Louise Cook v. Sheriff of Monroe County

[PUBLISH]

IN THE UNITED STATES COURT OF APPEALS

FOR THE ELEVENTH CIRCUIT FILED
________________________
U.S. COURT OF APPEALS
ELEVENTH CIRCUIT
No. 03-14784 March 10, 2005
________________________ THOMAS K. KAHN
CLERK
D. C. Docket No. 02-10064-CV-JLK

LOUISE COOK, as personal
representative of the Estate of
Daniel F. Tessier, and Jonathan
Tessier, a minor,

Plaintiff-Appellant,

versus

SHERIFF OF MONROE COUNTY,
FLORIDA, Rick Roth, Sheriff,
Defendant-Appellee.

________________________

Appeal from the United States District Court
for the Southern District of Florida
_________________________

(March 10, 2005)

Before HULL and MARCUS, Circuit Judges, and HANCOCK*, District Judge.

MARCUS, Circuit Judge:

*
Honorable James H. Hancock, United States District Judge for the Northern District of
Alabama, sitting by designation.
 This sad case arises out of the 1999 suicide death of Daniel Tessier

(“Tessier”), who, at the time of his death, was incarcerated at the Monroe County

Detention Center (“MCDC”). Louise Cook, as Personal Representative of the

Estate of Daniel F. Tessier (“Cook”), brought this action against the Sheriff of

Monroe County, Rick Roth, in his official capacity, on behalf of Tessier’s estate

and Jonathan Tessier, the minor child of Cook and Tessier. Cook alleges three

bases for liability: first, she claims that the Sheriff was deliberately indifferent to

Tessier’s medical needs, in violation of federal law, 42 U.S.C. § 1983; second, she

says that the Sheriff is liable under Florida tort law for negligent supervision,

training, and management of MCDC employees; finally, she asserts that the

Sheriff is vicariously liable under Florida tort law for the negligent failure of

MCDC employees to prevent Tessier’s suicide.

Cook’s case was tried in the United States District Court for the Southern

District of Florida,1 and Cook now appeals from the district court’s entry of

judgment as a matter of law for the Sheriff on all counts at the close of Cook’s

case. Cook also appeals the trial court’s in limine rulings excluding evidence of

1
Cook initially sued in the Circuit Court of the Sixteenth Judicial Circuit in Monroe
County, Florida, but, pursuant to the Sheriff’s motion for removal under 28 U.S.C. § 1441, the
case was removed to federal district court.

2
other suicides occurring in the MCDC, as well as the testimony of a suicide expert

retained by Cook.

After careful review of the record, we affirm the trial court’s judgment for

the Sheriff on Cook’s § 1983 and negligent training and supervision claims, but

we conclude that the trial court erred in granting judgment as a matter of law on

Cook’s vicarious liability negligence claim. We further hold that the trial court

acted within its discretion in excluding evidence of other MCDC suicides and the

testimony of Cook’s expert. We therefore affirm in part, reverse in part, and

remand for further proceedings consistent with this opinion.

I.

The essential facts are these. Daniel Tessier was arrested for auto theft on

May 18, 1999, and was subsequently processed and placed into the general

population (“Unit G”) of the MCDC. The following morning, May 19, 1999, at

10:30 a.m., Tessier made a written request to see a psychiatrist, stating: “NeeD To

se PHSYCAATRISe and docToR.” Deputy Kenneth Kerr, the detention deputy

assigned to Unit G that morning, testified at trial that he received and logged

Tessier’s request, which was then placed into a box designated for medical

requests. Pursuant to MCDC procedures, nurses are supposed to pick up all

medical requests during their twice-daily rounds and pass them on to facility

3
doctors. The date stamp on Tessier’s request, however, reads “May 20, 1999,”

indicating that MCDC’s medical department (known as “Medical”) did not receive

the request until the day after Tessier submitted it.

Deputy Kerr further testified that, when he observed Tessier on May 19,

Tessier seemed nervous and appeared to be having an anxiety attack. Tessier

approached Kerr later in the day complaining of chest pains, which prompted

Deputy Kerr to send Tessier to Medical. Deputy Kerr did not inform Medical of

Tessier’s apparent anxiety or his request to see a psychiatrist.

A nurse examined Tessier at 2:45 p.m. on May 19. Tessier complained of

difficulty breathing, pain in the left side of his chest cavity, and numbness in his

right hand. The nurse performed an electrocardiogram, the results of which were

“borderline.” The nurse then placed Tessier on sick call, noting in his chart that

the “inmate state[d] he fe[lt] better -- placed on Dr. call for re-eval.” Tessier was

returned to Unit G, but continued to complain of chest pains. Deputy Kerr

instructed Tessier to lie down and told him that if “he wasn’t feeling good in a

little while [Deputy Kerr] would send him back again.”

At approximately 4:00 that afternoon, May 19, Deputy Kerr received

instructions to transfer Tessier to Unit A, the MCDC’s disciplinary unit, and was

informed that Tessier’s phone privileges had been revoked for allegedly making

4
harassing phone calls to witnesses. Deputy Kerr transferred Tessier into the

custody of Deputy Robert Malopolski, telling him to “keep an eye on Tessier

because he had been complaining of chest pains.”

Tessier was placed alone in a cell in Unit A. Deputy Malopolski observed

Tessier to be nervous and anxious, and instructed him to take deep breaths and

relax, and to push the intercom on the wall if he needed assistance. Deputy

Malopolski thereafter responded to several intercom calls by Tessier. On one

occasion, at approximately 5:00 p.m. on May 19, Deputy Malopolski found

Tessier bent over on his knees on the floor of his cell, apparently having trouble

breathing. Deputy Malopolski then contacted Medical, which came and took

custody of Tessier.

Tessier stayed in Medical overnight, and Dr. Carol Daniels2 treated him the

following day, May 20, 1999, at 11:45 a.m. Dr. Daniels diagnosed Tessier with

pleuritis, a benign condition, and ordered that Tessier be given a chest x-ray and

Motrin. Tessier was discharged back to Unit A around 5:00 p.m the same day.

Deputy Malopolski observed that Tessier still appeared very nervous on his return.

2
Dr. Daniels, a medical doctor with a specialty in internal medicine, was employed by
Prison Health Services, a company with which the Sheriff contracted to provide medical services
at the MCDC.

5
 Deputy John Whortenbury took over the night shift in Unit A at 6:00 p.m.

on May 20. He was not advised that Tessier had visited Medical or that he had

requested to see a psychiatrist, although he was told that Tessier had lost his phone

privileges. Deputy Whortenbury observed Tessier to be “quiet, mostly polite,

nervous or concerned -- maybe apprehensive about being in Unit A. He had a

moderate energy level, and his mannerisms and conversation gave me the

impression that he was ok.”

Later that evening, at 9:20 p.m., Tessier made a second written request to

see a psychiatrist, this time stating: “Need To See PHSYCATRIST AT SOON AS

POSSIBLE. MeNTALY SICK, PROBLEM To BreaD.” Deputy Whortenbury

testified that he asked Tessier if the request was “something that needs to be done

now or can [it be] handled on the next scheduled basis,” and Tessier told him “the

next scheduled time would be fine.” Deputy Whortenbury then signed Tessier’s

request form and placed it in the pick-up box designated for medical requests.

At 9:35 the following morning, May 21, 1999, a deputy discovered Tessier

in his cell, having hanged himself from a bedsheet. The last hourly check on

Tessier occurred at 9:07 a.m., indicating that he had hanged himself sometime

between 9:07 and 9:35. Attempts to fully revive Tessier failed, and he died two

days later in the hospital when his family decided to discontinue life support.

6
 Cook’s case against the Sheriff proceeded to trial before a jury on August 6,

2003. Cook’s witnesses included, in addition to herself and Jonathan Tessier,

Deputies Kerr, Malopolski, and Whortenbury; Dr. Daniels; Dr. Tanju Mishara,

Ph.D., a psychologist who treated MCDC inmates; Captain Rick Remley, the

commander of detention services, who was in charge of MCDC operations at the

time of Tessier’s suicide; Major Tommy Taylor, the head of the Monroe County

Bureau of Corrections, which encompassed three detention facilities; and Sergeant

Fernando Lopez, who was the MCDC shift sergeant at the time of Tessier’s

suicide and the MCDC training sergeant at the time of trial. At no point during

trial did Cook seek to introduce the testimony of her suicide expert, Dr. Maris.

The three deputies and Dr. Daniels testified primarily about their

interactions with Tessier in the days and hours leading up to his suicide, as

described above. Dr. Mishara commented on Tessier’s requests to see a

psychiatrist, explaining that the second request, in particular, would have caused

her concern as a psychologist. On cross-examination, she clarified that the May

20 request was not “an emergency situation,” and would not have been

“interpret[ed] as someone who is going to be committing suicide unless there is a

history or is a mental illness or depression or something like that.” Instead, the

inmate “would be someone that would be on [the MCDC psychologists’] list the

7
next time that we are there.” Dr. Mishara did say, however, that “[i]f a person

came to me having written this [second request], I would certainly screen them for

suicide.” In addition, Dr. Mishara described the MCDC’s procedures for

processing and responding to inmate requests for psychiatric or psychological

help, as well as her involvement in training deputies in suicide prevention.

Captain Remley, Major Taylor, and Sergeant Lopez further elaborated on

MCDC procedures for training deputies in suicide prevention and for addressing

inmate medical requests. As to the former, MCDC deputies are trained in suicide

prevention, among other things, at the start of their employment, and are required

thereafter to attend an annual retraining class that includes viewing a suicide

prevention video.

