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Brooks v. Wilkinson County

United States District Court, M.D. Georgia, Macon Division

May 23, 2019

SHAUN DAVID BROOKS, Individually and as Administrator of the Estate of Cynthia Elaine Mixon, Plaintiff,
v.
WILKINSON COUNTY, GEORGIA, et al., Defendants.

          ORDER ON DEFENDANTS' MOTIONS FOR SUMMARY JUDGMENT AND MOTION IN LIMINE

          TILMAN E. SELF, III, JUDGE UNITED STATES DISTRICT COURT

         Cynthia Elaine Mixon entered the Wilkinson County Jail on Tuesday, January 27, 2015. The following day, she began displaying a variety of symptoms consistent with opioid withdrawal, including vomiting, diarrhea, and fever. Two days later, she suffered a seizure and ultimately died. Although the medical examiner concluded she died of hypertensive cardiovascular disease, Plaintiff, Mixon's son, disagrees. Plaintiff believes that Mixon died as a result of withdrawals from various drugs, including opioids and benzodiazepine, and that the conduct of several officials at Wilkinson County Jail, as well as the jail's policies, contributed to her death. He brings this action as the administrator of her estate and as an individual with a cause of action under Georgia's wrongful death statute.

         Three groups of Defendants filed separate motions for summary judgment and all Defendants joined in a single motion in limine. See [Docs. 27, 42, 43 & 44]. Following extensive review of the parties' briefing and the record before it, the Court GRANTS Defendants Wilkinson County and Sheriff Richard Chatman's Motion for Summary Judgment [Doc. 27] on the basis of Eleventh Amendment immunity and GRANTS in part and DENIES in part Defendants Diane Lindsey, Laffiani Boyd and Jared Rickerson's Motion for Summary Judgment [Doc. 42] and Defendant Thomas King's Motion for Summary Judgment [Doc. 43]. Finally, the Court GRANTS in part and DENIES in part Defendants' Motion in Limine [Doc. 44].

         To summarize the Court's ruling, Plaintiff may proceed against Defendants Lindsey, Boyd and King under § 1983 for their alleged deliberate indifference to Mixon's serious medical need and under Georgia law for allegedly breaching their ministerial duty to provide medical care to an inmate. As there has been no argument to the contrary, Plaintiff may still assert his wrongful death claim against these Defendants. Because there are no remaining claims against Defendants Wilkinson County, Sheriff Chatman or Rickerson, the Court DIRECTS the Clerk of Court to TERMINATE these Defendants as parties to this action.

         FACTUAL BACKGROUND

         On Tuesday, January 27, 2015, at approximately 11:00 p.m., Defendant Rickerson booked Mixon into Wilkinson County Jail for possession of hydrocodone with intent to distribute. See [Doc. 52, at ¶ 1; Doc. 27-9]. At the time of her booking, Mixon had valid prescriptions for and was taking: Xanax, Ambien, Soma, Morphine, Oxycodone, Adderall, Tegretol, Losartan, Prozac, Wellbutrin, Lidocaine Patch, and Ventolin Inhaler. [Doc. 52, at ¶ 1; Doc. 34-5]. Mixon discontinued her use of these drugs, albeit involuntarily, as a result of her detention. [Doc. 52, at ¶ 3; Doc. 56, at p. 26 ¶¶ 18-23].

         When Mixon arrived at the Wilkinson County Jail, Defendant Rickerson performed Mixon's intake screening. [Doc. 52, at ¶¶ 3, 10-14; Doc. 27-2, at ¶¶ 55-60]. Per Wilkinson County Jail's written policy, Defendant Rickerson completed a Medical History Form and a Medical Receiving Screening Form as part of the booking process. [Doc. 52, at ¶ 10; Doc. 30-7, at pp. 6-7]. These screening forms consist of a series of standard medical questions that the intake officer asks the detainee and a place to record their responses. [Doc. 52, at ¶ 11; Doc. 30-7, at pp. 6-7]. Defendant Rickerson testified that Mixon denied having any medical problem listed on the medical screening forms and did not inform him of any of the numerous medications she was taking. [Doc. 39, at 70:4-6]. Mixon's medical screening forms reflect that she was not taking medications that needed to be continued while detained. [Doc. 35-3, at p. 3]. However, Plaintiff maintains that Defendant Rickerson failed to thoroughly screen Mixon as required.[1] [Doc. 52, at ¶¶ 3 & 14]. Plaintiff does not dispute that Defendant Rickerson never interacted with Mixon after performing this screening and that she was not displaying symptoms of withdrawal when Defendant Rickerson booked her into the jail. [Doc. 39, at pp. 106 & 107 ¶¶ 23-2; Doc. 52-3, at ¶ 8; Doc. 37, at pp. 52-53 ¶¶ 22-11]. After Defendant Rickerson booked Mixon in, Officer Bernice Ford dressed her out and took her to the female dorm.[2] [Doc. 27-2, at ¶ 67; Doc. 53, at ¶ 7].

