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Shields v. Lemmon

United States District Court, S.D. Indiana, Indianapolis Division

September 30, 2019

PRINCOLA SHIELDS Estate of, by Debra Shields as Personal Representative, et al. Plaintiffs,
v.
BRUCE LEMMON, Commissioner, et al. Defendants.

          ORDER ON CROSS MOTIONS FOR SUMMARY JUDGMENT

          SARAH EVANS BARKER, JUDGE

         Plaintiffs in this cause, The Estate of Princola Shields (“the Estate”) and Princola’s mother, Debra Shields, filed suit against the Indiana Department of Corrections (“IDOC”) and Corizon Health, Inc. (“Corizon”) as well as various custodial and medical staff members, asserting claims under 42 U.S.C. § 1983[1] in connection with Princola’s tragic death by suicide on September 21, 2015, at the age of nineteen, while incarcerated in the Indiana Women’s Prison (“IWP”). Now before the Court are the Motions for Summary Judgment filed by Defendants IDOC, Sonya Johnson, Jessica Jonas, Danielle Katterhenry, Bruce Lemmon, [2] Deja Lewis, Keith Ray, Bonnie Russell, Renee Todd, David Walker, Michael Wilkerson, Nicole Wilson, and Rebecca Witter (collectively, “the IDOC Defendants”) [Dkt. 202] and Defendants Corizon, William J. Barnett, Vickie Burdine, Jana Cuffel, Debbie Durham, Talitha Moschell German, Keisha Hamer-Harris, Pamela Kirkwood, Julie Murphy, Daniel Prober, James Sackett, Shonda T. Simon, and Patricia Waltman (collectively, “the Medical Defendants”) [Dkt. 204], as well as the Cross Motion for Summary Judgment filed by Plaintiffs [Dkt. 224]. For the reasons detailed below, we GRANT IN PART and DENY IN PART the IDOC Defendants’ and the Medical Defendants’ Motions and DENY Plaintiffs’ Motion.[3]

         Factual Background [4]

         Princola’s Mental Health History Prior to Her Incarceration at the IWP

         Princola’s encounters with the criminal justice system that ultimately resulted in her incarceration at the IWP began on July 22, 2014, when she was charged in Johnson County, Indiana, with shoplifting. When she subsequently failed to appear for her scheduled court date, a warrant was issued for her arrest. On January 8, 2015, Princola was arrested on that warrant and incarcerated in the Johnson County Jail. The next day, on January 9, 2015, Princola told a corrections officer that she was going to kill herself and asked for a doctor and for medication. She was placed on suicide watch, a fact that was noted in her records and made a part of her file. On March 9, 2015, Princola again asked to see a mental health doctor. On March 11, 2015, she was diagnosed with major depressive disorder and placed on observation status. She was placed on a close watch on March 18, 2015. It is not clear from the record when precisely she was removed from close watch supervision.

         While incarcerated at the Johnson County Jail, she was involved in an altercation. As a result, she was charged with battery, resisting law enforcement, and disorderly conduct and ultimately sentenced on April 15, 2015 to a term of 365 days, with a projected release date of October 15, 2015.

         Princola was transferred to the Rockville Correctional Facility (“Rockville”) on April 27, 2015. A nurse conducted her intake screening, which consisted of a Suicide Potential Screening, a Psychiatric Screening, and an assessment of her current mental status. Following the intake screening, the nurse referred Princola to Rockville mental health staff and contacted a nurse practitioner, who prescribed Celexa, an antidepressant that Princola had reported taking prior to incarceration. On April 30, 2015, Ronald Benson, LMHC, conducted a Behavioral Health Intake exam of Princola. She reported that she began using drugs and alcohol at age fourteen and that as a child she was subjected to sexual, physical, and verbal abuse. Although she denied any history of suicidal thoughts, she indicated that she had attempted to commit suicide at age fifteen or sixteen by jumping out of a window. Mr. Benson assigned Princola a Mental Status Classification of “C” and noted that she would need to see the psychologist and a mental health professional.

