Qualified immunity may be asserted as a defense by providers of medical care in prisons and jails. In Wiertella v. Lake County, Ohio et al., 6th Cir., No. 24-3311, 6/24/2025), inmate Randy Wiertella died of hypertensive cardiovascular disease eight days after entering the jail because he never received his blood pressure medication, despite repeated requests. His estate filed suit under 42 U.S.C. § 1983, claiming that his constitutional rights under the Eighth and Fourteenth Amendments were violated by staff nurses Diane Snow and Christina Watson. The nurses moved for summary judgment on the basis of qualified immunity. The district court denied the motion, and the Sixth Circuit affirmed. Of note, this was a split decision with a vigorous dissent.
Wiertella was booked at the jail on December 2, 2018 to begin serving a 27-day sentence.
He entered the Jail without any of his medications, but a corrections officer recorded that Wiertella was taking medications for heart disease, diabetes, high blood pressure, and a psychiatric disorder. These were “essential medications” under the Jail’s policies and procedures. The medical-screening form states that Wiertella’s medications needed to be continuously administered. . . .
Watson reviewed and signed Wiertella’s medical-screening form on December 2, 2018. She was aware that Wiertella was booked without any medications and that Wiertella had been taking “essential medications” that needed to be continuously administered. . . .
Wiertella submitted an inmate request form for all of his medications on December 3 and a separate request for blood pressure medication on December 5. Watson ordered the diabetes medication, but never ordered any of the others.
Wiertella was eventually scheduled to have a sick call on December 10, 2018. . . . The sick-call log states that Wiertella needed to be seen for “BP check, no meds.” Snow testified that this meant that Wiertella “need[ed] his blood pressure checked because he’s got some sort of history of high blood pressure and he brought no meds in with him.” . . . There is no explanation in the record for why Wiertella was not scheduled for a sick call until December 10.
Wiertella was found in his cell nonresponsive and pronounced dead at 3:12 a.m. on December 10, 2018. The Estate’s expert, Dr. Jonathan Arden, concluded that Wiertella’s cause of death was hypertensive cardiovascular disease. Dr. Arden testified that “the discontinuance and failure to provide medications contributed to [Wiertella’s] blood pressure spiking and his risk of sudden death.”
In the following excerpts from the court’s analysis on appeal, citations and internal quotation marks are omitted to the maximum extent possible, but in some instances it has not been possible.
At summary judgment, a government official is entitled to qualified immunity unless the evidence, viewed in the light most favorable to the plaintiff, would permit a reasonable juror to find that (1) the defendant violated a constitutional right; and (2) the right was clearly established. We view the evidence in the light most favorable to the nonmovant and draw all reasonable inferences in his favor. . . .
[This] court has recognized that an Eighth Amendment failure-to-protect claim arising from conduct occurring before 2021 is governed by Farmer v. Brennan, 511 U.S. 825 (1994). Farmer’s first element is satisfied if the plaintiff proves that the inmate had an objectively “serious medical need[].” Snow and Watson do not dispute that the Estate satisfied this element. Wiertella had several conditions that had been “diagnosed by a physician as mandating treatment.” See Harrison v. Ash, 539 F.3d 510, 518 (6th Cir. 2008). The first requirement of Farmer has therefore been met.
Farmer next requires the plaintiff to prove that “[the] officer knew of the facts creating the substantial risk of serious harm,” that “the officer believed that this substantial risk existed,” and that “the officer ‘responded’ to the risk in an unreasonable way.”
Watson testified that she was aware that Wiertella had been booked without his medications, that he was on medications that needed to be continuously administered, and that these medications were classified as “essential” under the Jail’s policies. She stated that heart disease, high blood pressure, diabetes, severe sleep apnea, and depression are all serious medical conditions. Watson also considered medications for diabetes, heart disease, high blood pressure, and psychiatric disorders to all be essential medications. She further acknowledged the importance of taking medications for serious medical conditions because the failure to take those medications could lead to serious harm or even death. . . .
In light of the above testimony, the district court properly concluded that Watson was aware of a substantial risk to Wiertella if he did not timely receive his essential medications. Yet Watson did nothing to ensure that Wiertella received his blood-pressure medications – or any medication other than for his diabetes – in a timely manner. This was unreasonable.
[Snow] was . . . responsible for making sure that all the sick calls were set up correctly. Snow was not merely an administrator; she also performed the same duties as the other nurses, such as addressing the daily medical needs of inmates. Further, Watson testified that she believed that Snow had seen Wiertella. Snow disputed this fact, but we must view the evidence in the light most favorable to the Estate.
A jury could thus find that Snow was aware that Wiertella had been booked without essential medications that needed to be continuously administered. Snow testified that untreated high blood pressure can cause a substantial risk of harm to patients and that, if an inmate identified a need for high-blood-pressure medication, “it would be something that would need to be addressed as soon as possible.” Based on the above evidence, a jury could find that Snow was aware of the substantial risk that Wiertella faced, and that she unreasonably failed to ensure that Wiertella timely received all his essential medications.
To prove that Wiertella faced a substantial risk of serious harm, the Estate does not have to establish that Wiertella faced a substantial risk of dying within one week. . . . Moreover, a plaintiff can suffer serious harm without dying. For example, if the medical staff refuses to clean a prisoner’s wound, this can constitute serious harm even if the wound later heals. If an inmate experiences symptoms of depression because he is not timely receiving his psychiatric medication, this can constitute serious harm. See Richmond v. Huq, 885 F.3d 928, 942–43 (6th Cir. 2018). . . . And the interruption of a prescribed plan of treatment could constitute a constitutional violation. . . .
In establishing its § 1983 claim, the Estate concedes that it is required to identify a case with a similar fact pattern that would have given fair and clear warning to officers about what the law requires. The Estate cited, and the district court extensively analyzed, similarities between this case and Richmond. Richmond’s medical records indicated that she had been taking psychiatric medications before she arrived at the Wayne County Jail. This court held that her treating doctor at the jail had an obligation to take reasonable steps to ensure that Richmond timely received her medications. . . . Waiting for Richmond to have her psychiatric conditions addressed at an upcoming psychiatrist appointment scheduled 14 days later was not deemed sufficient to address her serious medical needs. . . .
This court in Richmond, moreover, held that prior caselaw had clearly established that neglecting to provide a prisoner with needed medication could constitute a constitutional violation. Richmond thus presents a similar fact pattern that gave Snow and Watson a fair and clear warning that failing to ensure that Wiertella timely received his essential medications was a violation of his constitutional rights under the Eighth and Fourteenth Amendments. The district court therefore did not err in concluding that Snow and Watson were not entitled to qualified immunity as a matter of law.