The MCDC also maintains a written manual, the Sheriff’s Policy and

Procedure Manual (the “Manual”), which Cook introduced into evidence, and

which includes a section on suicide prevention. The Manual contains a general

statement of the MCDC’s suicide prevention policy:

It is the policy of the Monroe County Detention Facilities that all
Detention Staff Members will be provided special training by
qualified instructors in order to observe inmates for suicide potential
during intake processing and for the identification and supervision of
suicide-prone inmates during their incarceration. The suicide
prevention and intervention program shall be developed[,] reviewed
and approved by a qualified medical or mental health professional.

8
In addition, the Manual outlines screening procedures to be followed during

inmate admission into the MCDC, including screening for alcohol or drug

dependence, psychiatric problems, and history of suicide attempts; it enumerates a

multitude of suicide risk factors and indicators; it prescribes crisis intervention

techniques, explaining how to interact with a suicidal inmate and what sort of

administrative and medical help to seek; and it establishes housing assignment

guidelines for suicidal inmates, including suicide watch procedures.

As to inmate medical requests, requests for psychological or psychiatric

help are treated in the same manner as any other medical request. The Manual

contains the general policy that “[i]nmates filling out a medical request slip will be

seen on the day the slip is completed or within twenty-four hours if the request is

not urgent.” According to the testimony of Major Taylor, requests for psychiatric

attention, like all other medical requests, are given to medical personnel, who

determine whether to refer the inmate to a psychiatrist.

After two days of testimony, when Cook had called all of her witnesses, the

Sheriff moved, pursuant to Federal Rule of Civil Procedure 50(a), for judgment as

a matter of law on all three of Cook’s claims. The district court, ruling from the

bench, granted the motion as to all claims, concluding that there had been no

showing of deliberate indifference or negligent training and supervision on the

9
part of the Sheriff, nor was the evidence sufficient to enable a reasonable person to

conclude that Tessier’s suicide was foreseeable and therefore to hold the Sheriff

vicariously liable for the failure of MCDC employees to prevent it. It is from this

ruling, as well as from the trial court’s in limine evidentiary rulings, that Cook

now appeals.

II.

We turn first to the district court’s evidentiary rulings on the admissibility

of evidence of other suicides occurring within the MCDC and of the testimony of

Cook’s suicide expert, Dr. Maris.

The legal framework against which we measure these evidentiary rulings is

clear. We review a trial court’s evidentiary rulings, including its rulings on the

admissibility of expert testimony, for abuse of discretion. See, e.g., United States

v. Frazier, 387 F.3d 1244, 1258 (11th Cir. 2004) (en banc); Wright v. CSX

Transp., Inc., 375 F.3d 1252, 1260 (11th Cir. 2004); Maiz v. Virani, 253 F.3d 641,

662 (11th Cir. 2001). As we have recently explained, “the deference that is the

hallmark of abuse-of-discretion review requires that we not reverse an evidentiary

decision of a district court unless the ruling is manifestly erroneous. Thus, it is by

now axiomatic that a district court enjoys ‘considerable leeway’ in making these

determinations.” Frazier, 387 F.3d at 1258 (citations and internal quotation marks

10
omitted). Abuse-of-discretion review “recognizes the range of possible

conclusions the trial judge may reach. ‘By definition . . . under the abuse of

discretion standard of review there will be occasions in which we affirm the

district court even though we would have gone the other way had it been our call.

That is how an abuse of discretion standard differs from a de novo standard of

review. As we have stated previously, the abuse of discretion standard allows “a

range of choice for the district court, so long as that choice does not constitute a

clear error of judgment.”’ Id. at 1259 (quoting Rasbury v. I.R.S. (In re Rasbury),

24 F.3d 159, 168 (11th Cir. 1994) (quoting United States v. Kelly, 888 F.2d 732,

745 (11th Cir. 1989))). “Thus, when employing an abuse-of-discretion standard,

we must affirm unless we find that the district court has made a clear error of

judgment, or has applied the wrong legal standard.” Id.

A.

First, Cook appeals from the district court’s order granting the Sheriff’s

Motion in Limine to Preclude Reference to Other Suicides. Cook sought to

introduce at trial evidence of five other suicides occurring in the MCDC within a

twenty-three-month period. Three of these suicides occurred prior to Tessier’s,

while two occurred afterwards. Cook argued that the other suicides were relevant

to her negligence claims “to show Defendant’s generalized business practice or

11
habit as regards the detection and prevention of suicides in general,” and relevant

to her § 1983 claim to “establish[] a pattern of negligence by inadequately

trained/supervised personnel, such to demonstrate the Sheriff’s deliberate

indifference.” Plaintiffs’ Response Memorandum in Opposition to Defendant’s

Motion to [sic] in Limine to Exclude Evidence of Other Suicides at 3, 6. In

concert with this evidence, Cook also sought to offer testimony from her suicide

expert that six suicides in twenty-three months was an excessively high rate.

The district court, however, found that the “record [was] devoid of evidence

showing that the previous suicides would be relevant to Defendant’s ability to

foresee the suicide of Plaintiffs’ decedent or to Defendant’s complete indifference

to the decedent,” and granted the Sheriff’s motion in limine. Cook v. Roth, 264 F.

Supp. 2d 1062, 1064 (S.D. Fla. 2003).3 Although the district court did not explain

its reasoning in its order, when the issue came up again during a sidebar at trial,4

the court explained: “The mere fact that there are or are not suicides, I think, is

3
At the March 7, 2003 status conference, Cook indicated her intent to introduce evidence
of the other suicides, and the Sheriff expressed his opposition to the admission of such evidence.
To resolve the issue, the district court afforded the parties the opportunity to file memoranda of
law explaining their arguments, and advised the parties that the issue was “akin to” evidence of
similar acts under Federal Rule of Evidence 404(b).
4
During Cook’s examination of Major Taylor, the Sheriff objected on relevancy grounds
to the question of whether suicide was the leading cause of death in the MCDC. After a
prolonged sidebar discussion among the parties and the court, the trial court again ruled that
Cook could “not go into, directly or indirectly, the other suicides.”

12
going to depend on [a variety of] factors. What is the jail population, where does

it come from, who are they, are they people that are more stable than others, all

sorts of factors. It’s awfully difficult.”

We conclude that the trial court acted within its broad discretion in ruling

that the evidence was not relevant.

“‘Relevant evidence’ means evidence having any tendency to make the

existence of any fact that is of consequence to the determination of the action more

probable or less probable than it would be without the evidence.” Fed. R. Evid.

401. “Evidence of other crimes, wrongs, or acts,” while “not admissible to prove

the character of a person in order to show action in conformity therewith,” “may,

however, be admissible for other purposes, such as proof of motive, opportunity,

intent, preparation, plan, knowledge, identity, or absence of mistake or accident.”

Fed. R. Evid. 404(b). Such evidence is properly admitted only if it “possess[es]

probative value that is not substantially outweighed by its undue prejudice.”

United States v. Jernigan, 341 F.3d 1273, 1280 (11th Cir. 2003) (quoting United

States v. Miller, 959 F.2d 1535, 1538 (11th Cir. 1992) (en banc)); see also Fed. R.

Evid. 403 (“Although relevant, evidence may be excluded if its probative value is

substantially outweighed by the danger of unfair prejudice, confusion of the

13
issues, or misleading the jury, or by considerations of undue delay, waste of time,

or needless presentation of cumulative evidence.”).

Cook’s argument appears to be that evidence of the other suicides is

admissible to demonstrate “knowledge” on the part of the Sheriff -- that is, to

prove, based on a pattern of suicides, that Tessier’s suicide was foreseeable. For

purposes of Cook’s § 1983 claim, this argument plainly fails. Under controlling

case precedent, § 1983 requires that the defendant have “notice of the suicidal

tendency of the individual whose rights are at issue in order to be held liable for

the suicide of that individual.” Tittle v. Jefferson County Comm’n, 10 F.3d 1535,

1539 (11th Cir. 1994) (en banc) (emphasis in original). Other suicides occurring

in the MCDC are in no way probative of the Sheriff’s knowledge of Tessier’s

suicidal tendencies. Thus, we have little trouble concluding that the trial court

acted within its discretion in determining that the evidence was not relevant to

Cook’s § 1983 claim.

Whether the occurrence of five other suicides within a twenty-three month

span is relevant to Cook’s negligence claims is a closer question. However, we

reiterate that we review a trial court’s evidentiary rulings only for abuse of

discretion, and “a district court enjoys considerable leeway in making these

14
determinations.” Frazier, 387 F.3d at 1258 (citations and internal quotation marks

omitted).

Cook suggests, in general terms, that the other suicides are relevant to her

negligence claims because the Sheriff’s awareness of the MCDC’s suicide rate

illustrates that his “failure to take reasonable precautions to prevent further

suicides, including that of Tessier,” was negligent. Plaintiffs’ Response

Memorandum in Opposition to Defendant’s Motion to [sic] in Limine to Exclude

Evidence of Other Suicides at 3. Whether a series of suicides is indeed probative

of any fact material to either of Cook’s negligence claims is a debatable issue. On

the one hand, the occurrence of six suicides within twenty-three months may

suggest that the MCDC’s procedures for identifying and responding to suicide

risks are deficient, particularly since Cook indicated that her suicide expert would

testify that this suicide rate was “off the board in terms of statistical anomaly” for

a facility with the population size of the MCDC. However, as the trial court

observed, Cook did not establish that six suicides in twenty-three months is an

unusually high rate for a facility like the MCDC -- that is, a facility whose

population is comparable in terms of factors such as the proportion of mentally

and emotionally unstable inmates. This failure to account for all (or even many)

15
of the factors pertinent to a facility’s suicide rate substantially diminishes, if not

eviscerates, the probative value of Cook’s proffered evidence.

Moreover, as Cook conceded at oral argument, two of the other five suicides

occurred after Tessier’s. Accordingly, for purposes of Cook’s claims, those two

suicides surely could not have served to put the Sheriff on notice of any

deficiencies in the MCDC’s procedures for detecting or addressing suicide risks.