         Princola’s Transfer to the IWP

         On May 3, 2015, while housed at Rockville, Princola was placed on suicide watch after she carved the word “pain” on her arm. On May 5, 2015, shortly after this incident, Defendant Patricia Waltman, M.D., a psychiatrist at Rockville, conducted a psychiatric evaluation of Princola. Based on that examination and Princola’s mental health history, which, as noted above, included physical, sexual, and verbal abuse and a prior suicide attempt, Dr. Waltman diagnosed Princola with post-traumatic stress disorder and depression. She prescribed Princola an antidepressant, Effexor. As a result of her self-mutilation, Princola was assigned a Mental Status Classification Code of “E, ” meaning that she needed to be transferred to a correctional facility that offered a higher level of mental health care than Rockville offered. For that reason, on May 11, 2015, Princola was transferred from Rockville to the Indiana Women’s Prison (“IWP”). After Princola transferred to the IWP, Dr. Waltman had no further involvement in her treatment.[5]

         Because she had engaged in self-harm while at Rockville, upon her transfer to the IWP Princola was placed directly into segregation on a mental health hold. At that time, IDOC contracted with Defendant Corizon Health, Inc. (“Corizon”) for the provision of medical services, including mental health services. On May 12, 2015, the day after Princola’s transfer, Defendant Daniel Prober, a psychologist at the IWP, evaluated her. Princola had recently been released from suicide observation and was housed in the Restrictive Housing Unit (“RSHU”)[6] at the IWP. During the examination, Princola did not express suicidal or homicidal ideations and was able to understand and refrain from harmful action. Dr. Prober concluded that Princola’s self-injuring behavior “may have been more related to how she sought attention than it was to depression, which was what she claimed.” Prober Decl. ¶ 4. Dr. Prober’s treatment plan was for Princola to continue to have routine meetings with mental health staff while in restrictive housing. Id.

         Princola’s Mental Health Treatment at the IWP from May 12, 2015 to June 16, 2015

         Princola attended two-hour group therapy sessions led by Defendant Willie Barnett, a behavioral health specialist, on May 13, 14, and 15, 2015. Barnett Aff. ¶ 3. Mr. Barnett’s responsibilities at the IWP were limited to leading group therapy sessions and facilitating discussions in those groups. Mr. Barnett was not a licensed mental health professional and therefore could not diagnose offenders’ mental health needs, order mental health treatment, develop treatment plans, or prescribe medication. If he had concerns about a patient based on an interaction he observed during a therapy session, he would report those concerns to the psychologist. Id. ¶ 2. According to Mr. Barnett, Princola’s participation was “okay” and she provided feedback to other group members during the May 13 and 14 group therapy sessions. Id. ¶¶ 3–4. The group watched a movie during the May 15 session, which Princola appeared to enjoy. Id. ¶ 5.

         On May 18, 2015, group therapy was offered to Princola, but she refused to participate. Id. ¶ 6. She returned to group therapy on May 19, 2015, and, despite reporting being sad, she participated actively and provided good feedback to other group members. She informed the group that her aunt had passed away and that she was concerned for her grandmother. Although at one point during the May 19 session Princola became somewhat disruptive, she was successfully redirected without incident. Id. ¶ 7.

         On May 19, 2015, Dr. Prober examined Princola for a second time, performing a Post-Suicide Observation Release examination. During that examination, Princola denied feeling urges to attempt suicide or to engage in self-harm and indicated that she was eager to be released from restrictive housing to the general population. Because she was not actively suicidal or self-injurious, Dr. Prober changed her Mental Status Classification Code from “E” to “C, ” which reflected a downgrade of her psychiatric impairment from “significant functional impairment” to “some functional impairment.” Prober Decl. ¶ 5. According to Dr. Prober, this change in classification did not affect the mental health treatment she received, but merely indicated to the Classification Department at which prisons she could be housed based on her mental health needs.[7] Id. On May 21, 2015, Dr. Prober confirmed with Princola’s caseworker that he had changed her classification code to “C” so that she was no longer a Special Needs Release. Id. ¶ 6.

         At the time period relevant to this litigation, Defendant Janet O’Neal was the Supervisor of Classification at the IWP. Ms. O’Neal had no role in Princola’s housing placement at IWP or the decision not to place Princola in a mental health unit at IWP nor was she otherwise involved with Princola’s care. O’Neal Decl. ¶¶ 6–7.

         Princola attended another group therapy session with Mr. Barnett on May 20, 2015. She was present only for a short period of time before she was removed and sent to a different unit in the prison. She participated without incident during the short time she was present. Barnett Aff. ¶ 8.