         The following morning, Mixon's friend, Neil Baggerly, visited the Wilkinson County Jail to deliver Mixon's prescribed oxycodone pills.[3] [Doc. 52, at ¶ 66; Doc. 30, at pp. 205-210]. Defendant King took the pills, but informed Baggerly that Mixon was not allowed to take that type of medication in the jail and that he would store the medication with her personal property. [Doc. 52, at ¶¶ 67-69; Doc. 30, at pp. 207-208]. Although former defendants Gary Butler and Sheila Cobb were also on duty that day, there is no evidence that they or any of the remaining Defendants knew that Mixon had a validly prescribed medication that she could not take while detained. [Doc. 27-2, at ¶ 70; Doc. 53, at ¶ 70].

         At some point in the afternoon or early evening, Mixon began showing symptoms of opioid withdrawal that included vomiting, diarrhea, and the inability to get out of bed. [Doc. 52, at ¶ 70; Doc. 52-3, at ¶ 8]. Mixon told other inmates that she believed she was detoxing. [Doc. 52, at ¶ 71; Doc. 52-3, at ¶ 8]. At 6:00 p.m. on Wednesday, Defendants Boyd and Lindsey came on duty, relieving Officers Butler and Cobb. [Doc. 27-2, at ¶ 83; Doc. 53, at ¶ 83]. At some point that evening, Jessica Hartley, an inmate detained with Mixon, told Defendant Boyd that Mixon was vomiting and had a headache, so Defendant Boyd gave Hartley some Tylenol to give to Mixon.[4] [Doc. 27-2, at ¶ 85; Doc. 27-12, at 10:35-11:02; Doc. 31, at 32:4-24]. Later that evening, Hartley again spoke with Defendant Boyd and asked him to turn on the TV so that Mixon and another inmate would have some light when they got up to vomit; Defendant Boyd did so. [Doc. 31, at 33:5-9; Doc. 52-3, at ¶ 12].

         By Thursday morning, Mixon's condition had worsened. [Doc. 52-3, at ¶ 16]. Plaintiff alleges that Mixon's symptoms included frequent vomiting, diarrhea, fever, shaking, severe fatigue and “he[r] heart felt like it was going to explode.” [Doc. 52, at ¶ 81; Doc. 52-3, at ¶ 17]. Plaintiff also alleges that Hartley informed Defendant King of Mixon's condition, but he failed to do anything. [Doc. 52, at ¶¶ 82 & 83; Doc. 52-3, at ¶¶ 18 & 19]. Defendant King maintains that Hartley never told him that Mixon was detoxing, that he never spoke with Mixon about her condition, and that he believed Mixon only had stomach problems or cramping. [Doc. 30, at 218:18-25; 219:1-14].

         On Thursday evening, Hartley again told Defendant Lindsey of Mixon's deteriorating condition and that she needed a doctor. [Doc. 52, at ¶ 85; Doc. 52-3, at ¶ 22]. Defendant Lindsey checked on Mixon, observed that she was “flushed, ” gave her some Tylenol, and told her that she would tell Defendant King to schedule her a visit with the doctor. [Doc. 52, at ¶ 89; Doc. 52-3, at ¶ 26; Doc. 38, at p. 133 ¶¶ 3-12, p. 135 ¶¶ 17-20]. Mixon told Defendant Lindsey that she was “okay” and that she was “just going to go to sleep.”[5] [Doc. 38, at p. 133 ¶¶ 11 & 12]. Defendant Lindsey noted on the jail log that Mixon was vomiting, had a fever, and needed to see a doctor, but took no further action. [Doc. 52, at ¶ 90; Doc. 38, at p. 134 ¶¶ 2-6].

