county jail contracted out psychiatric services to another county agency, which then hired a private physician as an independent contractor. 763 F.3d at 594. The court found that the physician could be sued under § 1983 because she was acting under color of state law. Id. at 595. Carl held that in determining whether a private prison doctor is a state actor for purposes of § 1983, the key question is if the doctor “exercise[s] powers which are traditionally exclusively reserved to the state.” Id. (quoting Wolotsky v. Huhn, 960 F.2d 1331, 1335 (6th Cir. 1992)). The court had no trouble in concluding that providing medical care to individuals in state custody constitutes a traditional state function. Id. at 596. Hence, the Carl physician's psychiatric evaluation of the incarcerated plaintiff was sufficient to qualify her as a state actor. Id. Likewise in this case, Dr. Kalfas was performing a traditional state function by treating individuals, including Plaintiff, who were detained in the CCDC. Therefore, Dr. Kalfas will be considered a state actor.

         Dr. Kalfas counters that Carl is distinguishable because the psychiatrist in that case contracted directly with a county agency. (Doc. # 100 at 3). Yet, Carl makes clear that “an employment relationship does not control whether a private individual acts under color of state law.” 763 F.3d at 597 (citing West, 487 U.S. at 56). Rather, “[i]t is the physician's function . . . that determines whether he is acting under color of state law.” Id. (alteration in original) (quoting West, 487 U.S. at 56).

         Accordingly, just last year, the Sixth Circuit found that a private subcontractor who provided healthcare in a county prison could be subject to liability under § 1983. In Winkler v. Madison County, 893 F.3d 877, 885 (6th Cir. 2018), the court adjudicated a § 1983 deliberative-indifference claim involving a county that had contracted with a private medical provider, Advanced Correctional Healthcare, Inc., which “in turn entered into a contract with Dr. Nadir H. Al-Shami to be the staff physician at several county jail facilities.” Although the court ultimately affirmed a grant of summary judgment for all defendants, including Dr. Al-Shami, it easily concluded that Dr. Al-Shami acted under color of state law, observing that “[t]he principle is well settled that private medical professionals who provide healthcare services to inmates at a county jail qualify as government officials acting under the color of state law for the purposes of § 1983.” Id. at 890.[3] Thus, the Court has little difficulty in finding Dr. Kalfas to have acted under color of state law.

         2. Deprivation of a constitutional right

         Having concluded that all the Defendants in this case acted under color of state law, the Court next turns to the first element of a § 1983 claim -"whether there was an actionable deprivation of a right secured under the Constitution or the laws of the United States.” Miller v. Calhoun Cty., 408 F.3d 803, 812 (6th Cir. 2005).

         Prisoners in state custody have a right to adequate medical care under the Eighth Amendment. Harrison v. Ash, 539 F.3d 510, 518 (6th Cir. 2008). Pretrial detainees like Smith have the same right by way of the Due Process Clause of the Fourteenth Amendment. Richmond v. Huq, 885 F.3d 928, 937 (6th Cir. 2018). The Sixth Circuit “has historically analyzed Fourteenth Amendment pretrial detainee claims and Eighth Amendment prisoner claims ‘under the same rubric.'” Id. (quoting Villegas v. Metro. Gov't of Nashville, 709 F.3d 563, 568 (6th Cir. 2013)).

         To establish a cause of action under § 1983 for failure to provide adequate medical treatment, a pretrial detainee must show that “the defendants acted with ‘deliberate indifference to [his] serious medical needs.'” Watkins v. City of Battle Creek, 273 F.3d 682, 686 (6th Cir. 2001) (quoting Estelle v. Gamble, 429 U.S. 97, 104 (1976)). A deliberate-indifference claim involves an objective and subjective component. Richmond, 885 F.3d at 937-38. “The objective component requires the plaintiff to show that the medical need at issue is ‘sufficiently serious.'” Id. at 938 (quoting Farmer v. Brennan, 511 U.S. 825, 834 (1994)). “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.'” Harrison, 539 F.3d at 518 (quoting Blackmore v. Kalamazoo Cty., 390 F.3d 890, 897 (6th Cir. 2004)).

         None of the Defendants in this case dispute that the objective component has been satisfied. Nor could they, as Plaintiff was diagnosed with an epidural abscess and osteomyelitis of the spine resulting in sepsis and paraplegia. (Docs. # 89-1 at 8 and 98-39); see Taylor v. Franklin Cty., 104 Fed.Appx. 531, 538 (6th Cir. 2004) (finding that a plaintiff whose undiagnosed spinal tumor resulted in paralysis had met the objective prong of the deliberate-indifference test); Ham v. Marshall Cty., No. 5:11-cv-11, 2012 WL 6675133, at *6 (W.D. Ky. Dec. 21, 2012) (holding that a jury could find the ...

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