united states district court eastern district of … · center burn unit before being discharged...

UNITED STATES DISTRICT COURT

EASTERN DISTRICT OF TENNESSEE

NORTHEASTERN DIVISION

MYRA BURGIN, as Administratrix )

and personal representative of the )

ESTATE of AMANDA LEE HILL, )

)

Plaintiff, )

)

v. ) NO. __________________

)

COCKE COUNTY, Tennessee, ) Jury of Twelve Demanded

a governmental entity; )

ARMANDO FONTES, )

Sheriff of Cocke County, individually; )

TOMMY LARGE, individually; )

VICKI CAMPBELL, individually; )

TIFFANY BALL, individually; )

AMBER OWENS, individually; )

DYLAN SWAIN, individually; )

ALYSSA LANE, individually; )

JASON PHILLIPS, individually; )

JOHN and JANE DOES 1-15, )

employees of the Cocke County Sheriff's )

Department, individually; )

)

Defendants. )

______________________________________________________________________________

COMPLAINT FOR DAMAGES

_______________________________________________________________________________

Lance K. Baker

Tenn. Bar #: 032945

THE BAKER LAW FIRM

550 Main Street, Suite 600

Knoxville, TN 37902

Tel: 865-525-7028

Fax: 865-525-4679

[email protected]

Counsel for Plaintiff

Case 2:17-cv-00173-JRG-MCLC Document 1 Filed 09/28/17 of 70 PageID #: 1

TABLE OF CONTENTS

I. NATURE OF ACTION. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

II. JURISDICTION AND VENUE. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9

III. PARTIES. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10

A. Plaintiff. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10

B. Defendants. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10

IV. FACTUAL ALLEGATIONS.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15

A. Ms. Hill Is the Victim of a Horrific Domestic Assault on September 1, 2016

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15

B. Ms. Hill is Arrested for a Probation Violation.. . . . . . . . . . . . . . . . . . . . . . . . . . . 16

C. Cocke County Corrections Officers and Jail Nurses Knew Ms. Hill Suffered

From Diabetes Mellitus Type 1, Required Having Her Glucose Level

Checked Regularly, Three Daily Insulin Injections and Medication, and That

She Also Suffered From Painful and debilitating Burn Wounds Over 10% of

the Surface Area of Her Body. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18

D. Diabetes Mellitus. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19

E. Ms. Hill Immediately Exhibited Tell-Tale Signs of Insulin-Deprivation and

Diabetic Ketoacidosis. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23

F. The Jail Nurse Treats Ms. Hill’s Devolving Medical Condition With

Phenergan – An Anti-Nausea Drug. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24

G. Ms. Hill’s Pleas for Medical Help During Her Final Hours Were Ignored by

Cocke County Jail Employees Because They Erroneously Believed She Was

Merely Suffering From Drug-Withdrawal Symptoms. . . . . . . . . . . . . . . . . . . . . . 25

H. Ms. Hill’s Death.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26

I. Sheriff’s Office Officials Attempt to Conceal the Circumstances Under

Which Ms. Hill Died In Their Custody. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28

J. Ms. Hill’s Cause-of-Death. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29

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K. Failed Inspections, De-Certifications, Missing Logs, and Sky-rocketing

Medical Expenses. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31

1. Failed inspections and de-certifications. . . . . . . . . . . . . . . . . . . . . . . . . . . 31

2. Real World Consequences. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33

3. Missing logs and files. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 34

4. Skyrocketing medical expenses. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 35

L. Cocke County Corruption. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 36

M. Ms. Hill Received No Form of Diabetes Treatment, Insulin Therapy, or

Thermal Burn Care at the Cocke County Jail. . . . . . . . . . . . . . . . . . . . . . . . . . . . 37

N. The Circumstances Require Discovery to Permit Plaintiff to More Precisely

Allege Her Claims. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 38

V. INSUFFICIENT POLICIES, PRACTICES, AND LACK OF ACCOMMODATIONS. . . . . 38

VI. DISABILITY DISCRIMINATION. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 40

VII. WAIVER OF IMMUNITY. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 41

VIII. CLAIMS FOR RELIEF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 42

COUNT ONE – VIOLATION OF CIVIL RIGHTS LAWS UNDER COLOR OF LAW

42 U.S.C. § § 1983 and 1988 – Deliberate Indifference to Serious Medical Needs

(Against Sheriff Fontes and Large). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 42

COUNT TWO – VIOLATION OF CIVIL RIGHTS LAWS UNDER COLOR OF LAW

42 U.S.C. § § 1983 and 1988 – Deliberate Indifference to Serious Medical Needs

(Against All Individual Defendants, Except Sheriff Fontes and Large). . . . . . . . . . . . . . 47

COUNT THREE – VIOLATION OF CIVIL RIGHTS UNDER COLOR OF LAW

42 U.S.C. §§ 1983 and 1988 – Failure to Train and Supervise/Acquiescing-In and

Ratifying Unconstitutional Conduct of Subordinates

(Against Sheriff Fontes and Jail Administrator Large). . . . . . . . . . . . . . . . . . . . . . . . . . . 52

COUNT FOUR – VIOLATION OF CIVIL RIGHTS UNDER COLOR OF LAW

42 U.S.C. §§ 1983 and 1988 (MONELL CLAIM) – Deliberate Indifference to

Serious Medical Needs (Against Cocke County).. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 54

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COUNT FIVE – VIOLATION OF CIVIL RIGHTS UNDER COLOR OF LAW

42 U.S.C. §§ 1983 and 1988 — (MONELL CLAIM)

Failure to Train and Supervise and Ratification of Unconstitutional Conduct

(Against Cocke County).. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 58

COUNT SIX – Failure to Accommodate and Discrimination on the Basis

of Disability Resulting in Physical Injury under Title II of the ADA and

Section 504 of the Rehabilitation Act

(Against Cocke County and Individual Defendants Sheriff Fontes and Large).. . . . . . . . 61

COUNT SEVEN – WRONGFUL DEATH

TENN. CODE ANN. §§ 20-5-106 et seq.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 63

COUNT EIGHT – OUTRAGEOUS CONDUCT/ INTENTIONAL INFLICTION

OF EMOTIONAL DISTRESS (Against All Individual Defendants). . . . . . . . . . . . . . . . 64

IX. JURY DEMAND.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 65

X. PRAYER FOR RELIEF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 65

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COMES MYRA BURGIN, as Administratrix and personal representative of the ESTATE

of AMANDA LEE HILL (“Plaintiff”), and files her Complaint against the Defendants: COCKE

COUNTY, Tennessee, ARMANDO FONTES, Sheriff of Cocke County, individually; TOMMY

LARGE, individually; VICKI CAMPBELL, individually; TIFFANY BALL, individually; AMBER

OWENS, individually; DYLAN SWAIN, individually; ALYSSA LANE, individually; JASON

PHILLIPS, individually; JOHN and JANE DOES 1-15, employees of the Cocke County Sheriff's

Department, individually (collectively, “Defendants”).

I. NATURE OF ACTION

“[I]t is unsafe for inmates. . . .”1

1. This is a civil action brought by Plaintiff, the Court-appointed Administratrix and

personal representative of the estate of her daughter, Amanda Lee Hill (“Ms. Hill”), who died as an

inmate in the Cocke County Jail after having being deprived of her constitutional right to adequate

medical care.

2. Ms. Hill was 32-years old and the recent (September 1, 2016) victim of a heinous

domestic assault during which her former boyfriend kidnaped and physically assaulted her, doused

her with rubbing alcohol and set her afire, causing second- and third-degree thermal burns from Ms.

Hill’s shoulders to her legs. Ms. Hill spent approximately two weeks in the Vanderbilt Medical

Center Burn Unit before being discharged into her mother’s care on September 12, 2016.

1Cocke County Mayor Ottinger speaking on September 7, 2017 about why the Tennessee

Corrections Institute’s review committee indicated that the jail was not re-certified.

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3. On September 26, 2016, while in excruciating pain and suffering from a debilitating

disease, Diabetes Mellitus, Type I, Ms. Hill called 911 to report domestic assault. When Cocke

County deputies arrived, they arrested her on an outstanding probation violation warrant.

4. On September 26, 2016, Ms. Hill was taken to the Cocke County Jail and ultimately

placed in a cell with other inmates. Even then, deprived of insulin, she was already suffering from

a serious medical condition, which was rapidly deteriorating. Her body required insulin. She

required medical care. But the Cocke County Jail is no place to be for an insulin-dependent diabetic.

Diabetics, like Ms. Hill, do not receive adequate medical care at the Cocke County Jail.

5. As for Ms. Hill, she also had a drug problem. As with other inmates considered to

suffer from drug addiction, the Sheriff, Jail Administrator, Corrections Officers, and Jail Nurses

erroneously viewed her cries as the complaints of a “junkie” suffering from detoxification. Suffering

unbearable pain due to the thermal burns, Ms. Hill begged, cried, or shouted to corrections officers,

nurses, and even other inmates for help and medical attention and insulin the entire time she was

conscious during her incarceration. Her cries – and those of other inmates on her behalf – were

largely disregarded, and became inaudible and unintelligible as she began to suffer the effects of

insulin-deprivation and Diabetic Ketoacidosis, among other conditions.

6. The absence of insulin leads to a buildup of glucose in the bloodstream. Many

diabetics modulate this buildup by administering injections of insulin. Diabetic Ketoacidosis occurs

when an individual’s body does not break down this glucose; rather, the body begins to break down

fat for fuel. Diabetic Ketoacidosis, Mayo Clinic, http://www.mayoclinic.org/diseases-conditions/

diabetic-ketoacidosis/basics/definition/con-20026470 (last visited September 24, 2017). This causes

“a buildup of toxic acids in the bloodstream,” which can, as in this instance, be fatal. Id.

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7. Just two-days after she entered the Cocke County Jail, Ms. Hill died in her cell,

having received no meaningful medicare despite her rapidly-deteriorating medical condition.

Notwithstanding the fact that her mother provided Jail Nurses with her Diabetes-related prescription

medication, burn bandages, and detailed instructions, Ms. Hill was not given medically-necessary

insulin injections and other medication and care by either correction officers or medical staff, was

never seen by a physician, and was not transported to a hospital – until she was already dead.

8. During Ms. Hill’s incarceration, knowing her fragile medical condition, Plaintiff and

other members of Ms. Hill’s family repeatedly attempted to check on her and to set up visitation with

her. Plaintiff had one brief conversation with her daughter, during which her daughter said she was

not getting her medicines from Jail employees and feared for her death. Plaintiff went to the Jail and

added money to Ms. Hill’s Jail commissary account. She provided Jail Nurses with all of Ms. Hill’s

medicine and burn-care bandages. Plaintiff and her brother also called the Jail repeatedly to check

on Ms. Hill and eventually spoke to a corrections officer who said Ms. Hill was “fine.” Ms. Hill’s

uncle also visited the Jail to schedule a family-visit with her. He set up visitation for Thursday,

September 29, 2016, and again was told by a Corrections Officer that his niece was “doing fine” and

that the Corrections Officer would have Ms. Hill call the Plaintiff. But by Wednesday night,

September 28, Ms. Hill was dead.

9. By Wednesday morning, September 28, at about 9:00 a.m., Ms. Hill’s conditioned

had worsened such that she was having difficulty breathing and exhibiting other tell-tale symptoms

that her body required insulin. Responding to these symptoms, the Jail Nurse gave Ms. Hill a shot

of Phenergan, a sedative used to relieve apprehension, to “calm her down.” Ms. Hill continued to

plead for someone to help her, as her body was beginning to shut down.

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10. Unmoved by her cries and screams, for approximately the next twelve hours,

everyone who could have helped her – the Sheriff, Jail Administrator, Nurses, and numerous

Corrections Officers – left her unaided, eventually unable to even sit up on her own, until she died

later that evening.

11. By late in the evening of September 28, 2016, two Corrections Officers were

purportedly passing out “night meds” discovered that Ms. Hill was unresponsive and not breathing.

Other witnesses state that Ms. Hill had stopped breathing long before Corrections Officers noticed

her.

12. Finding Ms. Hill “unresponsive” in her cell with her face in a pool of black vomit,

several Corrections Officers performed CPR. They attempted to use an am-bu bag but there was not

one in the building. Some witnesses state that EMTs were not called until Corrections Officers had

been working for half an hour to revive Ms. Hill. In any event, EMTs could not revive Ms. Hill and

ultimately transported her to the hospital, where a doctor pronounced her death.

13. At the hospital, Corrections Officers misrepresented and withheld the nature of the

circumstances of Ms. Hill’s condition to hospital medical staff, failing to explain that Ms. Hill had

been deprived of insulin for more than two days, had not eaten or drank water during her

incarceration, had been begging and crying for medical help for two days, and had collapsed in her

cell hours before she was eventually taken to the hospital.

14. Back at the Jail, having finally come to realize that Ms. Hill had indeed been in a

serious medical crisis during her incarceration, efforts were already underway to conceal the

complete lack of care and medical treatment afforded to Ms. Hill, as incident reports were falsified,

Jail employees were warned not to discuss the circumstances surrounding Ms. Hill’s death, even with

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Ms Hill’s mother, telephone recordings, medicine-logs, meal-logs, and other documentation

disappeared.

15. During all of this, Plaintiff, Ms. Hill’s mother, was never notified that her daughter’s

medical condition had deteriorated, even though she had repeatedly contacted Jail staff to check on

how she was doing. Finally, after her daughter had been pronounced dead at the hospital, two

officers went to her home shortly after midnight to inform her that her daughter had died.

