5th Cir. Pattern Jury Instr. (Civil) 10.12

Medical Care/Episodic Acts—Pretrial

Detainee)

1,2,3

Plaintiff [name] claims that Defendant [name]

violated [his/her] Fourteenth Amendment right to medical care while [he/she] was detained at [specify jail,

prison, or other facility].

1When deciding whether to give Instruction 10.11 or Instruction 10.

12, the district court must determine “whether the alleged unconstitutional conduct is a ‘condition of confinement’ or [an] ‘episodic act or

omission.’ When the alleged constitutional violation is a particular act or

omission by an individual that points to a derivative policy or custom of

the municipality , we apply the deliberate indifference standard.” Gibbs v.

Grimmette, 254 F .3d 545, 549 n.2 (5th Cir. 2001) (internal citation omitted) (emphasis added). On the other hand, if the allegation is that a condition of confinement violates the Constitution, the proper standard is

whether the condition is “reasonably related to a legitimate goal.” Garza

v. City of Donna , 922 F .3d 626, 632 (5th Cir. 2019) (quoting Bell v. Wolfish ,

441 U.S. 520, 539 (1979)). The Fifth Circuit recently discussed the

prerequisites for the use of a conditions-of-confinement theory of liability:

“a condition may take the form of ‘a rule,’ a ‘restriction,’ ‘an identifiable

extended condition or practice,’ or ‘acts or omissions’ by a jail official that

are ‘sufficiently extended or pervasive.’ ’’ Id. (quoting Estate of Henson v.

Wichita Cty., 795 F .3d 456, 468 (5th Cir. 2015)). The Fifth Circuit has also

described scenarios that do not establish conditions-of-confinement claims:

[I]solated examples of illness, injury, or even death, standing alone,

cannot prove that conditions of confinement are constitutionally

inadequate. Nor can the incidence of diseases or infections, standing

alone, imply unconstitutional confinement conditions, since any

densely populated residence may be subject to outbreaks. Allegations of insufficient funding are similarly unavailing.

Shepherd v. Dallas Cty. , 591 F .3d 445, 454 (5th Cir. 2009). To receive a

jury instruction using the reasonable-relationship standard, a plaintiff

must show “a pervasive pattern of serious deficiencies in providing for [a

detainee’s] basic human needs.” Id. In some cases, the plaintiff may

proceed on both theories, provided the evidence is sufficient to reach a

jury on both. See id. at 452 n.1 (“Further, the district judge is no more

required to classify a § 1983 lawsuit than any other case in which multiple

theories are pled in the alternative. In the present case, . . . a fact issue

existed only on the conditions of confinement claim.”).

2A different standard applies to excessive-force claims. See Instruction 10.10.

3The same distinction between episodic acts and conditions of

confinement applies to failure-to-protect cases. Hare v. City of Corinth ,7 4

F .3d 633, 643 (5th Cir. 1996) (en banc) (“[M]edical care and failure-to-protect cases should be treated the same for purposes of measuring

constitutional liability .”).

10.12CIVIL RIGHTS — 42 U.S.C. § 1983

123

A pretrial detainee who has not been convicted of a

crime has a right under the Fourteenth Amendment to

the United States Constitution to be protected from

impermissible punishment like denials of, or delays in,

providing certain medical care.

To recover damages for this alleged constitutional

violation, Plaintiff [name] must prove by a preponderance of the evidence that:

1.

4

Plaintiff [name] was exposed to a substantial

risk of serious harm;

2. Defendant [name] displayed deliberate indifference to that risk; and

3. the deliberate indifference harmed Plaintiff

[name].

5,6

The first element asks whether a reasonable person

would view Plaintiff [name]’s illness or injury as suf-

4If the “under color of law” element has not been conceded, it should

be addressed as the first element. Further instructions defining this element are found in Instruction 10.2.

5McCarty v. Zapata Cty. , 243 F . App’x 792, 794 (5th Cir. 2007) (per

curiam) (citing Mace v. City of Palestine , 333 F .3d 621, 625 (5th Cir. 2003)

(“[P]laintiff must establish resulting injuries.”); Victoria W. v. Larpenter ,

369 F .3d 475, 483 (5th Cir. 2004) (explaining prima facie case).

6If the claim is that health care was improperly delayed, then the

court should instruct the jury that “[a] delay in medical care violates the

[Fourteenth] Amendment only if it is due to deliberate indifference and

results in substantial harm,” Smith v. Milhauser , 444 F . App’x 812, 813

(5th Cir. 2011) (per curiam) (emphasis added) (citing Mendoza v. Lynaugh ,

989 F .2d 191, 195 (5th Cir. 1993)), but also that “[t]he pain suffered during

the delay itself . . . can constitute a substantial harm,” Westfall v. Luna ,

903 F .3d 534, 551 (5th Cir. 2018) (per curiam) (citing Alderson v. Concordia Par . Corr . Facility, 848 F .3d 415, 422 (5th Cir. 2017) (per curiam)). If

necessary , these instructions may be modified or limited in wrongful death

cases to reflect the state’s wrongful death statute. See Slade v. City of

Marshall, 814 F .3d 263, 264 (5th Cir. 2016) (“[A] plaintiff seeking to recover on a wrongful death claim under § 1983 must prove both the alleged

constitutional deprivation required by § 1983 and the causal link between

the defendant’s unconstitutional acts and omissions and the death of the

victim, as required by the state’s wrongful death statute.” (quoting Phillips

ex rel. Phillips v. Monroe Cty. , 311 F .3d 369, 374 (5th Cir. 2002))).