Officers are often called to respond with EMS on medical emergency calls. At times, the subject of the medical call is physically resistant to paramedics as they are attempting to assist the person with a life-threatening crisis. Officers are then faced with a dilemma regarding using force to assist the paramedics. This dilemma occurs because police are typically trained regarding the use of force against criminal suspects who are resisting arrest, rather than medical patients. This was the case in the Estate of Hill v. Miracle,[i] decided by the Sixth Circuit Court of Appeals in 2017. The relevant facts of Miracle are as follows:
In June 2013, Corey Hill suffered a diabetic emergency in his home due to his low blood-sugar level. Paramedics with Star Emergency Medical Service were dispatched to Hill’s home at 3:20 p.m. after Hill’s girlfriend, Melanie Worrall, called 911 for an ambulance. Two ambulance units and four paramedics, including Luke Streeter, arrived at the home and proceeded to the bedroom where Hill was lying down. Despite finding Hill very disoriented, the paramedics introduced themselves and tried to explain that they needed to check his blood-sugar level. Streeter attempted to prick Hill’s finger for this purpose, but an agitated and combative Hill pulled back from the paramedics. Eventually, Streeter managed to prick Hill’s finger, leading to the determination that Hill’s blood-sugar level was extremely low at 38. A normal blood-sugar range is anywhere between 60 and 110, and a blood-sugar level below that range can cause hypoglycemia. As blood sugar falls, the common effects are for a person to lose consciousness, become combative and confused, or suffer a seizure. A blood-sugar level of 38 is therefore considered a medical emergency and, if left untreated, can lead to prolonged seizure and death.
Deputy Christopher Miracle of the Oakland County Sheriff’s Department arrived at Hill’s home at some point after Streeter measured Hill’s blood-sugar level. As a member of the road patrol, Miracle’s duties included responding to calls for emergency medical services. He had encountered over a dozen diabetic emergencies throughout his career and was aware that persons suffering from low blood-sugar levels are often disoriented and unaware of their surroundings. When Miracle arrived, the paramedics were attempting to intravenously administer dextrose to Hill in order to raise his blood-sugar level. Hill became increasingly combative in resisting the paramedics’ efforts to insert an IV catheter into his arm.
Streeter was finally able to insert the catheter while the other paramedics held Hill down to the bed. At this point, a completely disoriented Hill swung a fist towards Streeter and ripped the catheter from his arm, causing blood to spray from the open vein. Streeter managed to finally stop the bleeding, but Hill continued to kick, swing, and swear at the paramedics as they tried to hold him down.
Miracle, who at that point had not joined in the attempt to physically restrain Hill, ordered Hill to “relax.” When Hill continued to kick and swing, Miracle informed Hill that he (Miracle) was going to use his taser. Miracle then deployed his taser in drive-stun mode directly to Hill’s right thigh.
To use a taser in drive-stun mode, an officer removes the hooks that spring from a taser and holds the device directly against a person’s skin. Drive-stun mode is usually not recommended because keeping the taser in contact with a person’s skin is difficult, yet necessary to render the taser effective. But Miracle did not want to shoot the hooks of his taser directly into Hill and, in addition, thought that deploying his taser in drive-stun mode was a better option than “hands-on stuff” because Miracle wanted to “minimize [the] damage” and “didn’t really know everything that was going on medically.” After Miracle held the taser against Hill’s thigh for a few seconds, Hill calmed down long enough for Streeter to reestablish the IV catheter and administer dextrose. As noted by Streeter, Hill “became an angel” and was “very apologetic” after the dextrose kicked in.
Streeter then checked Hill’s blood-sugar levels and performed an electrocardiogram test. The results of both tests were normal. Hill denied being in any pain at the time, but the paramedics nonetheless transported Hill to McLaren Oakland Hospital, where his care was transferred to Dr. Brian Tweedle. Once again, Hill’s blood-sugar level was measured as being within normal range. Medical records from the hospital note a taser puncture wound on Hill’s right thigh, but Dr. Tweedle testified that no treatment was rendered for the wound because it was not infected. Hill claims that, as a result of this incident, he suffered burns on his right thigh and that his diabetes worsened.[ii]
In January of 2015, Hill filed suit against Miracle and alleged that he used excessive force under the Fourth Amendment when he Tased him in drive-stun mode. He also sued for assault and battery under state law. Officer Miracle filed a motion for summary judgment and qualified immunity on these claims, which the district court denied. Miracle appealed the denial of his motions to the Sixth Circuit Court of Appeals.
