Johnson v. Adams - Appeal of Pretrial Detainee's Death

UNPUBLISHED UNITED STATES COURT OF AP PEALS FOR THE FOURTH CIRCUIT No. 24 - 7009 BEATRICE V. JOHNSON, individually and as personal representative of the Estate of Paul Ant ione Joh nson, Plaintiff - Appellant, v. TANYA ADAMS; J OYCE RICE; JANET WHITE; H ENRY WILLIAMS, LPN, Defendants - Appellees. Appeal from the United States District Court for the District of South Carolin a, at Orangeburg. Bruce H. Hendricks, District Jud ge. (5:22 - cv - 02129 - BHH) Submitted: December 2, 2025 Decided: March 4, 2026 Before AGEE and QUATTL EBAUM, Circu it Judges, and FLOYD, Senior Circuit Judge. Affirmed by unpublished per curiam opinion. ON BRIEF: Jordan C. Calloway, Rock Hill, South Carolina, Whitney B. Harrison, MCGOWAN, HOOD, FE LDER & PHIL LIPS, LLC, Colum bia, South Carolina, for Appellant. James G. Long III, Amelia S. Waring, MAYNARD NEXSEN PC, Columbia, South Carolina, for Appellee Henry Williams, LPN. Michael D. Freeman Sr., GRIFFITH, FREEMAN & LIIPFERT, LLC, Beaufort, S outh Carolina, for Appellees Tanya Ad ams, Joyce Rice, and Janet White. Unpublished opinions are not binding p recedent in this circuit.

2 PER CURIAM: This appeal stems from Paul Jo hnson’s untimely death while he was incarcerated at the Colleton County Detention Center (CCDC) as a pretrial detainee. Johnson was arrested and booke d into C CDC on Jul y 11, 2019. On July 17, 2019, he experien ced a medical emergency and was rushed to a nearby hospital. His health rapidly deteriorated and he passed awa y on July 1 9. Following Johnson’s death, his mother sued v arious CCDC employees under 42 U.S.C. § 1983, alleging deliberate indifference to her son’s medical needs in violation of the Fourteenth Amendment. In particu lar, she criticized th eir management of her son’s diabetes. Ms. Johnson named as defendan ts CCDC employees Tanya Adams, Joyce Rice, and Janet White (collectively, the “ CCDC Defendants ”) a nd Henry W illiams, LPN, a n urse who cared for her son during the relevant timeframe but was the employee of a private med ical contractor to CCDC. A fter discovery, Williams and the CCDC D efendants moved for summary judgment. Although their specific ratio nales sometimes differed, they argu ed that (1) they were not deliberately indifferent to Johnson’s serious medical needs, and (2) in any event, they were entitled to qualified immunity. Their motions were referred to a magistrate judge, who recomm ended they be granted in full. T he district court u ltimately adopted that recommendation over Ms. Johnson’s ob jections. We affir m. “We review a district court’s decision to grant summary judgment de novo.” United States v. 8.929 Ac res of Lan d in Arl ington Cnt y., 36 F.4t h 240, 25 2 (4th C ir. 2022). Summary judgment is appropriate “if the movant shows that there is no genuine dispute as to any material fact and the movant is entitled to judgment as a matter of law.” Fed. R.

3 Civ. P. 56(a). “A factual dispute is genuine only where the nonmovant’s version is supported by sufficient evidence to permit a reasonable jury to find in its favor.” 8.929 Acres of Land, 36 F.4th at 252 (citation modified). To survive summar y judgment on her deliberate indifference claims, Ms. Johnson must show that (1) [Johnson] had a medical condition or injury that posed a substantial risk of serious harm; (2) the defendan t[s] intentionally, knowingl y, or recklessly acted or failed to act to appropriately address the risk that the condition posed; (3) the defendant[s] kn ew or should have known (a) that [Johnson] had that condition and (b) that the defendan t[s’] action or inaction posed an unjustifiably high risk of harm; and (4) as a re sult, [Johnson] w as harmed. Short v. Hartma n, 8 7 F.4th 59 3, 611 (4t h Cir. 202 3). As to her claim against Williams, Ms. Johnson fails to raise a genuine dispute of material fact under the third elemen t. Ms. Johnson points to three factual con tentions in support of her argument that Williams should have known Johnson ha d a serious medical condition and that his action s posed an unjustifiably high risk o f harm: (1) an “ord er” that Johnson have his blood sug ar tested three times each day; (2) Johnson’ s purport ed deterior ation from J uly 11 thr ough the morning of J uly 17; a nd (3) Johnson’s c ondition on the morning and through the early afternoon of July 17. We ad dress each in turn, and conclude that Ms. Johnson does not identify an y reversible error in this case. First, Ms. Johnson points to an “Ad mission Data/History and Physical Form,” completed by medical staff, that bears a h andwritten notation stating, “BS x 3 times a day.” J.A. 123. However, we do not consider the merits of this poin t because she d id not raise this argument with sufficient specificity before the district court. “I f a party wishes to preserve an argument fo r appeal, the party must press an d not merely intimate the arg ument

