Standard C01.03.04: Inmates Requiring Immediate Medical Attention

KEY ISSUES:

Picture this scenario.  The local PD drives through the sally port with a drop off in your jail.

“Don’t worry about him – he got in a little accident with a chase we had.  He was drinking but it will wear off and he will be fine,” says the arresting PD officer.

Your admission officer looks at the fellow in the back of the car, who has dried blood across his face and appears to be unconscious and then back at the arresting officer, who is known for having little patience and is not the most personable individual from his department.

“Well, get on with it.  I have places to be,” says the arresting PD officer and begins to pull the arrestee out of the car to begin processing the paperwork.

What do you do?  Are you required to accept an arrestee if you think they need medical attention?  You aren’t a doctor, so how do you know the proper cause of action?  Can you refuse to accept and, if so, under what conditions and requirements?  Will the law support you?

Officers from allied agencies, the local PD, highway patrol, and sometimes even our own county law enforcement officers working the street can put our jails and the sheriff’s office, as a whole, into circumstances like this.  These situations can prove to be costly and have the potential to harm everyone involved.   There are countless instances where jails book individuals that have broken bones, are unconscious or are having physical convulsions; placing the individual in a detox or holding area temporarily, only to find an in-custody death or medical suit later on their hands.  Many jails do not have medical staff sitting around 24-7 with nothing to do but hang out in the booking area with Narcan.  While that would be a heavenly nirvana for most of us who work in a jail, that likely won’t be answered on our wishlist to Santa, nor by our county commissioners.  So, that likelihood results in requiring our jail staff, who are not trained medical experts, to make the call of whether to accept individuals with medical issues into the jail.

Remember, to establish a claim of deliberate indifference, plaintiffs must prove that the inmate’s medical needs were serious, that jail staff had actual knowledge of the serious medical need, and that the jail staffs’ failure to take any action to resolve the medical need were done deliberately.1    
OPERATIONAL APPLICATION:

Any sheriff who runs a jail knows that jails are the largest liability in county government.  Yet, every year numerous sheriffs and jails end up with costly litigation because of something that occurs right when that vehicle pulls up to the sally port door – something that could also be avoided with proper jail policies, procedures and their enforcement–especially with a bit of training.  Here are some discussion points to consider as it relates to this issue, addressed in Legal-Based Jail Guideline C01.03.04©  Inmates Requiring Immediate Medical Attention.

  • Policies should allow jail staff to require inmates in need of immediate attention for a serious medical problem to first be examined and approved for admission by a physician before being admitted to the jail. There are circumstances where immediate medical care is critical and even essential to the welfare of the inmate.  Accepting the individual can delay medical care and put unnecessary liability on the arresting officer, the officer’s agency, the jail staff and the sheriff.2
  • Definitions in policies are critical. Noting that this guideline depends on the interpretation of the word “serious” – a term that is vague at best –  consider what the Supreme Court said regarding serious medical needs:
    • An inmate’s medical need is serious if it 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.3
  • The court recognized that a booking officer without medical training may observe obvious signs concluding a need for immediate medical attention.  These signs may include being unconscious, seriously injured or seriously ill.

 

  • The arresting officer isn’t a medical expert any more than the booking officer in the jail is – why make that determination that the arrestee is fine if there are obvious signs that he/she may not be?  If you happen to have dedicated, trained medical staff at your jail, they can diagnose and then clear the individual.  If you do not, the arresting officer can be instructed to receive clearance by a physician and then bring the individual back before admitting the individual into the jail.

 

  • Communicate with allied agencies, fellow street officers and jail staff the rationale of why the policy exists.  Strictly adhering to these policies are not intended to slow them down or make their jobs difficult.  Yes, it may mean that the arresting officer will have to take some time taking the individual to get cleared by the hospital first before bringing the individual back, but imagine the time and headache saved by avoiding a lawsuit.

REFERENCES:

  1. Estelle v. Gamble, 429 U.S. 97 (1976); Gomm v. DeLand, 729 F. Supp. 767, 778 (D. Utah 1990).
  2. Estelle v. Gamble, 429 U.S. 97 (1976);
  3. Ramos v. Lamm, 639 F.2d 559 (CA10 1980), cert. denied, 450 U.S. 1041 (1981); Gomm v. DeLand, 729 F.Supp. 767, 778 (D. Utah 1990), affirmed, 931 F.2d 62 (CA10 1991).

 

DISCLAIMER:
The training materials provided are for use only within the scope of your jail and may not to be distributed otherwise without written permission by NIJO.  The information contained herein is to be used solely for training purposes and shall not be construed as legal advice.  Users of these materials should consult legal counsel to determine how the laws of their individual jurisdiction affect the application of these materials and guidelines to their individual circumstances.

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