Case: 24-40209 Document: 62-1 Page: 1 Date Filed: 01/28/2025
United States Court of Appeals
for the Fifth Circuit United States Court of Appeals
Fifth Circuit
____________ FILED
January 28, 2025
No. 24-40209
Lyle W. Cayce
____________
Clerk
Ignacia Carmona, Individually, and as the Independent Administrator
(pending court approval) for the Estate of Veronica Peranez Carmona, and as the
Next Friend for G.H., V.A.H., R.P., E.P., R.C.P., J.D.P., AND C.I.P.,
Plaintiff—Appellant,
versus
The City of Brownsville; Jesus Olvera, In his Individual and
Official Capacity; Pedro Dominguez, In his Individual and Official
Capacity; John Does 1-15,
Defendants—Appellees.
______________________________
Appeal from the United States District Court
for the Southern District of Texas
USDC No. 1:23-CV-84
______________________________
Before Jones, Barksdale, and Ho, Circuit Judges.
Rhesa Hawkins Barksdale, Circuit Judge:
In appealing from a final judgment, Ignacia Carmona (Plaintiff)
contests only the district court’s granting Officers Jesus Olvera and Pedro
Dominguez’ (Officers) qualified-immunity-based motion to dismiss, filed
pursuant to Federal Rule of Civil Procedure 12(b)(6) (failure to state claim).
At issue is whether the operative (first-amended) complaint, under 42 U.S.C.
§ 1983, plausibly alleges Officers possessed subjective knowledge of a
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No. 24-40209
substantial risk of serious harm to pretrial detainee Veronica Carmona
(Carmona). This deliberate-indifference claim arises out of her death while
in pretrial detention in the Brownsville, Texas, city jail. Plaintiff fails to
plausibly allege Officers possessed the requisite subjective knowledge.
AFFIRMED.
I.
In this appeal, Plaintiff claims Officers failed to provide medical care
to Carmona, in violation of her Fourteenth Amendment right to such care.
In her operative complaint, Plaintiff also asserted Fourteenth Amendment
claims against Brownsville and John Doe Defendants 1–15, but those claims
were dismissed; and, as noted, Plaintiff does not contest their dismissal.
Accordingly, this appeal from a final judgment concerns only Officers’
being granted qualified immunity against the deliberate-indifference claims.
Because they were dismissed at the motion-to-dismiss stage, the following is
based on the allegations in Plaintiff’s operative complaint.
During the early evening hours of 17 June 2021, Carmona was driving
a white Chevrolet Suburban in Brownsville, possibly under the influence of
alcohol and cocaine. She crashed into a traffic sign, drove into a parking lot,
and crashed into a parked vehicle. She exited the parking lot and crashed into
another vehicle stopped at a traffic light. Finally, she drove on the
expressway, exited it, and crashed into a brick apartment building. The
collision into the building was “severe” and caused the Suburban’s airbags
to deploy. Throughout the course of Carmona’s dangerous driving, the
Brownsville Police Department received multiple emergency calls about a
white Chevrolet Suburban being driven erratically.
Officers arrived at the scene approximately two minutes after
Carmona crashed into the building. Officers were aware of the emergency
calls concerning her other crashes and observed that the airbags had
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deployed. She had several visible injuries, including abrasions on her right
arm, a contusion on her right hand, abrasions on her right thigh, a laceration
on her right heel, a contusion on her left thigh, and an abrasion on her left
foot.
Officers did not seek any medical care for Carmona, even though she
had been involved in four vehicular accidents within a single night, including
colliding with the brick building. Instead of transporting her to a hospital or
calling for emergency medical services (EMS) to examine her, Officers took
her to the Brownsville jail. On the way there in Officer Olvera’s police
cruiser, Carmona twice intentionally banged her head against the partition
panel, exhibiting “bizarre” behavior.
Upon arriving at the jail, Carmona still did not receive any medical
attention or screening. Almost four hours after being booked, she was found
unresponsive in her cell and declared dead shortly thereafter. She died from
internal bleeding caused by lacerations to her liver as a result of the multiple
vehicular accidents.