         Dr. Prober saw Princola for another Post-Suicide Observation Release evaluation on May 28, 2015. She indicated her desire to move off the Mental Health Treatment Housing Unit as soon as possible. Princola did not express suicidal or homicidal ideation during the examination. She stated that she had been “going through something” but had not been suicidal when she carved the word “pain” into her arm and that she did not believe she would engage in any further self-harm since she had been prescribed and had begun taking an anti-depressant. Prober Decl. ¶ 7.

         On May 29, 2015, Princola participated in another group therapy session with Mr. Barnett. She discussed the passing of her aunt and her concerns about her mother, who was in the hospital. Although she provided some feedback to other group members, Princola had to be redirected because of disruptive behavior during the session. Barnett Aff. ¶ 9. Princola attended additional group therapy sessions on June 1 and June 3, 2015, for a total of four hours. She had to be redirected several times during those sessions for cross-talking. Id. ¶ 10.

         On June 2, 2015, Defendant Debbie Durham, LPN was scheduled to see Princola for a Nursing Sick Call in response to a request for health care that Princola had submitted regarding her esophagus. Durham Aff. ¶¶ 1, 3. As a licensed practical nurse, Nurse Durham’s duties as the IWP included triaging and assessing patients, taking vital signs, communicating the patient’s condition to the medical provider, and following the provider’s treatment orders or plan for the patient. Id. ¶ 2. Nurse Durham did not see Princola that day as scheduled, however, because Princola refused to follow through with her appointment. Id. ¶ 3.

         Princola’s First Suicide Attempt at the IWP

          Princola was placed in the RSHU on June 17, 2015, after receiving a disorderly charge following a conflict with another offender. Id. ¶ 4. When she arrived in the RSHU, Princola took her bedsheet and tied it around her neck. A “Signal 3000” (an emergency medical call within the IWP) was called and the Quick Response Team arrived and removed the sheet from Princola’s neck.

         When Nurse Durham arrived in response to the call, the bedsheet had already been removed by custody staff. Princola was crying, and when Nurse Durham tried to take her vital signs and get other medical information from her, she told Durham to go away and leave her alone. She repeated several times that she wanted to die and that she would kill herself. Nurse Durham notified mental health staff and the medication nurse of Princola’s placement in segregation. Durham Aff. ¶ 4. She also informed Dr. Prober of the incident, who ordered that Princola be placed on close observation status.[8] Prober Decl. ¶ 8. When Dr. Prober met with Princola later that evening, she expressed suicidal ideation in her thoughts and intentions and was unable to understand or agree to refrain from harmful action. Given this information, Dr. Prober’s treatment plan was to keep Princola on suicide watch. Id. Princola was monitored by nursing staff for the remainder of the evening but refused to have her vitals taken. Dkt. 206-1 at 101–03.

         Princola’s Treatment While on Suicide Watch from June 18, 2015 to June 22, 2015

         Dr. Prober met with Princola again on June 18, 2015, while she was on suicide watch. Princola initially refused to meet with Dr. Prober, but when she was advised that her mattress would be removed from her room, apparently as part of the IWP’s protocol for those on suicide watch, she changed her mind and agreed to talk with him. Id. ¶ 9. Princola discussed with Dr. Prober the incident that had led to her receiving a disorderly conduct charge and he expressed disappointment with her attitude and her one-word answers to his questions about the incident. Dr. Prober informed Princola that because of her lack of participation in their discussion, her blanket and mattress would be removed from her cell until 8:00 p.m. Id. Dr. Prober was concerned about further suicidal behavior, given Princola’s lack of engagement, and advised her that he would return in the evening to talk with her. Princola then became angry and disputed Dr. Prober’s statements. Because Princola expressed suicide ideation and her inability to understand or agree to refrain from harmful action, Dr. Prober concluded that she should remain on suicide monitoring. Id. ¶ 9.

         Nurse Durham evaluated Princola later that same day. Princola denied thoughts of hurting herself but expressed frustration that her mattress had been taken from her and would not be returned until 8:00 p.m. that evening. Nurse Durham noted that Princola’s mood was depressed and that she was crying, but that she did not express suicidal ideation and was able to understand and agree to refrain from harmful action. Durham Aff. ¶ 5. Another nurse evaluated Princola later that evening and she was kept on suicide observation by behavioral health staff. Id.; Dkt. 206-1 at 111–14.

