Lucas v. Turn Key Health Clinics, LLC

58 F.4th 1127

Yolanda LUCAS, as the Special Administrator of the Estate of Michelle Ann Caddell, deceased, Plaintiff - Appellant,

v. TURN KEY HEALTH CLINICS, LLC, a domestic limited liability corporation; Vic Regalado, individually and in his official capacity as Tulsa County Sheriff ; Gary Myers, MD, Defendants - Appellees,andShirley Hadden, Defendant.

No. 22-5002

United States Court of Appeals, Tenth Circuit.

FILED January 20, 2023

Lawrence R. Murphy, Jr. (Donald E. Smolen, II, Laura L. Hamilton, Dustin J. Vanderhoof, and John Warren, on the briefs), Tulsa, Oklahoma, for Plaintiff - Appellant.

Jo Lynn Jeter (Joel L. Wohlgemuth and W. Caleb Jones of Norman, Wohlgemuth, L.L.P., with her on the brief), Tulsa, Oklahoma, for Defendants - Appellees.

Before TYMKOVICH, KELLY, and MATHESON, Circuit Judges.

KELLY, Circuit Judge.

This case concerns the tragic death of Michelle Ann Caddell and the treatment, or lack thereof, she received for her cervical cancer as a pretrial detainee in the Tulsa County Jail. Yolanda Lucas, as special administrator of decedent Ms. Caddell's estate, initiated the case under 42 U.S.C. § 1983 bringing claims of deliberate indifference in violation of the Eighth and Fourteenth Amendments against Dr. Gary Myers and against Turn Key Health Clinics, LLC ("Turn Key") and Sheriff Vic Regalado in his official capacity through municipal liability, violations of the Equal Protection clause against Turn Key and Sheriff Regalado, and negligence and wrongful death under Oklahoma state law against Dr. Myers and Turn Key. I Aplt. App. 31–35.

The three Defendants individually moved to dismiss all claims and the district court granted the motions. Lucas v. Turn Key Health Clinics, LLC, 2021 WL 5828367 (N.D. Okla. Dec. 8, 2021). Dr. Myers is a medical doctor employed by Turn Key and responsible for Ms. Caddell's treatment. I Aplt. App. 13. Turn Key is a private correctional health care company that contracts with Tulsa County to provide medical staff and care in county jails. Id. 11–12. Sheriff Regalado is the Tulsa County Sheriff and sued only in his official capacity in an effort to hold Tulsa County and the Tulsa County Sheriff's Office liable. Id. 12.

Now on appeal, Plaintiff challenges the district court's determinations that she failed to plausibly allege (1) deliberate indifference to serious medical needs against Dr. Myers; (2) municipal liability against Turn Key and Sheriff Regalado; and (3) violation of the Equal Protection clause against Turn Key and Sheriff Regalado. She also challenges the finding that Dr. Myers and Turn Key are entitled to immunity for the state law claims under the Oklahoma Governmental Tort Claims Act ("OGTCA").¹ Our jurisdiction arises under 28 U.S.C. § 1291 and for the reasons discussed below, we affirm in part, and reverse in part.

Background

A. Factual Background

As alleged in the complaint, Ms. Caddell was arrested and booked in Tulsa County Jail on December 27, 2018, in the custody of the Tulsa County Sheriff's Office. I Aplt. App. 11, 14. She tested positive for chlamydia on January 23, 2019, and made her first complaint of vaginal discharge to jail medical staff on June 22, 2019. Id. 15. She submitted multiple requests on July 5, 6, and 7, for treatment related to hip and thigh pain and was evaluated on July 14 by Nurse Sellu, who noted the pain had begun four weeks earlier. Id. After reporting that she felt a blood clot on August 3, 2019, Ms. Caddell was evaluated by Dr. Myers on August 5 for hip pain and heavy menstrual bleeding. Id. Dr. Myers ordered blood work and noted Ms. Caddell had mild anemia but was otherwise healthy. Id. Ms. Caddell complained again of vaginal discharge on August 10 and Nurse Chumley ordered a culture of the discharge. Id. 16.

The blood work results four days later (August 14) revealed Ms. Caddell had mild leukocytosis — elevated white blood cell count (indicating sickness) — which Dr. Myers determined was normal and did not require follow up. Id. On August 15, the results of the culture came back and showed heavy E. Coli growth, associated with several virulence factors that contribute to disease. Id. In response to the buildup of all these symptoms, Ms. Caddell was only given Tylenol. Id. 17.

Ms. Caddell again complained to sick call of excessive vaginal bleeding on August 16. Id. Dr. Myers noted that on August 20, Ms. Caddell's complaints had resolved. Id. Yet, Ms. Caddell once again complained on August 24 to nursing staff of vaginal discharge as well as pain and difficulty with bowel movements. Further, on August 26, after not having seen a doctor in response to her August 24 request, made a follow-up request in which she apologized for her frequent sick calls but stated "there is something wrong with me and I hurt bad." Id. Dr. Myers saw Ms. Caddell on August 27 and wrote in his notes that Ms. Caddell's frequent sick calls "do not fulfill medical logic." Id. On September 3, Dr. Myers refused Ms. Caddell's request for more ibuprofen for her pain and determined that she was "abusing the [sick call] system." Id. (alteration in original).

