by Douglas Ankney

“This appeal arises from the tragic death of Antonio May,” began the decision of the U.S. Court of Appeals for the Eleventh Circuit on June 7, 2023. As longtime PLN readers know, “tragic” deaths are often those for which no one is held liable. Sure enough, the Eleventh Circuit had bad news for the dead man’s survivors, affirming a lower court’s decision not to blame May’s September 2018 death at Atlanta’s Fulton County Jail (FCJ) on officials there.

But the Court also reversed a grant of summary judgment to the jail’s privately contracted healthcare provider, Alabama-base NaphCare, Inc., whose expert had blamed May’s death on “excited delirium,” a diagnosis PLN has reported is widely considered “junk science.” [See: PLN, Apr. 2016, p.10.] 

May’s fate was sealed as he lay on the ground and spread his arms in front of Atlanta’s American Cancer Society building. To responding officers with the Atlanta Police Department (APD), security guards identified May as the person who had thrown rocks at the building and broken a window. May told cops he was not feeling well and wanted to go to jail. They took him to Grady Memorial Hospital for an examination by a psychiatrist, who released May for transport to FCJ.

At FCJ, an EMT and NaphCare employee, Travis Williams, conducted May’s intake screening. May indicated he was suicidal but denied planning to harm himself. An APD officer gave Williams the hospital paperwork “indicating doctors had diagnosed May as having methadone use disorder.” Williams then informed NaphCare medical provider David Didier that he had come from Grady Hospital with methadone use disorder and substance-induced psychotic disorder, that he voiced thoughts of suicide, and that he was possibly detoxing.

May was then sent to booking. During the booking process, “May displayed erratic behavior and signs of mental illness, claiming that people were watching him,” as the Court later recalled. Placed in a holding cell for observation by medical staff, May stripped himself naked and began banging on the glass on the door of the holding cell. He cursed at everyone who walked past. A drug screening would later show he tested positive for amphetamines, ecstasy and methamphetamine. May began masturbating in the holding cell—shockingly, a violation of state law. FCJ deputies ordered May to put his clothes on and to get on the floor. When he refused, deputies opened the door to the holding cell, and May took a fighting stance as he stepped toward them. Thereafter, a prolonged altercation ensued. May was Tasered, pepper-sprayed, punched, cuffed and ultimately strapped into a restraint chair.

He was transported in the chair to a shower for decontamination from the pepper spray. May continued to be combative as deputies dressed him and took him in the chair to the property room for an examination by medical staff. Didier conducted a visual evaluation, determined May was not in distress, and left the area to get his equipment for a full medical screening.

Meanwhile Lt. Derrick Page arrived. Because May no longer appeared to be resisting, he ordered May’s handcuffs be removed. Shortly thereafter, Page and the deputies discovered May was unconscious and unresponsive. Attempts to revive him were unsuccessful. According to the Medical Examiner’s report, “May died of sudden cardiovascular collapse due to probable excited delirium with physical restraint use and acute methamphetamine intoxication; the manner of death [was] listed as undetermined.”

Search for Justice Begins

April M. Myrick, the grandmother of two of May’s children, and Sheena Pettigrew, the mother of another child of his, filed a federal civil rights claim against Fulton County Sheriff Theodore Jackson and several FCJ deputies, as well as a state-law medical negligence claim against NaphCare and EMT Williams. The U.S. District Court for the Northern District of Georgia granted summary judgment to all Defendants. Plaintiffs appealed.

The Eleventh Circuit affirmed as to all Defendants except NaphCare. The Court observed “[a] plaintiff cannot succeed on a medical malpractice claim, even if there is evidence of negligence, ‘unless the plaintiff established by a preponderance of the evidence that the negligence either proximately caused or contributed to cause plaintiff harm,’” quoting Zwiren v. Thompson, 578 S.E.2d 862 (Ga. 2003). “To establish proximate cause by a preponderance of the evidence in a Georgia medical malpractice claim, the plaintiff must use expert testimony,” the Court continued, but “Georgia case law requires only that an expert state an opinion regarding proximate causation in terms stronger than that of medical possibility, i.e., reasonable medical probability or reasonable medical certainty.” Importantly, the Court concluded, “[w]hat amounts to proximate cause is undeniably a jury question.”

In the report of Dr. Timothy Hughes, he stated: “It is my expert opinion that had Mr. May been appropriately screened and examined with the correct and prompt follow through by NaphCare medical staff, to include immediate classification to suicide watch and to have appropriate sedation ordered for his methamphetamine-induced psychotic behavior, the events that transpired and culminated in an episode of excited delirium and subsequent sudden cardiac death—further exacerbated by the use of force— would in all probability not [have] occurred.”

The Court held that, “based on Dr. Hughes’ testimony, there is a genuine issue of material fact whether NaphCare employees were the proximate cause of May’s death. A reasonable jury could find that they were.” And where material facts are in dispute, summary judgment is inappropriate, the Court noted, under Fed. R. Civ. Proc. 56. Accordingly, the Court vacated the grant of summary judgment to NaphCare and remanded the case. Plaintiffs were represented by attorney Michael D. Harper of the Harper Law Firm PC in Atlanta. See: Myrick v. Fulton Cty., 69 F.4th 1277 (11th Cir. 2023).

The case has now returned to the district court, which adopted the Eleventh Circuit’s judgment as its own on July 26, 2023. Plaintiffs then filed to remove the case to state court on October 13, 2023, to try the state-law claims against NaphCare there. PLN will update developments in the case as they are available. See: Myrick v. Fulton Cty., USDC (N.D. Ga.), Case No. 1:19-cv-02440.  

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