NAM DANG, by and through his Power of Attorney, VINA DANG Plaintiff - Appellant,
SHERIFF, SEMINOLE COUNTY FLORIDA, OLUGBENGA OGUNSANWO, M.D., SANDRA WILT, RN, BRENDA PRESTON-MAYLE, RN, ALECIA SCOTT, LPN, in their individual capacities, et al., Defendants - Appellees.
from the United States District Court for the Middle District
of Florida D.C. Docket No. 6:14-cv-00037-GAP-TBS
ROSENBAUM, BLACK and SENTELLE, [*] Circuit Judges. 
SENTELLE, Circuit Judge.
Dang's health deteriorated while he was a pretrial
detainee in the John E. Polk Correctional Facility (the
"Jail"). Ultimately, Dang was diagnosed with
meningitis, which caused him to suffer multiple strokes
resulting in permanent injuries. Dang alleges § 1983
liability against several health care providers for providing
inadequate medical care while Dang was in Jail and Seminole
County Sheriff Donald Eslinger in his official capacity as
Sheriff. The district court granted summary judgment for all
the defendants. Dang brought the present appeal. We affirm
December 22, 2011, officers of the City County Investigative
Bureau ("CCIB") stopped Dang's car. Dang
alleges the officers pulled him from his vehicle, slammed him
to the ground, and put a knee on his neck before ultimately
releasing him. After this incident, Dang started experiencing
headaches and neck pain, and started taking large doses of
Aleve for relief. When the pain continued, Dang went to an
emergency room on January 12, 2012. He declined the
recommended testing to rule out meningitis.
January 26, law enforcement officers arrested Dang.
Dang's mother advised the arresting officers that he was
experiencing neck pain and headaches. The officers did not
allow Dang's mother to give him any medication, but
permitted her to place a medicated patch on his neck before
he was taken to Jail. After booking, Dang was asked several
questions about his health during his intake screening.
Dang's vitals were normal, and he did not inform the
intake officer that he was experiencing neck pain or
January 29, Dang was seen by Nurse Sandra Wilt, LPN, pursuant
to a "nurse sick call." Dang advised Wilt that he
was experiencing "[m]oderate to severe head and neck
pains, " possibly a "pinched nerve, " and a
"[s]tiff neck." After checking Dang's eyes and
the range of motion of his neck, Wilt observed that he had
minimal pain. Wilt ordered Motrin and a muscle rub and put in
an order for Dang to be seen by a doctor to get a
prescription for Robaxin, a muscle relaxant.
to Wilt's order, Dang saw Dr. Ogunsanwo, MD, on February
1. Dang stated he was experiencing headaches, neck pain, and
neck stiffness. Dang told Ogunsanwo about the incident with
the CCIB when he was allegedly "yanked out" of the
car and "slammed on the ground." After performing a
physical exam on Dang, Ogunsanwo noted that Dang had full
range of motion in his cervical spine with mild pain
elicited, normal gait, and no neurological deficit. His
temperature was 98.9. Ogunsanwo continued Dang on the Motrin
and muscle rub ordered by Wilt and prescribed Robaxin.
February 7, Brenda Preston-Mayle, RN, evaluated Dang and
completed a History and Physical Health Evaluation. Dang
informed Preston-Mayle about the incident with the CCIB and
that he had been experiencing head and neck pain. He also
described vision and hearing problems. Preston-Mayle took
Dang's vitals and noted a temperature of 98.9. His weight
was recorded as 132, eight pounds less than his intake
weight. Preston-Mayle offered to have Dang see a dental,
mental, or medical health doctor, but Dang declined.
February 9, Alecia Scott, LPN, saw Dang. Dang stated he had a
headache and that "no one was doing anything for
him." Scott assessed Dang and checked his vitals. She
recorded that he had full range of motion to his neck with no
swelling or redness. Dang was ambulatory and did not appear
to be in distress. However, Dang had a fever of 101.5. Scott
provided Dang with his Motrin and Robaxin, advised him to
drink plenty of fluids, and observed him for 15 to 20 minutes
before releasing him to his pod.
after Dang left the medical unit, Scott went to the hallway
and saw Dang on the floor against the wall. An officer told
Scott that Dang had "snatched away and slid down on the
wall and sat on the floor." Dang did not respond
verbally to the officer's request that he "get
up." Scott found Dang's behavior "bizarre"
and told him that if he continued to behave that way, he
would end up on suicide prevention. Dang got up and walked
away. Scott later directed Dang to mental health segregation
for observation and directed that his blood pressure be
monitored for five days. Later that night, Scott checked on
Dang and noted his temperature was down to 97.9. His behavior
and appearance were normal and she noticed no problems.
February 20, Sharyle Roberts, LPN, was notified of a
"Code Orange" medical emergency regarding Dang.
Roberts documented that Dang's pupils were equal and
reactive to light, his blood pressure was 136/85, and he had
a temperature of 99. Roberts noted that Dang appeared to be
passed out, was drooling, and exhibited fluttering eye
syndrome. Roberts believed the behavior was voluntary because
Dang wiped the drool from his mouth and when the room was
quiet, he "would open his eyes, look around, and then
close his eyes again." Roberts heard from Scott that he
had engaged in similar behavior two weeks prior. Roberts
admitted Dang to the infirmary and referred him to both
medical and mental health doctors.
February 21, Dr. Valerie Westhead, MD, a psychiatrist,
conducted a mental status examination of Dang. Dang had a
headache, a drop in blood pressure, and felt odd, but denied
hallucinations, delusions, or mood complaints. Westhead
concluded that Dang had an idiosyncratic reaction to the
muscle relaxants but no psychiatric issues. Westhead cleared
February 22, Martha Densmore, RN, saw Dang during her morning
rounds. Dang was rocking back and forth in his hard plastic
"boat" bed, but Densmore was able to check his
vitals and determined they were normal. Densmore testified
that he was alert, oriented, and voiced no complaints.
next morning, Dang informed Densmore of his two-week
headache. After observing that Dang had white patches on his
tongue, a 99-degree temperature, and was unsteady when he
attempted to stand, Densmore requested that Ogunsanwo see
Dang. A few hours later, Densmore observed Dang with his head
in the toilet trying to spit. He was incontinent and very
weak. Densmore asked Ogunsanwo to see him right away.
Ogunsanwo examined Dang and suspected he could have
meningitis. Ogunsanwo directed that Dang be transported to
the ER via a sheriff's patrol car, where he was diagnosed
with meningitis several days later.