Thus, the only even potentially relevant suicides are the three occurring prior to

Tessier’s.

As to those three suicides, regardless of whether they may possess some

probative value, the trial court did not abuse its discretion in finding any probative

value substantially outweighed by the risk of prejudice to the defendant or of

misleading the jury, since the record suggests that the facts and circumstances of

the other suicides differed materially from those surrounding Tessier’s. Cook

offered the district court no information whatsoever regarding the facts and

circumstances of the other suicides occurring within the MCDC. The Sheriff, in

his motion in limine to exclude the suicides, provided minimal details about four

of the five, including two of those occurring prior to Tessier’s. Inmate Larry

Hounshell committed suicide on December 29, 1997, after being incarcerated for

less than a day. In fact, Mr. Hounshell had not yet been booked, and committed

16
suicide in a holding cell by hanging himself from the cord attached to a telephone

in the cell. Inmate Ralph Ogden committed suicide on September 25, 1998, after

being incarcerated for about two hours. Like Mr. Hounshell, Mr. Ogden had not

yet been booked, and he committed suicide in a holding cell, hanging himself with

his underwear.

The differences between the circumstances of Tessier’s suicide and those of

these other decedents are numerous. Tessier had already been booked when he

committed suicide; his suicide occurred on the fourth day of his incarceration; he

committed suicide by hanging himself with a bedsheet; he was housed in an

isolation cell within Unit A, the MCDC’s disciplinary unit, at the time of his

suicide. Moreover, the record reveals that Tessier made two written requests to

see a psychiatrist during his incarceration, but received no psychiatric attention

before his suicide. Even comparing what precious little we know about the other

MCDC suicides to Tessier’s the material differences in facts and circumstances are

readily apparent.

Based on these factual differences among the suicides, and on the critical

comparative facts we don’t know anything about, the trial court reasonably

concluded that any probative value the other suicides might have was substantially

outweighed by their potential to mislead the jury and prejudice the defendant. See

17
Fed. R. Evid. 403. Thus, we conclude that the trial court did not abuse its

discretion in excluding evidence of other suicides occurring within the MCDC.

Cf. Watkins v. Bowden, 105 F.3d 1344, 1352 n.16 (11th Cir. 1997) (holding, in

the case of a First Amendment employer retaliation claim, that the district court

did not abuse its discretion in excluding testimony of other alleged victims of

retaliation on the grounds that their testimony “was (1) too far removed in time

from the period that [the plaintiff] worked in the office, and (2) not sufficiently

similar to [the plaintff’s] allegations to merit admission under Federal Rule of

Evidence 404(b)”); Brooks v. Scheib, 813 F.2d 1191, 1194 (11th Cir. 1987)

(“Courts traditionally have harbored strong misgivings about allowing allegations

of past wrongdoing to bias judges and juries reviewing new charges.”).

B.

Cook also appeals the trial court’s decision to exclude the testimony of her

proffered suicide expert, Dr. Ronald Maris, Ph.D.

Federal Rule of Evidence 702 lays out the circumstances in which expert

testimony is admissible:

If scientific, technical, or other specialized knowledge will assist the
trier of fact to understand the evidence or to determine a fact in issue,
a witness qualified as an expert by knowledge, skill, experience,
training, or education, may testify thereto in the form of an opinion or
otherwise, if (1) the testimony is based upon sufficient facts or data,

18
 (2) the testimony is the product of reliable principles and methods,
and (3) the witness has applied the principles and methods reliably to
the facts of the case.

Fed. R. Evid. 702.

A trial court, in determining the admissibility of expert testimony under

Rule 702, must conduct “a rigorous three-part inquiry,” considering whether

(1) the expert is qualified to testify competently regarding the matters
he intends to address; (2) the methodology by which the expert
reaches his conclusions is sufficiently reliable as determined by the
sort of inquiry mandated in Daubert; and (3) the testimony assists the
trier of fact, through the application of scientific, technical, or
specialized expertise, to understand the evidence or to determine a
fact in issue.

Frazier, 387 F.3d at 1260 (quoting City of Tuscaloosa v. Harcros Chems., Inc.,

158 F.3d 548, 562 (11th Cir. 1998)).

The proponent of the expert testimony carries a substantial burden under

Rule 702. “The burden of laying the proper foundation for the admission of the

expert testimony is on the party offering the expert, and admissibility must be

shown by a preponderance of the evidence.” Allison v. McGhan Med. Corp., 184

F.3d 1300, 1306 (11th Cir. 1999) (citing Daubert, 509 U.S. at 592 n. 10). Thus,

the proponent must demonstrate that the witness is qualified to testify

competently, that his opinions are based on sound methodology, and that his

testimony will be helpful to the trier of fact. See, e.g., Frazier, 387 F.3d at 1260

19
(“The burden of establishing qualification, reliability, and helpfulness rests on the

proponent of the expert opinion . . . .”); McCorvey v. Baxter Healthcare Corp., 298

F.3d 1253, 1257 (11th Cir. 2001); Maiz, 253 F.3d at 664.

In this case, the trial court did not abuse its discretion in concluding that

Cook failed to carry her burden of establishing that Dr. Maris’ testimony would

assist the jury, and therefore that his testimony was inadmissible under the third

prong of the Rule 702 inquiry.5 In reaching this conclusion, we reiterate that we

review a trial court’s ruling on the admissibility of expert testimony only for an

abuse of discretion, see, e.g., Gen. Elec. Co. v. Joiner, 522 U.S. 136, 138-39, 118

S. Ct. 512, 139 L. Ed. 2d 508 (1997); Allison, 184 F.3d at 1306, mindful of “the

Supreme Court’s directive that ‘it is very much a matter of discretion with the

court whether to receive or exclude the evidence,’ and that an ‘appellate court will

not reverse . . . unless the ruling is manifestly erroneous.’” Toole v. Baxter

Healthcare Corp., 235 F.3d 1307, 1312-13 (11th Cir. 2000) (quoting Joiner, 522

U.S. at 141). “This deferential standard is not relaxed even though a ruling on the

admissibility of expert evidence may be outcome-determinative,” Allison, 184

5
Because neither the trial court nor the Sheriff expressed any reservations about Dr.
Maris’ qualifications or his methodology (the first two factors in the Rule 702 inquiry), and
because Cook’s burden is to establish all three prongs of the Rule 702 inquiry, we need not and
do not consider these other two factors.

20
F.3d at 1306 (citing Joiner, 522 U.S. at 142-43), and thus we may affirm “even

though we would have gone the other way had it been our call.” Rasbury, 24 F.3d

at 168 (citation omitted).

With this deferential standard in mind, we look first to the nature of the

testimony Cook sought to introduce, and then to the trial court’s treatment of that

evidence. Cook initially indicated her intention to introduce Dr. Maris’ testimony

at the March 7, 2003 status conference, where she described Dr. Maris as “an

expert in suicide prevention in correctional facilities.” Cook conceded that she

had not yet filed any summary of Dr. Maris’ testimony with the trial court, but she

asserted that Dr. Maris would testify about

the procedures facilities should enact as well as how they should
follow procedure. . . . He basically is going to talk about what was
wrong with the procedures and policies of the [MCDC] and the fact
with a relatively small population that is a lot of suicides in a two year
period and something is intrinsically wrong with the system.

The trial court expressed reservations about the appropriateness of expert

testimony on these issues. The court stated:

That’s telling the jury how to rule. That may be invading the
province of the jury.

If he has some knowledge not within the general understanding
of the jury then an expert may be needed. I am not sure under
Daubert -- whether just coming in and saying we agree with the
defendant, we agree with the plaintiff and here’s how you should rule.

21
 Why can’t the lawyer argue what it is he is going to say about
the procedures are not correct and not right?

As to Cook’s argument that Dr. Maris’ testimony was relevant to

demonstrate that “the detention facility really should have been put on notice

because they had an inordinately high rate of suicide,” the trial court told Cook:

And you can argue that to the jury. You can say, look, you
don’t have to be a rocket scientist to understand if you have that kind
of suicide rate you ought to look at the procedures.

The lawyers can argue that. Having a witness argue it to the
jury is what I have a problem with.

The district court further observed that “[i]t may well be that we need some sort of

a Daubert hearing,” but, notably, Cook never moved for such a hearing, and none

was ever conducted.

Shortly thereafter, Cook filed an expert witness report, summarizing Dr.

Maris’ opinions. Without elaborating on the bases for these opinions, the report

laid out ten specific opinions that Dr. Maris had formed “with a reasonable degree

of medical, psychological, and suicidological certainty”:

First, MCDC failed to properly assess Tessier’s suicidality,
despite at least 2-3 written requests by Tessier for psychiatric
treatment. MCDC’s mental health and suicide assessment forms are
inadequate to detect either mental illness or impending suicide.
Daniel Tessier did in fact abuse alcohol and crack cocaine and had
prior suicide ideation (all known suicide risk factors) and MCDC’s
assessment procedures failed to detect this.

22
 Second, since MCDC’s own suicide prevention policies and
procedures admit that most jail suicides occur with[in] the first 72
hours of incarceration, Tessier should have been put on close
observation (viz., within arm’s reach 24/3) at admission. One hour
checks are grossly insufficient to prevent jail hangings (which can
occur in only 4 to 5 minutes; See Florida Model Jail Standards, 7.18).

Third, MCDC’s suicide prevention training procedures are
unclear and inadequate to prevent jail suicides. All that was
mentioned in the record was some available in-service suicide
prevention videos.

Fourth, had Daniel Tessier seen a psychiatrist @ MCDC and
been properly evaluated and treated for anxiety (e.g., given a
benzodiazepine) or depression (e.g. given an SSRI antidepressant), he
would more likely than not have not suicided at MCDC.