This action was filed on 6 June 2023, just shy of two years after
Carmona’s death, against Officers, Brownsville, and John Doe Defendants
1–15, claiming civil-rights violations under the Fourteenth Amendment and
state-law tort violations. The amended complaint did not include the latter
claims. Because only the claims under § 1983 against Officers, for which they
were granted qualified immunity, are at-issue in this appeal, only the
procedural history relevant to Officers is discussed below.
Officers moved to dismiss, asserting qualified immunity, and
requested a stay of discovery. The magistrate judge granted the stay, pending
resolution of Officers’ qualified-immunity defense, and granted Plaintiff
leave to amend her complaint in the light of Officers’ Rule 12(b)(6) motion.
The first-amended complaint was filed shortly thereafter.
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The magistrate judge recommended the district court grant Officers’
motion to dismiss, which it did in a comprehensive opinion. The court
concluded Officers were entitled to qualified immunity because the
complaint did not plausibly allege they possessed the requisite subjective
knowledge that Carmona was suffering from internal injuries. In support, the
court concluded “that when [an injured person’s] injuries are not visually
apparent and [that] person’s complaints are non-existent or do not reveal the
full extent of the injuries, then the responding official’s inaction does not
amount to deliberate indifference”. The court further concluded that the law
was not clearly established such that it would require an officer to seek
medical care for an individual involved in a vehicle accident when the alleged
facts did not permit the inference that the officer had subjective awareness of
internal injuries. The 4 March 2024 final judgment dismissed all claims in
the operative complaint.
II.
As noted, Plaintiff challenges only the Officers’ Rule 12(b)(6) motion- to-dismiss being granted, based on the district court’s concluding they were
entitled to qualified immunity. A district court’s decision on a Rule 12(b)(6)
motion is reviewed de novo, “accept[ing] all well-pleaded facts as true,
drawing all reasonable inferences in the nonmoving party’s favor”. Edmiston
v. Borrego, 75 F.4th 551, 557 (5th Cir. 2023) (citation omitted). “We do not,
however, accept as true legal conclusions, conclusory statements, or naked
assertions devoid of further factual enhancement.”
Id. (citing Benfield v.
Magee,
945 F.3d 333, 336–37 (5th Cir. 2019)).
In reviewing a ruling on a Rule 12(b)(6) motion, our court considers
only “the facts stated in the complaint and the documents either attached to
or incorporated in the complaint”. Ferguson v. Bank of New York Mellon
Corp., 802 F.3d 777, 780 (5th Cir. 2015) (citation omitted). Dismissal is
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proper where plaintiff fails to “plead sufficient facts to state a claim for relief
that is plausible on its face”. Id. Facial plausibility means the pleaded
“factual content . . . allows the court to draw the reasonable inference that
the defendant is liable for the misconduct alleged”. Ashcroft v. Iqbal,
556 U.S.
662, 678 (2009).
“Qualified immunity protects officers from suit unless their conduct
violates a clearly established [statutory or] constitutional right.” Converse v.
City of Kemah, 961 F.3d 771, 774 (5th Cir. 2020) (quoting Mace v. City of
Palestine,
333 F.3d 621, 623 (5th Cir. 2003)). Consistent with the motion-to-dismiss standard, our court reviews de novo the grant of a qualified-immunitybased motion to dismiss. E.g., Edmiston,
75 F.4th at 557. “Although qualified
immunity is nominally an affirmative defense, the plaintiff bears a heightened
burden to negate the defense once properly raised.” Newman v. Guedry,
703
F.3d 757, 761 (5th Cir. 2012) (citation omitted). Plaintiff bears the burden to
“plead facts which, if proved, would defeat the claim of immunity”. Waller
v. Hanlon,
922 F.3d 590, 599 (5th Cir. 2019) (citation omitted).
As noted, “a plaintiff seeking to overcome qualified immunity must
show: (1) that the official violated a statutory or constitutional right, and (2)
that the right was clearly established at the time of the challenged conduct”.
