Background
Nicholas Cory Plug was arrested on state methamphetamine charges and detained at the Van Buren County Jail. During booking, Plug disclosed regular methamphetamine use and reported several COVID-19 symptoms. Deputy Dillon Kelly recorded that information and transmitted it to the jail’s medical staff. Nurse Roslynn Hickmott subsequently examined Plug three times, tested him for COVID-19, and monitored symptoms that included elevated blood pressure, mumbling, increased sleep, and reduced appetite.
Early on October 16, 2020, Plug told Kelly that he felt ill. Kelly recognized a medical problem, contacted the staff doctor, and recommended hospital treatment. At the hospital, Plug was diagnosed with an acute ischemic left middle cerebral artery stroke and aphasia. The stroke caused permanent brain damage. Plug alleged that the stroke had occurred by October 14 and that the delay in treatment placed him outside the window for interventions that could have prevented the damage.
Plug sued Hickmott and Kelly under 42 U.S.C. § 1983 for deliberate indifference to his serious medical needs. He also asserted claims against Van Buren County and Sheriff Daniel Abbott for failure to train and supervise and for maintaining an unconstitutional policy concerning detainees experiencing drug-withdrawal symptoms. The district court granted summary judgment to all defendants, and Plug appealed.
The Court’s Holding
The Sixth Circuit affirmed. Assuming without deciding that Plug had an objectively serious medical need, the court held that no reasonable jury could find that Hickmott or Kelly acted with the recklessness required for a Fourteenth Amendment deliberate-indifference claim. The court emphasized that the governing standard requires more than negligence.
As to Hickmott, Plug remained alert, followed commands, moved all his limbs, reported no pain, and produced some clear and correct words. His elevated blood pressure was stable and being monitored. Although Plug’s expert opined that his symptoms should have suggested a possible stroke, the expert characterized Hickmott’s conduct as medical negligence, which was insufficient to establish deliberate indifference.
As to Kelly, the court found that he reasonably transmitted Plug’s booking information to medical staff and deferred to their judgment. Before October 16, Kelly observed no symptoms beyond those Hickmott had seen. Once Plug reported feeling ill and Kelly recognized a medical problem, Kelly contacted the staff doctor and affirmatively recommended hospital care. Because Plug failed to establish an underlying constitutional violation, his municipal-liability claims against the county and Sheriff Abbott also failed.
Key Takeaways
- A pretrial detainee’s deliberate-indifference claim requires conduct resembling reckless disregard; medical negligence alone is not enough.
- No reasonable jury could find that Plug’s symptoms made his stroke so obvious that Hickmott recklessly disregarded a serious medical need.
- Kelly reasonably relied on medical staff before Plug’s crisis became apparent and promptly sought emergency care once he recognized a medical problem.
- The claims against the county and sheriff failed because Monell liability requires an underlying constitutional violation.
Why It Matters
The decision illustrates the evidentiary gap between a potentially negligent failure to diagnose a serious condition and constitutionally actionable deliberate indifference. Even where delayed diagnosis allegedly causes permanent harm, a plaintiff must present evidence that each defendant recklessly ignored a known or obvious, unjustifiably high risk—not merely that a medical professional should have reached a different diagnosis.
The opinion also reinforces that nonmedical jail staff may reasonably defer to medical professionals when the need for different treatment is not obvious, and that municipal-liability claims generally cannot proceed without proof of an underlying constitutional violation.