Fifth, Officer Whortenbury should have read Daniel Tessier’s
2nd written request for psychiatric treatment . . . and notified the
MCDC Care Center . . . immediately. Two to three suicide “cries for
help” were ignored by MCDC.

Sixth, MCDC had an excessive number of suicides in a two
year period (viz., from 1997 to 99). The average jail suicide rate is
107/100,000 (Bonner, 1992). MCDC’s probably exceeds the average
rate (I am in the process of getting inmate population numbers which
will allow me to calculate that MCDC suicide rate). MCDC failed to
correct, modify, or otherwise change serious suicidogenic conditions
at their jail. Officer Kerr was personally involved with 3 of the
MCDC suicides.

Seventh, the cells at MCDC were not suicide proofed (See
Florida Model Jail Standards, 8.07).

Eighth, MCDC was deliberately indifferent to Daniel Tessier’s
serious medical needs.

23
 Ninth, MCDC violated Daniel Tessier’s constitutional right to
not suffer cruel and unusual punishment, by ignoring his written
requests for psychiatric treatment and evaluation.

Finally, had MCDC responded appropriately and promptly to
Daniel Tessier’s psychiatric condition, it is more likely than not that
he would not have committed suicide at the MCDC.

The Sheriff moved in limine to exclude or limit Dr. Maris’ testimony, on the

grounds that it was “not legally relevant to any of Plaintiff’s claims,” and that Dr.

Maris’ opinion that the MCDC was deliberately indifferent to Tessier was “a legal

conclusion that does little more than tell the jury what result should be reached.”

Defendant Roth’s Motion in Limine to Exclude/Limit Expert Witness Testimony

at 5, 2.

The court “tentatively granted” the Sheriff’s motion in limine to exclude Dr.

Maris’ testimony, providing further that “Plaintiffs may attempt to reintroduce

expert testimony at trial once they have established other evidence tending to

24
show deliberate indifference on the part of Defendant.”6 Cook, 264 F. Supp. 2d at

6
Our review of the complete record in this case reveals that Cook never attempted to
reintroduce Dr. Maris’ testimony, even though the trial court explicitly gave her the opportunity
to do so. Although this Circuit has not squarely addressed the issue, when a trial court rules in
limine tentatively to exclude evidence, most courts require that the party seeking admission of
the evidence offer the evidence again at trial in order to preserve the issue for appeal. See, e.g.,
Walden v. Ga.-Pac. Corp., 126 F.3d 506, 519 (3d Cir. 1997) (“[W]here a district court makes a
tentative in limine ruling excluding evidence, the exclusion of that evidence may only be
challenged on appeal if the aggrieved party attempts to offer such evidence at trial.”); Tennison v.
Circus Circus Enters., Inc., 244 F.3d 684, 689 (9th Cir. 2001); Rishell v. Wellshear, 1999 WL
426193, at **6 (10th Cir. June 25, 1999) (unpublished); Jenkins v. Keating, 147 F.3d 577, 581
(7th Cir. 1998); United States v. Holmquist, 36 F.3d 154, 166 & n.12 (1st Cir. 1994); see also
Fed. R. Evid. 103 (a) (“Once the court makes a definitive ruling on the record admitting or
excluding evidence, either at or before trial, a party need not renew an objection or offer of proof
to preserve a claim of error for appeal.” (emphasis added)).

We need not consider whether to adopt this rule, however, because the trial court
explicitly indicated to Cook, during trial, that her objection to the exclusion of Dr. Maris’
testimony was preserved. During a sidebar conversation on the issue of whether Cook could ask
Major Taylor whether suicides were the MCDC’s leading cause of death, Cook explained that
“our expert that we are not going to bring down because he already has been stricken, he would
have testified that statistically with an inmate population that we have in this facility . . . six
[suicides in twenty-three months] would have been off the board in terms of statistical anomaly.”
She further stated that her expert would have testified that the MCDC’s suicide rate was eight to
ten times higher than average, and she observed that “[w]ithout the suicide and the nexus and
without the expert of suicodology,” it would be difficult to meet the deliberate indifference
standard.

The court responded: “Your record is protected on that. There is no difficulty at all in
taking this to the Eleventh Circuit.” Later in the same sidebar exchange, the court stated: “It may
be that [the] Appellate Court will say no, Judge King, you are wrong. . . . I feel very good that we
have an Appellate Court that looks at all the cases and I am glad they are there because it’s a
safety valve, because I do make mistakes.”

Because these comments by the trial court created the clear impression that Cook had
done all she needed to do to preserve her objection to the exclusion of Dr. Maris’ testimony, we
cannot conclude that Cook’s failure to reoffer the testimony at trial amounted to a waiver of the
issue. Cf. Thurber Corp. v. Fairchild Motor Corp., 269 F.2d 841, 843 n.2 (5th Cir. 1959)
(holding, in a case where the district court “initially excluded some of [appellant’s proffered
evidence] altogether, had tentatively ruled that other portions were admissible for limited use, but
later declined to permit introduction of any,” that appellant “did not have to reoffer it formally at
the several stages when introduction would have been pertinent,” since appellant’s objection had

25
1064. The court reasoned:

The record at this time is incomplete regarding the totality of the
evidence to be yet presented on this issue. Plaintiffs may, or may not,
meet their burden of demonstrating that the threshold (on deliberate
indifference) has been met. This burden of proof must be met prior to
the offering of expert testimony on screening procedures. Thus, the
expert is precluded from testifying until such time as Plaintiffs
present other evidence, besides inadequacies in the screening process,
which give rise to a strong likelihood of deliberate indifference on the
part of Defendant.7

Id. at 1063.

Although the trial court did not say so explicitly, the concerns it expressed

about Dr. Maris’ testimony in its order and the status conference (namely, whether

Dr. Maris possessed any specialized knowledge not within the general

been “sharply brought to the Court’s attention and by it articulately rejected,” and appellant was
therefore “entitled to accept the Court’s ruling at face value”).
7
We note that the trial court’s tentative ruling on the admissibility of Dr. Maris’ testimony
focused only on the testimony’s relevance to Cook’s § 1983 claim. The record makes clear,
however, that Cook was offering the testimony to prove her negligence claims, as well. See, e.g.,
Plaintiffs’ Response Memorandum in Opposition to Defendant’s Motion to [sic] in Limine to
Exclude/Limit Expert Witness Testimony at 3 (stating that Dr. Maris would testify “to the
appropriate standard of care in detention facilities, the adequacy of medical and psychological
care afforded inmates, and how such relates to the facts of our case”); id. at 6 (“Dr. Maris will
offer testimony regarding the appropriate and governing standards of mental health care for
inmates in jails and prisons instituted for the detection and prevention of suicide. Dr. Maris will
explain the heightened degree of suicide risk for inmates and testify as to the reasonableness of
Monroe County Detention Center policy/procedures, and the adequacy of the training,
supervision and management of detention personnel.”). In reviewing the trial court’s ruling, we
therefore consider whether Dr. Maris’ testimony would assist the trier of fact in understanding
matters related to Cook’s § 1983 claim or to either of her negligence claims.

26
understanding of the jury and whether his opinions were anything Cook’s lawyers

could not just argue to the jury themselves) are best interpreted as implicating the

third prong of the Rule 702 inquiry -- helpfulness to the trier of fact. “By this

requirement, expert testimony is admissible if it concerns matters that are beyond

the understanding of the average lay person. Proffered expert testimony generally

will not help the trier of fact when it offers nothing more than what lawyers for the

parties can argue in closing arguments.” Frazier, 387 F.3d at 1262-63 (citation

omitted) (citing United States v. Rouco, 765 F.2d 983, 995 (11th Cir. 1985)

(observing that expert testimony is admissible if it offers something “beyond the

understanding and experience of the average citizen”)).

Moreover, “nothing in either Daubert or the Federal Rules of Evidence

requires a district court to admit opinion evidence which is connected to existing

data only by the ipse dixit of the expert.” Michigan Millers Mut. Ins. Corp. v.

Benfield, 140 F.3d 915, 921 (11th Cir. 1998) (quoting Joiner, 522 U.S. at 146).

“A court may conclude that there is simply too great an analytical gap between the

data and the opinion proffered.” Joiner, 522 U.S. at 146 (holding that the trial

court did not abuse its discretion in excluding testimony on that basis). Thus, a

trial court may exclude expert testimony that is “imprecise and unspecific,” or

whose factual basis is not adequately explained. Frazier, 387 F.3d at 1266

27
(finding no abuse of discretion when the trial court concluded that an “imprecise

and unspecific” expert opinion would not assist the jury, and observing that the

expert’s “imprecise opinion easily could serve to confuse the jury, and might well

have misled it”); see also id. at 1263 (“Because of the powerful and potentially

misleading effect of expert evidence, sometimes expert opinions that otherwise

meet the admissibility requirements may still be excluded by applying Rule 403. . .

. Simply put, expert testimony may be assigned talismanic significance in the eyes

of lay jurors, and, therefore, the district courts must take care to weigh the value of

such evidence against its potential to mislead or confuse.” (citation omitted)).

Dr. Maris’ testimony suffers from both of these defects. Some of the

opinions expressed in his report concern matters that arguably lie within the

understanding of the average lay person, making expert testimony unnecessary.

Others are unsubstantiated by any factual basis, so that Cook has failed to carry

her burden of demonstrating that they would be helpful to the jury. In addition,

much of Dr. Maris’ testimony is further lacking in any factual foundation, as

required by Federal Rule of Evidence 702. See Fed. R. Evid. 702 (permitting

expert testimony only if “the testimony is based upon sufficient facts or data”).

Because the trial court excluded Dr. Maris’ testimony in its entirety, we evaluate

28
each of his ten proffered opinions in turn, concluding that the trial court acted

within its discretion in excluding all of them.