         The next day, on June 19, 2015, Dr. Prober again met with Princola for a Suicide Observation assessment. Princola did not express suicidal ideation and was able to understand and agree to refrain from harmful action. She indicated that she wanted to be released from suicide precautions, but Dr. Prober explained that that would not occur that day (which was a Friday) because, among other reasons, it was his general practice not to release offenders from suicide precautions on Fridays due to mental health staff not being present in the facility on weekends. Accordingly, Dr. Prober advised that Princola’s suicide observation level would be continued throughout the weekend. Id. ¶ 10. Princola accused Dr. Prober of acting punitively by failing to release her from suicide precautions that day. Id.

         That same day, on June 19, 2015, Defendant Vickie Burdine, M.D. conducted a mental health examination of Princola for medication management purposes. Burdine Aff. ¶ 3. Dr. Burdine was the psychiatrist at the IWP and her primary role was to prescribe and manage offenders’ psychiatric medications. She was not responsible for monitoring the day-to-day mental health needs and functioning of patients, duties which were performed by other mental health staff members, including the psychologist, licensed clinical social workers, and others with varying degrees and levels of experience. Id. ¶ 2. At the time of her exam, Dr. Burdine took note of Princola’s mental health history, including her suicide attempt earlier that week. Princola denied feeling suicidal but still exhibited some symptoms of anxiety and depression and was easily overwhelmed. Dr. Burdine noted that Princola had a history of non-suicidal self-injury and that she had recently cut herself, although the cuts were superficial. Id. Following the examination, Dr. Burdine prescribed Remeron, an antidepressant, continued her Effexor prescription, and scheduled Princola to return to the clinic in two weeks. Id.

         Nurse Durham monitored Princola on June 19, 2015, while she was on suicide watch. When examined, Princola denied suicidal thoughts and was pleasant and cooperative. Durham Aff. ¶ 6. She was continued on suicide observation. Id.

         The next day, June 20, 2015, while still on suicide watch, Princola was monitored by Defendant Talitha Moschell-German, RN. As a Registered Nurse, Moschell-German’s duties at the IWP included triaging and assessing patients, taking vital signs, communicating the patient’s condition to the medical provider, and following the provider’s treatment orders or plan for the patient. Nurse Moschell-German completed the mental health checklist regarding Princola’s appearance and behavior. Princola did not express suicidal ideation, was able to understand and agree to refrain from harmful action and raised no complaints. Following her assessment, Nurse Moschell-German contacted Dr. Prober and received verbal orders to continue Princola’s suicide observation at the same level. Moschell-German Aff. ¶¶ 2–3. Nurse Moschell-German assessed Princola again on June 21, 2015. Princola again denied suicidal thoughts, was able to understand and agree to refrain from harmful action, and expressed no complaints. Dr. Prober again gave verbal orders to Nurse Moschell-German to continue Princola’s suicide observation at the same level. Id. ¶ 4.

         Defendant Keisha Hamer-Harris, LPN monitored Princola on June 21 and June 22, 2015, while she was on suicide watch. Nurse Hamer-Harris performed a mental status checklist at each assessment and all findings were normal. On both days, Princola denied wanting to harm herself or others and reported no physical health issues that needed to be addressed. Hamer-Harris Aff. ¶¶ 3–4. After June 22, 2015, Nurse Hamer-Harris had no further involvement with Princola’s treatment. Id. ¶ 5.

         Dr. Prober performed another suicide monitoring assessment of Princola on June 22, 2015. During the assessment, Princola reported that she was not suicidal and acknowledged that she understood that she had time to serve in the RSHU due to her disciplinary violations. Prober Aff. ¶ 11. At all relevant times, it was IWP policy that custody staff monitor at fifteen-minute intervals offenders who are on suicide precautions and document their observations. Part of Dr. Prober’s June 22 assessment included a review of the documentation produced by custody staff of their observations of Princola while on suicide watch. After reviewing that documentation and speaking with Princola, Dr. Prober advised her that, although he was discontinuing her suicide observation, he would continue to prohibit her from possessing a bra or regular bedding because he was concerned that she might at some point use such materials to engage in self-harming behavior. Id. Princola was upset by these restrictions, arguing that there were other offenders who had all of their property and personal garments returned to them once they were released from suicide precautions. She complained that she was being mistreated and indicated that she would refuse to attend group therapy if she had limits on her undergarments. She stated that Dr. Prober’s undergarment restrictions were “mean” and insensitive to her feelings as a survivor of sexual assault. Id. Dr. Prober advised her that he would be mindful of her wishes to have her property returned and to have all restrictions lifted, but that the previously identified restrictions would remain until further notice. Id.