         The following morning, Mixon began having seizures. [Doc. 52, at ¶ 93; Doc. 30, at p. 223 ¶¶ 17-21]. Officer Ford-a former defendant in this action-called EMS who transported Mixon to the hospital. [Doc. 27-2, at ¶ 143; Doc. 53, at ¶ 143]. The doctors pronounced Mixon dead shortly after she arrived. [Doc. 52, at ¶ 93; Doc. 30, at p. 227 ¶¶ 22-25]. The medical examiner who conducted Mixon's autopsy concluded that her cause of death was hypertensive cardiovascular disease.[6] See [Doc. 27-17, at p. 4]. However, Plaintiff's expert witnessed opined that Mixon most likely died of a seizure caused by benzodiazepine withdrawal. See generally [Doc. 34-1].

         STANDARD OF REVIEW

         Summary judgment is appropriate “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). A dispute is genuine if the evidence would allow a reasonable jury to return a verdict for the nonmovant and a fact is material if it “might affect the outcome of the suit.” Anderson v. Liberty Lobby, Inc., 477 U.S. 242, 248 (1986). In considering this motion, “the evidence of the [nonmovant] is to be believed, and all justifiable inferences are to be drawn in [the nonmovant's] favor.” Id. at 255. However, the Court need not draw “all possible inferences” in favor of the nonmovant. Horn v. United Parcel Servs., Inc., 433 Fed.Appx. 788, 796 (11th Cir. 2011).

         The movant “bears the initial burden of informing the district court of the basis for its motion[] and identifying those portions of the pleadings, depositions, answers to interrogatories, and admissions on file, together with the affidavits, if any, which it believes demonstrate the absence of a genuine issue of material fact.” Jones v. UPS Ground Freight, 683 F.3d 1283, 1292 (11th Cir. 2012) (internal quotation omitted) (citing Celotex Corp. v. Catrett, 477 U.S. 317, 323 (1986). The burden then shifts to the nonmovant “to rebut that showing by producing affidavits or other relevant and admissible evidence beyond the pleadings.” Jones, 683 F.3d at 1292 (quoting Josendis v. Wall to Wall Residence Repairs, Inc., 662 F.3d 1292, 1315 (11th Cir. 2012)). Alternatively, a movant may prevail on a motion for summary judgment by showing that the non-moving party “has failed to make a sufficient showing on an essential element of her case with respect to which she has the burden of proof.” Celotex Corp., 477 U.S. at 323.

         DISCUSSION

         A. Defendants' Wilkinson County and Chatman's Motion for Summary Judgment [Doc. 27] [7]

         The Court grants Defendants Wilkinson County and Chatman's Motion for Summary Judgment because the promulgation of policies related to the provision of healthcare in county jails is a state, rather than a county, function as a matter of Georgia law. Consequently, Plaintiff cannot show that Mixon was harmed by an unconstitutional policy promulgated by Defendant Wilkinson County. Moreover, because Defendant Chatman was acting as an arm of the state in establishing healthcare policies in Wilkinson County Jail, he is cloaked with Eleventh Amendment Immunity.

         The Eleventh Amendment protects a state from an unconsented-to suit in federal court. See Pennhurst State Sch. & Hosp. v. Halderman, 465 U.S. 89, 100 (1984). This immunity from suit does not apply to local governments-such as Defendant Wilkinson County- but does protect individuals acting as “arms of the state.” See Monell v. Dep't of Soc. Servs. of City of New York, 436 U.S. 658, 690 n.54 (1978); see also Manders v. Lee, 338 F.3d 1304, 1308 (11th Cir. 2003). In Manders, the Eleventh Circuit summarized when Eleventh Amendment immunity protects defendants that are not technically the State, but are acting as an arm of the state:

Eleventh Amendment immunity bars suits brought in federal court when the State itself is sued and when an arm of the State is sued. To receive Eleventh Amendment immunity, a defendant need not be labeled a ‘state officer' or ‘state official,' but instead need only be acting as an ‘arm of the State,' which includes agents and instrumentalities of the State. Whether a defendant is an ‘arm of the State' must be assessed in light of the particular function in which the defendant was engaged when taking the actions out of which liability is asserted to arise.