Dr. Maris’ first opinion -- that the MCDC’s assessment procedures failed to

identify Tessier’s suicidal tendencies -- arguably involves no “scientific, technical,

or other specialized knowledge,” Fed. R. Evid. 702, and offers nothing “beyond

the understanding and experience of the average citizen,” Rouco, 765 F.2d at 995.

The testimony of the three MCDC deputies makes abundantly clear that the

MCDC failed to detect that Tessier was suicidal. Accordingly, the trial court acted

within its discretion in determining that expert testimony to this effect was not

appropriate.

Dr. Maris’ second opinion -- that Tessier should have been put on close

observation, and that hourly checks are insufficient -- may involve matters beyond

the understanding of the average layperson. However, notably absent from this

opinion are (a) any finding that MCDC personnel should have known Tessier was

suicidal, and (b) any reference to -- let alone explication of -- any generally

accepted standard of care for dealing with suicidal inmates. Because Dr. Maris’s

opinion that Tessier should have been placed under close observation is without a

sufficient factual or medical foundation, again, the district court acted within its

discretion in excluding it as being either unhelpful or misleading to the jury. Cf.

29
Frazier, 387 F.3d at 1266 (observing that an expert’s “imprecise opinion easily

could serve to confuse the jury, and might well have misled it”).

Dr. Maris’ third opinion -- that the MCDC’s suicide prevention training was

inadequate -- is without foundation, since Dr. Maris has articulated neither a

generally accepted standard for suicide prevention training in jails, nor an

explanation of how or why he believes the MCDC’s training to be inadequate.

Thus, this opinion “is connected to existing data only by the ipse dixit of the

expert,” Michigan Millers, 140 F.3d at 921 (quoting Joiner, 522 U.S. at 146), and

was thus properly excludable by the district court.

Dr. Maris’ fourth opinion -- that had Tessier received psychiatric treatment,

he probably would not have committed suicide -- is similarly unsubstantiated and

unspecific. It is presented without any supporting factual foundation, analysis, or

explanation, and thus the trial court acted within its discretion in excluding it, too.

Dr. Maris’ fifth opinion -- that Deputy Whortenbury should have read

Tessier’s request for a psychiatrist and notified Medical -- “offers nothing more

than what lawyers for the parties can argue in closing arguments.” Frazier, 387

F.3d at 1262-63. The notion that a correctional officer should read and respond to

an inmate’s medical request seems to us to be well within the understanding of the

30
average layperson, and the trial court did not abuse its discretion in concluding

that expert testimony on this point was not needed.

Dr. Maris’ sixth opinion -- that the MCDC’s suicide rate was

disproportionately high -- is, like the testimony regarding training and supervision,

not relevant to any fact in issue, since the trial court excluded all evidence

pertaining to other suicides occurring within the MCDC. Thus, the trial court

acted within its discretion in excluding this opinion.

Dr. Maris’ seventh opinion -- that the MCDC’s cells were not “suicide

proofed” is indecipherable. Without any explanation of what this means or how it

may be relevant, the district court acted well within its discretion in excluding this

imprecise and unspecific opinion.

Dr. Maris’ eighth opinion -- that MCDC “was deliberately indifferent” to

Tessier’s medical needs -- is another conclusion that “is connected to existing data

only by the ipse dixit of the expert.” Michigan Millers, 140 F.3d at 921 (quoting

Joiner, 522 U.S. at 146). The opinion is unsubstantiated by any proffered facts,

explanation, or analysis, and the trial court therefore acted within its discretion in

excluding it.8

8
The Sheriff urged the trial court to exclude this opinion on the ground that it was “a legal
conclusion that does little more than tell the jury what result should be reached.” Defendant
Roth’s Motion in Limine to Exclude/Limit Expert Witness Testimony at 2. Although testifying

31
 Dr. Maris’ ninth opinion -- that the MCDC violated Tessier’s constitutional

right to be free from cruel and unusual punishment -- is a purely legal conclusion

and is presented without any supporting factual basis. The trial court therefore

acted well within its discretion in excluding it.

Dr. Maris’ final opinion -- that “had MCDC responded appropriately and

promptly to Daniel Tessier’s psychiatric condition,” he probably would not have

committed suicide -- is nearly identical to his fourth opinion, and was properly

excluded for the same reasons.

In holding that the trial court did not abuse its discretion in excluding Dr.

Maris’ testimony in its entirety, we stress that the burden of laying the proper

foundation for the admission of expert testimony rests with its proponent. See,

e.g., Allison, 184 F.3d at 1306. Presenting a summary of a proffered expert’s

testimony in the form of conclusory statements devoid of factual or analytical

experts may not offer legal conclusions, Federal Rule of Evidence 704(a) provides, in relevant
part, that “testimony in the form of an opinion or inference otherwise admissible is not
objectionable because it embraces an ultimate issue to be decided by the trier of fact.” Fed. R.
Evid. 704(a); see also United States v. Milton, 555 F.2d 1198, 1203 (5th Cir. 1977) (“Rule 704
abolishes the per se rule against testimony regarding ultimate issues of fact. By the same token,
however, courts must remain vigilant against the admission of legal conclusions, and an expert
witness may not substitute for the court in charging the jury regarding the applicable law.”) (The
Eleventh Circuit has adopted as precedent the decisions of the former Fifth Circuit rendered prior
to October 1, 1981. Bonner v. City of Prichard, 661 F.2d 1206, 1209 (11th Cir. 1981).). Because
we have upheld the district court’s exclusion of this opinion on other grounds, we need not and
do not decide whether an expert opinion on “deliberate indifference” amounts to a conclusion of
law.

32
support is simply not enough. The party offering the expert must present the

witness’ proposed testimony in a form that persuades the trial court that the

testimony will in fact assist the trier of fact. As we have held previously, carrying

this burden requires more than “the ipse dixit of the expert.” Michigan Millers,

140 F.3d at 921. In upholding the trial court’s exclusion of Dr. Maris’ testimony,

we do not suggest that it would have been impossible for Cook to extract from Dr.

Maris some admissible expert opinions; we simply find that Cook did not carry her

substantial burden of doing so here.

We recognize that a Daubert hearing before the trial court might have given

Cook an additional opportunity to meet this burden, but we note that the trial court

was under no obligation to hold one. As we have explained previously, “Daubert

hearings are not required, but may be helpful in ‘complicated cases involving

multiple expert witnesses.’” United States v. Hansen, 262 F.3d 1217, 1234 (11th

Cir. 2001) (quoting City of Tuscaloosa, 158 F.3d at 564-65 n. 21.). We also

review a trial court’s decision on whether to hold a Daubert hearing for abuse of

discretion. As the Supreme Court has explained:

Our opinion in Joiner makes clear that a court of appeals is to apply
an abuse-of-discretion standard when it ‘review[s] a trial court’s
decision to admit or exclude expert testimony.’ 522 U.S., at 138-139,
118 S.Ct. 512. That standard applies as much to the trial courts
decisions about how to determine reliability as to its ultimate

33
 conclusion. Otherwise, the trial judge would lack the discretionary
authority needed both to avoid unnecessary ‘reliability’ proceedings
in ordinary cases where the reliability of an expert’s methods is
properly taken for granted, and to require appropriate proceedings in
the less usual or more complex cases where cause for questioning the
expert’s reliability arises. Indeed, the Rules seek to avoid
‘unjustifiable expense and delay’ as part of their search for ‘truth’ and
the ‘jus[t] determin[ation]’ of proceedings. Fed. Rule Evid. 102.

Kumho Tire Co. v. Carmichael, 526 U.S. 137, 152-53, 119 S. Ct. 1167, 143 L. Ed.

2d 238 (1999); see also Toole, 235 F.3d at 1312 (“[W]e grant the district court the

same broad latitude when deciding how to determine the reliability of expert

testimony as it enjoys in determining whether the testimony is reliable.”). Because

this is not a “complicated case[] involving multiple expert witnesses” -- Dr. Maris

was the only proffered expert -- we cannot conclude that the district court abused

its discretion by not holding a Daubert hearing.

Again, we stress that it was Cook’s burden -- not that of the trial court -- to

lay the foundation for admission of Dr. Maris’ testimony; because Cook failed to

do so, the district court acted within its discretion in excluding Dr. Maris’

testimony in its entirety.

III.

We turn now to the district court’s ruling, at the close of Cook’s case, on the

Sheriff’s motion for judgment as a matter of law on all three of Cook’s claims.

34
 We review the district court’s grant of judgment as a matter of law de novo,

applying the same Rule 50(a) standard that guided the trial court. See, e.g.,

McCormick v. Aderholt, 293 F.3d 1254, 1258 (11th Cir. 2002); Mendoza v.

Borden, Inc., 195 F.3d 1238, 1244 (11th Cir. 1999); Walker v. NationsBank of

Fla., N.A., 53 F.3d 1548, 1555 (11th Cir. 1995). A motion for judgment as a

matter of law is properly granted if “there is no legally sufficient evidentiary basis

for a reasonable jury to find for [the non-moving] party on that issue.” Fed. R.

Civ. P. 50(a). In applying this standard, we examine the evidence in a light most

favorable to the non-moving party. McCormick, 293 F.3d at 1258.

“Although the existence of a genuine issue of material fact precludes

judgment as a matter of law, ‘a jury question does not exist because of the

presence of a “mere scintilla of evidence.”’ A motion for judgment as a matter of

law will be denied only if ‘reasonable and fair-minded persons in the exercise of

impartial judgment might reach different conclusions.’” Mendoza, 195 F.3d at

1244 (citations omitted) (quoting Walker, 53 F.3d at 1555 (quoting Verbraeken v.

