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Holder v. Saunders

United States District Court, E.D. Kentucky, Southern Division

October 7, 2019

STACY M. SAUNDERS, et al, Defendants.



         Plaintiff Christopher Holder brings a Bivens claim against Dr. Terry King and Dr. Stacy Saunders, both of whom were formerly employed as psychologists at United States Penitentiary- Big Sandy. Specifically, the Complaint alleges that Dr. King and Dr. Saunders violated Holder's Eighth Amendment rights by failing to protect him from a fellow inmate. Though the matter was initially slated for trial, the parties agreed to submit it for adjudication on the briefs. [DE 148.] The Court has reviewed the parties' submissions [DE 155; DE 158; DE 159] and renders these final findings of fact and conclusions of law pursuant to Fed.R.Civ.P. 52(a). For reasons discussed below, the Court enters judgment in favor of defendants Dr. King and Dr. Saunders.


         Inmate, A.T. assaulted and stabbed his fellow inmate Christopher Holder on May 7, 2012, while they were incarcerated at USP Big Sandy. As a result of the attack, Holder suffered a broken ankle and multiple lacerations all of which were treated at the facility.

         The attack occurred after A.T., a bi-racial male who self-identifies as a black male, accused another black male, Holder, of conspiring with the “Brotherhood” to assassinate him. [DE1, 1-3.] After making the accusation, A.T. retreated to an upstairs residential area, but was followed by Holder, who claims that he was seeking to “peacefully resolve” the rift. [DE 155 at 9.] The defense maintains that Holder continued to argue with A.T. and followed him upstairs to confront him. [DE 15, 32-33.] There is no dispute, however, that once they were both upstairs, A.T. reached in his pocket, produced a shiv and lunged toward Holder, stabbing him multiple times before the parties hit the ground and were separated. [DE 9-6, at 52.]

         BOP records show that A.T. had violently attacked an inmate at another institution. This attack led to A.T.'s designation as a “psych alert” inmate because the attack arose from his “delusional belie[f] system relative to racial issues.” [DE 27-1, at 1.] Because of his psychological designation, A.T. was required to meet personally with a psychologist for screening upon arriving at USP Big Sandy. [DE 89-5, at 23.] This screening was performed by defendant Dr. King, who was chief psychologist.

         Dr. King reviewed A.T.'s records before meeting him. These records included entries from the Psychological Data System (“PDS”) and the BOP's SENTRY database. [DE 89-5, at 27.] BOP records revealed that A.T. had a history of mental illness, but previous treating psychologists had expressed uncertainty regarding the nature and severity of A.T.'s mental health problems. In 2008, A.T. participated in an inpatient mental health study at a federal medical institution. Though the full study was not made available to Dr. King, a July 2009 PDS entry contained the study's conclusion that A.T. had both an Axis I diagnosis related to substance abuse issues and an Axis II antisocial personality order. [DE 89-2, at 6.] A later PDS entry from FDC Philadelphia stated that A.T. did not “have a formal mental health diagnosis per se” and that his psych alert status was instead “maintained as a valid management tool because of his history of engaging in serious violence possibly as the result of beliefs and perceptions regarding social dynamics that may not be fact based.” [DE 89-2, at 6.] A.T. was also examined at the Oklahoma Transfer Center in July 2011. The psychologists there did not observe any signs of a mental illness.

         Based on a review of A.T.'s BOP records and the September 8, 2011 personal interview, Dr. King determined that A.T. was not experiencing “significant mental health problems.” Dr. King then referred A.T. for further evaluation and treatment. Though A.T. was released to the general population, his psych alert status remained intact. [DE 89-5, at 33.]

         As a follow up, A.T. was scheduled on September 20, 2011 to meet with defendant Dr. Saunders, a former staff psychologist, but A.T. did not show up for the appointment.[1] Dr. Saunders met A.T. for the first time about a week later on September 26, 2011, when he told her that he did not “trust white psychs” because of past negative experiences with them. [DE 27-1, 1-3.] In the meeting, A.T. expressed special disdain for the psychologists at a previous institution who had placed him in the Segregated Housing Unit (“SHU”). [DE 27-1, at 3.] A.T. further indicated to Dr. Saunders that beginning in his early thirties, he began to realize that he had “special abilities, ” including the power to sense the thoughts of others.