Manders v. Lee, 338 F.3d 1304, 1308 (11th Cir. 2003) (internal citations omitted). The court then described its familiar, four-factor test for determining whether an official is acting as an arm of state: “(1) how state law defines the entity; (2) what degree of control the State maintains over the entity; (3) where the entity derives its funds; and (4) who is responsible for judgments against the entity.” Id. at 1309. Other courts applying this test have concluded that a variety of government officials are (and are not) arms of the state depending not only on their position, but also the specific factual context in which they were exercising their authority. See, e.g., Pelliterri v. Prine, 776 F.3d 777, 780 (11th Cir. 2015) (holding that sheriff was acting as arm of the state when he refused to rehire a deputy sheriff); Temple v. McIntosh Cty., No. 2:18-cv-91, 2019 WL 287482, at *4 (S.D. Ga. Jan. 22, 2019) (holding that sheriff was an acting as arm of the state when performing traditional law enforcement function). But see Dukes v. Georgia, 428 F.Supp.2d 1298 (N.D.Ga. 2006) (holding that sheriff was not acting as arm of the state when providing medical care to inmates in county jail); Lightfoot v. Henry Cty. Sch. Dist., 771 F.3d 764, 767 (11th Cir. 2014) (holding that school district and school board are not arms of the state); Miller v. Advantage Behavioral Health Sys., 677 Fed.Appx. 556, 558 (11th Cir. 2017) (holding that community service board was not acting as arm of the state in ADEA discrimination suit).

         With this background law in mind, the issue now before the Court is whether a sheriff acts as an arm of the state in providing medical care to inmates in a county jail. This is not the first time a court in this district has confronted this issue. In Youngs v. Johnson, the plaintiff alleged that while he was detained at Muscogee County Jail, he fractured his hip when another inmate attacked him. No. 4:06-cv-19 (CDL), 2008 WL 4816731, at *3 (M.D. Ga. Oct. 30, 2008). Plaintiff alerted the jailers on duty that he hurt his leg in an altercation with the other inmate, but they did not treat his injury as an emergency until approximately seven hours after they were informed of his injury. Id. at *4. Plaintiff filed a § 1983 claim against the sheriff of Muscogee County in his official capacity for the delay in treating his fractured hip and the sheriff asserted Eleventh Amendment immunity. Id.

         Applying the Manders factors, the court concluded that the sheriff's provision of medical care to inmates in a county jail is a county rather than a state function. Id. at *8. In reaching this conclusion, the court relied heavily on Georgia Code Annotated § 42-5-2(a) (“the Statute”) which makes it the duty of the “governmental unity, subdivision, or agency having the physical custody of an inmate to maintain the inmate, furnish him food, clothing, and any needed medical and hospital attention.” Based on the Statute, the court found that the first factor weighed against finding that the Sheriff was acting as an arm of the state because “[a]lthough the sheriff's obligation to provide county inmates with medical services is directly derived from the State, the provision of medical care is directly delegated through the county entity.” Id. at *7. The court likewise found that the second factor weighed against the Sheriff because the Statute gave counties control over the maintenance of their jails. Id. Finally, the court found that the third factor weighed against finding that the Sheriff was acting as an arm of the state because the Statute required counties to pay for medical necessities. Youngs, 2008 WL 4816731, at *8. Although the Court found that the fourth factor weighed in favor of finding that the sheriff was acting as an arm of the state because the State could be liable for paying for a judgment against the sheriff, the Court concluded that the other three factors outweighed this factor. Id. Other cases, with varying degrees of thoroughness, agreed with the result in Young. See Trammell v. Paxton, Civil Action File No. 2:06-CV-193, 2008 WL 7514367, at *15 (N.D.Ga. Sept. 29, 2008); Hooks v. Bogdon, No. 7:05-CV-42 (HL), 2007 WL 2904009, at *2 (M.D. Ga. Sept. 29, 2007); Dukes v. Georgia, 428 F.Supp.2d 1298, 1321-22 (N.D.Ga. 2006); Green v. Glynn Cty., No. Civ. A. CV201-52, 2006 WL 156873, at *3 (S.D. Ga. Jan. 19, 2006)).

         And then came Lake v. Skelton, 840 F.3d 1334 (11th Cir. 2017). In Lake, the Eleventh Circuit held that a sheriff is entitled to Eleventh Amendment immunity with regard to the provision of food to inmates in county jails. In reaching this conclusion, the Court applied the four Manders factors, but rejected the reasoning of the Youngs court along the way. Beginning with the first factor, the Court held that, with respect to county jails, Georgia Code Annotated § 42-5-2 “imposes two separate duties: the county must fund the provision of medical care, and the sheriff must select an appropriate provider and ensure that inmates receive care when necessary.” Id. at 1341. In other words, the Court rejected Youngs's position that counties in Georgia delegate their duties under Georgia Code Annotated § 42-5-2 to the county sheriff. Instead, the Court explained, any duty a county sheriff has under Georgia Code Annotated § 42-5-2 is directly imposed by the State. Id. In short, the Eleventh Circuit rejected Youngs's reasoning as to the first Manders factor and found that this factor weighed in favor of finding that the sheriff was entitled to Eleventh Amendment immunity.