Westinghouse Elec. Corp., 881 F.2d 1041, 1045 (11th Cir. 1989))). “These

standards require us to consider ‘whether the evidence presents a sufficient

disagreement to require submission to a jury or whether it is so one-sided that one

party must prevail as a matter of law.’” Id. (citation omitted) (quoting Combs v.

35
Plantation Patterns, 106 F.3d 1519, 1526 (11th Cir. 1997)). “If the facts and

inferences point overwhelmingly in favor of one party, such that reasonable people

could not arrive at a contrary verdict, then the motion was properly granted.” Id.

(citation and internal quotation marks omitted) (quoting Combs, 106 F.3d at

1526).

With this standard in mind, we address in turn the trial court’s rulings on

each of Cook’s three claims.

A.

First, Cook argues that deficiencies in MCDC procedures for processing and

responding to inmate medical requests, as well as the Sheriff’s failure to

adequately train and supervise MCDC employees in suicide prevention, displayed

deliberate indifference to the medical needs of suicidal detainees like Tessier, in

violation of 42 U.S.C. § 1983. Section 1983 provides, in pertinent part:

Every person who, under color of any statute, ordinance, regulation,
custom, or usage, of any State or Territory or the District of
Columbia, subjects, or causes to be subjected, any citizen of the
United States or other person within the jurisdiction thereof to the
deprivation of any rights, privileges, or immunities secured by the
Constitution and laws, shall be liable to the party injured in an action
at law, suit in equity, or other proper proceeding for redress . . . .

42 U.S.C. § 1983.

36
 A § 1983 claim is predicated on an alleged violation of an underlying

constitutional right. In the case of a pre-trial detainee like Tessier, “the Eighth

Amendment prohibitions against cruel and unusual punishment do not apply.”

Belcher v. City of Foley, 30 F.3d 1390, 1396 (11th Cir. 1994) (quoting Tittle, 10

F.3d at 1539 n.3). Nevertheless, “in regard to providing pretrial detainees with

such basic necessities as . . . medical care[,] the minimum standard allowed by the

due process clause is the same as that allowed by the eighth amendment for

convicted persons.” Id. (quoting Hamm v. DeKalb County, 774 F.2d 1567, 1574

(11th Cir. 1985)). Thus, pretrial detainees like Tessier plainly have a Fourteenth

Amendment due process right “to receive medical treatment for illness and

injuries, which encompasses a right to psychiatric and mental health care, and a

right to be protected from self-inflicted injuries, including suicide.” Id. (citations

omitted); see also Cagle v. Sutherland, 334 F.3d 980, 985 (11th Cir. 2003).

“[I]n a prisoner suicide case, to prevail under section 1983 for violation of

substantive rights, under . . . the . . . fourteenth amendment, the plaintiff must

show that the jail official displayed ‘deliberate indifference’ to the prisoner’s

taking of his own life.” Cagle, 334 F.3d at 986 (quoting Edwards v. Gilbert, 867

F.2d 1271, 1274-75 (11th Cir. 1989)). “To establish a defendant’s deliberate

indifference, the plaintiff has to show that the defendant had ‘(1) subjective

37
knowledge of a risk of serious harm; [and] (2) disregard[ed] . . . that risk; (3) by

conduct that is more than mere negligence.” Id. at 987 (quoting McElligott v.

Foley, 182 F.3d 1248, 1255 (11th Cir. 1999)). Under this Circuit’s precedent, in a

prison suicide case, deliberate indifference requires that the defendant deliberately

disregard “a strong likelihood rather than a mere possibility that the self-infliction

of harm will occur.” Id. at 986 (emphasis in original) (quoting Popham v. City of

Talledega, 908 F.2d 1561, 1563 (11th Cir. 1990)). “[T]he mere opportunity for

suicide, without more, is clearly insufficient to impose liability on those charged

with the care of prisoners.” Id. (quoting Tittle, 10 F.3d at 1540).

When, as here, the defendant is the county sheriff, the suit is effectively an

action against the governmental entity he represents -- in this case, Monroe

County. McMillan v. Monroe County, 520 U.S. 781, 785 n.2, 117 S. Ct. 1734,

138 L. Ed. 2d 1 (1997); see also Kentucky v. Graham, 473 U.S. 159, 165-66, 105

S. Ct. 3099, 87 L. Ed. 2d 114 (1985) (“Personal-capacity suits seek to impose

personal liability upon a government official for actions he takes under color of

state law. Official-capacity suits, in contrast, generally represent only another way

of pleading an action against an entity of which an officer is an agent. As long as

the government entity receives notice and an opportunity to respond, an

official-capacity suit is, in all respects other than name, to be treated as a suit

38
against the entity. It is not a suit against the official personally, for the real party

in interest is the entity.” (citations and internal quotation marks omitted)).

Thus, to succeed on her § 1983 claim, Cook must establish that the Sheriff

himself, as representative of Monroe County, was deliberately indifferent to the

possibility of Tessier’s suicide, since neither respondeat superior nor vicarious

liability exists under § 1983. Belcher, 30 F.3d at 1396. As the Supreme Court has

explained, its holding in Monell v. New York City Department of Social Services,

436 U.S. 658, 98 S. Ct. 2018, 56 L. Ed. 2d 611 (1978), established that “a

municipality can be found liable under § 1983 only where the municipality itself

causes the constitutional violation at issue. Respondeat superior or vicarious

liability will not attach under § 1983.” City of Canton v. Harris, 489 U.S. 378,

385, 109 S. Ct. 1197, 103 L. Ed. 2d 412 (1989) (emphasis in original). Thus, only

when a “policy or custom” of the municipality inflicts the injury does § 1983

liability exist. Id. A failure to adequately train municipal employees constitutes

an actionable policy or custom for § 1983 purposes “only where the failure to train

amounts to deliberate indifference to the rights of persons with whom the

[employees] come into contact.” Id. at 388; see also id. at 389; Belcher, 30 F.3d at

1397-98.

39
 Accordingly, “our first inquiry . . . is the question whether there is a direct

causal link between a municipal policy or custom and the alleged constitutional

deprivation.” City of Canton, 489 U.S. at 385. After thorough review of the entire

record in this case, we conclude that there is not. Cook in essence offers two

municipal policies or customs that she believes establish such a link: first, the

County’s allegedly deficient procedures for processing and responding to inmate

medical requests; and second, the County’s failure to adequately train MCDC

employees in suicide prevention. However, we need look no further than Cook’s

failure to establish that the County should have foreseen Tessier’s suicide to

conclude that any deficiencies that may exist in MCDC polices do not rise to the

level of deliberate indifference.

Foreseeability, for the purpose of establishing deliberate indifference,

requires that the defendant have had “subjective knowledge of a risk of serious

harm,” meaning, in a prison suicide case, knowledge of “a strong likelihood rather

than a mere possibility that the self-infliction of harm will occur.” Cagle, 334

F.3d at 986 (emphasis in original). Moreover, because respondeat superior

liability does not attach under § 1983, the defendant himself -- in this case, the

Sheriff (as representative of the County) -- must have had this knowledge.

40
 The record in this case is utterly devoid of any evidence that the Sheriff had

any such knowledge. As we have explained previously, “[n]o matter how

defendants’ actions might be viewed, the law of this circuit makes clear that they

cannot be liable under § 1983 for the suicide of a prisoner who never had

threatened or attempted suicide and who had never been considered a suicide

risk.” Tittle, 10 F.3d at 1540 (quoting Schmelz v. Monroe County, 954 F.2d 1540,

1545 (11th Cir. 1992) (citation and internal quotation marks omitted)). Cook has

presented no evidence that Tessier had previously attempted suicide or had ever

been considered a suicide risk. Whether the failure of MCDC employees to

identify Tessier as a suicide risk on May 19-21, 1999 amounts to negligence on

their part is a wholly different question, which we address in a wholly different

manner in Part II.B, infra. But, no negligence on the part of MCDC employees

could alter the fact that the Sheriff -- the sole defendant in this § 1983 action --

himself had no actual knowledge that Tessier might take his own life.

Cook argues that the MCDC’s allegedly defective procedures amount to

“deliberate indifference toward a class of suicidal detainees to which Tessier

belongs, and that the deliberate indifference toward that class caused

constitutional harm to Tessier individually.” Appellant’s Br. at 29 (emphasis in

original). However, as we have explained previously, under our precedent, the

41
defendant must have had “notice of the suicidal tendency of the individual whose

rights are at issue in order to be held liable for the suicide of that individual.”

Tittle, 10 F.3d at 1539 (emphasis in original). Deliberate indifference, in the jail

suicide context, is not a question of the defendant’s indifference to suicidal

inmates or suicide indicators generally, but rather it “is a question of whether a

defendant was deliberately indifferent to an individual’s mental condition and the

likely consequences of that condition.” Id. (emphasis added). For this reason,

“[a]bsent knowledge of a detainee’s suicidal tendencies, [our] cases have

consistently held that failure to prevent suicide has never been held to constitute

deliberate indifference.” Popham, 908 F.2d at 1564. Thus, even if Cook had

established the Sheriff’s deliberate indifference toward suicidal inmates in general

-- and, on this record, precious little evidence points to such a conclusion -- this

would not suffice to demonstrate the foreseeability of Tessier’s suicide and to hold

the Sheriff liable under § 1983.9

Because Cook has failed to demonstrate that Tessier’s suicide was

foreseeable to the Sheriff, the sole defendant in this case, “there is no legally

9
Because Tessier’s suicide was not foreseeable, we need not and do not consider whether
the remaining elements of deliberate indifference are present here -- namely, whether the County,
through its policies, disregarded the risk of suicide, by conduct that was more than merely
negligent. See Cagle, 334 F.3d at 987.

42
sufficient evidentiary basis for a reasonable jury to find” deliberate indifference.

