Court Rules On LEOs’ Legal Duty To Bring Delusional Subjects To Medical Care

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A U.S. Court of Appeals has ruled that LEOs have no obligation to transport delusional subjects to a hospital instead of to jail in the absence of evidence of special medical risks.

A three-judge panel in the 6th appellate circuit last month reversed a lower court that had denied qualified immunity and summary judgment to officers and jailers in the in-custody death of an off-his-meds suspect with bipolar disorder.

“[T]here was no violation of a clearly established constitutional right,” the panel ruled, “and the officers did not act with the recklessness that would permit them to be liable….” The court’s jurisdiction covers Ohio, Michigan, Kentucky, and Tennessee.


The case involved a federal civil rights suit and state claims brought by the dead man’s mother, who was with him when he was arrested for disturbing the peace at a big-box hardware store in Bedford Heights, OH. She’d brought him there to collect his last paycheck after he’d been fired for skipping work. When a delay developed, the subject began “kicking and throwing paint cans” and “talking a lot of gibberish.”

Officers responding to a 911 call patted him down and discovered a container of pills in his pocket. The subject and his mother both stated that these were for his bipolar condition and that he had “not taken his medication for days or weeks.”

According to an officer’s later testimony, the suspect was “rambling and ranting and raving about every possible topic.” Among other things, he claimed that he sold “$5,000 gloves” to local stores, that he had a “million-dollar cell phone,” that he made “lots of money” with internet businesses, that he was a state trooper, and that his father was “the son of Satan.”

His bizarre and agitated monologue continued after an officer delivered him to jail. Correctional officers removed his handcuffs and belt and segregated him in an interview room to chill out so he could be booked.

During some eight hours’ detention, he did calm down “from time to time”—enough to be fed (despite having a spoon, he “ate with his hands and spilled food all over himself”) and to answer some “medical screening” questions (he denied having any “psychiatric issue”).

Then during one of the lulls in his “unusual behavior,” a correctional officer let him out of the room without handcuffs so he could make a phone call to arrange bail.

“Without warning,” the appellate panel noted, the suspect threw the officer “to the floor and began choking him.” Another officer jumped on the man’s back and he “started choking her too.” Cops rushed into the jail and pulled him into a restraint chair.

At that point, an administrator “noticed something wrong.” Someone took the subject’s pulse: weak. Resuscitation attempts failed. He was sped by emergency rescue squad to the hospital, where he was pronounced dead. An autopsy showed that he “died as a result of a sudden cardiac event during a physical altercation in association with bipolar disease.”


A subsequent civil suit by the suspect’s mother alleged that officers and their agency were liable for the fatality because of their “negligence,” “deliberate indifference,” and “lack of adequate training.” A federal district judge denied defense motions to dismiss the case on grounds of qualified immunity. The Appeals Court panel determined that to be a reversible error.

The Court acknowledged that a detainee has a constitutional right to “medical treatment for a serious medical need. But given the particulars of this case, the panel explained, there is no precedent that “clearly required [the officers at the initial scene] to do more than what they did—collect [the subject’s] pills, note his aggressive behavior and [that he] was bipolar and off his medications, and inform the jailers….

“In short, no clearly established law, here or anywhere else from what we’ve seen, required the arresting officers to drive [the suspect] to a hospital rather than the jail under these circumstances.”

At the jail, the appellate judges stated, nothing “alerted the [correctional] officers that mental instability of this sort required immediate medical attention…. [The subject] did not demonstrate any suicidal tendencies…and he did not have any apparent risk of seizures…. For that matter there was nothing to suggest he was at risk of the heart attack that ended up killing him.”

Like the cops in the field, the jailers were not obligated “to do more than what they did: They kept him in seclusion for everyone’s safety, waited until he was calm to feed him and book him, asked him about any psychiatric diagnoses during the medical screening….

“From the arrest to the initial detention to the booking to the attack, each officer treated [the subject] respectfully and carefully in light of his behavior and mental condition…. None had reason to believe he was suffering more than a typical arrestee [or that] he was so delusional that he would act out dangerously, much less die of a heart attack….”

In conclusion, the panel noted, “Police officers face tough judgment calls about what to do with the mentally ill. Arrestees do not normally arrive at jail toting their medical records. Psychiatric problems do not always manifest themselves with clarity. And not even clear psychiatric problems always reveal their potential for serious harm—as here a heart attack.

“Perhaps those truths counsel in favor of more policies and training designed to minimize tragic injuries and deaths…. And perhaps police would be wise to err on the side of calling a doctor in cases like this one.” But that said, no constitutional or state law violations warranted money damages against the officers or their agency, the Court declared.

The case, Anita Arrington-Bey v. City of Bedford Heights, can be accessed in full by clicking here.

For a thorough explanation of guidelines from the US Supreme Court on when lower courts should grant qualified immunity, see this new article from the Americans for Effective Law Enforcement Monthly Law Journal. Click here to read it.

Our thanks to Atty. Michael Brave of LAAW International, LLC, for alerting us to the Ohio case.

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