McBeth v. Physician Health Partners, Inc.

          ORDER GRANTING IN PART AND DENYING IN PART DEFENDANTS' SUMMARY JUDGMENT MOTION, AND GRANTING DEFENDANTS' RULE 702 MOTION

          WILLIAM J. MARTINEZ UNITED STATES DISTRICT JUDGE.

         Plaintiff Juanita McBeth broke her arm when she fell onto a concrete floor at the Pueblo County Detention Center. She claims that Defendant Daniel Fitzgerald, an EMT at the Detention Center, was deliberately indifferent to her medical needs, needlessly leaving her in pain overnight. She therefore sues Fitzgerald for violation of her Fourteenth Amendment Due Process right to adequate medical care in pretrial detention. She also sues Fitzgerald, together with his employer, Physician Health Partners, Inc. (collectively, “Defendants”), for medical malpractice.^[1]

         Currently before the Court are two motions: Defendants' Motion for Summary Judgment (“Summary Judgment Motion”) (ECF No. 88), and Defendants' Motion to exclude Plaintiff's Expert Witness Christa A. Bakos, R.N. (“Rule 702 Motion”) (ECF No. 92). For the reasons explained below, the Court denies the Summary Judgment Motion as to McBeth's deliberate indifference claim, but grants it as to McBeth's medical malpractice claim. As for the Rule 702 Motion, it is granted because McBeth's expert's testimony is largely irrelevant if there is no longer a medical malpractice claim for the jury to decide, and it is otherwise improper expert testimony.

         I. SUMMARY JUDGMENT ANALYSIS

         A. Legal Standard

         Summary judgment is warranted under Federal Rule of Civil Procedure 56 “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); see also Anderson v. Liberty Lobby, Inc., 477 U.S. 242, 248-50 (1986). A fact is “material” if, under the relevant substantive law, it is essential to proper disposition of the claim. Wright v. Abbott Labs., Inc., 259 F.3d 1226, 1231-32 (10th Cir. 2001). An issue is “genuine” if the evidence is such that it might lead a reasonable trier of fact to return a verdict for the nonmoving party. Allen v. Muskogee, 119 F.3d 837, 839 (10th Cir. 1997).

         In analyzing a motion for summary judgment, a court must view the evidence and all reasonable inferences therefrom in the light most favorable to the nonmoving party. Adler v. Wal-Mart Stores, Inc., 144 F.3d 664, 670 (10th Cir. 1998) (citing Matsushita Elec. Indus. Co. v. Zenith Radio Corp., 475 U.S. 574, 587 (1986)). In addition, the Court must resolve factual ambiguities against the moving party, thus favoring the right to a trial. See Houston v. Nat'l Gen. Ins. Co., 817 F.2d 83, 85 (10th Cir. 1987).

         B. Facts

         The following facts are undisputed unless attributed to a party, or otherwise noted.^[2]

         On the evening of June 1, 2016, police officers arrested McBeth-apparently for driving while intoxicated-and booked her into the Pueblo County Detention Center. (ECF No. 25 ¶¶ 15-16; ECF No. 88 at 3, ¶ 3; ECF No. 103 at 2, ¶ 3.) McBeth made comments that the arresting officer interpreted as an expression of suicidal intent, so she was taken to a changing cell where she would be required, for her own protection, to remove her clothing and instead wear only a smock. (ECF No. 88 at 3, ¶ 6.)

         On duty at the Detention Center that night was Defendant Fitzgerald, an EMT employed by Physician Health Partners, which provides medical services at the Detention Center under a contract with Pueblo County, Colorado. (Id. ¶¶ 1-3.) When detention officers took McBeth to the changing cell, Fitzgerald was nearby, but outside of the cell. (Id. at 4, ¶ 7.)

         The summary judgment record does not state whether McBeth voluntarily removed her clothes or if detention officers forcibly removed them.^[3] At some point, however, she was standing naked in the corner of the changing cell, facing the wall, and struggling against detention officers' attempts to control her. That is where a Detention Center video (Defendants' Exhibit E, see ECF No. 94) begins. The video, which has no audio, depicts two detention officers holding McBeth by her arms and struggling to control her, with a third detention officer holding a smock and seemingly looking for an opportunity to place it on McBeth. A fourth officer stands behind the rest of them, pointing a taser at McBeth's back. The struggle lasts for about twenty seconds, after which the officer with the smock moves out of the way and the officers attempting to control McBeth by her arms step to the side, giving the officer with the taser a clear shot. That officer discharges his taser, with the two prongs striking McBeth on the left side of her back. McBeth immediately falls backward and the officers on either side of her let go of her arms. McBeth does nothing to break her own fall and so her back, elbows, and head strike the concrete floor with an appreciable amount of force.