         Dr. Saunders discussed with A.T. the possibility that his perceptions and beliefs might be symptomatic of a mental health condition. While A.T. was somewhat receptive to the theory, he voiced opposition to taking antipsychotic medications. In her documents, Dr. Saunders observed that A.T.'s impulses were “within normal limits” and that his “[m]ental status [was] remarkable for delusional processes and auditory hallucinations.” Dr. Saunders opted to keep A.T.'s psych alert designation in place based on the belief that he had “untreated symptoms and could evidence behavioral disturbance based on delusional/hallucinatory content.” She scheduled an appointment to follow up with A.T. two weeks later. [DE 27-1, at 4.]

         At the time of A.T.'s first meeting with Dr. Saunders, he was designated by the BOP as a Care Level One-Mental Health inmate. Per BOP's Program Statement 5310.13, Treatment and Care of Inmates with Mental Illness, an individual is considered to meet Care Level One if he: (1) shows no significant level of functional impairment associated with a mental illness and demonstrates no need for regular mental health interventions; and (2) has no history of serious functional impairment due to mental illness or if a history of mental illness is present, the inmate has consistently demonstrated appropriate help-seeking behavior in response to any re-emergence of symptoms. Care Level One inmates are not required to receive any regular mental health services. Nor do they require a treatment plan.

         A.T. missed his October 11, 2011 follow-up appointment with Dr. Saunders, who rescheduled the appointment and saw him two days later. [DE 27-1, at 6.] During the session, Dr. Saunders asked A.T. how he had been feeling/functioning since his last appointment. A.T. refused to answer the question and told Dr. Saunders that “they” had advised him not to speak with her. Dr. Saunders gathered that, by “they, ” A.T. meant legal counsel, but it was not clear when he was given this advice. Dr. Saunders suggested to A.T. that voices in his head may be “impairing his perception of reality.” Dr. Saunders's notes reveal that she was under the impression that A.T.'s impulse control was within normal limits, but that his “[m]ental status [was] remarkable for delusional processes and auditory hallucinations.” Dr. Saunders kept A.T.'s psych alert status intact and scheduled another follow-up appointment.

         On November 15, 2011, A.T. missed another appointment with Dr. Saunders, but saw her a week later, on November 21, 2011. [DE 27-1, 8-9.] Dr. Saunders's notes describe A.T.'s behavior as agitated and hostile. During the meeting, Dr. Saunders informed A.T. that he was under no obligation to stay and speak with her. In response, A.T. told Dr. Saunders that no longer wanted to see a psychologist but promised he would reach out via a “cop-out” form if he needed her help. Dr. Saunders documented her impression that A.T.'s cognitive processes were logical and goal oriented, and his impulse control was within the normal limits. She scheduled a follow up appointment in 90 days. [DE 27-1, at 9.]

         On December 23, 2011, there was a lockdown at USP Big Sandy. Pursuant to prison policy, Dr. Saunders went and met with all psych alert inmates, including A.T. [DE 89-5, at 112.] A.T. reported to Dr. Saunders that he was doing well overall, though he was having some trouble sleeping. Dr. Saunders advised A.T. that she would discuss these issues with him following the completion of the lockdown. In her treatment notes, Dr. Saunders stated that A.T.'s cognitive processes were logical and coherent and that his impulse control appeared to be within normal limits. [DE 27-1, at 10.]

         Dr. Saunders visited A.T. in his cell four days later as a result of another lockdown. A.T. indicated to Dr. Saunders that he was doing well and denied having any issues requiring clinical intervention. [DE 27-1, at 11.] Dr. Saunders observed no “indications of a thought disorder, psychosis, or disturbance of perception.” [DE 27-1, at 11.] She further opined that this attention, concentration, and impulse control were within normal limits. [DE 27-1, at 11.]