Converse, 961 F.3d at 774 (5th Cir. 2020) (citation omitted). Therefore, to
succeed in opposition to qualified immunity asserted in a Rule 12(b)(6)
motion to dismiss, even where plaintiff adequately pleads the violation of a
federal right (statutory or constitutional) (first prong), plaintiff still must
adequately plead that “defendant’s conduct was objectively [un]reasonable
in light of clearly established law” (second prong). Thompson v. Upshur Cnty.,
245 F.3d 447, 457 (5th Cir. 2001).
We have discretion as to which of the two prongs should be analyzed
first; but, “often the better approach to resolving cases in which the defense
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of qualified immunity is raised is to determine first whether the plaintiff has
alleged a deprivation of a [federal] right at all”. Cope v. Cogdill, 3 F.4th 198,
204 (5th Cir. 2021) (citation omitted). For the reasons that follow, Plaintiff
fails to plausibly allege violation of the claimed constitutional right.
Therefore, we do not reach the second prong (whether right clearlyestablished).
A.
Where the claimed constitutional violation involves the Fourteenth
Amendment right to medical care, Plaintiff must allege facts, which, if
proved, would show Officers exhibited deliberate indifference to Carmona’s
serious medical needs. Sims v. Griffin, 35 F.4th 945, 949 (5th Cir. 2022); see
also Hare v. City of Corinth,
74 F.3d 633, 636 (5th Cir. 1996) (en banc).
“Deliberate indifference is an extremely high standard to meet.” Domino v.
Tex. Dep’t of Crim. Just.,
239 F.3d 752, 756 (5th Cir. 2001). To show
deliberate indifference, Plaintiff must plausibly allege that Officers “(1)
w[ere] aware of facts from which the inference could be drawn that a
substantial risk of serious harm exists, and (2) actually drew the inference”.
Sims, 35 F.4th at 949–50 (citation omitted). (Although some of our court’s
prior opinions “posited a third element—that the official subjectively
intended that harm occur”—our court has since held we “cannot endorse
this [third-element requirement] because it departs from controlling
Supreme Court and Fifth Circuit law”. Dyer v. Hous.,
964 F.3d 374, 380 (5th
Cir. 2020) (en banc) (citation omitted).)
Serious harm, in this context, is not “just any harm”; rather, the
medical need must be “so apparent that even laymen would recognize that
care is required”. Rogers v. Jarrett, 63 F.4th 971, 976 (5th Cir.), cert. denied,
144 S. Ct. 193 (2023). In other words, Officers must have been subjectively
aware of the “severity of [Carmona’s] condition”.
Id. Alleging only that
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defendant was aware that a potential for serious harm existed is not sufficient.
Id. at 976–77.
In that regard, mere negligence does not rise to the level of deliberate
indifference. Dyer, 964 F.3d at 381 (“[D]eliberate indifference cannot be
inferred merely from a negligent or even a grossly negligent response to a
substantial risk of serious harm”.). The Supreme Court has clearly
articulated that “an official’s failure to alleviate a significant risk that he
should have perceived but did not, while no cause for commendation”, does
not amount to the requisite subjective knowledge of a substantial risk. Farmer
v. Brennan,
511 U.S. 825, 838 (1994). In other words, “[l]iability attaches
only if officials actually knew—not merely should have known—about the
risk”. Rogers,
63 F.4th at 977.
B.
We first address Plaintiff’s blanket allegation that Officers “drew the
inference that [Carmona] faced a substantial risk of harm or death from the
auto collision(s) she was involved in” and acted with deliberate indifference
by failing to seek medical care. This statement “merely restates the standard
required to demonstrate the requisite subjective knowledge”. Edmiston, 75
F.4th at 560. “[W]e must carefully discern factual allegations from legal
conclusions in plaintiffs’ complaint”, omitting the latter from our evaluation
of the sufficiency of the complaint.
Id. (citing Doe v. Robertson,
751 F.3d 383,
388 (5th Cir. 2014) (alleging defendants “exhibited deliberate indifference”
was “merely a legal conclusion”, even if it “might have been couched as a
factual allegation”) (citation omitted)).