         Fitzgerald, still outside the cell, heard the commotion and an officer's announcement that a taser would be fired. (ECF No. 88 at 4, ¶ 9.) By the time the taser was fired, Fitzgerald was in a position to see inside the changing cell because he “saw Ms. McBeth fall to the ground, striking her [left] arm on the ground.” (Id.)

         The video shows that, soon after hitting the ground, McBeth puts her right hand to her forehead in a gesture reminiscent of having a terrible headache. One of the officers soon grabs McBeth's right arm and pulls it away from her forehead and across her body, rolling her onto her stomach. The same officer then removes the taser prongs from McBeth's back.

         At this point, Fitzgerald enters the video. He kneels next to McBeth's right hip and examines her back, where the taser prongs had been. Although not clear in the video due to the positions of the detention officers relative to the camera, he also assessed that McBeth's “pulse was normal, and she had good capillary refill, including in [her left arm]. Ms. McBeth was also able to acknowledge the sensation in her injured arm.” (ECF No. 88 at 4, ¶ 10.)^[4] Fitzgerald further says that McBeth “did not have any obvious signs of broken bones or other injuries.” (Id.) McBeth's expert claims, to the contrary, that the video shows “visible bruising on Ms. McBeth's left arm.” (ECF No. 103 at 7, ¶ 24; ECF No. 92-1 at 7.)

         Fitzgerald's examination took approximately 13-15 seconds, during which he concluded that McBeth had suffered no significant injuries. (ECF No. 103 at 3, ¶ 7; Defendants' Exhibit E.) The video then shows him exiting the changing cell, after which a detention officer places the smock over McBeth like a blanket. One detention officer appears to be asking something of McBeth, but McBeth waives that officer away with her right arm. All of the officers then exit the picture (and presumably the cell). The video ends with McBeth, still on her stomach, propping herself up with her right arm and looking at her left arm, which is in a somewhat unnatural position, although it is not visibly injured.

         The record does not state whether Fitzgerald observed McBeth in this position. But at some point soon after his interaction with McBeth, Fitzgerald “contacted Nurse Brandi Atencio to relay his observations of Ms. McBeth, and he was instructed [that] no further care was needed for Ms. McBeth unless something about her condition changed.” (ECF No. 88 at 5, ¶ 13.)

         McBeth spent the night in the changing cell. (Id. ¶ 14; ECF No. 103 at 4, ¶ 10.) According to Fitzgerald, he “periodically checked on Ms. McBeth by observing her in the cell sleeping with no apparent signs of distress.” (ECF No. 88 at 5, ¶ 14.) But McBeth says that she repeatedly called out through the night “that she needed medical attention and that her arm was in pain, ” but to no avail. (ECF No. 103 at 4, ¶ 10.)

         Fitzgerald conducted McBeth's “Receiving Screening” the following morning (June 2, 2016) at 5:49 AM. (ECF No. 88 at 5, ¶ 15.) He had tried to conduct that screening the previous evening (before the incident in the changing cell) but could not due to McBeth's intoxication and refusal to cooperate. (Id. at 3, 5, ¶¶ 4, 15.) According to Fitzgerald, McBeth complained of “arm pain” during the June 2 Receiving Screening. (Id. at 5, ¶ 16.) But, says Fitzgerald, “Ms. McBeth's vital signs, including her pulse and the capillary refill in her arm, and both were still normal. Ms. McBeth's sensory motor sensation was also normal. There was bruising, but no signs of fracture.” (Id. (citations omitted).)

         McBeth tells a different story of the Receiving Screening. She says that she specifically complained of a broken arm, not just arm pain, and that she was using her right arm to hold up her left arm, because she could not lift the latter. (ECF No. 103 at 4-5, ¶¶ 12-13.) Fitzgerald “told her to move her fingers; when she complied, Defendant Fitzgerald told her she was ‘fine.' . . . Fitzgerald told her that, when he had broken his arm in the past, he could not move his fingers.” (Id. ¶ 13 (citation omitted).) As for Fitzgerald's claims about checking vital signs such as pulse and capillary refill, McBeth asserts that “Fitzgerald never physically examined her, merely visually inspected her arm.” (Id.)

         Fitzgerald's shift ended at 7:00 AM that morning. (ECF No. 88 at 5, ¶ 17.) “He advised Randy Allen, the EMT who came on shift after him, about the incident involving Ms. McBeth.” (Id.)

         McBeth apparently appeared in court that morning because deputies escorting her from the courthouse back to the Detention Center noticed that she was in significant pain. (ECF No. 103 at 5, ¶¶ 14-16.) A sergeant then arranged for photographs to be taken of McBeth's injuries. (Id. ¶ 17.) Those photos show significant bruising on McBeth's left arm and possibly a deformity-something consistent with a fractured bone poking from under the skin. (ECF No. 103-3.)

         At 9:50 AM, after the photos were taken, EMT Allen examined McBeth. (ECF No. 103 at 5, ¶ 18.) His ...