Estate v. Hillsborough Cnty. House of Corr.

561 F.Supp.3d 71

ESTATE OF Nicholas SACCO

v.HILLSBOROUGH COUNTY HOUSE OF CORRECTIONS, et al.

Civil No. 1:20-cv-447-JL

United States District Court, D. New Hampshire.

Signed May 20, 2021

Christine M. Craig, Anthony Carr, Shaheen & Gordon PA, Dover, NH, for Joanne Sacco.

Donald L. Smith, Jonathan A. Lax, Devine Millimet & Branch PA, Manchester, NH, for Hillsborough County House of Corrections, Lauelle Bancroft, Erica Gustafson, Dorothea Malo.

Todd J. Hathaway, Abby Tucker, Wadleigh Starr & Peters PLLC, Manchester, NH, for American Institutional Medical Group, LLC, Christopher Braga.

MEMORANDUM ORDER

Joseph N. Laplante, United States District Judge

Nicholas Sacco tragically perished after experiencing opioid withdrawal while a pretrial detainee in the custody of the Hillsborough County Department of Corrections. His Estate has filed this lawsuit to hold the County, eight of its nurses who encountered Sacco while detained, and the County's outside medical providers legally responsible for his death. But the question before the court¹ is whether the nurses’ alleged acts and failures to act are enough to sustain the difficult burden of stating a claim for constitutionally inadequate medical care and overcome the broad statutory immunity afforded to New Hampshire government employees. This court has jurisdiction over the Plaintiff's federal claims under 28 U.S.C. §§ 1331 and 1343 because the claims present federal questions and arise from federal civil rights statutes, and supplemental jurisdiction over its state law claim under 28 U.S.C. § 1367(a).

The eight nurses (the "Nurse Defendants") argue that the Plaintiff merely states a claim for negligent or inadvertently deficient medical care, and something more is required to support a claim that the medical care was so deficient that it violated Sacco's constitutional rights. Without facts that could show they did not believe in the legality of their actions, the Nurse Defendants also argue that they are immune from the Plaintiff's state law negligence claim under RSA 507-B:4.

After considering the parties’ submissions and hearing oral argument, the court grants the motion in part and denies it in part. The Plaintiff has agreed to dismiss its claims against defendants Bryanna Gue and Nicole Masci, so the defendants’ motion is granted as to those two defendants. Six Nurse Defendants remain. The motion is granted as to Nurses Hrubiec, Coulombe, and Morrison and denied as to the other three nurses.

The allegations against Nurses Hrubiec, Coulombe, and Morrison show that Sacco's condition was not clearly worsening during their limited contact with him and did not warrant further medical intervention at that time. Their actions with respect to Sacco were reasonable and therefore not deliberately indifferent. By contrast, the allegations against Nurses Malo, Gustafson, and Bancroft suggest that Sacco's serious medical condition was worsening while in their care, there were available treatment avenues to prevent his demise, and they chose not to utilize them. This is marginally sufficient to state a claim for deliberate indifference and overcome a statutory immunity defense at the 12(b) stage. Their motion to dismiss is denied.

I. Applicable legal standard

To defeat a Rule 12(b)(6) motion, the Plaintiff must plead "factual content that allows the court to draw the reasonable inference that the defendant is liable for the misconduct alleged." Martinez v. Petrenko, 792 F.3d 173, 179 (1st Cir. 2015). This standard "demands that a party do more than suggest in conclusory terms the existence of questions of fact about the elements of a claim." A.G. ex rel. Maddox v. Elsevier, Inc., 732 F.3d 77, 81 (1st Cir. 2013). In ruling on such a motion, the court accepts as true all well-pleaded facts set forth in the complaint and draws all reasonable inferences in the Plaintiff's favor. See Martino v. Forward Air, Inc., 609 F.3d 1, 2 (1st Cir. 2010). The court may also consider judicially noticed documents, matters of public record, and documents introduced by the Plaintiff in its objection to the motion to dismiss or concessions in that objection, without converting the 12(b)(6) motion into a motion for summary judgment. See Breiding v. Eversource Energy, 939 F.3d 47, 49 (1st Cir. 2019) ; Greene v. Rhode Island, 398 F.3d 45, 49 (1st Cir. 2005).

II. Background

The court draws the relevant factual background from the Plaintiff's First Amended Complaint (doc. no. 21). At 2:38 p.m. on Thursday, May 16, 2019, Sacco was booked as a pretrial detainee at the Valley Street Jail² for theft-related charges and ordered to be detained for 72 hours because the charges resulted in a probation violation.³ Because weekend hours are not counted towards the 72-hour hold, Sacco was scheduled to be released on Tuesday, May 21, 2019.⁴

During the booking process, Nurse Gue, an employee of the County⁵ working at Valley Street, completed a mental health screening for Sacco, during which Sacco denied drug or alcohol use.⁶ Nurse Gue also noted that Sacco denied "psych history" but had a history of asthma and used an inhaler, and had a severe allergy to dairy products.⁷ Sacco was approved to be housed in general population.⁸ On May 17, Nurse Katelyn Hrubiec attempted to complete a Medical History and Screening form for Sacco, but was unable to do so because Sacco had a court hearing and had been transported out of the jail.