Fed. R. Civ. P. 50(a). Accordingly, the district court properly entered judgment as

a matter of law for the Sheriff on Cook’s § 1983 claim.

B.

Cook’s second claim is that the Sheriff is liable for Tessier’s suicide death

under Florida tort law, since Tessier’s suicide was a probable and foreseeable

consequence of the Sheriff’s negligent failure to train and supervise MCDC

employees. This claim is barred by Florida’s sovereign immunity law; we,

therefore, conclude that the district court did not err in granting the Sheriff’s

motion for judgment as a matter of law on this claim as well.

As a panel of this Court has previously acknowledged, under Florida law, “a

governmental agency is immune from tort liability based upon actions that involve

its ‘discretionary’ functions.” Lewis v. City of St. Petersburg, 260 F.3d 1260,

1266 (11th Cir. 2001) (citing Dep’t of Health & Rehabilitative Servs. v. Yamuni,

529 So.2d 258, 260 (Fla. 1988)). As the Supreme Court of Florida has explained

recently, “if a duty of care is owed, it must then be determined whether sovereign

immunity bars an action for an alleged breach of that duty. In making this

assessment, it is necessary to ascertain the character of the allegedly negligent

governmental act or omission. As this Court has determined, basic judgmental or

43
discretionary governmental functions are immune from legal action, whereas

operational acts are not protected by sovereign immunity.” Pollock v. Fla. Dep’t

of Highway Patrol, 882 So. 2d 928, 933 (Fla. 2004) (citation omitted).

A discretionary function, under Florida law, is one in which “the

governmental act in question involved an exercise of executive or legislative

power such that, for the court to intervene by way of tort law, it inappropriately

would entangle itself in fundamental questions of policy and planning.”

Henderson v. Bowden, 737 So. 2d 532, 538 (Fla. 1999) (citation and internal

quotation marks omitted). “An ‘operational’ function, on the other hand, is one

not necessary to or inherent in policy or planning, that merely reflects a secondary

decision as to how those policies or plans will be implemented.” Id. (citation and

internal quotation marks omitted). Florida’s discretionary function exception to its

general waiver of sovereign immunity “is grounded in the doctrine of separation of

powers,” and “it would be an improper infringement of separation of powers for

the judiciary, by way of tort law, to intervene in fundamental decisionmaking of

the executive and legislative branches of government, including the agencies and

municipal corporations they have created.” Kaisner v. Kolb, 543 So. 2d 732, 736-

37 (Fla. 1989).

44
 Applying these Florida sovereign immunity principles, in Lewis v. City of

St. Petersburg, a panel of this Court addressed a tort claim brought on behalf of the

estate of a motorist shot and killed by St. Petersburg police officers, alleging that

the city negligently failed to train the officers. Although, under Florida law, “an

employer is liable in tort for reasonably foreseeable damages resulting from the

negligent training of its employees and agents,” Lewis, 260 F.3d at 1265, the

Court affirmed the dismissal of plaintiff Lewis’ negligent training claim, finding it

barred by Florida sovereign immunity law. The Court observed that “Lewis does

not challenge the implementation or operation of the City’s police training

program as it relates to the officers involved in the shooting, but rather Lewis

challenges the City’s policy decisions regarding what to include in the training of

its police officers.” Id. at 1266. The Court reasoned that “[a] city’s decision

regarding how to train its officers and what subject matter to include in the

training is clearly an exercise of governmental discretion regarding fundamental

questions of policy and planning.” Id. Thus, Lewis’ challenge to the

reasonableness of these training policies was barred by “the ‘discretionary’

function exception to [Florida’s] waiver of sovereign immunity.” Id.

Here, as in Lewis, the challenged actions are the Sheriff’s decisions

regarding “how to train its [corrections] officers and what subject matter to include

45
in the training.” Id.; see, e.g., Appellant’s Br. at 27 (“MCDC’s suicide awareness

and prevention training consists of films shown once a year. . . . Surely more

effective methods of supervising and training detention officers were available to

the Sheriff.”); id. (characterizing the issue as “[w]hether the Sheriff’s methods of

training and supervising personnel were reasonably effective, and whether more

effective methods could have prevented Daniel Tessier’s suicide”).

Thus, as in Lewis, “the acts which [Cook]’s negligent training claim

challenge[s] are ‘discretionary’ governmental functions immune from tort

liability.”10 Lewis, 260 F.3d at 1266. To find otherwise would amount to judicial

intervention, by way of tort law, into the fundamental decisionmaking of the

legislative and executive branches -- a practice against which the Florida courts

have repeatedly cautioned. See, e.g., Henderson, 737 So. 2d at 538; Kaisner, 543

So. 2d at 736-37. Accordingly, we affirm the trial court’s grant of judgment as a

matter of law on Cook’s negligent training and supervision claim.11 See Kaisner,

10
Accordingly, we note that even if the district court had abused its discretion in
excluding as irrelevant Cook’s proffered evidence of other suicides occurring in the MCDC --
which it did not -- such an error would in no way affect Cook’s negligent training and
supervision claim, since sovereign immunity is a legal limitation that no amount of relevant
evidence can overcome.
11
The trial court granted judgment as a matter of law on the ground that Cook’s evidence
demonstrated that the training supplied “was sufficient.” The court “recognize[d] that [Lewis]
indicate[d] that there is no duty to train per se,” but did not rule on this ground, reasoning that “in
a real world, logically, a sheriff in a county situation, governmental situation, would
understandably feel an obligation to do training.” Because we conclude that Cook’s negligent

46
543 So. 2d at 734 (“A court must find no liability as a matter of law if either (a) no

duty of care existed, or (b) the doctrine of governmental immunity bars the

claim.”).

C.

Cook’s third claim is that the Sheriff is vicariously liable, under Florida tort

law, for the negligence of MCDC employees in failing to take appropriate

measures to prevent Tessier’s suicide death. Because the evidence was sufficient

to support a jury verdict in Cook’s favor on this claim, we reverse the district

court’s grant of judgment as a matter of law for the Sheriff and remand for trial on

the merits of this claim.12

It is long established that, under Florida law, corrections officers owe

individuals within their custody a duty to use reasonable care for their safety. See,

training claim is barred by Florida sovereign immunity law, we need not and do not consider
whether the evidence presented could support a jury finding of negligence.
12
As a preliminary matter, the precise scope of a sheriff’s vicarious liability for
negligence committed by jail employees is a question of Florida sovereign immunity law, which
we need not address in depth, since the parties do not dispute that the Sheriff may be held
vicariously liable if MCDC employees are found to have acted negligently. It suffices here to
note that a sheriff, as “an official of a political subdivision” of the state, Beard v. Hambrick, 396
So. 2d 708, 712 (Fla. 1981), is liable under Florida law “for a wrongful act or omission of any
employee of the agency while acting within the scope of his office or employment under
circumstances in which the state or agency, if a private person, would be liable to the claimant in
accordance with the general laws of the state.” Dep’t of Health & Rehabilitative Servs. v.
McDougall, 359 So. 2d 528, 532 (Fla. Dist. Ct. App. 1978).

47
e.g., Kaisner, 543 So.2d at 734 (observing that any individual placed in custody or

otherwise detained by law enforcement officers is owed a common law duty of

care); Hargrove v. Town of Cocoa Beach, 96 So. 2d 130 (Fla. 1957) (recognizing

liability in negligence when an inmate died of smoke inhalation due to corrections

officer’s leaving the jail unattended); Hutchinson v. Miller, 548 So. 2d 883, 885

(Fla. Dist. Ct. App. 1989) (“Clearly, the sheriff and his deputies owed the decedent

the duty to use reasonable care for his safety when he was incarcerated.”). Thus,

when acts or omissions of a corrections officer result in injury to an inmate within

the officer’s custody, the officer may be liable in negligence for the harm suffered

by the inmate.13

Self-infliction of injury, however, is treated as an independent intervening

cause, which may suffice to break the causal connection between the conduct of

13
Although the Sheriff has not raised sovereign immunity as a defense to Cook’s
vicarious liability negligence claim, it bears noting that, under Florida law, a county’s treatment
of an individual inmate in its custody is an operational function, for which the State of Florida
has waived governmental immunity. See, e.g., Henderson, 737 So. 2d at 538-39 (“A person
taken into custody . . . is owed a common law duty of care. Numerous cases have recognized that
this duty of exercising reasonable care exists and that it is an operational level function.” (citation
and internal quotation marks omitted); Dep’t of Health & Rehabilitative Servs. v. Whaley, 574
So. 2d 100, 101 (Fla. 1991) (holding that the assignment of juveniles to a particular room within
a detention facility is an operational function not protected by sovereign immunity); Kaisner, 543
So. 2d at 738. When the challenged action involves not “the policies themselves,” but “the way
[they] were implemented,” the action is operational rather than discretionary. Id. at 738.
Because Cook’s vicarious liability claim challenges the manner in which MCDC procedures
were implemented through individual corrections officers -- not the procedures themselves -- that
claim is not barred by sovereign immunity.

48
the corrections officer and any injury sustained by the inmate. See, e.g., Guice v.

Enfinger, 389 So. 2d 270, 271 (Fla. Dist. Ct. App. 1980). However, causation is

not defeated, and the officer is not relieved of liability, if the intervening cause

“was foreseeable or reasonably might have been foreseen by the wrongdoer.”

Schmelz v. Sheriff of Monroe County, 624 So. 2d 298, 298 (Fla. Dist. Ct. App.

1993).

Thus, in suicide cases, Florida courts have treated as the key inquiry

whether “it was reasonably foreseeable that harm would befall [the inmate] either

directly or indirectly as a result of the actions and omissions of the [corrections

officers].” Overby v. Wille, 411 So. 2d 1331, 1332 (Fla. Dist. Ct. App. 1982).

