Estate of Ryan L. Clark, Plaintiff-Appellee,
Bruce Walker and Tina Kuehn, Defendants-Appellants.
March 28, 2017
from the United States District Court for the Eastern
District of Wisconsin. No. 14-C-1402 - Charles N. Clevert,
Flaum, Kanne, and Hamilton, Circuit Judges.
Hamilton, Circuit Judge.
Clark committed suicide five days after entering the custody
of the Green Lake County Jail in Wisconsin. The officers on
duty at the time of his death did not know that Clark had a
high risk of committing suicide. When he entered the jail,
however, he was assessed as having a maximum risk of suicide.
The intake staff who were aware of that risk-Officer Bruce
Walker and Nurse Tina Ku-ehn-had not initiated the jail's
suicide prevention protocol. Clark's estate brought this
suit under 42 U.S.C. § 1983 alleging that Walker and
Kuehn violated Clark's Eighth Amendment rights by acting
with deliberate indifference toward his serious risk of
and Kuehn moved for summary judgment. They argued there was
insufficient evidence to allow a jury to find deliberate
indifference, and they invoked qualified immunity. In a
detailed order, the district court denied their motions. See
Estate of Clark v. County of Green Lake, No.
14-C-1402, 2016 WL 4769365 (E.D. Wis. Sept. 12, 2016). The
court found numerous issues of material fact regarding
Clark's suicide risk, the defendants' knowledge of
that risk, and who was responsible for initiating the suicide
protocol (Walker or Kuehn). The court also rejected
defendants' qualified immunity arguments. As a
preliminary matter, the court determined that Kuehn was
unable to invoke qualified immunity because she was a private
contractor, not a government employee. On the merits, the
court ruled that both defendants were not shielded by
qualified immunity because it was clearly established in the
Seventh Circuit that inmates have the right to be free from
deliberate indifference to a known risk of suicide. Both
this is an appeal from a denial of summary judgment, our
jurisdiction is quite limited. We have jurisdiction to review
only the denial of qualified immunity and only to the extent
the denial turned on questions of law. This narrows our
consideration to two issues: whether Nurse Kuehn was entitled
to qualified immunity as a private medical contractor, and
whether it was clearly established that Clark had a right to
be free from deliberate indifference to his serious risk of
suicide. We agree with the district court on both points, so
we affirm its denial of summary judgment for these two
Factual and Procedural Background
Clark's History of Suicidal Behavior
review on appeal from denial of summary judgment based on
qualified immunity is limited to questions of law, so we
recount the facts as stated by the district court in its
assessment of the summary judgment record. See Locke v.
Haessig, 788 F.3d 662, 665 (7th Cir. 2015).
Clark struggled for years with alcoholism and depression. In
2009 he was released from Wisconsin state prison after
serving time for his fifth offense of operating a vehicle
under the influence of alcohol. His release was subject to
extended supervision. Over the next two years he was admitted
to the Green Lake County Jail approximately eight times. Each
time his extended-supervision officer placed him on a
"hold" due to alleged violations of his supervision
rules, and each time he was intoxicated.
records show that Clark received regular medical treatment
for depression while in custody. He was frequently given
medication for depression, such as sertraline and
fluox-etine, and his jail record stated that he experienced
"anxiety attacks" when he did not receive his
medication. The jail records also documented Clark's
serious risk of suicide. This included documentation of
instances of self-harm, including a suicide attempt in 2011.
At times in the past, the jail had put Clark on "Special
Watch Observation, " where he was observed every fifteen
minutes to prevent suicide.
Intake, Confinement, and Suicide
23, 2012, Clark was admitted once more to the Green Lake
County Jail because he violated supervision rules by drinking
alcohol. His breath test showed a blood alcohol level of
0.27, more than three times the legal limit for driving.
Defendant Walker performed the intake process. Following
standard practice, Walker administered the Spillman Initial
Inmate Assessment, which is a software program that includes
a suicide risk assessment. The program provides questions for
the intake officer to ask the inmate, and it uses the
inmate's responses to estimate his suicide risk.
on Clark's responses, the Spillman Assessment calculated
that he was at a "maximum" suicide risk. According
to the jail administrator, the Spillman Assessment is not
dispositive, and officers have discretion to initiate the
suicide protocol based on other factors, such as when an
inmate expressly says that he is contemplating suicide.
Walker testified that he thought the Spillman Assessment
automatically produced a maximum suicide rating for all
inmates intoxicated at the time of the test. Officer
testimony indicated that officers made discretionary