Qualified Immunity
The court of appeals first discussed qualified immunity and noted that qualified immunity is intended to allow public officials to perform their jobs without harassment and liability when they act reasonably, but yet hold them accountable if they exercise their power irresponsibly. The court also discussed the two-pronged test to determine if an officer is entitled to qualified immunity. Specifically, the court stated
We ask two questions in evaluating whether a law-enforcement officer is entitled to qualified immunity on an excessive-force claim: “(1) whether the officer violated the plaintiff’s constitutional rights under the Fourth Amendment; and (2) whether that constitutional right was clearly established at the time of the incident.” Kent v. Oakland County, 810 F.3d 384, 390 (6th Cir. 2016).[iii]
Qualified Immunity – Prong One – Did Officer Miracle violate Hill’s rights under the Fourth Amendment?
The court of appeals first examined the standard by which officers are evaluated for uses of force against criminal suspects. The court stated
To evaluate whether an officer has used excessive force in violation of the Fourth Amendment, we employ an objective-reasonableness test, asking “whether the officers’ actions are objectively reasonable in light of the facts and circumstances confronting them, without regard to their underlying intent or motivation.” Graham v. Connor, 490 U.S. 386, 397, 109 S. Ct. 1865, 104 L. Ed. 2d 443 (1989) (internal quotation marks omitted). We must keep in mind that “[t]he ‘reasonableness’ of a particular use of force must be judged from the perspective of a reasonable officer on the scene, rather than with the 20/20 vision of hindsight.” Id. at 396. Graham proceeds to set out a three-factor test to aid the courts in assessing objective reasonableness in the typical situation of a law-enforcement officer accused in a civil suit of using excessive force. Those three factors are: (1) “the severity of the crime at issue,” (2) “whether the suspect poses an immediate threat to the safety of the officers or others,” and (3) “whether he is actively resisting arrest or attempting to evade arrest by flight.” Id.[iv]
The district court, in denying qualified immunity for Officer Miracle, used the above framework to analyze Hill’s case. Since Hill was not a criminal suspect, the court determined that two of the three factors, particularly the seriousness of the crime and whether he was actively resisting arrest, weighed against Officer Miracle’s use of force. The court of appeals likened this to being “equivalent to a baseball player entering the batter’s box with two strikes already against him.”[v]
The court of appeals then suggested a “more tailored set of factors be considered in medical-emergency” case. Specifically, the court stated
Where a situation does not fit within the Graham test because the person in question has not committed a crime, is not resisting arrest, and is not directly threatening the officer, the court should ask:
(1) Was the person experiencing a medical emergency that rendered him incapable of making a rational decision under circumstances that posed an immediate threat of serious harm to himself or others?
(2) Was some degree of force reasonably necessary to ameliorate the immediate threat?
(3) Was the force used more than reasonably necessary under the circumstances (i.e., was it excessive)?
If the answers to the first two questions are “yes,” and the answer to the third question is “no,” then the officer is entitled to qualified immunity.[vi]
The court of appeals then set out to apply the facts of Hill’s case to the factors above. First, the court noted that Hill was experiencing a hypoglycemic episode that rendered him incapable of making sound decisions. Further, if untreated, the court noted that this condition “would likely have led to a prolonged seizure and death.”[vii] As such, his resistance was a significant threat to Hill’s own safety. Additionally, Hill resisted four paramedics by kicking his feet and swinging his fists in the direction of the paramedics. Thus, the paramedics were in physical danger. In addition to the physical danger in this case, there was also the danger of blood-borne pathogens. The paramedics did not know whether Hill had hepatitis C, HIV, or other contagious conditions and his resistance cause blood to spray when he ripped the catheter out of his arm. A paramedic testified that if the blood got in their eyes, mouth, or face they would be at risk of potential infections if Hill were infected.
Hill argued that the paramedics and police could have just stepped away from him and then they would not have been at any risk. However, this overlooks the fact that that would have had “potentially fatal consequences for Hill.”[viii]
The court then examined the second factor to consider above, which is whether some degree of force was necessary to ameliorate, or mitigate, the threat. The court noted that Hill was violently resisting four paramedics as they were attempting to provide him lifesaving assistance. Hill had ripped the catheter from his arm, and the paramedics were attempting to reinsert it, as Hill violently resisted their attempts. Thus, the court of appeals determined that some degree of force was necessary to mitigate the threat posed by Hill as the paramedics attempted to provide lifesaving treatment.