Relatedly, Plaintiff makes numerous allegations which we cannot
accept in our evaluation of the complaint, as they “stop[] short of the line
between possibility and plausibility”. Iqbal, 556 U.S. at 678 (citation
omitted). For example, Plaintiff alleges that “it would have been apparent to
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[Officers] that [Carmona] was in tremendous pain”. This “awareness” of
Carmona’s pain, however, is not based on anything she said or did (such as
clutching her abdomen or telling Officers she was in “tremendous pain”);
rather, these allegations impute such awareness to them, based on
Carmona’s physical condition and the general proposition that “liver
lacerations can cause extreme pain”.
Additionally, Plaintiff alleges that Officers: “likely attended police
academy training”, during which, “they likely learned that they—when
responding to car crashes—have a responsibility to act in good faith to
provide emergency medical services to those occupants of vehicles involved
in car crashes”; “very likely learned that they should have conducted a head- to-toe assessment [of Carmona]”; and “very likely learned to recognize
appropriate first aid measures for internal bleeding—including calling EMS
or taking victims to a hospital where needed”. (Emphasis added.) These
allegations, however, are purely conjectural and amount to nothing more
than conclusory statements masquerading as factual allegations.
Accordingly, these are not well-pleaded allegations and are omitted from our
evaluation of the sufficiency of the complaint under the Rule 12(b)(6)
standard. See Edmiston, 75 F.4th at 561.
Turning to the facts that are well-pleaded, and viewing them in the
requisite light most favorable to Plaintiff, Officers: arrived at the scene of the
final accident knowing Carmona had been in several automobile collisions
earlier in the day; observed she had crashed her automobile into a brick
apartment building with enough force to deploy the Suburban’s airbags;
observed she had visible physical injuries, including contusions, abrasions,
and lacerations; and, despite these observations, did not call EMS, take her
to a hospital, or seek any other medical attention on her behalf.
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Presumably, Officer Dominguez’ involvement ended at the scene of
the accident, as the complaint references only Officer Olvera regarding
traveling from the final accident site to the jail. Consequently, the allegation
that Carmona “exhibited bizarre behavior” while traveling to the jail by
“banging her head” against the partition panel in Olvera’s police cruiser is
only relevant to his subjective state-of-mind.
The thrust of Plaintiff’s allegations is that the risk of internal injuries
from an automobile accident is so obvious that even a layperson would have
thought it wise to have Carmona examined. (The complaint includes a
section entitled “Even a Layman is Aware of the Risk of Internal Bleeding
from a Car Crash”.) The district court noted correctly, however, that the
relevant question was not whether automobile accidents can cause massive
internal bleeding, but whether there were plausible allegations that Officers
were subjectively aware of facts which demonstrated Carmona was suffering
from internal injuries. In determining Officers were entitled to qualified
immunity, the court concluded correctly that the complaint did not plausibly
allege that the need for care for internal injuries was so obvious that Officers
could be found to have the requisite subjective awareness of the need.
In pushing back against this conclusion, Plaintiff relies heavily on
Nerren v. Livingston Police Dep’t, 86 F.3d 469 (5th Cir. 1996), to support her
allegation that Officers exhibited deliberate indifference. In Nerren, our court
affirmed the denial of qualified immunity—but at the summary-judgment, not
motion-to-dismiss, stage—by ruling that a reasonable juror could find the
arresting officers were deliberately indifferent to Nerren’s constitutional
right to medical care.
Id. at 473.
Along that line, Nerren was involved in an automobile accident and
fled the scene. Id. at 470. When officers later arrested him, he stated he was
in pain and requested medical care.
Id. Instead of providing it, one of the
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arresting officers expressly denied it, stating that he was doing so because
Nerren fled the scene of the accident. Id. at 470–71. He was taken to jail
without receiving medical care.
Id. at 471. When released the following day,
he went to the hospital, where a laparoscopic examination revealed a large
amount of internal bleeding.
Id. Similar to the instant action, Nerren’s
internal bleeding was caused by a torn liver.
Id.
Akin to the summary-judgment record in Nerren, Plaintiff alleged that
Carmona had abrasions as a result of the accident, she was in pain, and the
arresting officers were aware she had been involved in an automobile
collision. See id. Plaintiff’s claim fails, however, because of one key factual
distinction. In Nerren, the summary-judgment record showed the arresting
officers were subjectively aware Nerren was in pain and wanted medical care
because he explicitly stated as much.