         The Court then turned its attention to the second Manders factor and concluded that state law vests control over the provision of food in the State rather than the county. Id. at 1342-43. In reaching this conclusion, the Court relied on the fact that a State statute guaranteed inmates certain minimum standards of access to food while detained. Id. (citing Ga. Code Ann. §§ 42-4-32). Georgia has similar statutes guaranteeing inmates in jails minimum access to medical care. See Ga. Code Ann. § 42-4-32. The final departure from the Youngs decision relates to the third Manders factor. While the Youngs court focused on whether the State or county funded the function at issue (the provision of medical care), the Lake Court focused on which entity funded the sheriff's office generally. Compare Youngs, 2008 WL 4816731, at *8 with Lake, 840 F.3d at 1343-44. Because the State is responsible for funding the sheriff's office, the Lake Court concluded that this factor weighed in favor of finding that the sheriff was entitled to Eleventh Amendment immunity. Lake, 840 F.3d at 1343-44.

         After the Eleventh Circuit decided Lake, another court in this district again considered whether a sheriff acts as an arm of the state when he provides medical care to an inmate in a county jail. See Palmer v. Correct Care Sols., LLC, 291 F.Supp.3d 1357, 1366 (M.D. Ga. 2017). In Palmer, the court concluded that

Although the Eleventh Circuit has not yet held that a Georgia Sheriff is protected by the Eleventh Amendment for his failure to provide constitutionally mandated medical care to county jail detainees, a constitutional claim arising from the failure to provide food, which the Eleventh Circuit held in Lake [] cannot be asserted against a Georgia sheriff in his official capacity in federal court because of the Eleventh Amendment, appears indistinguishable for Eleventh Amendment purposes from a claim arising from the failure to provide medical care.

Id. at 1360. The Palmer court went on to note that it was likely sufficient to rest its holding on the proposition that “because the provision of medical care cannot be distinguished from the provision of food for Eleventh Amendment purposes, Lake [] requires a finding of immunity in this case.” Id. at 1362. Nevertheless, the Palmer court performed a full Manders analysis-informed by the Eleventh Circuit's guidance in Lake-and concluded-as expected-that a sheriff is entitled to Eleventh Amendment immunity when providing medical care to inmates in county jails. See Id. at 1363-66.

         The Court agrees with the court in Palmer that it was probably unnecessary for it to conduct its own Manders analysis in light of Lake, and, in an effort to avoid reinventing the wheel (particularly a wheel as well made as Palmer), the Court will rest its decision on the proposition that “because the provision of medical care cannot be distinguished from the provision of food for Eleventh Amendment purposes, Lake [] requires a finding of immunity in this case.” Id. at 1362. Thus, the Court finds that, under Georgia law, a sheriff acts as an arm of the state when he provides medical care to inmates in a county jail and is therefore entitled to Eleventh Amendment immunity. Consequently, Defendant Chatman is entitled to Eleventh Amendment immunity in this case.

         As noted above, Defendant Wilkinson County is also entitled to summary judgment because Mixon did not die as a result of an official policy promulgated by Defendant Wilkinson County. As a local government, the Eleventh Amendment does not protect Defendant Wilkinson County from liability. See Monell, 436 U.S. at 690 n.54. However, “[i]t is only when the execution of the government's policy or custom . . . inflicts the injury that the municipality may be held liable under § 1983.” Springfield v. Kibbe, 480 U.S. 257, 267 (1987) (internal quotations omitted). In short, local governments are not vicariously liable for injuries caused by their employees. See City of Canton v. Harris, 489 U.S. 378, 385 (1989) (“Respondeat superior or vicarious liability will not attach under § 1983.”). Thus, the Court's first task in assessing whether a local government is subject to liability under § 1983 for a particular harm is to locate an official local government policy or custom that caused the harm. See id.

         In this case, Plaintiff argues that Defendant Wilkinson County had an official policy of “drying out” inmates who were going through drug withdrawal and a policy of failing to adequately screen incoming inmates for medical conditions. See [Doc. 49, at pp. 5-18]. Assuming for the sake of this motion only that these policies and customs actually existed, it cannot be said that these policies were promulgated by an official policymaker for Defendant Wilkinson County. For starters, both policies related to medical care in a county jail, which the Lake court concluded was the exclusive policy arena of the county sheriff as a matter of Georgia law. See Lake, 840 F.3d at 1341 (concluding that sheriff acts on behalf of the State when promulgating policies related to the provision of food and healthcare in county jails and that county's exclusive function is to fund provision of the same). Thus, if Defendant King, as jail administrator, was promulgating policies related to the provision of medical care in the county jail, he must have done so based on authority delegated to him by Defendant Chatman.