Lastly, the court examined the third factor, particularly whether the force used was more than necessary under the circumstances. Here, after telling Hill to “relax” and Hill’s non-compliance, Officer Miracle used his Taser, in drive-stun mode, on Hill’s thigh. Miracle testified that he used drive-stun mode to “minimize the damage” to Hill in consideration of his medical emergency.
Hill argued that Officer Miracle should have first tried to handcuff or physically restrain him prior to using the Taser. However, the court of appeals noted that four paramedics had been unable to physically restrain Hill, and they do not “fault Miracle for not joining the fray.”[ix] Hill also argued that the use of the Taser in drive-stun mode is not generally recommended, and therefore, it constituted excessive force. However, the court of appeals noted that drive-stun mode is not recommended because it is difficult to keep the Taser in contact with a person, not because it automatically constitutes excessive force. Officer Miracle testified that he used drive-stun mode to minimize injury to Hill, since he was undergoing a medical emergency. As such, the court determined that the use of the Taser was not more than necessary under the circumstances of Hill’s case.
The court of appeals then held
We are not holding that a law-enforcement officer is always justified in using a taser to gain control over a person suffering from a medical emergency. But under the circumstances, Miracle’s use of force was objectively reasonable. Four paramedics were unable to physically restrain Hill, whose health was rapidly deteriorating and who was unresponsive to Miracle’s command to “relax.” We conclude that a reasonable officer on the scene, without “the 20/20 vision of hindsight,” would be justified in taking the same actions as Miracle.[x]
Qualified Immunity – Prong Two – Was the law clearly established?
While resolution of the first prong of the qualified immunity test in favor of the officer not violating the Fourth Amendment entitles Officer Miracle to qualified immunity, the court of appeals also set out to examine prong two. The court of appeals noted that for the law to be clearly established, “the contours of the right must be sufficiently clear that a reasonable official would understand that what he is doing violates that right.”[xi] Here, the court of appeals noted that Hill pointed to no case law that supports his contention that the law was clearly established. The court stated
Hill has not pointed us to any caselaw that demonstrates a “prior articulation of a prohibition” against the type of force exerted against him. See Champion v. Outlook Nashville, Inc., 380 F.3d 893, 902 (6th Cir. 2004) (“To demonstrate that the Officers unreasonably violated a clearly established right, the Plaintiffs must therefore show the prior articulation of a prohibition against the type of excess force exerted here.”).[xii]
Thus, the court held that the law was not clearly established. Therefore, Officer Miracle is entitled to qualified immunity on the Fourth Amendment claim.
The State Law Claim of Assault and Battery
The court of appeals noted that the district court denied governmental immunity for Officer Miracle on the state law claim. However, the court of appeals determined that the district court used the incorrect standard in making that determination. The court of appeals stated
The Michigan Supreme Court in Odom held that a defendant did not need to show that his actions were “justified” or “objectively reasonable under the circumstances” in order to qualify for governmental immunity. Id. at 220, 229. Instead, an officer who commits an intentional tort is entitled to governmental immunity if he shows that “(a) the acts were undertaken during the course of employment and the employee was acting, or reasonably believed that he was acting, within the scope of his authority, (b) the acts were undertaken in good faith, or were not undertaken with malice, and (c) the acts were discretionary, as opposed to ministerial.” Id. at 228.[xiii]
The court of appeals concluded that, for the reasons previously discussed, no reasonable jury could conclude that Officer Miracle acted in bad faith or with malice when he used the Taser once, in drive-stun mode, for a few seconds, in order to assist the paramedics in gaining control of Hill for the purpose of providing him lifesaving medical treatment.
Therefore, the court reversed the holding of the district court and granted qualified immunity to the officer on all claims.
Note: Court holdings can vary significantly between jurisdictions. As such, it is advisable to seek the advice of a local prosecutor or legal adviser regarding questions on specific cases. This article is not intended to constitute legal advice on a specific case.
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Citations
[i] 853 F.3d 306 (6th Cir. 2017)
[ii] Id. at 310-311
[iii] Id. at 312 (emphasis added)
[iv] Id. at 312-313 (emphasis added)
[v] Id. at 313
[vi] Id. at 314 (emphasis added)
[vii] Id. at 315
[viii] Id.
[ix] Id.
[x] Id. (emphasis added)
[xi] Id. at 316
[xii] Id. (emphasis added)
[xiii] Id. at 317 (emphasis added)