Id. at 470. In contrast, Plaintiff did not
allege Carmona requested medical care. To the extent Plaintiff pleaded
Officers were aware she was in “tremendous pain”, and for the reasons
discussed above, we do not accept the allegation as it is not well-pleaded.
Arguably, had Plaintiff alleged Carmona complained of abdominal
pain or clutched her abdomen, such conduct would have allowed an inference
that Officers were aware she was suffering from internal injuries. Cf. Sims,
35 F.4th at 948 (officers not entitled to qualified immunity where detainee
overdosed on narcotics and called out for help “at least 62 times”). But
generally alleging that the risk of internal injuries from an automobile
accident is so obvious that even a layperson is aware of such risk does not
permit an inference of Officers’ subjective awareness that Carmona was
suffering from internal bleeding, resulting from a lacerated liver. Our court
has consistently held that, when an arrestee suffers from non-visible injuries
and the complaints are non-existent or do not reveal the full extent of the
injuries, the responding official’s inaction does not constitute deliberate
indifference. Compare Rogers,
63 F.4th at 976 (head injury sustained after a
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ceiling collapse insufficient to show subjective awareness of risk where
detainee had no visible injuries) with Dyer, 964 F.3d at 381–82 (a reasonable
trier of fact could conclude that officers who observed arrestee “str[ike] his
head violently against the interior of [the] patrol car over 40 times”, causing
a visible head injury, were subjectively aware of risk of severe head trauma).
In a belated attempt to salvage her inadequate allegations, Plaintiff
states that, unlike the plaintiff in Nerren, who survived being denied medical
care, “[Carmona] is dead. And the district court stayed discovery . . . before
Plaintiffs could attempt to learn what [Carmona] might have told the
officers—or what they may have told her”. But Plaintiff does not challenge
on appeal the order staying discovery, including not contending the
extenuating circumstances making it difficult, if not impossible, to ascertain
what conversations did or did not take place between Carmona and Officers,
merit an exception to the rule “that a plaintiff asserting constitutional claims
against an officer claiming [qualified immunity] must survive the motion to
dismiss without any discovery”. Carswell v. Camp, 54 F.4th 307, 311 (5th Cir.
2022), cert. denied,
144 S. Ct. 73 (2023) (emphasis in original).
In any event, the circumstances do not change Plaintiff’s burden.
Plaintiff was required to plead facts which, if proved, showed Officers were
“aware of facts from which the inference could be drawn that a substantial
risk of serious harm exists”,—the serious harm being internal bleeding in this
instance—“and actually drew the inference”. Rogers, 63 F.4th at 976.
Viewing the well-pleaded facts in the light most favorable to
Plaintiff—i.e., Officers were aware Carmona was involved in multiple
automobile collisions, and she had visible abrasions and contusions on her
extremities—Plaintiff, at most, alleged that Officers should have known
Carmona was at-risk for internal bleeding. But, as discussed supra, actual
knowledge is required for liability to attach. Id. at 977.
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Because Plaintiff fails to allege sufficient facts to plausibly show
Officers were subjectively aware of the risk of internal bleeding, her
allegations do not state a deliberate-indifference claim. And, as noted,
because Plaintiff fails to allege violation of a constitutional right, we do not
reach the second prong of the qualified-immunity test—whether that right
was clearly established at the time of the violation.
III.
For the foregoing reasons, the qualified-immunity-based dismissal of
the deliberate-indifference claims against Officers was proper; the judgment
is AFFIRMED.
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James C. Ho, Circuit Judge, concurring in the judgment:
I agree that Plaintiff has failed to adequately allege Defendants’ actual
knowledge of the risk of serious medical harm presented in this case. I write
separately to note that, under our circuit precedent, actual knowledge is not
the only way that Plaintiff could have survived dismissal. “[O]ur court has
emphasized that an ‘official’s knowledge of a substantial risk of harm may be
inferred if the risk was obvious.’” Kelson v. Clark, 1 F.4th 411, 419 (5th Cir.
2021) (quoting Easter v. Powell,
467 F.3d 459, 463 (5th Cir. 2006)). But
Plaintiff fails to make this argument, so I express no view on it.
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