Facts
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After a long run triggered a latent medical condition, Darren Boykin died. On a hot Texas summer day in 2019, Boykin fled from Texarkana College police officers on foot. They caught him after a half-mile chase. He resisted; they subdued him. Soon, several officers from the Texarkana, Texas Police Department arrived, including Brent Hobbs, Jerrika Weaver, and later a sergeant, William Scott. Boykin had difficulty walking to Weaver’s patrol car, so the officers carried him. Once Boykin was in the car, he complained of being unable to breathe. Hobbs responded by turning up the air conditioning. He attributed Boykin’s breathing complaints to breathing hard from intense exercise, and he relayed this assessment to Scott.
Just after Scott arrived, Weaver departed with Boykin for the jail. Over the ten-minute drive, Boykin’s condition deteriorated. A few minutes in, Boykin told Weaver that he was “about to pass out,” and cried for help. Boykin then flopped into the divider. Weaver reacted to the sound, peeked into the rearview mirror, and offered Boykin “some water up there at the jail.” Boykin then seemed to lose consciousness. But Weaver sustained a one-sided conversation. At one point, Weaver looked back at Boykin, who was flopped over and unconscious. As Weaver continued talking, they drove past Wadley Hospital. They arrived at the jail about four minutes later.
When Weaver opened the rear door, she found Boykin unresponsive and pulseless. Weaver then examined him, began resuscitation efforts, and radioed for emergency medical assistance. Even though the paramedics restored Boykin’s pulse, he eventually died at Wadley Hospital. The officers never knew that Boykin had sickle cell trait, an uncommon, red-blood-cell condition. Although generally asymptomatic, sickle cell trait increases the risk of sudden death after extreme exercise. This complication is called Exercise Collapse Associated with Sickle Cell Trait, or ECAST. Boykin’s flight from police precipitated an ECAST event, which caused his death.
Members of Boykin’s family and his estate (plaintiffs) sued the Officers in federal court under 42 U.S.C. § 1983. Plaintiffs alleged that the Officers were deliberately indifferent to Boykin’s serious medical needs. After discovery, the district court granted summary judgment. The 5th affirmed.
Analysis
The deliberate indifference standard requires proof that an official actually inferred a risk of serious harm and disregarded it. To prevail on a deliberate indifference claim, a detainee must show that an official: (1) knew “facts from which the inference could be drawn that a substantial risk of serious harm exists,” (2) that they “actually drew the inference,” and (3) “disregarded that risk.” See Baldwin. Deliberate indifference is an extremely high standard. See Domino.
Plaintiffs allege that the Officers were deliberately indifferent to Boykin’s medical needs by ignoring his complaints and refusing to provide him medical care. There were facts from which a reasonable officer could infer that Boykin’s health was at serious risk. But we must resolve whether there is adequate evidence that the Officers actually knew that Boykin’s needs were serious. The actual-knowledge inquiry is “subjective,” so we ask what the officials knew, not what they should have perceived but did not.
A. Officers Hobbs and Scott
The most plaintiffs can show is that Hobbs and Scott misconstrued the symptoms of an ECAST event for those of exercise exhaustion. This cannot sustain an inference of actual knowledge. No evidence shows that any Officer knew that Boykin was having an ECAST event, or even that he was vulnerable to one. So this presents a “symptoms-only scenario,” where officials had to assess the risk to the detainee’s health based on symptoms alone. Because law enforcement officers lack a medical professional’s training, we afford them “latitude.” As a result, we have granted qualified immunity when law enforcement misconstrued the symptoms of a serious medical condition for intoxication. See Roberts. And when an officer mistook the symptoms of a serious illness for a mild one. See Estate of Cheney.
Hobbs likewise mistook the symptoms of a serious condition for exercise exhaustion. Boykin had just sprinted a half mile on a Texas summer day. With this context, Hobbs viewed Boykin’s complaints of being unable to breathe as indicating that he was breathing hard from exhaustion. Boykin was alert, talking, and his chest was rising and falling, which confirmed to Hobbs that Boykin was, in fact, breathing. Hobbs rendered aid consistent with his assessment: he increased the air conditioning. Of course, Hobbs was wrong. Boykin was having a medical emergency. But no evidence suggests that Hobbs actually knew this, nor were Boykin’s needs obvious enough for a jury to reasonably infer actual knowledge.
Scott had even less reason to know. He was the “on-duty sergeant.” When he arrived, Hobbs reported, Boykin says he can’t breathe, but you can hear him hollering from the back seat. Weaver told Scott, “He just ran too much.” Scott then got into his car and followed Weaver to the jail. Scott was on scene for about a minute, and he never interacted with Boykin. Quite understandably, Scott relied on Hobbs and Weaver’s assessment: that Boykin could breathe, but was breathing hard from exhaustion. Without interacting with Boykin further, Scott could not have learned more. Nor does his reliance on his subordinates’ benign explanation allow a jury to reasonably infer that Boykin’s needs were obvious to Scott.