         Princola’s Mental Health Treatment from June 23, 2015 to August 10, 2015

         Dr. Prober met with Princola on June 23, 2015 for another Post-Suicide Observation Release assessment. Princola reported that her mood was good and that she had been attending group therapy. However, she indicated that she was upset that Dr. Prober continued prohibiting her from possessing a bra and certain other personal items. She did not express suicidal ideation and was able to understand and agree to refrain from harmful action. Prober Aff. ¶ 12.

         Princola attended several group therapy sessions between June 25, 2015 and June 30, 2015. Her behavior was satisfactory during the June 25 session and she reported that she had learned to be responsible for her own actions. At the June 26 session, the group watched a movie. Princola had to be redirected at the June 29 session because of her immature behavior. She also attended group therapy on June 30, and, although she participated and gave feedback to the group, she asked to leave after the first hour of the two-hour session. Barnett Aff. ¶¶ 13–15.

         On June 30, 2015, Princola again met with Dr. Prober for a Post-Suicide Observation Release assessment. Princola did not express suicidal ideation and was able to understand and agree to refrain from harmful action. She reported that she had engaged in a temper tantrum over the weekend and had left her Serious Mental Illness group after only one hour. Princola then reiterated her previous request that she be permitted to have a bra and regular bedding, stating that she had other property in her possession that she could use to self-injure. Dr. Prober advised her that there was a concern about her continuing mood problems, citing the fact that she had previously engaged in a suicidal gesture by wrapping a bedsheet around her neck. Princola rejoined that that incident had occurred some time prior and that he could not withhold her property indefinitely. Dr. Prober told her that he believed she could be improving her quality of life but that she was using her incarceration and status in the RSHU as an excuse not to do so. Princola then told Dr. Prober that she did not like him and did not look forward to meeting with him. At that point, Dr. Prober advised her that she was by her attitude being destructive to her therapy. Prober Aff. ¶ 13.

         Princola attended group therapy with Mr. Barnett on July 1 and 2, 2015. Her attitude and behavior throughout both sessions were appropriate. Princola also participated in group therapy on July 7, 2015. She then refused to attend group therapy on July 8, 2015 but returned on July 9, 2015 and behaved appropriately. Barnet Aff. ¶¶ 16–20.

         Dr. Prober met with Princola on July 9, 2015 for a Post-Suicide Observation Release assessment. Princola reported that she was functioning well and apologized for her behavior at their last meeting. She asked reasonable questions about her medication and the manner in which her medication would be handled at the time of her release. She denied suicidal thoughts and was able to understand and agree to refrain from harmful action. Prober Aff. ¶ 14.

         Princola attended group therapy with Mr. Barnett on July 10, 2015 and behaved appropriately. Barnett Aff. ¶ 21. She also participated in group therapy on July 13 and 14, 2015. Princola informed Mr. Barnett that she would like her name removed from the group list because she would not be back to group therapy. Mr. Barnett told her that he would keep her name on the group list but that she could refuse group therapy if she preferred. Id. ¶¶ 22–23.

         On July 21, 2015, the medical staff was alerted that Princola had been placed in the RSHU. Nurse Durham attempted to examine Princola for an Initial Segregation Review, but she (Princola) refused to have her vital signs measured or to answer any questions other than to deny having any suicidal thoughts. Nurse Durham was unable to complete a full suicide screen, however, because Princola would not answer any questions and kept telling Durham to leave her alone. Nurse Durham noted that Princola had no physical health issues which precluded her placement in segregation and notified behavioral health staff of her placement. Durham Aff. ¶ 7.