         At A.T.'s request, Dr. Saunders saw him again about two weeks later, on January 17, 2012. A.T. had reported on his cop-out form that he was having trouble sleeping and was extremely irritated by the prison staff's efforts to “double-cell” him. [DE 27-1, at 12.] He also warned that he would use his full powers to “protect and defend” himself and that any perceived threats would be “repelled with maximum force and velocity.” [DE 27-1, at 12.]

         A.T. discussed the plight of his ancestors and his special cognitive abilities during his session with Dr. Saunders. Also, he produced an old photograph depicting a lynching and compared the individuals holding up the victim's body to the staff members at USP Big Sandy. Dr. Saunders explained to A.T. that the photograph was very old and that none of the members of the prison staff were alive when the depicted events took place. A.T. was apparently confused by Dr. Saunders's response. Nevertheless, he quit talking about the photograph and put it away. The session continued until A.T. stated that he was “done” and abruptly exited Dr. Saunders's office. [DE 27-1, at 12.] In her notes, Dr. Saunders described A.T. as being “hostile and animated” and obsessed with “racial and persecutory themes.” [DE 27-1, at 12.] She also documented that A.T.'s level of insight and impulse control appeared to be “limited.” [DE 27-1, at 12.] She scheduled A.T. for a follow up in 4-6 weeks and kept his psych alert designation in place. [DE 27-1, at 12.]

         On February 6, 2012, Dr. Saunders reclassified A.T. to a Care Level Two-Mental Health inmate based on “his presentation of psychotic symptoms consistent with a diagnosis of Schizophrenia.” [DE 27-1, at 13.] She revised A.T.'s diagnoses to include Axis I Schizophrenia and expressed her desire to see him on a monthly basis given his “presentation and history of violence.” [DE 27-1, at 13.]

         Because Dr. Saunders had elevated A.T. to Care Level Two, she created a treatment plan as required by the BOP. [DE 89-8, at 86.] In the plan, Dr. Saunders indicated that A.T. was experiencing symptoms including paranoid delusions, auditory hallucinations, disorganized speech, and affective flattening. [DE 27-1, at 15.] Dr. Saunders set a series of targets aimed at managing A.T.'s symptoms and helping him maintain an adequate level of function. As for intervention, the plan required Dr. Saunders to meet with A.T. at least once every twelve weeks. [DE 27-1, at 16.]

         When Dr. Saunders presented A.T. with the treatment plan, he refused to sign it. [DE 27-1, at 18.] In response, Dr. Saunders scheduled A.T. for a follow-up appointment on February 21, 2012. A.T. skipped this appointment and Dr. Saunders rescheduled for March 1, 2012. Again, A.T. was a no show. [DE 27-1, at 20.] Dr. Saunders's notes from March 1, 2012 indicated that she would schedule a follow-up in ten to twelve weeks, but that A.T. could request an earlier appointment. [DE 27-1, at 20.]

         Dr. Saunders did not see A.T. again until May 7, 2012, the day he attacked Plaintiff Holder. Following the altercation, Dr. Saunders was called into the SHU to speak with A.T. [DE 27-1, at 21.] A.T. admitted to attacking Holder but could not recall his name. A.T. proclaimed that Holder was a legitimate threat and that his “powers of protection” had saved him once again. Dr. Saunders's notes reflect her opinion that A.T.'s violent outburst was “rooted in delusional thinking and based on distorted perceptions which lack basis in reality.” Her PDS entry also referenced A.T.'s history of assaultive behavior, his belief in his special powers to sense danger and respond proactively, and his distrust of individuals who were white. [DE 27-1, at 21.]

         The next day Dr. Saunders submitted an official incident report. [DE 27-1, at 24.] Dr. Saunders warned staff to be cautious in their interactions with A.T. given his “history of incident reports for weapon possession while on the compound.” [DE 27-1, at 25.] The report also stated that “[w]hile the prediction of risk to perpetrate violent acts with certainty is a difficult venture, [A.T.] is considered to be at a high risk to commit future acts of violence given his psychosis and history.” [DE 27-1, at 25.] The report ended by ...

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