4 during the proceedings before the district court.” CoreTel Va., LLC v. Verizon Va., LLC, 808 F.3d 978, 98 8 (4th Cir. 201 5) (citation modified). “In other words, the party must raise the argument in a manner sufficien t ‘to alert the district court to the specific reason’ the party seeks relief.” Id. (quoting United S tates v. Bennett, 698 F.3d 19 4, 199 (4t h Cir. 2012)). Ms. Johnson ’s two fleeting reference s to a “determination made on the medical record that as a diabetic, [Johnson’s] BS levels needed to be checked three (3) times a day,” J.A. 103 3; J.A. 7 27 n.2, cannot preserve her b roader, new argument on ap peal that a genuine dispute exists as to whether W illiams “i gn or[ed] a p hysician’s order for thrice - daily blood sugar tests,” Opening Br. at 30. ∗ We consider this argument waived. Moving on to Joh nson’s alleged deterioratio n between July 11th and 17th, there is no evidence that Williams shou ld have been aware of a serious med ical condition affecting the decedent. During this time frame, Joh nson was under near - constant observation by CCDC staff and never made a single complaint abou t his health. The record is replete with observations of Johnson an d recorded interactions with Jo hnson during the relevant period. See J.A. 114, 12 0 – 138, 245 – 48, 280 – 88, 319 – 41. Moreover, Williams was no t working on July 15 and 16 (the two days prior to Johnson’s medical emergency), further ∗ Ms. Johnson more thoroughly p ressed a different argument before the district court on a similar issue, which was that Williams ignored a medical st andard of care (rather than a physician’s order) dictating th at diabetic inmates should receive blood sugar assessments three times per day. But this d ispute is not material. Even if a gen uine question exists as to the standard of care, Williams’ failure to conduct checks with this frequen cy could only sustain a finding of negligence — not deliberate indifference. Such “a deviation from the accepted standard of care, standing alone. .. is insufficient to clear the high bar of a constitutional claim.” Jackson v. Lightsey, 775 F.3d 170, 179 (4th Cir. 201 4) (citation modified). “Negligence or malpractice in the provision o f medical services does not constitute a claim under § 1983.” Wright v. Collins, 766 F.2d 84 1, 849 (4th Cir. 198 5).

5 undermining the notion h e should have been aware of a serious medical cond ition. Insofar as Ms. Johnson claims Johnson was skip ping meals, the record shows that Johnso n missed only one meal du ring that period (not the multiple claimed by Ms. Johnson) on a day Williams was not even present. W illiams’ failure to act in these circumstances does not meet the h igh bar required to establish deliberately indifferent conduct. See Short, 87 F.4t h at 611. Finally, the proffered evidence of Johnson’s apparent “ dif ferent look ” and general lethargic appearance provides only mere “speculation” that Jo hnson exhibited signs of a serious medical need during this time, which cannot sustain a “ reasonable inference ” that Williams should have known Johnson was suffering from a serious medical condition. See Sedar v. Re ston Town Ctr. Prop., LLC, 988 F. 3d 756, 76 5 (4th Cir. 2021). The final factual contention Ms. Jo hnson poin ts to in support of h er deliberate indifference claim against Williams relates to the events of July 17. In particular, she cites Williams’ response to Johnson ’s (1) breathing troubles, (2) inability to walk to his breathing treatment, (3) incoherent and confusing answers at his mental health v isit and blood suga r readi ng of 245, an d (4) general lethargy. But once again, none of the se — either independently or taken together — are sufficient to show that Williams was deliberately indifferent to Johnson’s serious medical needs. Williams’ actions throughout th e day of July 17 were both objectively reasonable and consistent with the supervising physician’s recommendations. The record shows Williams monitored Johnson’s breathing troubles and ordered breathing treatment. Such conduct hardly co nstitutes, at minimum, the sort o f “reckless” conduct required for a deliberate indifference claim. S hort, 87 F.4th at 611. Though he did not further explore Joh nson’s inability to walk to his breathing treatment,

6 Johnson di d not exhi bit this he alth probl em again after completion of the breathin g treatment. And Williams followed the directives of the physician and mental health provider after Johnson’s behavior during his mental health visit and his blood sugar reading of 245. Ms. Johnson’s “mere difference of opinion” with the medical staff’s “sound professional judgment” cannot “give rise to a [ constitutional] violation.” United States v. Clawson, 650 F.3 d 530, 538 (4th Cir. 2011) (evaluating deliberate ind ifference under the Eighth Amendment); Ma ys v. Sprinkle, 992 F.3d 295, 300 (4th C ir. 2021) (expla ining that a pretrial detainee establishes a violation of his Fourteenth Amendment rights wh ere he shows deliberate indifference under precedent interpreting the Eighth Amendment). And again, Williams’ failure to admin ister prompt medical intervention in response to mere general lethargy cannot sustain a find ing that he was indifferent to a serious medical need. For these reasons, Ms. Johnson has failed to raise a genuine dispute as to whether Williams’ actions met the high bar of d eliberate indifference. W e accordingly need not reach the question of whether Williams had qualified immunity from civil suit. Finally, we affirm the district court’s grant of summary judgmen t for the CCDC Defendants because Ms. Johnson has failed to preserve the arguments she now raises against those Defendants on appeal. Presently, Ms. Johnson contends that the CCDC employees were deliberately indifferent to Johnson’s serious medical needs by failing to adequately communicate with med ical personnel about Johnson’s d eteriorating condition. However, she failed to raise this argument before either the mag istrate judge or district court, and therefore this argument is procedurally barred on appeal. Ms. Johnson raises n o

7 other argument urging reversal of the lower court’s grant o f summary judgment as to her claims against the CCDC Defendants. Th e judgment of the trial court is AFFIRMED.