In this symptoms-only situation, we owe the Officers latitude. The most plaintiffs can show is that Hobbs mistook ECAST symptoms for exercise exhaustion, and that Scott relied on this mistake. No reasonable jury could find that this gave either officer actual knowledge. Hence the qualified immunity analysis for Scott and Hobbs ends, and we affirm summary judgment on the claims against them.
B. Officer Weaver
But a reasonable jury could find that Weaver discovered Boykin’s needs. At the scene, she had the same knowledge as Hobbs and Scott: that Boykin was reporting difficulty breathing, which she too misinterpreted as a reaction to exertion. Just like the others, this is not enough to show her actual
knowledge at the scene. But on the drive to jail, Boykin’s condition deteriorated, and he eventually lost consciousness. Because Weaver could observe this deterioration, she could have discovered Boykin’s medical needs.
Recall that a few minutes into the drive, Boykin appeared to lose consciousness and stopped responding to Weaver. The rear compartment camera shows Boykin clearly, and his medical distress is obvious; he was unconscious, barely breathing, and his face was twitching. Weaver denies that she discovered Boykin’s condition. And the video is ambiguous whether she did, since what she saw from the driver’s seat is unclear. With ambiguous video evidence, we must credit plaintiffs’ account if sufficient evidence supports it.
The video evidence here shows that Weaver could have learned that Boykin had fallen unconscious. Several times, Weaver looked back at him. At one point, she glanced at her rearview mirror, seemingly in response to Boykin’s silence. She reacted to his condition, looking over her shoulder at him. She then said, “You know you’re going to jail either way right?” Less than a minute later, she glanced at the rearview mirror and asked, “Hey, Darren. Are you getting air back there?” When Boykin was silent, she looked back over her shoulder at him again.
From Boykin’s obvious distress in the video, Weaver’s glances to the rear, and her contemporaneous reactions to this distress, a reasonable jury could infer her actual knowledge. Although a jury might ultimately find otherwise, we cannot do the same without usurping the factfinder’s role. While Weaver’s demeanor suggests that she was unaware of Boykin’s condition, other evidence suggests that she was. This conflicting evidence creates a genuine dispute whether Weaver was deliberately indifferent.
However, even if Weaver learned of Boykin’s distress, we still grant her qualified immunity. At the second stage of the immunity analysis, we ask whether the detainee’s right to treatment for serious medical needs was clearly established such that every reasonable official would understand that what they are doing violates that right.
Plaintiffs frame the allegedly violated right too broadly. They claim that all they need show is that Weaver refused to treat Boykin, ignored his complaints, intentionally treated him incorrectly, or engaged in any similar conduct that would clearly evince a wanton disregard for any serious medical needs.Yet plaintiffs cannot rest on “generalized propositions.” Instead, they must identify “similar circumstances” in previous cases that established particular conduct as unlawful.
Our framing is consequently narrower: Was it clearly established in August 2019 that an officer who observes a serious threat to a detainee’s life during transport to jail must immediately secure aid? No. Until 2021, our court had not established that failing to promptly call for emergency assistance in response to a serious threat to an inmate’s life constitutes deliberate indifference. It was only in Cope that our court held that watching an inmate attempt suicide and failing to immediately call for emergency medical assistance violated the Constitution. Even if Cope recognized a duty to intervene in an inmate’s serious medical emergency, Boykin died in 2019—two years before Cope established this duty. So Cope cannot clearly establish Weaver’s alleged neglect as unconstitutional.
Allen does not show that Weaver deprived Boykin of a clearly established right either. There, a police officer allegedly shot a suspect five times, causing him to crash his car into a tree. The detainee was “bleeding, moaning, . . . and in obvious and critical need of emergency medical care.” The officer delayed six minutes before summoning medical aid. This stated a violation of clearly established law. But Boykin’s needs were not so obviously extreme. Hence Allen addressed different circumstances, and it cannot establish Weaver’s particular conduct as unlawful.
Plaintiffs’ other cases likewise addressed more obvious needs, and more deliberate neglect. Simply put, plaintiffs offer no case that clearly established, in 2019, that an officer who observes a serious threat to a detainee’s life during transport to jail must immediately secure aid. So they fail to overcome qualified immunity, and Weaver enjoys the immunity as a matter of law. We thus affirm summary judgment on plaintiffs’ claim against her.
For these reasons, we AFFIRM the district court’s grant of summary judgment to the Officers.
https://www.ca5.uscourts.gov/opinions/pub/24/24-40472-CV0.pdf