16. An autopsy was performed on Ms. Hill’s body. At the time of her death, she was

severely dehydrated. Toxicology results showed the presence of numerous substances, including

oxycodone, methamphetamine, and promethazine (Phenergan). This finding prompted the medical

examiner to list Ms. Hill’s cause of death as “acute combined drug overdose.” Ms. Hill had been

taking oxycodone and morphine – prescribed by her doctors at Vanderbilt Medical Center – for pain

associated with her thermal burns.2 And she had promethezine in her system because she had

received a Phenergan injection earlier that day from a Jail Nurse.

17. Significantly, according to information and data published by the National Institute

of Health and other reliable sources, the levels of oxycodone, methamphetamine, and promethazine

in Ms. Hill’s system were each well below what is reasonably considered to be a fatal dosage.

18. In addition to these non-lethal compounds, the report also showed Ms. Hill had

Acetone in her blood stream. Acetone produced in the body is a result of uncontrolled diabetes.

2Notably, at least three Cocke County Corrections Officers who, upon information and

belief, interacted with Ms. Hill during her short incarceration were terminated for smuggling

methamphetamine and oxycodone into the Jail and distributing them to inmates. The former

officers were charged with official misconduct and introducing contraband into a penal facility.

Two other officers who interacted with Ms. Hill and purportedly discovered her unconscious on

the date of her death were also terminated for “serious policy violations and potential civil rights

violations” and their actions are currently under investigation by the FBI.

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Specifically, it is “a product of diabetic- and fasting-induced ketoacidosis.” According to the

National Institute of Health, Diabetic Ketoacidosis (“DKA”) is a life-threatening condition that can

occur when there is a complete lack of insulin, as in Type I Diabetes, or inadequate insulin levels

associated with stress or severe illness in either Type I or Type II Diabetes.3

19. What we know is that Ms. Hill was deprived of insulin for the length of her

incarceration and was severely dehydrated at the time of her death. The source for Acetone is

insulin-deprivation. While the sources of both Oxycodone and Phenergan are known, the source for

meth, during her incarceration, is not. Perhaps she had used it before she entered the Jail. Perhaps

she got it from a Jail employee. What is also known is that DKA occurs when there is not enough

insulin in the body, resulting in high blood glucose; the person is dehydrated; and too many ketones

are present in the bloodstream, making it acidic.

20. From the minute she was booked at the Cocke County Jail, Ms. Hill’s pleas for

medical attention and insulin were altogether disregarded by Jail employees and nurses. Upon

information and belief, every Corrections Officer who came into contact with her during her

incarceration, and particularly the Jail Nurses, were deliberately indifferent to her rapidly-devolving

– and ultimately fatal – medical condition. No one showed any semblance of professionalism or

compassion toward her, writing her off as “a drug addict going through withdrawals.”

21. During her entire confinement at the Cocke County Jail, Ms. Hill had noticeable and

obvious symptoms of insulin-deprivation and dehydration that any trained corrections officer or

3In forensic pathology, acute complications of Diabetes Mellitus – which Ms. Hill had

suffered from since she was an adolescent – as a cause of death is often difficult to diagnose.

Fatal DKA is, however, easily diagnosed when biochemical investigations complement an

autopsy and histology.

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nurse would have recognized. Nevertheless, not a single officer or nurse made a real effort to help

her or provide her with meaningful – much less adequate – medical care.

22. Jail staff and nurses at the Cocke County Jail are, according to the Tennessee

Corrections Institute (“TCI”), of poor quality. They also lack sufficient training to recognize and/or

appreciate serious medical conditions of inmates. In Ms. Hill’s case, this lack of quality and training

led Jail employees to trivialize and not take seriously Ms. Hill’s very serious medical problems, as

well as those of other inmates. And those deficiencies also contributed to the overall gross neglect

of Ms. Hill during her incarceration, leading to her eventual death while in-custody.

23. Furthermore, Cocke County maintained a custom or policy that resulted in deficient

employee-training in dealing with medical crises and this deficiency led to the deprivation of Ms.

Hill’s civil rights and to her death.

24. Ms. Hill’s death while under the medical supervision of Cocke County may not

indicate alone that Cocke County’s training program for Jail personnel was inadequate, but the

surrounding allegations – that Ms. Hill died from a denial of treatment for Diabetes after nearly three

full days of asking for that exact type of treatment and then manifesting alarming symptoms – does

demonstrate that Jail personnel, and particularly, the Individual Defendants, were inadequately

trained.

25. Here, but for the inadequate medical training, Ms. Hill would not have died or

suffered other deprivations. Instead, she would have been provided adequate treatment.

26. Furthermore, Ms. Hill’s death was the direct and proximate result of Cocke County’s

(a) failure to train and supervise the corrections officers and jail nursing personnel to insure that

existing protocols and applicable standard operating procedures were followed, and (b) failure to

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promulgate sufficient reasonable and necessary medical care protocols and procedures to provide

for the adequate monitoring, medical examination, and care of inmates housed in the Cocke County

Jail.

27. In addition, Ms. Hill’s death was also the direct and proximate result of all of the

Defendants’ deliberate indifference to and reckless disregard for her serious medical conditions. Her

death – and her terrible suffering – were preventable by reasonable and timely medical intervention.

The failure and refusal to (a) follow applicable medical protocols and standard operating procedures

during Ms. Hill’s incarceration, (b) secure and arrange for appropriate medical care for Ms. Hill, (c)

monitor Ms. Hill’s medical condition in an adequate manner, and (d) render reasonable and

necessary medical examination and care to Ms. Hill, who was involuntarily in their custody and care,

constituted behavior that shocks the conscious.

28. Ms. Hill’s death was the direct and proximate result of Sheriff Fontes and Jail

Administrator Large’s (a) failure to train and supervise corrections officers and other jail personnel

over whom they had supervisory authority to insure that existing protocols and applicable standard

operating procedures were followed, and (b) failure to promulgate sufficient reasonable and

necessary protocols to provide for the adequate monitoring, medical examination and care of inmates

in the Cocke County Jail. Defendants ratified, encouraged or promoted a policy, custom or

procedure that violated Ms. Hill’s substantive due process rights.

29. Frankly, considering the nature, severity, and extent of Ms. Hill’s medical conditions

– i.e., (a) second and third degree burns on 10% of her body that required application of antibiotic

cream daily, antibiotic medication, antihistamines, pain medication, and daily dressing of all of the

wounds; and (b) Diabetes Mellitus Type 1, requiring a special diet and multiple forms of insulin-

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injections three times each day – it was clearly irresponsible for Cocke County, Sheriff Fontes, and

the officers who arrested Ms. Hill on September 26, 2016 to take her into custody and incarcerate

her, knowing that the Cocke County Jail and the employees who work there were completely

incapable of providing the type of treatment required to satisfy her very serious medical needs.

30. Ms. Hill should have been safe and protected in the custody of law enforcement

officers. Instead, she was grossly neglected – her increasingly emergent and worsening medical

condition all but ignored, while she suffered unbearable pain from second- and third-degree burns

– by the Defendants.

31. Defendants were all required to take reasonable measures to guarantee the safety of

all inmates and have a duty to protect them from harm. Here, they failed to take any such measures

to protect Ms. Hill. Therefore, Plaintiff alleges claims for deliberate indifference to providing

adequate medical care to inmates, failure to train and supervise, disability discrimination, wrongful

death; and outrageous conduct.

32. Plaintiff requests compensatory and punitive damages, as well as attorneys’ fees,

costs, expenses, and all other available and appropriate relief.

II. JURISDICTION AND VENUE

33. This Court has original jurisdiction pursuant to 28 U.S.C. §§ 1331 and 1343 over

Plaintiff's claims arising under the Constitution of the United States and 42 U.S.C. § 1983.

34. This Court has supplemental jurisdiction over any claims brought under Tennessee

law pursuant to 28 U.S.C. §1367, as such claims are so related to claims in the action within the

original jurisdiction of this Court that they form part of the same case or controversy under Article

III of the Constitution.

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35. Venue lies in the United States District Court for the Eastern District of Tennessee

because a substantial part of the events or omissions giving rise to Plaintiff's claims occurred in

Cocke County. 28 U.S.C. § 1391(b)(2).

III. PARTIES

A. Plaintiff

36. Plaintiff, Myra Burgin (“Plaintiff”), is the lawful and duly-appointed Administratrix

and personal representative of the Estate of her late daughter, Amanda Lee Hill. During all relevant

times, Plaintiff and Amanda Lee Hill were citizens and residents of Cocke County, Tennessee.

B. Defendants

37. Cocke County, Tennessee (“Cocke County”) is a governmental entity and political

subdivision of the State of Tennessee, duly organized, which funds and maintains the Cocke County

Jail and employs the persons working there. Cocke County, as a local government, is a public entity

in accordance with 42 U.S.C. § 12131(1) and 42 U.S.C. § 12111(5). Cocke County, upon

information and belief, is also a recipient of federal financial assistance as required under 29 U.S.C.

§ 794.

38. Cocke County owns the Cocke County Jail located in Newport, Tennessee. Cocke

County is responsible for, among other things, providing adequate funding for the operation of the

Cocke County Jail, including funding for training the Sheriff, the Sheriff's employees, corrections

officers, and nurses, and funding to allow for adequate staffing and training of the Cocke County Jail.

At all times pertinent to the matters alleged herein, Cocke County has employed fifteen (15) or more

employees. It may be served through its chief executive officer, County Mayor Crystal Ottinger, at

the Cocke County Courthouse, 360 East Main Street, Newport, TN 37821.

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39. Cocke County possessed the power and authority to adopt policies and prescribe

rules, regulations, and practices affecting all facets of the training, supervision, control, employment,

assignment and removal of individual members of the Sheriff’s Office, and to assure that said

actions, policies, rules, regulations, practices and procedures of the Sheriff’s Office and its

employees and agents comply with the laws and constitutions of the United States and of the State

of Tennessee.

40. Cocke County and the Sheriff’s Office are answerable for the safekeeping of persons

in their custody and responsible for all matters relating to the selection, supervision, promotion,

training, and discipline of employees, including uniformed and non-uniformed employees.

41. At all times relevant to this Complaint, Defendant, Sheriff Armando Fontes (“Sheriff

Fontes”) was the duly-elected Sheriff of Cocke County, Tennessee, statutorily responsible for the

screening, hiring, firing, training and the supervision of Sheriff’s Office personnel; and responsible

for the safety and welfare of those in his custody. Specifically, as sheriff, Fontes was responsible

for operating the Cocke County Jail and overseeing daily facility operations. That responsibility

included, but was not limited to, supervising the Individual Defendants, who served at his will in

their respective duties at the jail; providing sufficient training to those Defendants and creating and

implementing adequate policies and procedures to ensure that inmates were provided prompt and

adequate medical care; and providing adequate staffing at the Cocke County Jail to further ensure

that inmates received prompt and adequate medical care.

42. Sheriff Fontes is the proper party to be sued under 42 U.S.C. §1983. Sheriff Fontes

is sued in his individual capacity and as principal on his official bond. Sheriff Fontes was operating

under color of law. Sheriff Fontes is a “policymaker” within the meaning of that term as applied by

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the Supreme Court in Pembauer v. City of Cincinnati, 479 U.S. 469 (1986), and as the official head

of a “public entity” providing services, programs, or activities. Sheriff Fontes is, upon information

and belief, a citizen and resident of Cocke County and may be served with process at the Cocke

County Sheriff's Office, 111 Court Avenue, Newport, Tennessee, TN 37821.

43. At all times relevant to this Complaint, Defendant, Tommy Large (“Jail Administrator

Large” or “Large”), was employed by the Cocke County Sheriff's Office as the Jail Administrator.

Large acted with the authority invested in him by virtue of employment with Cocke County, and is

a state actor under § 1983. As a supervisor at the Cocke County Jail, Large’s responsibilities

included, but were not limited to, supervising medical staff in their respective duties at the Jail,

providing sufficient training to Jail employees, including corrections officers, and creating and

implementing adequate polices and procedures to ensure that inmates were provided prompt and

adequate medical care, and providing adequate staffing at the Cocke County Jail to further ensure

that inmates received prompt and adequate medical care. At all relevant times, Large was jointly

responsible with Sheriff Fontes for the management of the Cocke County Jail.

44. Large is sued in his individual capacity and as principal on his official bond. Large

was operating under color of law. Large is, upon information and belief, a citizen and resident of

Cocke County and may be served with process at the Cocke County Sheriff's Office, 111 Court

Avenue, Newport, Tennessee, TN 37821.

45. At all times relevant to this Complaint, Defendant, Vicki Campbell (“Nurse

Campbell”), was employed by the Cocke County Sheriff's Office as Nurse. Nurse Campbell is sued

in her individual capacity and as principal on his official bond. Nurse Campbell was operating under

color of law. Nurse Campbell is, upon information and belief, a citizen and resident of Cocke

-12-


County and may be served with process at the Cocke County Sheriff's Office, 111 Court Avenue,

Newport, Tennessee, TN 37821.

46. At all times relevant to this Complaint, Defendant, Corrections Officer Tiffany Ball

(“Officer Ball”), was employed by the Cocke County Sheriff’s Office as deputy and/or corrections

officer and a supervisor. Officer Ball is sued in her individual capacity and as principal on his

official bond. She was operating under color of law. Officer Ball is, upon information and belief,

a citizen and resident of Scott County and may be served with process at the Cocke County Sheriff's

Office, 111 Court Avenue, Newport, Tennessee, TN 37821.

47. At all relevant times to this Complaint, Defendant, Corrections Officer (“Alyssa

Lane”), was employed by the Cocke County Sheriff's Office as deputy and/or corrections officer.

Officer Lane is being sued in her individual capacity and as principal on her official bond. Officer

Lane was operating under color of law. Officer Lane is, upon information and belief, a citizen and

resident of Cocke County and her last known address is at the Cocke County Sheriff's Office, 111

Court Avenue, Newport, Tennessee, TN 37821.