The next day, at around 9:20 p.m., Sacco complained to Nurse Masci that he was feeling dizzy and stated that he was detoxing from 5 grams of daily heroin use, with his last use two days prior on May 16, the day he was booked.⁹ Nurse Masci took Sacco's vitals and noted that his sitting pulse was 112 and sitting blood pressure was 128/84.¹⁰ Nurse Masci placed Sacco on detoxification watch and advised him that he would be moving cells, to which Sacco responded "no, it's okay, I just need to sleep, you don't have to do all that."¹¹ About an hour later, Nurse Erica Gustafson saw Sacco after he requested to see a nurse due to asthma symptoms. Nurse Gustafson recorded Sacco's pulse as 124 and observed no shortness of breath or wheezing.¹² Sacco then stated that it was not actually his asthma that was bothering him, but that he was just not feeling well. Sacco reported feeling dizzy, stated he was detoxing, and asked to go to the hospital.¹³ Nurse Gustafson told Sacco that she was about to begin detox checks and would follow up with him when she returned. She suggested he "relax and stay in bed when possible," gave him a Styrofoam cup for hydration, and assured him that the staff would continue to monitor his vital signs and well-being and would follow up with detox checks while he was detained.¹⁴

At around 11:45 p.m., Nurse Gustafson completed a detox check for Sacco.¹⁵ She noted that Sacco had increased appetite, fluids, and sleep, but complained of nausea and vomiting. Sacco's standing blood pressure was 112/74 and his standing pulse was 128. Nurse Gustafson reported that he was alert and oriented, upright, and had a "steady strong gait."¹⁶ She further noted that Sacco should remain on detox watch as he was "at risk for detox."¹⁷ Less than two hours later, at around 1:00 am on May 19, Nurse Gustafson returned to Sacco's cell. During this encounter, Sacco reported that he forgot to previously tell the nursing staff that was he was also detoxing from alcohol and "benzos."¹⁸ He also told Nurse Gustafson that he took "benzos" without a prescription and that he tried to get as much as possible every day off the street. Nurse Gustafson noted that Sacco's vital signs were within normal limits, he was alert and oriented, upright, and had a steady gait.¹⁹ She then collected a urine sample from Sacco, which was positive for fentanyl and negative for all other substances.²⁰

Two hours later, Sacco requested a nurse because he was complaining of restlessness and leg cramps. Nurse Gustafson advised that these were typical detox symptoms. Sacco requested medication or to go to the hospital, but Nurse Gustafson declined to hospitalize him and advised him that no medications are given during third shift and that the staff would continue to monitor him.²¹ At around 8:15 a.m. that morning, Nurse Laura Morrison completed a detox check for Sacco.²² During the check, Sacco complained of nausea and vomiting and had a standing blood pressure of 112/70 and standing pulse of 122.²³ Nurse Morrison returned to Sacco's cell around 1pm that afternoon. Sacco reported no complaints of nausea, vomiting, or diarrhea and stated he was doing "a little better."²⁴

At 5:00 p.m. on May 19, Nurse Dorothea Malo completed a detox check for Sacco. During the check, Sacco complained of restlessness, agitation, nausea, vomiting, lightheadedness, decreased appetite, increased fluid intake, and no energy.²⁵ Sacco had a standing pulse of 125 and a standing blood pressure of 114/76.²⁶ Nurse Malo advised to continue the detox watch.

Just after midnight on May 20, Nurse Gustafson completed another detox check for Sacco.²⁷ During the check, Sacco complained of weakness, aches, cold sweats, dizziness, lightheadedness, decreased appetite, restlessness, lack of sleep, nausea, diarrhea, and vomiting. His standing pulse was 111 and his standing blood pressure was 117/70. Nurse Gustafson reported that Sacco was alert and oriented and displayed a slow, steady upright gait.²⁸ She noted that he was "at risk for detox" and advised to continue the detox watch.

Sacco was next examined at 5:30 a.m. on May 20 by Registered Nurse Luella Bancroft.²⁹ Sacco had requested a nurse after complaining of shortness of breath and lightheadedness. Nurse Bancroft examined Sacco and noted that his lungs were clear bilaterally and he did not appear in distress. She recommended he slow down his breathing.

Less than three hours later, Nurse Hrubiec performed a detox check on Sacco.³⁰ His standing pulse was 114 and his standing blood pressure was 114/68. During the check, Sacco reported...