On September 15, Ms. Caddell saw Nurse Suzanne who noted that Ms. Caddell's symptoms of blood clots and painful excessive vaginal bleeding began 10 months prior. Id. 18. Recognizing the severity of these symptoms, Nurse Suzanne placed a referral to an obstetrician. Id. On September 20, Ms. Hadden, Turn Key's administrator at the jail, denied the referral until Ms. Caddell's complaints of heavy bleeding for months could be verified. Id. 13, 18. Ms. Caddell received a complete blood count test on September 23 showing that she was experiencing abnormal uterine bleeding and had a sharp drop in hemoglobin levels within the prior six weeks. Id. 18. Ms. Caddell finally saw an obstetrician on September 27, Dr. Hameed, who opined that she had invasive cervical cancer and ordered a pap smear to confirm. Id. Ms. Caddell was seen by jail medical staff on October 3 for pain levels reaching 10/10 before the results of her pap smear on October 6 showed atypical squamous cells. Id. 19.

A follow-up pap smear was ordered, but never performed. Id. Ms. Caddell did not receive treatment or see a doctor from October 6 until October 30. Id. On October 30, she was soaking through a pad from heavy bleeding every 20 minutes and began discharging tissue from her vagina. Id. Because no OBGYN would be at the jail until November 10, jail medical staff transferred her to Hillcrest Hospital. Id. There, Hillcrest physicians determined she had at least stage three cervical cancer and administered morphine for Ms. Caddell's extreme pain. Id. On November 5, Dr. Myers, Turn Key, and/or Sheriff Regalado released Ms. Caddell from custody to deal with her cancer. Id. On November 9, Hillcrest also determined that Ms. Caddell had deep vein thrombosis (DVT) in her left leg. Id. 20. Ms. Caddell began receiving cancer treatment and passed on August 16, 2020. Id.

B. Procedural Background

In her complaint, Plaintiff brought claims of deliberate indifference under the Eighth and Fourteenth Amendments against Dr. Myers and against Turn Key and Sheriff Regalado through municipal liability. I Aplt. App. 31–34. Plaintiff also asserted violations of the Equal Protection clause against Turn Key and Sheriff Regalado. Id. 34. Lastly, Plaintiff asserted negligence and wrongful death under Oklahoma state law against Dr. Myers and Turn Key. Id. 35.

The district court granted Defendants’ motions to dismiss. First, the court found that on the deliberate indifference claim against Dr. Myers, the complaint stated a claim for malpractice rather than a constitutional violation because Dr. Myers and other Turn Key staff provided "a litany of medical treatment." II Aplt. App. 375. Because there was no underlying constitutional violation by Dr. Myers, the court found that there could be no municipal or organizational liability for Sheriff Regalado or Turn Key under Monell. Id. 377. As for the Equal Protection claim, the court held the complaint failed to allege causation between Turn Key and Sheriff Regalado's policy of not providing feminine hygiene products and Ms. Caddell's treatment. Id. Lastly, the court found that Dr. Myers was immune from liability under the OGTCA on any state law claims. Id.

Discussion

We review de novo the district court's dismissal of a complaint under Federal Rule of Civil Procedure 12(b)(6) for failure to state a claim. C1.G on behalf of C.G. v. Siegfried, 38 F.4th 1270, 1276 (10th Cir. 2022). We accept a complaint's well-pleaded allegations as true, viewing all reasonable inferences in favor of the nonmoving party, and liberally construe the pleadings. Id. To survive a motion to dismiss, the complaint must allege sufficient facts to state a claim for relief plausible on its face. Ashcroft v. Iqbal, 556 U.S. 662, 678, 129 S.Ct. 1937, 173 L.Ed.2d 868 (2009).

A. Jurisdiction

A district court order must be final to be appealable. 28 U.S.C. § 1291. Here, one named defendant, Defendant Shirley Hadden, was not served in the district court. Ms. Hadden was Turn Key's Health Services Administrator at the jail. She is not a party to the appeal and is listed as a defendant on the district court docket, though not included in the judgment. Under Bristol v. Fibreboard Corp., an unserved defendant "does not prevent" an order from being final and the district court is not required to enter an order dismissing that defendant prior to entering judgment. 789 F.2d 846, 847 (10th Cir. 1986). In Adams v. C3 Pipeline Construction Inc., the court explained that whether the judgment is final depends on the district court order's substance and objective intent. 30 F.4th 943, 958 (10th Cir. 2021). Dismissal of served defendants is not final if the district court makes clear that it expects further proceedings against unserved defendants. Id.

Here, the district court did not enter an order dismissing Ms. Hadden but indicated in its opinion and order that she had never been...