48. At all relevant times to this Complaint, Defendant, Corrections Officer Amber Owens

(“Officer Owens”), was employed by the Cocke County Sheriff's Office as a deputy and/or

corrections officer. Officer Owens is sued in her individual capacity and as principal on her official

bond. Officer Owens was operating under color of law. Officer Owens is, upon information and

belief, a citizen and resident of Cocke County and may be served with process at the Cocke County

Sheriff's Office, 111 Court Avenue, Newport, Tennessee, TN 37821.

49. At all relevant times to this Complaint, Defendant, Corporal Jason Phillips (“Cpl.

Phillips”), was employed by the Cocke County Sheriff's Office as a deputy and/or corrections officer.

-13-


Cpl. Phillips is being sued in his individual capacity and as principal on his official bond. Cpl.

Phillips was operating under color of law. Cpl. Phillips is, upon information and belief, a citizen and

resident of Cocke County and may be served with process at the Cocke County Sheriff's Office, 111


50. At all relevant times to this Complaint, Defendant, Corrections Officer Dylan Swain

(“Officer Swain”), was employed by the Cocke County Sheriff's Office as deputy and/or corrections

officer. Officer Swain is being sued in his individual capacity and as principal on his official bond.

He was operating under color of law. Officer Swain is, upon information and belief, a citizen and

resident of Cocke County and may be served with process at the Cocke County Sheriff's Office, 111


51. Plaintiff also sues the fictitious Defendants, John and Jane Does 1-15, as their true

identities and/or capacities and/or other facts showing their culpability are presently unknown.

These Defendants are sued in their individual capacities as Cocke County Sheriff's Office corrections

officers, deputies, nurses, or employees, and as principals on their official bonds. They include any

unknown officers or deputies of the Cocke County Sheriff's Office who failed to provide adequate

medical care to Ms. Hill, subjected her to cruel and unusual punishment, failed to protect her from

harm and/or failed to insure that she received medical attention, and failed to train or supervise such

officers in the provision of adequate medical care.4

52. Various persons or entities not made Defendants in this lawsuit, including but not

limited to Cocke County officials or Cocke County Sheriff's Office employees, have participated

4Under Rules 4(m) and 15(c) of the Federal Rules of Civil Procedure, Plaintiff will seek

leave of this Court to amend her Complaint to set forth the true names and capacities of such

Defendants when their identities are ascertained.

-14-


with Defendants in the violations asserted in this Complaint and have performed acts and made

statements in furtherance thereof.

IV. FACTUAL ALLEGATIONS

A. Ms. Hill Is the Victim of a Horrific Domestic Assault on September 1,

2016.

53. On September 1, 2016, Ms. Hill’s former boyfriend kidnaped her, physically assaulted

her, doused her body with rubbing alcohol, and set her afire.

54. Ms. Hill suffered second- and third-degree full-thickness burns to her abdomen, right

upper arm, right hip, and right thigh, covering approximately 10% of the total body surface area

(“TBSA”).

55. Ms. Hill was taken to the Vanderbilt Medical Center burn unit, where she was

hospitalized for twelve days. On September 7, 2016, surgeons performed surgery on Ms. Hill to

place skin grafts measuring 847 cm squared on her burns, noting that she was suffering the highest

measurable level of pain (“10/10”). See attached, Collective Photographs.

56. According to her family and medical history, Ms. Hill suffered from Diabetes

Mellitus Type I5 since she was an adolescent and had also been fighting poly-substance dependence

and post-traumatic stress disorder (“PTSD”).

57. Her doctors at the Burn Unit at Vanderbilt Medical Center stated that Ms. Hill

“[n]eed[ed] aggressive outpatient therapy in the burn clinic to minimize scarring and prevent

5Type 1 Diabetes, once known as juvenile diabetes or insulin-dependent diabetes, is a

chronic condition in which the pancreas produces little or no insulin. Insulin is a hormone needed

to allow sugar (glucose) to enter cells to produce energy. Type 1 diabetes has no cure. Treatment

focuses on managing blood sugar levels with insulin, diet and lifestyle to prevent complications.

See http://www.mayoclinic.org/diseases-conditions/type-1-diabetes/home/ovc-20340976 (last

visited September 27, 2017).

-15-


contractures.” They also prescribed a series of medications for pain relief, anxiety, depression, and

sleeping.

58. Ms. Hill discharged from the Vanderbilt Medical Center Burn Unit on September 12,

2016 – and was released to her mother’s care.

59. Attending to Ms. Hill’s extensive burns required Plaintiff to bathe the wounds daily

and wrap them in antibiotic strips, gauze, and ace bandages.

B. Ms. Hill is Arrested for a Probation Violation.

60. While recovering at home, on or about September 25, 2016, Ms. Hill called 911 to

report a domestic disturbance (a male acquaintance was harassing her). Officers appeared and were

unable to locate the man. However, on the following morning (September 26, 2016), Ms. Hill again

called 911 to make a similar report. When officers responded, they arrested Ms. Hill for violating

her probation terms. This was the last time Plaintiff would see her daughter alive.

61. Plaintiff took most of Ms. Hill’s medicines to the Jail on September 26, 2016 and

gave them to a Jail Nurse. She informed the nurse that the insulin was prescribed by the doctor and

Ms. Hill was to receive it three times a day.6 The Nurse told Plaintiff that she would make sure that

her daughter was taken care of. Plaintiff also told the Nurse about Ms. Hill’s burns and skin grafts

6Ms. Hill had also been jailed in 2015. She had become very ill during that incarceration,

due to mis-use of insulin. Corrections officers had given her the wrong kind of insulin. They

were giving her two different kinds (eight shots a day) of insulin that were never to be mixed,

and was never prescribed by her doctor. During her 2015 incarceration, a corrections officer also

gave Ms. Hill an excessive insulin dose. Ms. Hill argued with the officer that it was too much,

and the officer responded that the dosage was on her chart and that’s what she was getting. Not

surprisingly, Ms. Hill subsequently suffered seizures during that incarceration as a result of the

lack of insulin. Her daughter having reported these serious failures to her, Plaintiff began to call

the Jail every day demanding that they give her daughter the medicine she needed. She did this

until Ms. Hill was eventually released.

-16-


and that they had to be medicated and regularly wrapped in clean bandages. The Nurse assured

Plaintiff that she would see that all of this was done correctly.

62. Plaintiff talked to Cocke County Detective Jason Ramsey, who was attempting to get

Ms. Hill transferred to a facility in Nashville, where she could spend her sentence. Detective

Ramsey informed Plaintiff that Ms. Hill was set to be transferred on October 3, 2016.

63. Ms. Hill had a single telephone conversation with her mother while she was

incarcerated, on September 26, 2016, at about 10:30 p.m. During the brief call, Plaintiff told her

daughter that she was going to be moved to another facility in a few days. Ms. Hill responded that

she was not receiving any insulin treatments or other medical care and that she was afraid she was

going to die. Ms. Hill, having spent the day in custody, also told Plaintiff that the Sheriff’s Office

was not going to help her and were not going to move her anywhere.7

64. The next day, September 27, 2016, Plaintiff went to the Jail and added funds to Ms.

Hill’s Jail commissary account to permit Ms. Hill to call her and to purchase items needed while she

was incarcerated. Throughout the day, Plaintiff waited for her daughter to call. But she never did.

Concerned about her daughter’s well-being, especially considering her serious medical conditions

(the burn wounds and diabetes), Plaintiff called the Jail several times to check on her daughter’s

health, but no one answered. Ms. Hill’s mother and uncle called the Jail again later that same

evening and finally, someone answered. The officer who answered told them that Ms. Hill “was

fine” and that he would “go back right now” and tell her about the money Plaintiff had added to her

commissary account and have her call Plaintiff. She did not call.

7Incidentally, although its attorney did not deny the existence of this call, Cocke County

could not locate an audio of the call and thus, did not produce it.

-17-


65. Ms. Hill’s uncle, Wade Burgin, asked if he could set up family visitation with Ms.

Hill and the officer told him to come to the Jail and set up a time. So, on September 27, 2016, Ms.

Hill’s uncle appeared at the Jail and scheduled visitation for Thursday, September 29, 2016. The

officer told Mr. Burgin that his niece was “doing fine” and, again, he would have her call the

Plaintiff. She did not call.

66. Plaintiff did not hear from her daughter that day, and again, no one answered the

telephone when she again called the Jail. Finally, at about 12:15 a.m., on September 29, 2016, just

hours before she was set to visit her daughter, Plaintiff was awakened by the sound of pounding on

her door. When she answered, two Cocke County officers were standing before her and asked if she

was Ms. Hill’s mother. She responded that she was. Both officers remained silent. Plaintiff asked

them what was wrong, and asked if her daughter was dead. One of the officers said “well, yes

ma’am, she is, it was a medical emergency.”

C. Cocke County Corrections Officers and Jail Nurses Knew Ms. Hill

Suffered From Diabetes Mellitus Type 1, Required Having Her Glucose

Level Checked Regularly, Three Daily Insulin Injections and

Medication, and That She Also Suffered From Painful and debilitating

Burn Wounds Over 10% of the Surface Area of Her Body.

67. Ms. Hill had been incarcerated in the Cocke County Jail in 2015. Her Jail records

showed that she was a Type I Diabetic.

68. Ms. Hill’s mother had also informed a Jail Nurse of her daughter’s medical conditions

and provided her with various prescription medications (not prescription pain medication). The

medicines appear to have included: Lantus (insulin injection), humalog (insulin injection), sertraline

(anti-depressant), Tylenol, minocycline (broad spectrum antibiotic), as well as medicines for anti-

nausea, anti-itch, and anti-diarrhea.

-18-


69. At or around intake, Ms. Hill purportedly completed a medical questionnaire that

disclosed again that she was a Type I Diabetic, had just received skin-grafts for thermal burns on her

“R hand, arm, and stomach” (although the largest and most severe burn and graft was on her thigh),

suffered from depression, used insulin for Diabetes, antibiotic cream for the burns, had to have the

burns dressed daily, and had a seizure disorder.

70. Another medical form, apparently completed by a Jail employee at intake, stated that

Ms. Hill “claims to be diabetic and states she uses humilog and lantis,” that she required medication

and that she was on a “special diet prescribed by a physician.” The form also stated that Ms. Hill

claims to have been hospitalized “approximately three weeks ago for diabetic issues.” Of course, this

is incorrect, as her recent hospitalization was related exclusively to the burns.

D. Diabetes Mellitus

71. Since her diagnosis of Type I Diabetes, Ms. Hill had successfully self-managed her

medical condition with daily insulin injections comprised of both long and short acting insulin,

because there is no cure for Diabetes Mellitus Type I.

72. Without proper insulin treatment and the ability to routinely manage her Type-I

Diabetes, like other Type I Diabetics, Ms. Hill would die.

73. Because of this disease, Ms. Hill’s pancreas could not naturally produce insulin

necessary to control normal bodily functions. The lack of normally and naturally occurring insulin

leads to increased blood-sugar levels and urine glucose.

74. Ms. Hill’s medical condition constituted a disability under Title II of the ADA,

because it substantially limited and impaired the operation of her major bodily functions, including

her neurological, brain, digestive, and bowel functions if blood sugars are out of control.

-19-


75. As a result of her disability, Diabetes Type-I limited Ms. Hill’s ability to eat, think,

and concentrate due to her inability to control her blood sugar naturally.

76. As a result of her medical condition, Ms. Hill had to monitor her blood-sugar

frequently to keep levels within the target range. To do this, she had to administer numerous

injections of both long and short-acting insulin three-times a day to ward off diabetic complications.

77. In order to manage her diabetic disability, Ms. Hill had to keep her medication and

monitoring devices in her possession. Without them, she risked the dangerous onset of Diabetic

Ketoacidosis. Ms. Hill used a combination of short-acting and long-acting insulin that she routinely

administered and carried her insulin bottles and injections with her on a daily basis.

78. Insulin and oral medications which lower blood glucose levels are used to

accommodate a host of diabetic problems, specifically issues arising from hypoglycemia,

hyperglycemia, and Diabetic Ketoacidosis.

79. While incarcerated at the Cocke County Jail, Ms. Hill suffered a myriad of diabetic

complications, including hyperglycemia and Diabetic Ketoacidosis. Hyperglycemia can cause a host

of symptoms and can also eventually lead to more severe consequences.

80. Thus, in situations where a person like Ms. Hill was unable to take medication to

address hyperglycemia (high blood-glucose) for an extended period of time, the likelihood of

experiencing these health complications rises.

81. The symptoms of mild to moderate hyperglycemia include hunger, thirst and

dehydration, headache, nausea, fatigue, blurry vision, frequent urination, and itchy and dry skin.

Individuals with hyperglycemia can also have sweet fruity smelling breath, which can be mistaken

for the smell of alcohol. In addition to these short-term consequences of acute hyperglycemia,

-20-


chronic high blood glucose levels can cause a number of very serious long-term complications, such

as nerve damage, heart disease, blindness, kidney failure, stroke, and death.

82. Failure to administer insulin in a timely manner to a person with Type-1 Diabetes

suffering from hyperglycemia can lead to Diabetic Ketoacidosis (“DKA”). DKA is a potentially fatal

condition caused by severely elevated blood-glucose levels and a shortage of insulin. In response

to high blood-sugars and inadequate insulin, the body switches to burning fatty acids and producing

acidic ketone bodies that cause most of the symptoms and complications. DKA is a medical

emergency and without treatment, it will lead to Peripheral Neuropathy (nerve damage), blindness,

systemic organ failure, or death. Similarly, failure to appropriately monitor blood-sugar levels can

lead to a drastic drop in blood-sugar levels resulting in the diabetic losing consciousness, going into

a coma, or dying.