Florida’s courts have repeatedly stressed that this basic question is not one

for the court to answer as a matter of law, but rather is properly left to the trier of

fact for resolution. See, e.g., Schmelz, 624 So. 2d at 299 (“The question of

whether an intervening cause is foreseeable is for the trier of fact. Confronted

with conflicting evidence as to the foreseeability of [the inmate’s] actions, it was

for a trier of fact to determine whether [the inmate’s] own actions constituted the

unforeseeable intervening cause of his injuries.” (citation omitted) (citing Gibson

v. Avis Rent-A-Car Sys., Inc., 386 So. 2d 520 (Fla. 1980))); Hutchinson, 548 So.

2d at 885 (“Whether the [sheriff and his deputies] were negligent in failing to

49
protect the decedent, and whether the harm which befell him, albeit at his own

hand, was within the scope of such negligent conduct so as to make such harm

reasonably foreseeable under the facts here, are issues for the trier of fact.”);

Overby, 411 So. 2d at 1332 (observing that “the question of whether the

intervening cause was foreseeable is ordinarily one for the trier of fact,” and

holding that “it was error to find that, as a matter of law, injury to [the inmate] was

not reasonably foreseeable”).

Indeed, under Florida law, the evidentiary threshold for sending this claim

to the jury is low. “Only a total absence of evidence to support an inference that

the intervening cause was foreseeable justifies the court in removing the question

from the trier of fact.” Overby, 411 So. 2d at 1332 (emphasis added); see also

Moore v. Morris, 475 So.2d 666, 668 (Fla. 1985) (“Summary judgments should be

cautiously granted in negligence and malpractice suits. The law is well settled in

Florida that a party moving for summary judgment must show conclusively the

absence of any genuine issue of material fact and the court must draw every

possible inference in favor of the party against whom a summary judgment is

sought. A summary judgment should not be granted unless the facts are so

crystallized that nothing remains but questions of law. If the evidence raises any

issue of material fact, if it is conflicting, if it will permit different reasonable

50
inferences, or if it tends to prove the issues, it should be submitted to the jury as a

question of fact to be determined by it.” (citations omitted))

Nevertheless, without specifically acknowledging Florida law’s strong

preference for a jury’s resolution of the foreseeablity question, the district court

found the evidence insufficient as a matter of law to support Cook’s negligence

claim. The court reasoned:

The red flags that have been alluded to that the plaintiffs suggest
should have alerted persons to the fact that he was a suicide risk do
not rise to the level of being foreseeable. . . . The evidence is simply
not there that there was anything that would alert a reasonable person
following the established policies and procedures of the Monroe
County Sheriff’s Office for the handling of inmates that would have
alerted anyone to the fact that he was a suicide risk.

After thorough review of the evidence presented at trial and of the applicable

Florida law, we disagree.

Four Florida cases involving negligence claims arising out of prison

suicides guide our analysis. In Guice v. Enfinger, the First District Court of

Appeals addressed the case of an inmate who was arrested while intoxicated and

subsequently placed in the jail sickbay, where he apparently slept for several

hours, before an employee discovered that he had hanged himself by his belt. The

court concluded that “the deceased suicide was not sufficiently foreseeable to

impose upon the Sheriff’s employees the duty to remove the deceased’s belt,”

51
finding “no facts in the record to indicate that the deceased had suicidal tendencies

and no facts to indicate that the booking officer at the jail should have been

suspicious of suicidal tendencies of the deceased.” Guice, 389 So. 2d at 271.

However, in three subsequent cases involving prison suicides, Florida’s

courts found summary judgments to have been entered erroneously, based on the

existence of some evidence to support a jury finding of negligence. In Overby v.

Wille, the decedent had flagged down a policeman and requested to be taken to a

mental health facility, explaining that he thought he might have hurt someone.

Instead, he was placed in jail, where he hanged himself by his belt. The Fourth

District Court of Appeals concluded that the decedent’s request to be taken to the

mental health facility, as well as his unprovoked violent behavior during the

booking process, and the fact that jail employees labeled him a “probable Signal

20,” a designation that “refers to mental and emotional instability of some type,”

constituted sufficient evidence to support a finding that his suicide was

foreseeable. See Overby, 411 So. 2d at 1332-33. “Under these circumstances,”

the court concluded, “it was error to find that, as a matter of law, injury to Overby

was not reasonably foreseeable.” Id. at 1334.

In Hutchinson v. Miller, the decedent was a fifteen-year-old boy, in jail

awaiting trial on a criminal charge, who was harassed, taunted, and threatened

52
with sexual abuse by other juvenile inmates. The Fifth District Court of Appeals

concluded that this treatment, “coupled with his withdrawal, his crying and his

written appeals for help via his requests for transfer, all of which were known to

[the sheriff and his deputies], could justify the inference that some harm to

decedent was foreseeable.” Hutchinson, 548 So. 2d at 885. Thus, the court

concluded, the negligence claim had been improperly removed from the purview

of the trier of fact. Id.

Finally, in Schmelz v. Sheriff of Monroe County, the Third District Court of

Appeals reversed the summary disposition of a claim involving an inmate whose

suicide attempt left him severely brain damaged. Although the inmate “had never

either threatened, attempted, or even talked about suicide,” the booking officer

observed him as subdued and depressed, felt “he might try to do something,” and

placed him on suicide watch. In addition, the watch officer observed him as “real

flustered,” nervous, and worried. Based on this “conflicting evidence as to the

foreseeability of Schmelz’ actions,” the court concluded that “it was for a trier of

fact to determine whether Schmelz’ own actions constituted the unforeseeable

intervening cause of his injuries.” Schmelz, 624 So. 2d at 299.

The evidence in the case before us, as in Overby, Schmelz, and Hutchinson,

is “conflicting” as to foreseeability, but is sufficient to enable a jury to find that

53
Tessier’s suicide was a reasonably foreseeable consequence of acts and omissions

of MCDC employees. While Tessier never threatened or otherwise mentioned

suicide, evidence presented at trial revealed that Tessier made two written requests

to see a psychiatrist, one on each of the two days immediately preceding his

suicide. And, in his second request, Tessier stated that he was “mentally sick” and

asked to see a psychiatrist “as soon as possible.” In spite of these requests, Tessier

was never seen by any mental health professional. Moreover, MCDC Deputies

Kerr, Malopolski, and Whortebury all observed him as being nervous and anxious.

Deputy Kerr specifically observed Tessier apparently having an anxiety attack,

and based on Tessier’s complaints of chest pain, Deputy Kerr sent him to Medical.

Tessier’s nervous, anxious condition prompted Deputy Malopolski to instruct him

to take deep breaths and relax, and to push the intercom on the wall if he needed

assistance. Deputy Malopolski thereafter responded to several intercom calls by

Tessier, and on one occasion found Tessier bent over on his knees on the floor of

his cell, apparently having trouble breathing, after which Deputy Malopolski sent

him back to Medical.

Under Florida law, these facts amount to sufficient evidence “such that

reasonable people, in the exercise of impartial judgment, might reach differing

conclusions” as to the foreseeability of Tessier’s suicide and, accordingly, the

54
negligence of MCDC employees in failing to prevent it. Williams v. Motorola,

Inc., 303 F.3d 1284, 1289-90 (11th Cir. 2002). The Sheriff’s motion for judgment

as a matter of law on this claim should, therefore, have been denied, and the case

submitted to the jury as finder of fact. See id. Accordingly, reverse the judgment

of the district court as to this claim and remand for further proceedings consistent

with this opinion.14

IV.

After carefully reviewing the record, we conclude that the district court

erred in granting judgment as a matter of law for the Sheriff on Cook’s vicarious

liability negligence claim under Florida law. However, we affirm the district

court’s grant of judgment as a matter of law in favor of the Sheriff on Cook’s §

1983 claim and on her Florida law negligent training and supervision claim. We

further hold that the district court acted within its discretion in excluding evidence

of other suicides within the MCDC and the testimony of Cook’s proffered suicide

14
On remand, our earlier conclusion that the district court acted within its discretion in
excluding the testimony of Dr. Maris, Cook’s proffered suicide expert, should not be read to
preclude Cook from re-urging Dr. Maris’ testimony, nor should it be read as barring the district
court from reconsidering whether Dr. Maris’ testimony might assist the trier of fact in resolving
Cook’s vicarious liability negligence claim. We remind Cook that if she seeks to reintroduce Dr.
Maris’ testimony, she must present it in a manner sufficiently precise, specific, and well-
grounded to persuade the trial court that it would indeed assist the trier of fact.

55
expert. Accordingly, we reverse the district court’s judgment as a matter of law on

the vicarious liability negligence claim, and affirm in all other respects.

On remand, the district court should consider whether to continue to

exercise supplemental jurisdiction over Cook’s state law vicarious liability

negligence claim, which is all that remains in this case. Because no basis for

original federal jurisdiction presently exists, the district court has the discretion to

decline to exercise supplemental jurisdiction. See 28 U.S.C. § 1367(c) (“The

district courts may decline to exercise supplemental jurisdiction over a claim . . . if

. . . (3) the district court has dismissed all claims over which it has original

jurisdiction.”); see also, e.g., Rose v. City of Fort Lauderdale, 279 F.3d 1271, 1288

(11th Cir. 2002) (observing that whether to continue to exercise supplemental

jurisdiction is a decision that “should be and is vested in the sound discretion of

the district court”). In making this decision, the court “should take into account

concerns of comity, judicial economy, convenience, fairness, and the like.” Lewis,

260 F.3d at 1267 (citations and internal quotation marks omitted). Because this

case was originally filed in state court and removed to federal court pursuant to 28

U.S.C. § 1441, if the district court declines to continue to exercise supplemental

jurisdiction, Cook’s remaining claim should be remanded to state court. See id.

AFFIRMED IN PART, REVERSED IN PART, and REMANDED.

56