United States District Court, S.D. Indiana, Indianapolis Division
PRINCOLA SHIELDS Estate of, by Debra Shields as Personal Representative, et al. Plaintiffs,
BRUCE LEMMON, Commissioner, et al. Defendants.
ORDER ON CROSS MOTIONS FOR SUMMARY JUDGMENT
EVANS BARKER, JUDGE
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 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,
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.
Mental Health History Prior to Her Incarceration at the
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
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.
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
Transfer to the IWP
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.
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”) 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.
Mental Health Treatment at the IWP from May 12, 2015 to June
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.
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.
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. 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.
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. ¶¶
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.
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.
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.
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.
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.
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. 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
Treatment While on Suicide Watch from June 18, 2015 to June
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.
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.
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.
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.
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.
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.
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.
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.
Mental Health Treatment from June 23, 2015 to August 10,
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.
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.
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.
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.
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.
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. ¶¶
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. ¶
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.
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.
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.
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.
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.
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.
Second Suicide Attempt at the IWP
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.
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.
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. ¶
Mental Health Treatment from August 14, 2015 to September 20,
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.
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.
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.
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 ...