83. DKA is usually triggered by:

# An illness. An infection or other illness can cause your body to

produce higher levels of certain hormones, such as adrenaline or

cortisol. Unfortunately, these hormones counter the effect of insulin

— sometimes triggering an episode of diabetic ketoacidosis.

# A problem with insulin therapy. Missed insulin treatments or

inadequate insulin therapy can leave you with too little insulin in your

system, triggering diabetic ketoacidosis.

# Other possible triggers of diabetic ketoacidosis include physical or

emotional trauma, drug abuse, and certain medications, such as

corticosteroids and some diuretics.8

8http://www.mayoclinic.org/diseases-conditions/diabetic-ketoacidosis/basics/causes/con-2002647

0.

-21-


84. Someone diagnosed with DKA may be treated in the emergency room or admitted

to the hospital.9

85. When an inmate like Ms. Hill is not able to take the appropriate medication for a

period ranging from several hours to several days, he or she can experience DKA. Left untreated,

DKA will eventually result in death. DKA requires immediate hospitalization, often in the intensive

care unit.

86. A person suffering from DKA will show classic warning signs, including vomiting,

dehydration, shortness of breath, confusion, inability to consume or retain food, and coma-like

symptoms of unconsciousness. Ms. Hill exhibited all of these symptoms during her incarceration.

9Treatment usually involves:

# Fluid replacement. You’ll receive fluids – either by mouth or

through a vein (intravenously) – until you’re re-hydrated. The fluids

will replace those you've lost through excessive urination, as well as

help dilute the excess sugar in your blood.

# Electrolyte replacement. Electrolytes are minerals in your blood

that carry an electric charge, such as sodium, potassium and chloride.

The absence of insulin can lower the level of several electrolytes in

your blood. You'll receive electrolytes through a vein to help keep

your heart, muscles and nerve cells functioning normally.

# Insulin therapy. Insulin reverses the processes that cause diabetic

ketoacidosis. In addition to fluids and electrolytes, you'll receive

insulin therapy – usually through a vein. When your blood sugar

level falls below 240 mg/dL (13.3 mmol/L) and your blood is no

longer acidic, you may be able to stop intravenous insulin therapy and

resume your normal insulin therapy.

http://www.mayoclinic.org/diseases-conditions/diabetic-ketoacidosis/basics/treatment/con-20026

470.

-22-


E. Ms. Hill Immediately Exhibited Tell-Tale Signs of Insulin-Deprivation

and Diabetic Ketoacidosis.

“She’s just coming off drugs, she’ll be alright.”10

87. Within hours of being booked, Ms. Hill began to experience symptoms of a serious

medical problem, short of breath, confused, loss of appetite, fatigued, and feeling very ill. She knew

precisely what it was because she knew the symptoms: she needed insulin.

88. She informed a Corrections Officer on duty that day that she needed medical help and

that she needed her insulin injections as soon as possible. She was ignored.

89. According to other inmates, immediately after Ms. Hill was placed in a cell, it was

clear that she was very sick.

90. Ms. Hill’s cell-mate asked one of the Corrections’ Officers to help Ms. Hill or to take

her to the hospital. She was also ignored.

91. According to Brittany Turner, a Corrections Officer at the Jail, Ms. Hill was very sick

early in the day of September 28, 2016 (the day she died). Other Corrections Officers asked their

supervisor, Officer Tiffany Ball, to get Ms. Hill medical help, but Officer Ball curtly responded,

“she’s just coming off drugs, she’ll be alright.”

92. According to at least one corrections officer who worked at the Jail during the period

in which Ms. Hill was confined, the Jail staff intentionally neglected Ms. Hill, who begged for

medical help the entire time of her confinement. They told her she was just a “junkie” going through

“withdrawals.”

10Officer Tiffany Ball, when asked by other officers to get Ms. Hill medical help.

-23-


93. Other Corrections Officers also asked both Sheriff Fontes and Jail Administrator

Large to get Ms. Hill medical help as soon as possible. Neither did.

F. The Jail Nurse Treats Ms. Hill’s Devolving Medical Condition With

Phenergan – An Anti-Nausea Drug.

94. As the day (September 28, 2016) went on, Ms. Hill’s medical condition progressively

worsened.

95. Ms. Hill’s cell-mate stated that Ms. Hill was never provided insulin during her

incarceration. Nor was she apparently provided any of the other medicines that her mother brought

to the Jail and gave to a Jail Nurse. Ms. Hill’s burns were never treated or dressed during her

confinement and she was not given the broad-spectrum antibiotics prescribed by her Vanderbilt

doctors and provided to the Jail Nurse.

96. At or around a little after 9:00 a.m. on September 28, 2017, Ms. Hill’s cell-mate

started shouting that Ms. Hill could not breathe and needed medical help. Officers Swain and Owens

responded. The nurse was called. According to her incident report, Officer Owens entered Ms.

Hill’s cell and witnessed her “tossing and turning on her mat.” Officer Owens asked what was

wrong and Ms. Hill “advised to me that she could not breathe and her chest was hurting.”

97. According to Officers Swain and Owens, Nurse Campbell arrived and “assessed” Ms.

Hill. She told Ms. Hill “to breathe in long breathes instead of panting.” At about 9:17 a.m., Nurse

Campbell told Ms. Hill that “she would bring her some medication to help with the sickness.”

According to Officer Swain, Nurse Campbell then left the cell, stating, “that’s detox for you.”

Officers Swain and Owens left Ms. Hill and returned to their duties. They did not return to check

on Ms. Hill’s well-being at any time thereafter.

-24-


98. Nurse Campbell, however, did return to Ms. Hill’s cell at approximately 9:51 a.m.

and, seeking to quiet Ms. Hill, gave her “a shot of Phenergan in her left hip,” to “calm her down,”

then left the cell.11 By this time, Ms. Hill was unable to even stand on her own.

G. Ms. Hill’s Pleas for Medical Help During Her Final Hours Were Ignored

by Cocke County Jail Employees Because They Erroneously Believed

She Was Merely Suffering From Drug-Withdrawal Symptoms.

99. According to other inmates in or near Ms. Hill’s cell at the time, after the shot of

Phenergan was administered by Nurse Campbell, Ms. Hill “begged and pleaded” for help and insulin

“all day long” on September 28, 2016 and no one came to help her.

100. The repeated refusals of Jail employees to intervene and provide Ms. Hill with

meaningful medical aid appears to have been prompted by the determination by Jail Administrator

Large, who was not a medical professional, and Jail Nurses, including Nurse Campbell, that Ms. Hill

was merely going through “withdrawals” because she was a drug addict, and that she did not require

medical attention, much less hospitalization.

101. On September 28, 2016, according to a cell-mate, Ms. Hill “was throwing up blood

all day.” All of Ms. Hill’s cell-mates continued to ask any Corrections Officer who happened to be

nearby to help her. Eventually, Large himself came into Ms. Hill’s cell, looked at her, and said,

“that’s what meth will do for you,” and walked away.

11Phenergan (promethazine) works by changing the actions of chemicals in your brain.

Promethazine also acts as an antihistamine, blocking the effects of the naturally occurring

chemical histamine in your body. Phenergan is used to treat allergy symptoms such as itching,

runny nose, sneezing, itchy or watery eyes, hives, and itchy skin rashes. Phenergan also prevents

motion sickness, and treats nausea and vomiting or pain after surgery. It is also used as a

sedative or sleep aid. See https://www.drugs.com/phenergan.html (last visited September 27,

2017).

-25-


H. Ms. Hill’s Death

102. By the last few hours of her life, Ms. Hill was essentially an invalid. She could not

walk. She could not stand. She could not go to the restroom. Then, according to various incident

reports of corrections officers, at a few minutes before 11:00 p.m. on September 28, 2016, Officer

Lane and Cpl. Phillips began distributing night medication to inmates.

103. A few minutes later, at about 11:03 p.m., Cpl. Phillips purportedly called Nurse

Campbell and informed her that Ms. Hill’s blood-glucose level was high. Nurse Campbell directed

Cpl. Phillips to give Ms. Hill “20 units of Humulin R and 15 units Lantus.”

104. Officer Lane purportedly “began to get Inmate Hills Insulin and Medication ready to

dispense to her.” She also purportedly “advised Cpl. Phillips to go to the Office to get Hill’s

bandages for her burns on her legs and arms.”12

105. Five minutes later, according to Officer Lane, other inmates in Ms. Hill’s cell “sat

Inmate Hill up on her mat to help her to the door to get her insulin and medication.” However, “they

stated that she was not gonna be capable of standing and walking to the door because she was weak.”

106. Around this time, according to Officer Lane, another inmate “yelled that inmate Hill

had quit breathing.”13

107. Cpl. Phillips went over to where Ms. Hill was laying and “checked her for breathing

and found that she was not breathing I immediately started CPR.” Officer Lane “then tried to call

12If she did either, it would have been the first time someone had distributed Ms. Hill’s

medicine or cleaned and dressed her burns.

13In contrast to Cpl. Phillips and Officer Lane’s reports and other incident reports, upon

information and belief, the reports are false. Witnesses state that the officers were not checking

Ms. Hill’s “glucose level” when she stopped breathing, but that Ms. Hill had stopped breathing

well before any Cpl. Phillips and Officer Lane “checked” on her..

-26-


for assistance,” but her “radio was dead.” She ran “to the Office” and “grabbed the radio off the

charger and called for assistance from the annex,” advising “Sgt. Ball that we had an inmate who

had ‘quit breathing and was bleeding.’”

108. Cpl. Phillips reported that he observed blood coming from Ms. Hill’s mouth and nose

and “ran over to the med cart to check for an AED” (an automated external defibrillator), but there

was no AED in the medical cart.14

109. According to Officer Lane, “Deputies Vaughn and Ochs” began “to assist Cpl.

Phillips. Deputy Ochs took over and started CPR” and “Sgt. Ball and Deputy Willis entered the Old

Jail to help assist officers.”

110. Deputy Vaughn instructed Cpl. Phillips to find a am-bu bag (a hand-held device

commonly used to provide positive pressure ventilation to patients who are not breathing or not

breathing adequately). There was not one in the building. So, Cpl. Phillips ran toward the Annex

(a nearby building) to get an amu bag but “was unable to due to a train.” Cpl. Phillips “was standing

in the road waiting on the train to pass when the ambulance pulled up.” He then “escorted the EMTs

to the third floor and took them in the back door and into 3 cell,” where, at about 11:22 p.m., Deputy

Vaughn was doing CPR. EMTs then moved Ms. Hill to the center of the cell, placed a CPR

machine on her, moved her onto the stretcher, and transported her to the hospital ER, where she was

pronounced dead at about 11:50 p.m.

14Yet, at least one other Corrections Officer who was purportedly on duty at the time

stated that he was asked to perform CPR on Ms. Hill before EMTs arrived, and that Ms. Hill’s

body “was cold to the touch,” and when he began CPR, black vomit/blood was forced out of her

mouth. He further stated that corrections officers “worked on” Ms. Hill for at least half an hour

or longer before EMTs were ever contacted.

-27-


111. An autopsy was ordered. Curiously, although Sheriff Fontes purportedly stated that

Ms. Hill had died of a drug overdose, and although she had stopped breathing, the EMTs who arrived

at the Jail and transported her to the hospital did not administer Nalaxone.

I. Sheriff’s Office Officials Attempt to Conceal the Circumstances Under

Which Ms. Hill Died In Their Custody.

112. After Ms. Hill’s death, an “investigation” was purportedly conducted into the

circumstances. According to a news release by Sheriff Fontes, “[b]ased on the investigation so far

the death appears to be some sort of medical issue and there is no evidence of physical trauma.”

113. Sheriff Fontes and Large engaged in an effort to conceal the inexcusable neglect of

Jail employees in disregarding, failing to recognize, or failing to treat Ms. Hill’s serious medical

problem. For example, according to one Corrections Officer, Sheriff Fontes instructed Jail

employees“not to say a word about what happened” to Ms. Hill “or there would be major

repercussions.”

114. Similarly, at least one Jail employee stated that Large “disposed of evidence that was

located on the floor of Ms. Hill’s cell,” to purportedly keep anyone from discovering forensic

evidence that might reveal another story about Ms. Hill’s death, and also “pressured at least one

Corrections Officer to keep silent about “what really happened” to Ms. Hill and to “stop asking

questions about it.” In addition, one Corrections Officer had discussed her knowledge of the

circumstances of Ms. Hill’s death with Ms. Hill’s family and was summoned by Large, interrogated

by him, and warned to cease talking to them.

115. After Ms. Hill’s death, certain Corrections Officers made statements, verbally and/or

in writing, that indicated Ms. Hill was still conscious, alert, lucid, and possibly even talking minutes

before she purportedly collapsed in her cell while Officer Lane and Cpl. Phillips were there to check

-28-


her glucose level. Specifically, misrepresentations were made to medical professionals at the

hospital where Ms. Hill was taken. For example, Cpl. Phillips and Officer Lane told the emergency

room staff that Ms. Hill had “refused her medication” earlier in the day. To be sure, there is no

documentary evidence that Ms. Hill was even offered insulin at any time. Further, this is contrary

to what numerous witnesses state happened on the day Ms. Hill died. He also stated that Ms. Hill

had just became unresponsive when he was purportedly checking her glucose level, a fact which

numerous witnesses to the incident dispute.

116. Of course, these representations are false. After all, witnesses have stated that Ms.

Hill had collapsed and stopped breathing well before Officer Lane and Cpl. Phillips supposedly

showed up to “check her glucose levels” – which, incidentally, would have been a first that anyone

did so during her incarceration. Yet, Officer Lane and Cpl. Phillips implausibly maintained that

before they encountered Ms. Hill, she was conscious and alert, and they likely do so in an attempt

to deflect or escape liability for their neglect – and the Cocke County Sheriff’s Office’s neglect – of

Ms. Hill and her ultimate death.