         The next day, on July 22, 2015, Dr. Prober placed Princola on a mental health hold prior to her placement back in restrictive housing. He also conducted a Post-Suicide Observation Release follow-up at that time. Princola reported that she had been placed in the RSHU for fighting but claimed that she had not actually been fighting. She denied suicidal thoughts and denied having any psychotic symptoms. She was able to understand and agree to refrain from harmful action. Dr. Prober noted that Princola did not meet serious mental illness criteria at that time and concluded that she could be placed in restrictive housing with routine monitoring by mental health staff. Prober Aff. ¶ 15.

         On July 23, 2015, IWP Correctional Sgt. Rebecca Witter received information that Princola had made statements indicating that she wanted to hurt herself. Pursuant to IDOC policy and her training, Sgt. Witter notified Leslie Weaver, MHP about those statements and Ms. Weaver met with Princola later that same day. Witter Decl. ¶ 5. Princola provided Ms. Weaver information regarding her adolescence, her incarceration, and the status of her conduct reports. Ms. Weaver noted that Princola presented this information “in a way that blame[d] others and denie[d] the need for [Princola] to take personal responsibility for [her] actions.” Dkt. 206-1 at 185. Princola also reported that she had had photographs confiscated from a letter she had received earlier that day and was very upset that she would be given a conduct report for that, when she did not request that the pictures be sent to her. Id. By the end of the session, Princola stated that she felt better after speaking with Ms. Weaver and that she was mostly just upset when she reported to custody staff thoughts of self-harm. She denied having suicidal thoughts at that time. Id.

         The next day, on July 24, 2015, Princola attended a group therapy session with Mr. Barnett. The group watched a movie that Princola appeared to enjoy. Barnett Aff. ¶ 24. Approximately one week later, on July 31, 2015, Dr. Burdine refilled Princola’s prescriptions for Effexor and Remeron until she could be scheduled for an appointment. Burdine Aff. ¶ 4.; Dkt. 206-1 at 190–91.

         On August 5, 2015, Princola was again placed in the RSHU. Defendant Shonda Simon, LPN was the nurse on the restrictive housing unit that day and was notified of Princola’s placement. Nurse Simon completed the Initial Segregation Review and noted that Princola was taking “psyche meds” and had made suicide attempts “in [M]ay 2015 and [J]une 2015 (wrapped sheet around neck).” Dkt. 206-1 at 192. However, Princola did not report any issues that day that precluded her from being housed in segregation. Id. Dr. Prober attempted to meet with Princola on August 6, 2015, but she refused. Prober Aff. ¶ 16.

         Dr. Burdine evaluated Princola on August 7, 2015 to assess how the medications she had been prescribed were working. Princola asked for medications for depression and raised a concern regarding problems with sleep. Dr. Burdine noted that Princola was compliant with her medication schedule, was showing moderate improvement, and had denied experiencing any significant side effects or other issues. Dr. Burdine decided to continue Princola on the same medications (Remeron and Effexor) at the same doses she had previously been prescribed and made orders for Princola to return to the clinic in two months. Burdine Aff. ¶ 5.

         Later that day, on August 7, 2015, Princola had a Behavioral Health Segregation Visit with Dr. Prober. Princola reported that she was returning to the RSHU because she had been involved in a fight. She denied suicidal ideation and was able to understand and agree to refrain from harmful action. According to Dr. Prober, he believed that Princola’s presenting concerns appeared to be behavioral in nature as opposed to being related to any psychiatric illness. She had been released from suicide precautions more than thirty days earlier and Dr. Prober concluded that at that point there was no reason to place her in Serious Mental Illness groups. Prober Aff. ¶ 17.

         Princola’s Second Suicide Attempt at the IWP

          Four days later, on August 11, 2015, while in segregation, Princola again wrapped a bedsheet around her neck and attempted suicide by tying the sheet to the support piece of her “desk/seat combo” in her cell and pulling the sheet tight against her neck with downward force. Dkt. 206-1 at 203. Thomas Davis, RN responded to examine Princola and a knife was used to cut the bedsheet from her neck. Her neck was reddened but unchaffed. The incident lasted less than four minutes and Princola never lost consciousness. She refused to talk after being cut loose. Id. Princola was placed on suicide observation following this attempt and Dr. Prober met with her later in the day for an initial suicide observation visit. Prober Aff. ¶ 18. She expressed suicidal ideation and was unable to understand or agree to refrain from harmful action. Dr. Prober continued Princola on suicide observation and increased her monitoring to “close observation.” Id.