         The record confirms that Defendant King made policy decisions for the county jail under the direction of Sheriff Chatman and notified the sheriff of even minor changes in “unwritten policies” such as choosing suppliers for the commissary. See [Doc. 30, at pp. 99:6-24, 103:6-12]. Because Defendant King was promulgating policies based on authority delegated to him from Sheriff Chatman, the policy decisions he made cannot be attributed to Defendant Wilkinson County. See Lake, 840 F.3d at 1342 (holding that where defendant's functions derive from sheriff's authority under state law, that defendant is also performing a state rather than county function). Thus, Defendant Wilkinson County is also entitled to summary judgment.

         B. Defendants Lindsey, Boyd and Rickerson's Motion for Summary Judgment [Doc. 42]

         The Court turns its attention to Defendants Lindsey, Boyd and Rickerson's Motion for Summary Judgment. As discussed previously, Plaintiff asserts claims against Defendants Boyd and Lindsey under § 1983 for their alleged deliberate indifference to Mixon's serious medical need.[8] See [Doc. 1, at ¶¶ 115-131]. Plaintiff also asserts state-law claims against these Defendants and Defendant Rickerson for negligent failure to provide medical care. See [Id. at ¶¶ 168-183].

         1. § 1983 Deliberate Indifference Claim

         Defendants Lindsey and Boyd argue that they are entitled to qualified immunity with regard to Plaintiff's deliberate indifference claim. See [Doc. 42-1, at pp. 3-13]. Predictably, Plaintiff disagrees. Whether a defendant is entitled to qualified immunity begins with a two-step burden-shifting analysis:

the public official must first prove that he was acting within the scope of his discretionary authority when the allegedly wrongful acts occurred . . . . Once the defendant establishes that he was acting within his discretionary authority, the burden shifts to the plaintiff to show that qualified immunity is not appropriate.

Penley v. Eslinger, 605 F.3d 843, 849 (11th Cir. 2010) (quoting Lee v. Ferraro, 284 F.3d 1188, 1194 (11th Cir. 2002)). Defendants Lindsey and Boyd argue that “[a] jail official performing law enforcement duties [is] clearly acting within their discretionary authority.” [Doc. 42-1, at p. 3] (citing Skrtich v. Thornton, 280 F.3d 1295, 1303 (11th Cir. 2002). Plaintiff does not dispute this. Because the Court agrees that Defendants Lindsey and Boyd acted within their discretionary authority, the burden shifts to Plaintiff to show that these Defendants are not entitled to qualified immunity.

         A plaintiff shows that a defendant is not entitled to qualified immunity by alleging facts that would support a finding that “the official's conduct violate[d] clearly established law.” Lee, 284 F.3d at 1194. Thus, Plaintiff must show that Defendants Lindsey and Boyd actually violated Mixon's rights and the right was clearly established at the time of the incident. Id. The analysis can begin with either element. Keith v. Dekalb Cty., 749 F.3d 1034, 1048 (11th Cir. 2014).

         The Court begins with the question of whether Plaintiff sufficiently alleged a constitutional violation. Plaintiff alleges that Defendants Lindsey and Boyd's deliberate indifference to Mixon's serious medical need violated her constitutional rights. In Farrow v. West, the Eleventh Circuit summarized the requirements for a deliberate indifference claim:

To show that a prison official acted with deliberate indifference to serious medical needs, a plaintiff must satisfy both an objective and a subjective inquiry. First, a plaintiff must set forth evidence of an objectively serious medical need. Second, a plaintiff must prove that the prison official acted with an attitude of “deliberate indifference” to that serious medical need.

320 F.3d 1235, 1243 (11th Cir. 2003) (internal citations omitted). A medical need is objectively serious if it “has been diagnosed by a physician as mandating treatment or . .. is so obvious that even a lay person would easily recognize the necessity for a doctor's attention.” Farrow, 320 F.3d at 1243 (quoting Hill v. Dekalb Reg'l Youth Det. Ctr., 40 F.3d 1176, 1187 (11th Cir. 1994)). Alternatively, a plaintiff can establish an objectively serious medical need by showing that a delay in treatment worsens the condition. See Mann v. Taser Int'l, Inc., 588 F.3d 1291, 1307 (11th Cir. 2009). Under any of these approaches, a plaintiff must ...


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