J. Ms. Hill’s Cause-of-Death.

117. According to the toxicology on postmortem blood, the results were significant for

fourteen (14) compounds, including Oxycodone, methamphetamine, and Promethazine. However,

Acetone was also present and she was dehydrated. The medical examiner has preliminarily

determined that the cause-of-death was “acute combined drug overdose (oxycodone,

methamphetamine, and promethazine).”

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118. Ms. Hill had been taking Oxycodone and Morphine – prescribed by her doctors at

Vanderbilt Medical Center – for pain associated with her burns.15 And Nurse Campbell gave Ms.

Hill a shot of Phenergan (Promethezine) at approximately 11:00 a.m. on the day she died.

119. What is more, according to information and data published by the National Institute

of Health and other reliable medical sources, the levels of Oxycodone, methamphetamine, and

Promethazine in Ms. Hill’s system were each insufficient to be reasonably considered a fatal dosage.

120. More importantly, Acetone produced in the body is a result of uncontrolled diabetes.

Specifically, it is “a product of diabetic- and fasting-induced ketoacidosis.” Isopropyl alcohol is

currently considered a marker of ketoacidosis. The compound can be detected in several situations

of forensic interest, beyond direct exposure to isopropyl alcohol itself, and is characterized by,

among other things, increased acetone levels. Results of isopropyl alcohol determination in cases

of sudden death in diabetics have been reported.

121. According to the National Institute of Health, diabetic ketoacidosis (“DKA”) is a

life-threatening condition that can occur when there is a complete lack of insulin, as in Type 1

diabetes, or inadequate insulin levels associated with stress or severe illness in either Type 1 or type

2 diabetes. See https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4500977/. In the realm of forensic

15Notably, at least three Cocke County Corrections Officers who, upon information and

belief, interacted with Ms. Hill during her short incarceration were terminated for smuggling

methamphetamine and oxycodone into the Jail and distributing them to inmates. The former

officers were charged with official misconduct and introducing contraband into a penal facility.

Two other officers who interacted with Ms. Hill and purportedly discovered her unconscious on

the date of her death were also terminated for “serious policy violations and potential civil rights

violations.”

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pathology, acute complications of Diabetes Mellitus – which Ms. Hill suffered from since she was

an adolescent – as a cause of death is often difficult to diagnose. Fatal DKA is, however, easily

diagnosed when biochemical investigations complement an autopsy and histology.

122. Ms. Hill was deprived of insulin for the entire length of her incarceration and was

severely dehydrated at the time of her death. DKA occurs when there is not enough insulin in the

body, resulting in high blood-glucose levels; the person is dehydrated; and too many ketones are

present in the bloodstream, making it acidic.16

K. Failed Inspections, De-Certifications, Missing Logs, and Sky-rocketing

Medical Expenses.

1. Failed inspections and de-certifications.

123. On July 16, 2016, the Cocke County Jail failed to pass a state inspection after

Detention Facilities Specialist Gwen Beavers reported “alarming deficiencies regarding the structure

of the building, security, and medical services,” all which Ms. Beavers said was a result of the jail

being overcrowded and lack of the manpower. Specifically, the Tennessee Corrections Institute

(“TCI”)17 refused to certify the Jail,18 noting, among many others, the following deficiencies:

16The hospital examination of Ms. Hill found “copious amount of black emesis on the

patient and in the Pt’s throat.” Black emesis, or black vomit, can be caused by a variety of

medical conditions, including diabetic ketoacidosis, hepatitis, and drug overdose, among many

others. Acetone levels associated with diabetic or fasting ketoacidosis range from 10-70 mg/dL.

Ms. Hill’s acetone level was measured at 15 mg/dL.

17Under the authority of T.C.A. § 41-4-140, the Tennessee Corrections Institute (“TCI”) is

required to establish minimum standards for adult local jails, lock-ups, workhouses and detention

facilities in the state.

18The TCI’s Board of Control establishes the standards to inspect and certify local

correctional facilities. Inspections and re-inspections are conducted within the mandated time-

frame to ensure compliance of all standards for the purpose of certification.

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# medication distribution receipt system is inconsistent with missing

signatures for distribution;

# facility policy has not been met in regard to annual approval of

Medical Protocols;

# poor and untimely security checks; and

# poor “staff performance quality.”

124. On September 8, 2016, the TCI refused to certify the Jail upon reinspection, noting,

among many others, these deficiencies:

# limited staff is affecting the ability to perform required functions

relating to security, custody, and supervision of inmates, as well as

impeding staff ability to maintain compliance with TCI Minimum;

Standards and Agency Post Positions;


signatures for distribution;

# insufficient staffing is resulting in security checks being conducted

visually by camera; and

# “the low quality of officer performance is reflective of the minimal

staff available to complete daily operational task to the level of

acceptance.”

125. On June 27, 2017, the TCI again refused to certify the Jail, finding the following

deficiencies:

# overcrowded and understaffed;

# under-staffing makes “it virtually impossible to meet the needs of

the facility and perform the required task to ensure safety and

security”;

# cannot properly supervise inmates;

# inadequately trained;

# improper documentation and logs;

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# no record of meals provided;

# minimal documentation kept for inmates who require special

observation;

# poor documentation kept for medicine distribution;

# inmates are not permitted a telephone call before being processed;

# security checks on inmates are not being timely properly

conducted; and

# “Documentation of checks on special observation inmates is

pre-timed in exact 15 minute increments and contains missing

results.”

126. Finally, on August 28, 2017, the TCI inspector again decided not to certify the Jail,

listing, among other deficiencies,

# lack of training of medical staff;


signatures for distribution; and

# failure of medical staff to maintain inventory of medical

instruments and equipment.

127. On September 7, 2017, Mayor Crystal Ottinger and Sheriff Fontes appeared before

the Cocke County Corrections Partnership workshop to discuss their recent appearance before the

TCI in Nashville. Mayor Ottinger bluntly stated that the TCI’s review committee indicated that the

jail was not re-certified because the committee "believes it is unsafe for inmates and staff."

2. Real World Consequences

128. These deficiencies have real world consequences. In this case, a number of the

deficiencies found by the TCI inspector directly and/or indirectly impacted Ms. Hill’s inadequate

medical treatment, including the under-staffing, failures in medicine-distribution policy, poor staff

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performance, poor quality staff, inadequately training, improper documentation and logs of meals

and medicine, failure to allow Ms Hill to make a telephone call before being processed, failure to

perform security checks on inmates, and failure to have emergency medical devices in the building

housing the Jail.

129. Perhaps the most critical of the failures was the failure to require Jail employees to

document checks on special observation inmates. Here, it appears that there are no “real checks” on

such inmates at all, as the log inspected was pre-timed in exact 15 minute increments containing

“missing results.”19

3. Missing logs and files

130. Also, Plaintiff’s counsel made multiple public records’ requests (October 25, 2016

and December 12, 2016) to the Cocke County Mayor and Sheriff Fontes seeking information and

documents concerning Ms. Hill’s incarceration and medical treatment. As it turns out, the County

Attorney could not produce a number of documents because they were never created and did not

exist. Those documents included a log that exhibited glucose-test results during Ms. Hill’s

incarceration, a log that exhibited the medicine that was actually dispensed to Ms. Hill during her

incarceration, and a log that exhibited Ms. Hill’s dietary history during her incarceration Also

19There have been other serious real world consequences as well. For example, in August

2016, after an inmate overdosed on drugs smuggled into the Jail, Sheriff Fontes stated:

“This is a prime example of the amount of catastrophic liability our

jail faces daily. I have reported time and time again to the County

Commission that we need adequate manpower and a better

physical facility.”

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missing is a recording of Ms. Hill’s telephone call with her mother on September 26, 2016 – the last

communication her mother would ever have with her – during which she says she is not receiving

medicine and is afraid she was going to die.

4. Skyrocketing medical expenses

131. In addition to all of this, Jail medical expenses are increasingly becoming a problem

for Cocke County. Sheriff Fontes has reported that medical expenses in the jail continue to mount.

For instance, with two months remaining in the 2016-17 fiscal year, Jail medical expenses were “in

the red” by $22,000. According to Cocke County Finance Director Anne Bryant-Hurst, referring to

the 2016-17 fiscal year, “[t]his is the most catastrophic year for medical expenses that we’ve had.”

At an April 2017 meeting of the Cocke County Legislative Body Finance Committee, Bryant-Hurst

implored that the commissioners must figure out a solution to the medical costs. Commissioner

Robert Green referred to the “skyrocketing medical costs” at the Jail and said, “[t]he current budget

earmarked $170,000 for medical expenses but those costs now have risen to over $500,000, and has

meant a transfer of monies from other areas of the budget to meet the costs.”

132. The natural consequence of such “skyrocketing medical costs” is the inclination when

warned about a financial crisis to cut costs. Here, that would mean not sending seriously ill inmates

to the hospital for treatment.20

133. The upshot is that, having accepted Ms. Hill into their facility as an inmate, Cocke

County and its Jail employees could not then abandon her to die. They had plenty of reasons – all

of which were entirely legitimate – to take Ms. Hill to a hospital or another facility to properly insure

20It appears that someone at the Sheriff’s Office realized this from the beginning, as

Plaintiff was informed early on (September 26-27) that her daughter would be moved to another

facility that could better accommodate her medical needs.

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that she received an appropriate level of care, given her severe burns and Diabetes Mellitus Type

I. But they did none of this, and the recent budgetary constraints lend substantial credibility to the

notion that Jail officials abused whatever discretion they had by accepting and retaining an inmate

requiring such medical attention as Ms. Hill in the Jail.

L. Cocke County Corruption

134. The Cocke County Sheriff’s Office is not, according to reports from Sheriff Fontes

over the past year or so, a bastion of law enforcement morality. On August 30, 2016, three weeks

before Ms. Hill’s incarceration, two terminated employees of the Sheriff’s Office – Autumn Davis,

a nurse, and Shayelen Scheffers, a corrections officer, were indicted by a Cocke County Grand Jury

for obtaining controlled substances by fraud and conspiracy to possess a controlled substance. Davis

used her position as a nurse to get Oxycodone and Hydrocodone pills and Scheffers helped.

135. On March 30, 2017, Charles Webb, a former employee accused of bringing drugs into

the Cocke County Jail Annex, was indicted by a Cocke County Grand Jury for four counts of

introduction of drugs into a penal institution. Since the indictment, Webb has been fired and an

investigation began, according to the Cocke County Sheriff's Office.

136. More recently, Officer Lane and Cpl. Phillips, the officers who purportedly

discovered Ms. Hill in her cell moments before she died, were also terminated on June 29, 2017 for

“committing serious policy violations and potential civil rights violations.” Lane and Phillips

purportedly discovered Ms. Hill unresponsive in her cell on the evening of September 28, 2016. In

a release about the firings, Sheriff Fontes stated, “[i]n this case, I can’t give any details, with these

two employees, they were in clear violation of departmental policy . . . . And they also in my

opinion, I think that they are potentially in violation of civil rights, based on their actions.” Sheriff

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Fontes stated that he personally contacted the FBI to investigate this case due to the potential of civil

rights violations.21

137. Two weeks later, on July 13, 2017, still two more Jail employees were terminated for

smuggling methamphetamine into the Jail to give to inmates. On August 17, 2017, the Cocke

County Sheriff's Office also arrested the two, Kyle VanDaley and Heather Boyd, who were charged

with official misconduct and introducing contraband into a penal facility.22

M. Ms. Hill Received No Form of Diabetes Treatment, Insulin Therapy, or

Thermal Burn Care at the Cocke County Jail.

138. Ms. Hill’s multiple and serious medical conditions required that she be carefully

observed and cared for during her incarceration. Through it all, however, Ms. Hill’s Diabetes was

never given the slightest form of medical attention by Cocke County Sheriff’s Officials, Jail Nurses,

or Corrections Officers. Although her mother had provided almost all of her prescription

medications to a Jail Nurse, Ms. Hill was never given a single insulin injection of any form or type.

Her second- and third-degree burns, then covered by skin-grafts, were not medicated, wrapped, or

otherwise bandaged during her incarceration. Nor was she given antibiotics to ward off an infection

in her numerous burn wounds. Her strict dietary requirements were altogether disregarded and she

was severely dehydrated when she died. She was not seen or examined by a medical doctor or taken

to a hospital until she had already died.

21Although requested by Plaintiff’s counsel, only part of Cpl. Phillips’ and Officer Lane’s

employment files were turned over, due to, upon information and belief, a pending investigation

by the FBI concerning potential civil rights violations.

22After the incident involving Ms. Hill, Jail Administrator Large resigned. No reason for

his resignation was provided.

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N. The Circumstances Require Discovery to Permit Plaintiff to More

Precisely Allege Her Claims.

139. Due to Ms. Hill’s death, Plaintiff was compelled to file this Complaint without the

benefit of information available only to her daughter. Moreover, Ms. Hill would have been better

able to identify culpable parties and describe more fully the details of her incarceration.

Furthermore, Plaintiff was not permitted to visit or talk to her daughter other than for one brief

conversation during her confinement and to learn the precise circumstances of how she was treated.

Finally, more precise allegations might have been made if Cocke County had more fully responded

to Plaintiff’s public records request.

140. Accordingly, many of the allegations in this Complaint have been made upon

information and belief, but after a full investigation. Consequently, more precise allegations cannot

be made at this time.

V. INSUFFICIENT POLICIES, PRACTICES, AND LACK OF ACCOMMODATIONS

141. At all relevant times, Cocke County and Sheriff Fontes had a policy and practice of

reducing medical expenses.

142. At all relevant times, there was no full-time medical doctor present at the Jail.

Medical care was routinely administered by Corrections Officers and/or Jail Nurses.