         Princola’s Treatment While on Suicide Watch from August 12, 2015 to August 13, 2015

          Princola continued to be monitored on close observation by the nursing staff on August 12, 2015. She was awakened from sleep for her suicide assessment and refused to have her vital signs taken, stating, “Leave me alone. I want to go back to sleep.” Dkt. 206-1 at 212. She did answer all of the nurse’s questions, however, and denied wanting to hurt herself. Id. Dr. Prober met with Princola later that day. She did not express suicidal ideation and was able to understand and agree to refrain from harmful action. Prober Aff. ¶ 19. Dr. Prober allowed her to have a toilet, a soft covered book, eyeglasses, a drinking cup, a suicide gown, a suicide blanket, one additional blanket, and only finger foods. Id. He ordered that close observation of Princola be continued. Id. Nurse Simon evaluated Princola that evening and described her behavior as “agitated, ” her speech “delayed, ” her affect “flat, ” and her mood “irritable.” Dkt. 206-1 at 219. Princola refused to let Nurse Simon take her vital signs but denied any threats of self-harm. Simon Aff. ¶ 4. Nurse Simon noted in Princola’s medical records that the plan was to continue close observation. Id.

         Nurse Simon evaluated Princola again the next day, on August 13, 2015. Princola once again refused to allow Nurse Simon to take her vital signs. Nurse Simon noted that Princola’s mood was “depressed” and her affect was “flat, ” but that she did not express suicidal ideation and was able to understand and agree to refrain from harmful action. Id. ¶ 5. Later that day, Dr. Prober met with Princola for a suicide observation visit. She did not express suicidal ideation, denied suicidal urges, and was able to understand and refrain from harmful action. Dr. Prober reviewed the reports from custody staff of their observations of Princola while on suicide precautions and then determined that she could be released from close observation. Dr. Prober permitted Princola to have hygiene supplies, toilet paper, pencils, pens, a regular restrictive housing uniform, regular bedding, underwear (but still no bra), a drinking cup, and regular meals. Prober Aff. ¶ 20.

         Princola’s Mental Health Treatment from August 14, 2015 to September 20, 2015

          On August 14, 2015, Dr. Prober met with Princola for a One Day Post-Suicide Watch assessment. Princola told Dr. Prober that she was not depressed and therefore wanted to meet with the psychiatrist to have her Effexor gradually discontinued because she experienced withdrawal when she tried to discontinue it herself. Dr. Prober advised her to continue taking her medications as prescribed, citing the fact that, throughout her incarceration, she had experienced a number of episodes of dysphoric mood that had led to self-injuring behaviors. Dr. Prober observed that Princola appeared to find this discussion upsetting. She also stated that she wanted to start group therapy that day (a Friday), but Dr. Prober advised her that she would start on Monday, August 17, 2015. Princola did not express suicidal ideation, denied having thoughts of wanting to hurt herself, and was able to understand and agree to refrain from harmful action. Prober Aff. ¶ 21.

         Princola attended group therapy with Mr. Barnett each day from August 17, 2015 to August 19, 2015. Her behavior during each session was appropriate, although she left the August 18 session after the first hour of the two-hour session. Barnett Aff. ¶¶ 25–27.

         Dr. Prober met with Princola on August 19, 2015 for a Post-Suicide Observation Release meeting. At the meeting, Princola stated that she had been told that she would be in the RSHU for the remainder of her sentence, which was set to end in early October. She had previously authored a note requesting to be housed in Unit 10, rather than the RSHU, but she did not discuss that note during her meeting with Dr. Prober. Princola told Dr. Prober that she was reading several books and was working on writing her own book, titled, “The Worst Vacay Ever.” Prober Aff. ¶ 22. Her demeanor and behavior during the meeting were otherwise unremarkable. She did not express suicidal ideation and was able to understand and agree to refrain from harmful action. Dr. Prober permitted her to have her bra and other undergarments. Id. Dr. Prober did not evaluate Princola again after the August 19 assessment. Id. ¶ 23.

         Princola attended group therapy led by Mr. Barnett on August 20 and 21, 2015. On August 20, she participated in the group session but then became disrespectful and had to be removed from the group. Barnett Aff. ¶ 28. She returned to group ...


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