143. Pursuant to jail policy and long-standing practice, Ms. Hill did not receive her insulin

medication or other treatment to assist her with managing her diabetes, and her Type-I diabetes was

not reasonably monitored. Similarly, Ms. Hill did not receive her prescribed medication and

bandages to treat and dress her thermal burns.

144. Cocke County, Sheriff Harris, and Large failed to provide diabetic appropriate

nutrition at the jail, feeding diabetic disabled inmates like Ms. Hill a diet that is invariably high in

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simple carbohydrates and sugar. Ms. Hill was denied access to diabetic-appropriate nutrition and

instead received the same meals as the general population. Her meals were also unpredictable in

timing and content and were inappropriate for disabled diabetics, contrary to medical directions.

145. As a result of Cocke County’s policy of under-staffing and under-funding, Ms. Hill’s

mealtimes and blood-sugar checks were irregular and were not timed by corrections officers to allow

coordination with access to basic diabetic accommodations, including blood-sugar checks and

insulin administration.

146. Ms. Hill was also forced to eat diabetic-inappropriate meals without first being

allowed to check her blood sugar or take insulin, or being required to forgo blood sugar checks or

insulin entirely.

147. As a result of these policies and practices of under-staffing, under-funding, and failure

to train, the corrections officers and medical staff were unable to provide diabetic inmates with

accommodations to basic diabetes care, including regular blood-sugar checks and insulin

administration, in coordination with regular mealtimes and a diabetic-appropriate diet.

148. All of this is the functional equivalent of receiving no accommodations or treatment

at all and is the direct result of Cocke County’s, Sheriff Fontes, and Large’s policy and practice.

149. Disabled diabetic inmates deprived of insulin like Ms. Hill and other inmates,

including those withdrawing from opiates or medications at Cocke County Jail are routinely allowed

to suffer, without any medical support, for extended periods of time, at most being taken to the

emergency room after their condition has severely deteriorated.

150. The custom, policies and practices at Cocke County constitutes deliberate indifference

because they inflict needless suffering on inmates.

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151. Insulin deprivation for all Type-I diabetics is life-threatening and requires treatment

in a hospital and it is often fatal.

152. Death due to insulin deprivation, high blood sugar and Diabetic Ketoacidosis is a

known occurrence in jails of which all the named Defendants were aware.

153. Despite knowledge of her condition and disability by the Defendants, Ms. Hill never

received insulin, never received a special diet of any kind, and was never provided a blood glucose

monitor needed to self-manage and regulate her insulin levels.

VI. DISABILITY DISCRIMINATION

154. Ms. Hill began experiencing symptoms of high blood-sugar due to her lack of insulin

immediately upon being booked. She became unable to eat or drink, was confused, began suffering

from dizzy spells and was unable to move easily. She repeatedly reported to multiple persons at the

Jail that she was a Type-I diabetic, that she needed insulin because she was suffering from high

blood sugar.

155. Instead of accommodating Ms. Hill or providing her care, Jail staff came to Ms. Hill’s

cell and remarked that she was a “junkie” going through “detox’ or “withdrawals.”

156. Despite pleas for medical care and as a result of an official policy and practice of

deliberate indifference or failure to train, neither of the Individual Defendants provided her with the

insulin she needed and, aside from a single instance early on the day she died when Nurse Campbell

gave her a shot of Phenergan to “calm her down,”never checked her medical condition.

157. Ms. Hill immediately exhibited signs and symptoms of DKA. By that point, she

could no longer drink water, walk, or stand, and was suffering from abdominal pain. Her condition

was known to the personnel at the Jail, including all Individual Defendants.

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158. Despite Ms. Hill’s deteriorating medical condition and plea for medical attention, she

was never seen by a doctor.

159. Over the next several hours, Ms. Hill became disoriented, periodically unresponsive,

and stopped eating and drinking in sufficient amounts. As her condition deteriorated, she exhibited

classic symptoms associated with DKA: dehydration, difficulty breathing, confusion, and inability

to eat or drink. When Ms. Hill was periodically lucid, she again asked for a doctor and for her

injections.

160. From the morning of September 26, 2016 until she died at approximately 11:50 p.m.

on September 28, 2016, Ms. Hill’s diabetes was never checked, as all of the Individual Defendants

continued to deny her accommodations for her diabetes and remained deliberately indifferent to her

obvious serious medical condition.

161. As a result of the insulin-deprivation and untreated DKA, Ms. Hill began losing

feeling in her extremities and her body started to lose its ability to regulate temperature. With her

blood glucose at dangerous levels, she ultimately became non-coherent and unresponsive. Only then

– after she had died – did anyone call EMTs to transport her to the hospital.

VII. WAIVER OF IMMUNITY

162. Cocke County has waived immunity for negligence of the county and county

employees, misconduct of deputies acting under color of law, and for the negligence of deputies or

employees of the Cocke County Sheriff’s Office or the county, as set out in Tenn. Code Ann.

§29-20-305, and for intentional acts or misconduct done by deputies under color of law, as set out

in Tenn. Code Ann. §8-8-302-302.

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163. There is no immunity for individuals for criminal conduct, or conduct which is willful

or malicious.

VIII. CLAIMS FOR RELIEF

COUNT ONE

VIOLATION OF CIVIL RIGHTS LAWS UNDER COLOR OF LAW

42 U.S.C. § § 1983 and 1988

Deliberate Indifference to Serious Medical Needs

(Against Sheriff Fontes and Large)

164. Plaintiff incorporates by reference all the above allegations as if fully set forth herein.

165. Under 42 U.S.C. § 1983, a person has a federal cause of action for money damages

against an individual acting under color of state law who deprives another of rights, privileges, or

immunities secured by the United States Constitution and federal laws. Here, Sheriff Fontes and

Large were acting under color of state law.

166. Sheriff Fontes and Large both acted in violation of 42 U.S.C. § 1983, and in

deliberate indifference to the serious medical needs of Ms. Hill.

167. Upon information and belief, from the point of Ms. Hill’s arrest and incarceration,

Defendants had notice of her serious medical conditions and disability.

168. During her booking, Ms. Hill and/or her mother told the corrections officers, and the

Jail medical staff about her medical conditions and the specific treatments they required, including

the insulin combination injections needed to manage her Type-I diabetes.

169. Sheriff Fontes and Large were responsible for development and implementation of

policies and procedures for medical care at the Jail and by actions and inaction implemented the

unconstitutional customs, policies and practices which resulted in Ms. Hill’s injuries and death.

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170. Sheriff Fontes and Large failed to create and implement sufficient policies and

procedures regarding providing medical care to inmates and failed to provide proper staffing,

supervision and discipline of corrections officers and nurses in order to prevent deliberate

indifference to the medical needs of inmates as occurred here.

171. Sheriff Fontes and Large, despite their duty to do so, failed to ensure that Ms. Hill as

an inmate received adequate and prompt medical care and instead were deliberately indifferent to

her serious medical needs, both in the policies and practices implemented at the Jail and by failing

to intervene when Ms. Hill’s condition and disability were known.

172. Pursuant to Cocke County’s Jail policy implemented by Sheriff Fontes and Large, and

long-standing practice, while incarcerated in the Cocke County Jail on September 26-28, 2016, Ms.

Hill did not receive her insulin medication or other treatment to assist her with managing her

diabetes, and her Type-I diabetes was not reasonably monitored. Nor did either insure that Ms. Hill

was provided with her medication and bandages to treat her second- and third-degree thermal burns.

173. Pursuant to Cocke County’s Jail policy under Sheriff Fontes and Large, and

long-standing practice, Ms. Hill was also prohibited from using her insulin medication, glucose

monitor, and injections while incarcerated. This is contrary to the standard of care for jails.

174. Cocke County has a long-standing policy and practice whereby disabled diabetic

inmates being deprived of insulin and other inmates withdrawing from opiates or medications are

routinely left to suffer, without any medical support, for extended periods of time, or, at most, being

taken to the emergency room after the condition has severely deteriorated.

175. Corrections officers and nurses working under Sheriff Fontes and Large, by policy

and practice, also inexplicably denied Ms. Hill access to the necessary non-prescription medications

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she needed in treat her conditions and prevent high blood sugar, Diabetic Ketoacidosis, permanent

nerve damage, and infection.

176. All of these customs, policies, and practices constitute deliberate indifference because

they inflict needless suffering on inmates whose care is entrusted to the county. Application of these

customs and policies to Ms. Hill constituted deliberate indifference because it placed her health and

safety at risk from known complications of insulin deprivation, Diabetic Ketoacidosis, organ systems

failure, or medication withdrawal.

177. An individual officer engages in conduct in violation of the Eighth or Fourteenth

Amendment where he or she demonstrates deliberate indifference to the serious needs of an inmate

or pre-trial detainee, such as Ms. Hill, by intentionally denying or delaying adequate medical care

for said person. Deliberate indifference may be found to exist where an officer denies or delays

obtaining treatment for an inmate or pre-trial detainee under facts and circumstances that would

cause a layperson to conclude medical treatment was needed. Here, under the facts and

circumstances alleged above, a reasonable layperson would have concluded that Ms. Hill needed

medical treatment during her first few hours of confinement.

178. At various times during her brief incarceration, several of the Individual Defendants,

including Large, Nurse Campbell, and Officer Ball, as described above, characterized Ms. Hill as

a “junkie” and/or directed others not to give her aid, stating that she was merely going through

“withdrawals” or “detox” and that nothing was seriously wrong with her, medically speaking. These

remarks were made notwithstanding Ms. Hill’s two very serious and worsening medical conditions.

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179. Insulin deprivation for all Type-I diabetics is life-threatening, requires treatment in

a hospital, and is ordinarily fatal. Death due to insulin deprivation, high blood sugar, and Diabetic

Ketoacidosis is a known occurrence in jails of which Sheriff Fontes and Large were well aware.

180. Sheriff Fontes and Large deliberately ignored Ms. Hill’s requests and allowed their

employees to do the same, without consequence. Throughout Ms. Hill’s incarceration, she never

received insulin or a special diet of any kind, nor was she ever provided a blood-glucose monitor to

self manage and regulate her insulin levels.

181. Hearing and observing the Individual Defendants’ disregard of Ms. Hill’s constant

pleas and cries for help, other inmates repeatedly complained on her behalf. Large was exposed to

Ms. Hill, hearing, seeing, and observing her during that time. It is simply implausible to believe that

he was unaware of Ms. Hill’s rapidly-devolving medical condition. Yet, he did nothing to aid her.

182. Upon information and belief, Sheriff Fontes and Large had actual knowledge of the

physical signs and symptoms of the serious medical conditions exhibited by Ms. Hill. They also had

actual knowledge of, but disregarded, the serious health risks to Ms. Hill by failing to provide her

with any semblance of meaningful medical care, much less adequate medical care, for both her

Diabetes Mellitus Type 1 and the second- and third-degree thermal burns covering 10% of her

body’s surface area.

183. Upon information and belief, Sheriff Fontes and Large both had actual knowledge

that, as early as September 27, 2016, Ms. Hill’s medical condition had so rapidly deteriorated that

she began to exhibit numerous signs and symptoms that she was critically ill, e.g., unable to sit up,

stand, or walk, nauseated, extremely fatigued, and suffering from severe dehydration. If Sheriff

Fontes and Large had instructed any of the Individual Defendants to merely check Ms. Hill’s glucose

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level during this period, it would have likely prompted them to seek or advocate for appropriate

medical attention for her, including hospitalization. Nevertheless, they failed to insure that Ms. Hill

was provided adequate medical care.

184. This failure to provide medical care was knowing and intentional, not merely

inadvertent or negligent.

185. Significantly, Diabetic Ketoacidosis (“DKA”) responds to fluid replacement,

electrolyte replacement, and insulin therapy. If either Sheriff Fontes or Large had responded to Ms.

Hill’s symptoms and cries for help, or to the plea of other inmates to help her, her condition could

have been treated, and it is likely that she would have survived.

186. Even a layperson would have noticed – and several of them did – that Ms. Hill was

very sick. It did not take someone with a medical background to recognize that Ms. Hill was

seriously ill.

187. By not seeing to Ms. Hill’s serious need for medical attention, Sheriff Fontes and

Large allowed her medical condition to become increasingly critical, quickly escalating into a life-

threatening condition that ultimately proved fatal. Their failure to provide adequate medical care

to Ms. Hill resulted in her suffering unnecessary, excruciating, and unbearable pain.

188. If Ms. Hill had been taken to the hospital on September 26-27, 2016, or even early

on September 28, 2016, and been examined by competent medical personnel, they would have

properly diagnosed the problem and began to effectively treat it. Instead, they intentionally or

recklessly ignored Ms. Hill’s serious medical needs and failed to provide any medical care at all, all

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of which made her condition substantially worse. There is verifying medical evidence that

establishes the detrimental effect of the delay in medical treatment in this instance.

189. This failure to provide medical treatment rose to a Constitutional violation. As a

proximate result of the conduct of Sheriff Fontes and Large, the untreated conditions, Diabetic

Ketoacidosis, and extensive second- and third-degree thermal burns, resulted in serious pain and

suffering, and eventually, one of the conditions resulted in Ms. Hill’s death.

190. Based on the foregoing, Sheriff Fontes and Large exhibited deliberate indifference

to Ms. Hill’s serious need for adequate medical care which directly caused her death, as described

herein, and are therefore liable to Plaintiff pursuant to the provisions of 42 U.S.C § 1983.

191. At the time of this incident, the law was clearly established that the Defendants’

deliberate indifference to the serious medical needs of an inmate or pretrial detainee is a

constitutional violation such that Sheriff Fontes and Large are not entitled to qualified immunity.

192. Plaintiff therefore seeks any and all damages allowable, attorney’s fees pursuant to

42 U.S.C. § 1988, costs of this action, and discretionary costs.

COUNT TWO

VIOLATION OF CIVIL RIGHTS LAWS UNDER COLOR OF LAW

42 U.S.C. § § 1983 and 1988


(Against All Individual Defendants, Except Sheriff Fontes and Large)


194. Under 42 U.S.C. § 1983, a person has a federal cause of action for money damages

against an individual acting under color of state law who deprives another of rights, privileges, or

immunities secured by the United States Constitution and federal laws. Here, each of the Individual

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Defendants – along with all of the John and Jane Doe Defendants – were acting under color of state

law.

195. Here, under the facts and circumstances alleged above, a reasonable layperson would

have concluded that Ms. Hill needed medical treatment during her first few hours of confinement.

196. Upon information and belief, from the point of Ms. Hill’s arrest and incarceration,

each Defendant had notice of her serious medical conditions and disability. The Individual

Defendants, including the John and Jane Doe Defendants, knew that Ms. Hill had multiple serious

medical conditions and that it was getting worse as she untreated.

197. During her arrest and booking, Ms. Hill and/or her mother told the arresting officers,

the Corrections Officers, and the Jail medical staff about her conditions and the specific treatments

required for each, including the insulin combination injections needed to manage her Type-I

diabetes.

198. Nurse Campbell’s history of medical care at the Cocke County Jail shows a standard

practice of lacking necessary medication, denying inmates medication, and denying reasonable

disability accommodations.

199. Despite Ms. Hill’s pleas for help, Nurse Campbell never treated Ms. Hill or responded

to her deteriorating medical condition before or after giving her a shot of Phenergan to “calm her

down.” Rather, Nurse Campbell viewed Ms. Hill as drug addict suffering through a typical

detoxification period. Her condition was never meaningfully evaluated and Ms. Hill remained

deprived of necessary insulin as her high blood sugar and DKA symptoms were ignored.

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200. Even though Nurse Campbell was aware of Ms. Hill’s condition and its dangers, and

witnessed Ms. Hill’s symptoms, Nurse Campbell inexplicably failed to provide her with the insulin

or other medical care she needed.

201. Nurse Campbell had a duty to provide medical care and she failed to do so. Instead,

she acted with deliberate indifference to the known medical disability and conditions that plagued

Ms. Hill and eventually led to her death.

202. As a result of the many deficiencies in the policies and procedures at the Cocke

County Jail, Nurse Campbell’s inaction made it more difficult for inmates like Ms. Hill to receive

emergency medical care and placed the decision of whether medical care was needed in the hands

of untrained corrections officers, as opposed to licensed medical personnel on staff.

203. But all of the Individual Defendants, including the John and Jane Doe Defendants –

each and every one of them – ignored Ms. Hill’s increasingly serious then critical medical

conditions.

204. At various times during her brief incarceration, several of the Individual Defendants,

as described above, characterized Ms. Hill as a “junkie” and directed others not to give her aid,

stating that she was merely going through “withdrawal” or “detoxification” and that nothing was

seriously wrong with her, medically speaking. These remarks were made notwithstanding Ms. Hill’s

two very serious medical conditions.

205. Hearing and observing the Individual Defendants’ disregard of Ms. Hill’s constant

pleas and cries for help, other inmates in her cell and nearby repeatedly complained on her behalf.

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Each of the Individual Defendants were exposed to Ms. Hill during her incarceration, hearing,

seeing, and observing her during that time. It is implausible to believe that any of them were

unaware of Ms. Hill’s rapidly devolving medical condition.

206. Upon information and belief, all of the Individual Defendants, including the John and

Jane Doe Defendants, had actual knowledge of, but disregarded, the serious health risks to Ms. Hill

by failing to provide her with any semblance of meaningful medical care, much less adequate

medical care, for both her Diabetes Mellitus Type I and the second- and third-degree thermal burns

covering 10% of her body’s surface area.

207. Upon information and belief, all of the Individual Defendants, including the John and

Jane Doe Defendants, had actual knowledge that as early as September 27, 2016, Ms. Hill’s medical

condition had so rapidly deteriorated that she began to exhibit numerous signs and symptoms that

she was critically ill, e.g., she was not able to sit up, stand, or walk, was nauseated, extremely

fatigued, and suffering from severe dehydration. If the Individual Defendants had merely checked

her glucose level during this period, it should have prompted them to seek or advocate for

appropriate medical attention for her, including hospitalization. Nevertheless, they failed to provide

Ms. Hill with adequate medical care.

208. Significantly, Diabetic Ketoacidosis (“DKA”) responds to fluid replacement,

electrolyte replacement, and insulin therapy. If the Individual Defendants had responded to Ms.

Hill’s symptoms and cries for help, or to the plea of other inmates to help her, her condition could

have been treated, and it is likely that she would have survived.

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209. All of this demonstrates that each Individual Defendant’s failure to attend to

Plaintiff’s serious medical needs or provide medical care to her constituted a Constitutional

violation.

210. By not seeing to Ms. Hill’s serious need for medical attention, the Individual

Defendants, including the Jane and John Doe Defendants, allowed her medical condition to become

increasingly critical, quickly escalating into a life-threatening condition that ultimately proved fatal.

211. The failure of the Individual Defendants, including the Jane and John Doe

Defendants, to provide adequate medical care to Ms. Hill resulted in her suffering hours and days

of unnecessary, excruciating, and unbearable pain.

212. If the Individual Defendants, including the Jane and John Doe Defendants, had taken

Ms. Hill to the hospital on September 26, 2016 and allowed her to be examined, medical personnel

would have properly diagnosed the problem and began to effectively treat it. Instead, they all

ignored Ms. Hill’s serious medical needs and failed to provide any medical care at all, all of which

made her condition substantially worse, then one or more of them lied to medical professionals about

Ms. Hill’s condition. There is verifying medical evidence that establishes the detrimental effect of

the delay in medical treatment in this instance.

213. This failure to provide medical treatment rose to a Constitutional violation. As a

proximate result of the conduct of the Individual Defendants, including the Jane and John Doe

Defendants, the untreated conditions, Diabetic ketoacidosis, resulted in serious pain and suffering,

and eventually, one of the conditions resulted in Ms. Hill’s death.

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214. Based on the foregoing, the Individual Defendants exhibited deliberate indifference

to Ms. Hill’s serious need for adequate medical care, which directly caused her death, as described

herein, and they are therefore liable to Plaintiff pursuant to the provisions of 42 U.S.C § 1983.

215. At the time of this incident, the law was clearly established that the Defendants’

deliberate indifference to the serious medical needs of an inmate or pretrial detainee is a

constitutional violation such that the Individual Defendants are not entitled to qualified immunity.

216. Plaintiff therefore seeks any and all damages allowable under federal law, attorney’s

fees pursuant to 42 U.S.C. § 1988, costs of this action, and discretionary costs.

COUNT THREE

VIOLATION OF CIVIL RIGHTS UNDER COLOR OF LAW

42 U.S.C. §§ 1983 and 1988

Failure to Train and Supervise/Acquiescing-In and

Ratifying Unconstitutional Conduct of Subordinates

(Against Sheriff Fontes and Jail Administrator Large)

217. The allegations of the preceding paragraphs of this Complaint are hereby incorporated

by reference into this Count of the Complaint, as if set forth verbatim herein.

218. Cocke County, Sheriff Fontes, and Large each failed to adequately train their

corrections officers and medical staff in regard to the medical needs of disabled insulin-dependent

diabetics and inmates suffering severe thermal burns.

219. Sheriff Fontes and Jail Administrator Large had a duty to train and supervise their

corrections officers to insure the provision of adequate medical care to inmates with serious medical

needs. They failed to train and supervise the Individual Defendants, including the John and Jane Doe

Defendants, properly; failed to investigate allegations of inadequate medical care; and subsequently

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attempted to conceal the unreasonable deprivation of medical care by refusing to conduct any

meaningful investigation of the circumstances surrounding Ms. Hill’s in-custody death, implausibly

using Ms. Hill’s past drug addiction as an excuse, notwithstanding the fact that she had been

incarcerated for more than two and a-half days. Sheriff Fontes and Large at least implicitly

authorized, approved, or knowingly acquiesced in the unconstitutional conduct alleged herein by

erroneously signaling that Ms. Hill died of a drug overdose and not reprimanding anyone for their

actions or inactions concerning Ms. Hill.

220. Sheriff Fontes and Large had an opportunity to implement corrective action against

the various officers or nurses involved, but did not. Instead, they implicitly authorized, approved,

or knowingly acquiesced in those officers’ conduct, implicitly acquiescing in the deprivation of

medical care and cruel and unusual punishment as well.

221. Upon information and belief, none of the officers or nurses whose actions or inactions

resulted in Ms. Hill’s death received disciplinary action of any kind.

222. It is highly unlikely that the death of an inmate such as that described herein would

not be reviewed by Sheriff Fontes and Large. Still, there have been no results made public or

otherwise provided regarding an investigation into Ms. Hill’s death. Sheriff Fontes was involved,

at least in part, in creating and enforcing all of the Cocke County Sheriff’s Office’s policies. Here,

he did not punish officer misconduct, but “rubber stamped” it.

223. Ratification of the heinous conduct described herein by Sheriff Fontes and Large sent

a message to corrections officers and nurses that they are allowed to do whatever they want,

whenever they want, to whomever they want, irrespective of the United States Constitution.

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224. Defendants’ actions proximately caused Ms. Hill’s death. Their conduct was

intentional, malicious, willful, wanton and in reckless disregard of Ms. Hill’s constitutional rights

and/or grossly negligent in that it shocks the conscience and is fundamentally offensive to a civilized

society, so as to justify the imposition of punitive damages on these Defendants.

225. Plaintiff therefore seeks any and all damages allowable under federal law, attorney’s

fees pursuant to 42 U.S.C. § 1988, costs of this action, and discretionary costs.

COUNT FOUR


42 U.S.C. §§ 1983 and 1988

(MONELL CLAIM)


(Against Cocke County)


227. The United States Constitution requires that an inmate or a pretrial detainee be

provided adequate medical care while in the custody of any governmental entity.

228. A governmental entity may be held liable based upon its officers’ deliberate

indifference to and violation of any citizen’s constitutional rights where a custom, policy, or

procedure of the municipality is found to be the proximate cause of the constitutional violation.

229. Additionally, a governmental entity may be held liable where its supervisory officials

and officers ratify an illegal action of lower-tier officers or employees or where the officials and

officers at the executive level take actions that themselves constitute deliberate indifference and are

the driving force behind the constitutional injury.

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230. Pursuant to Cocke County’s and Jail policy and their long-standing practice, Ms. Hill

did not receive her normal diabetic-treatment and was prohibited from using her insulin medication,

monitor, and injections, while incarcerated. This is contrary to the standard of care for jails.

231. Disabled diabetic inmates taking insulin and inmates in need of other similar

medications are common occurrences at the Cocke County Jail.

232. Cocke County has a long-standing policy and practice of depriving disabled diabetic

inmates of insulin and routinely leaving other inmates withdrawing from opiates or medications to

suffer, without any medical support, for extended periods of time, or, at most, being taken to the

emergency room after condition has severely deteriorated. For example, during Ms. Hill’s previous

incarcerations at Cocke County Jail, she was deprived of insulin and prescribed medication,

notwithstanding having informed corrections officers and nurses that she suffered from diabetes and

required insulin therapy.

233. Under those policies and practices, despite knowledge of the disability and serious

medical needs of Ms. Hill, Cocke County failed to provide adequate medical care to her and did

thereby deprive her of her rights under the Constitution of the United States in violation of 42 U.S.C.

§ 1983.

234. But for this unconstitutional policy, the Individual Defendants and the John and Jane

Doe Defendants would not have exhibited deliberate indifference to Ms. Hill’s serious need for

adequate medical care throughout her incarceration from September 26, 2016 to September 28, 2016.

Instead, they would have provided her the necessary medical attention and/or immediately sent her

to the hospital or otherwise afforded her adequate medical care once she began experiencing the tell-

tale signs of Diabetic Ketoacidosis.

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235. Defendants Sheriff Fontes and Large are supervisory officials for the Jail and were

authorized and responsible for development and implementation of the policies and procedures for

medical care at the Jail, and by their actions and inactions, they established the unconstitutional

customs, policies and practices, as described above. They jointly implemented and applied these

policies and practices by intentionally denying Ms. Hill medical care and in preventing the proper

treatment of a Type-I Diabetic.

236. While Ms. Hill was detained and pursuant to the policy and practice towards inmates

needing medical attention, Cocke County denied her access to the necessary non-prescription

medications she needed to treat her conditions and to prevent further injury, including infection, high

blood sugar, Diabetic Ketoacidosis, and permanent nerve damage.

237. Cocke County’s policies and practices were deliberately indifferent to the medical

needs of its inmates, such as Ms. Hill. This custom, policy and practice constitutes deliberate

indifference because it inflicts needless suffering on inmates. As a result, Ms. Hill was deprived of

fundamental rights guaranteed by the United States Constitution, including the right of access and

receipt of adequate medical care while in custody.

238. Despite Ms. Hill’s pleas for help, her deteriorating medical condition was never

meaningfully evaluated and she remained deprived of necessary insulin as her high blood sugar and

DKA symptoms were ignored and her second-and third-degree thermal burns went untreated.

239. Cocke County, Sheriff Fontes, and Large failed to create and implement sufficient

policies and procedures regarding providing medical care for inmates, and to ensure adequate

training regarding medical care for inmates. They further failed to provide proper staffing,

supervision and discipline of employees in order to prevent deliberate indifference to the medical

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needs of inmates as occurred here with virtually no access to medical care, despite knowledge of the

medical condition.

240. As a result of these policies and practices, during her incarceration at the Cocke

County Jail, Ms. Hill suffered from Diabetic Ketoacidosis, high blood sugar, dehydration, and died.

Her symptoms were obvious, made known multiple times by her and others to each of the Individual

Defendants, including corrections officers and nurses, Sheriff Fontes, and Large. Ms. Hill’s

symptoms would have demonstrated to a lay person that immediate medical care was required.

241. Cocke County’s application of this custom and policy to Ms. Hill constituted

deliberate indifference because it placed her health and safety at risk from known complications of

insulin deprivation, Diabetic Ketoacidosis, organ systems failure, or medication withdrawal.

242. Cocke County also has a policy and practice of not adequately funding inmate

medical care with deliberate indifference to the serious medical needs of inmates, such as Ms. Hill,

and thereby contributed to cause Ms. Hill’s injuries, as described in the facts above.

243. Ms. Hill’s death was proximately caused by Cocke County’s unconstitutional

customs, policies and procedures.

244. For all of these reasons, Cocke County abdicated its governmental responsibilities

to provide a safe and secure incarceration environment to inmates suffering Diabetes or from drug

addiction.

245. Based on the foregoing, Plaintiff seeks any and all damages allowable under federal

law; attorney’s fees pursuant to 42 U.S.C. § 1988; costs of this action; and discretionary costs.

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COUNT FIVE


42 U.S.C. §§ 1983 and 1988

(MONELL CLAIM)

Failure to Train and Supervise and

Ratification of Unconstitutional Conduct

(Against Cocke County)


by reference into this Count of the Complaint, as if set forth verbatim herein.

Defacto Policy, Practice, or Custom

247. Cocke County had a duty of care to Ms. Hill to ensure that its officers and agents were

properly trained in the appropriate procedure for provision of adequate medical care. This duty

extends to ensuring that officers and agents were properly trained concerning the limits of their

authority to withhold medical care, particularly as to inmates presenting a serious medical need. The

duty further extends to ensure that supervisory officers are properly trained not to overlook or

condone unnecessary and unreasonable deprivations of adequate medical care by officers and agents.

These duties were all breached, as described herein.

248. Cocke County, through its policies and procedures, has failed to adequately train and

supervise its employees, officers and agents (including medical personnel) to provide inmates

adequate medical care for serious medical needs. For example, but for Cocke County’s improper

policies and procedures, (a) Ms. Hill’s medical condition would not have been permitted to go

completely untreated and to worsen throughout his incarceration, resulting in a horrible painful

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death; (b) someone in the Jail would have provided him medical care instead of trivializing and

disregarding the severity of his condition because of his drug addiction; and © the truth of Ms. Hill’s

medical condition would have been explained to medical professionals.

249. By ratifying the mistreatment of Ms. Hill by the Individual Defendants, including the

John and Jane Doe Defendants, Sheriff Fontes and Large acquiesced in the unconstitutional conduct

of their subordinates through the execution of their job functions. These actions constitute

ratification and render Cocke County liable to Plaintiff.

250. Upon information and belief, Cocke County has failed to develop a lawful policy of

providing adequate medical care to inmates and failed to train its officers and agents in the proper

manner in which to provide adequate medical care. No such policy exists, and if it does, it is so

ineffectual to be no policy at all. Cocke County’s failure to develop and promulgate lawful policies

outlining the guidelines for the appropriate provision of adequate medical care and to properly train

officers and agents to follow such guidelines constitute deliberate indifference to the Constitutional

rights of citizens.

251. The actions of the Individual Defendants, including the John and Jane Doe

Defendants – and the failed TCI Jail inspections for 2016 and 2017 – evidence a complete lack of

training in the proper methods related to providing adequate medical care to inmates requiring it and

a lack of quality in Jail personnel. The failure of supervisors to recognize or appreciate the gravity

of those officers’ actions implies that they, too, found no wrong in the conduct, giving them and

other officers the “green light” to continue to violate the civil rights of inmates in this manner.

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252. Official policy usually exists in the form of written policy statements, ordinances, or

regulations, but may also arise in the form of a widespread practice that is so common and well-

settled as to constitute a custom that fairly represents municipal policy.

253. The acts and omissions of the aforementioned officers and supervisors demonstrate

that prior to September 26, 2016, Cocke County had developed and maintained a defacto policy,

custom, or practice exhibiting deliberate indifference to the deprivation of adequate medical care to

inmates in serious medical need, which ultimately caused violations of Ms. Hill’s civil rights.

254. Here, the Individual Defendants, including the John and Jane Doe Defendants, rightly

believed their actions would not be properly monitored or corrected by supervisory officers and that

their misconduct would be tolerated and accepted.

255. All of these failures demonstrate a policy, practice, or custom that resulted in Ms.

Hill’s death. Cocke County, while having established certain “policies and procedures” regarding

the procedure for the provision of medical care, fail to adhere to or enforce those policies and/or to

appropriately discipline and/or sanction those who disregard those policies and procedures,

establishing, by custom and usage, a de facto policy of, among other things, allowing the unnecessary

and unreasonable deprivations of adequate medical care to go unchecked.

256. Such acts and omissions on the part of all Defendants, including the Doe Defendants,

constitute a violation of §1983 and were done to deprive Ms. Hill of her rights under the Eighth and

Fourteenth Amendments.

257. The actions of Defendants were done with actual malice and willful and wanton

indifference toward Ms. Hill and with deliberate disregard for her Constitutional and statutory rights,

constitute deliberate indifference, and were the direct and proximate cause of her death.

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Ratification of Unconstitutional Conduct

258. Here, Sheriff Fontes said there would be an investigation into Ms. Hill’s death, but

upon information and belief, Sheriff Fontes and Large abandoned the investigation.

259. By ratifying the behavior of the Individual Defendants, including the John and Jane

Doe Defendants, Cocke County, Sheriff Fontes, and Large knowingly acquiesced in and ratified the

unconstitutional conduct of their subordinates through the execution of their job functions.

260. Plaintiff is entitled to punitive and actual damages, pursuant to 42 U.S.C. §1988.

Plaintiff is also entitled to an award of attorneys' fees, costs and expenses under 42 U.S.C. §1988.

COUNT SIX

Failure to Accommodate and Discrimination on the Basis of Disability Resulting in

Physical Injury under Title II of the ADA and Section 504 of the Rehabilitation Act.

(Against Cocke County and Individual Defendants Sheriff Fontes and Large)


by reference, as if set forth verbatim herein.

262. Ms. Hill brings this claim against Defendants Cocke County, Sheriff Fontes, and

Large (Title II and Section 504). Cocke County’s jail is a “instrumentality” as that term is defined

in Title II of the ADA, 42 U.S.C. § 12131 (1)(B).

263. Cocke County receives federal financial assistance and thus is subject to suit under

Section 504. It is also a “public entity” providing services, programs, or activities as those terms are

used by Title II of the ADA and Section 504 and is subject to suit under those statutes.

264. Cocke County constitutes a “public entity” providing services, programs, or activities

as those terms are used by Title II of the ADA and Cocke County is subject to suit for monetary

relief under that statute. Cocke County and its officials, Sheriff Fontes and Large are not immune

-61-


from suit. In addition, Congress has validly abrogated their sovereign immunity under Title II in

regard to the allegations at issue in this lawsuit because their conduct independently also violates the

Constitution’s guarantee of substantive due process and equal protection clause.

265. Cocke County’s Jail is an “instrumentality” as that term is defined in Title II of the

ADA, 42 U.S.C. § 12131 (1)(B). This is so because, as stated above, Cocke County is subject to

Title II and obligated to provide reasonable accommodations to disabled individuals in its custody.

Cocke County’s Jail is the instrumentality through which such accommodations must be provided,

if they are provided at all, to detainees at the jail. Accordingly, Cocke County is subject to suit under

Title II of the ADA.

266. As stated, Ms. Hill was at all times a qualified individual with a disability pursuant

to the ADA and § 504. She had a condition, Diabetes Mellitus Type-I, which substantially limited

at least one major life activity and/or has a history of a disability. 42 U.S.C. § 12102.

267. Cocke County, Sheriff Fontes, and Large discriminated against Ms. Hill by placing

her in administrative segregation and by failing to accommodate her, solely by reason of her

disability.

268. Ms. Hill requested reasonable accommodations for her diabetes, but Defendants

unlawfully refused her request. These reasonable accommodations include providing blood-sugar

checks and insulin administration; access to the kiosk; and access to medical treatment and

equipment.

269. Ms. Hill required reasonable accommodations in order to manage her diabetes.

270. Defendants intentionally discriminated against Ms. Hill because they limited, treated,

and classified her in a way which adversely affected her opportunities and condition and denied her

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receipt of services and benefits of Defendants’ public entities because of her disability. 42 U.S.C.

§ 12132; 29 U.S.C. 794.

271. These Defendants administered and applied their policies, practices and procedures

in a method that discriminated against Ms. Hill on the basis of disability and denied her the receipt

of their services and benefits.

272. Accommodating Ms. Hill would not have caused undue hardship to these Defendants

or resulted in a fundamental alteration of the Jail’s programs.

273. As a direct and foreseeable result of these violations of Ms. Hill’s federally-protected

rights, Ms. Hill suffered permanent physical injury and ultimately died.

COUNT SEVEN

WRONGFUL DEATH

TENN. CODE ANN. §§ 20-5-106 et seq.



275. Plaintiff brings this action as the Court-appointed Administratrix and personal

representative of the Estate of Amanda Lee Hill, as authorized by Tenn. Code Ann. §§ 20-5-106 et

seq., the Tennessee wrongful death statute. Plaintiff is a citizens and resident of Cocke County,

Tennessee, and Ms. Hill was, before her death, a citizen and resident of Cocke County, Tennessee.

276. Defendants owed a duty of due care to Ms. Hill at all times relevant to this action, and

violated that duty in the manner alleged herein.

277. Defendants knew that Ms. Hill, an inmate in their custody and care, had a serious

medical need, as evidenced by his numerous and worsening symptoms. Despite knowing that Ms.

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Hill was seriously ill and that her condition was rapidly getting worse, Defendants ignored her

repeated complaints and symptoms, and the complaints of other inmates on her behalf, and failed

to render any meaningful medical care to Ms. Hill throughout her brief incarceration.

278. The foregoing acts of the Defendants proximately caused fatal injuries to Ms. Hill,

entitling Plaintiff to recover compensatory damages from Defendants for all such damages. Said

damages include, but are not limited to, the pain and suffering Ms. Hill suffered before her death,

Ms. Hill’s medical, funeral, and/or related burial expenses.

279. The above acts of negligence and negligence per se of the Defendants were performed

knowingly, wantonly and with gross disregard for the safety and welfare of Ms. Hill. Said acts

entitle Plaintiff to joint and several judgments for punitive damages from all Defendants.

280. Based upon the foregoing allegations, Plaintiff is entitled to recover a judgment

against the Defendants, jointly and severally, in the amount of Five-Million ($5,000,000) Dollars in

compensatory damages, and Five Million ($5,000,000) Dollars in punitive damages.

COUNT EIGHT

OUTRAGEOUS CONDUCT/ INTENTIONAL

INFLICTION OF EMOTIONAL DISTRESS

(Against All Individual Defendants)



282. The allegations outlined herein against the Individual Defendants, including the John

and Jane Doe Defendants, while acting under color of law, were outrageous and utterly intolerable

in a civilized society, and were done with a reckless disregard of the probability of causing emotional

distress.

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283. The conduct of the Individual Defendants, including the John and Jane Doe

Defendants, as alleged above, was outrageous. They knew, or should have known, that their conduct

would result in serious injuries and severe emotional distress to Ms. Hill, and their conduct was

perpetrated with the intent to inflict, or with reckless disregard of the probability of inflicting, mental

anguish, and severe emotional distress upon Ms. Hill.

284. The wrongful acts of the Individual Defendants, including the John and Jane Doe

Defendants, were willful, oppressive, intentional and malicious; therefore, punitive damages should

be assessed against them in an amount deemed sufficient to punish and deter them and others in

similar positions of authority from engaging in similar conduct in the future. By reason thereof,

Plaintiff claims punitive damages in an amount to be proven at trial.

IX. JURY DEMAND

285. Pursuant to Federal Rule of Civil Procedure 38(b), Plaintiff demands a trial by jury

of all of the claims asserted in this Complaint so triable.

X. PRAYER FOR RELIEF

WHEREFORE, Plaintiff prays:

A. That Defendants be served with a copy of this Complaint and be required to answer;

B. That the Court find that Defendants have engaged in the conduct and statutory and

common law violations alleged herein;

C. That Plaintiff, as Administratrix and personal representative of the Estate of Amanda

Lee Hill, be awarded such damages as will fully compensate the estate for all injuries caused by

Defendants’ actions and that a judgment in favor of Plaintiff be entered;

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D. That Plaintiff, as Administratrix and personal representative of the Estate of Amanda

Hill, be awarded compensatory damages in an amount to be determined by the trier of fact, not to

exceed $5,000,000;

E. That Plaintiff, as Administratrix and personal representative of the Estate of Amanda

Lee Hill, be awarded punitive damages against the Defendants in an amount to be determined by the

trier of fact, not to exceed $5,000,000;

G. That Plaintiff, as Administratrix and personal representative of the Estate of Amanda

Lee Hill, recover costs for this suit, including reasonable attorneys’ fees and discretionary costs, as

provided by law;

H. That Plaintiff, as Administratrix and personal representative of the Estate of Amanda

Lee Hill, be awarded pre-judgment and post-judgment interest as permitted by common law or

applicable statute and such other or further relief as may be just and proper.

Respectfully submitted, this 28th day of September, 2017.

/s/ Lance K. Baker

Lance K. Baker

Tenn. Bar #: 032945

THE BAKER LAW FIRM

550 Main Street, Suite 600

Knoxville, TN 37902

Tel: 865-525-7028

Fax: 865-525-4679

[email protected]

Counsel for Plaintiff

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