Estate of Anthony Mouradian v. Jackson County

United States Court of Appeals
For the Seventh Circuit
Chicago, Illinois 60604
Argued February 19, 2026
Decided July 17, 2026
Before
FRANK H. EASTERBROOK, Circuit Judge
DORIS L. PRYOR, Circuit Judge
JOSHUA P. KOLAR, Circuit Judge
No. 25-2132
ESTATE OF ANTHONY
MOURADIAN,
Plaintiff-Appellant,
v.
JACKSON COUNTY, et al.,
Defendants-Appellees.
Appeal from the United States District
Court for the Western District of
Wisconsin.
No. 23-cv-167-wmc
William M. Conley,
Judge.
O R D E R
Anthony Mouradian, a pretrial detainee at the Jackson County jail, struggled
with his mental health before tragically committing suicide on May 28, 2020. His Estate
brought an action under 42 U.S.C. § 1983, alleging Jackson County, various jail officials,
and the jail psychologist, Dr. Ashley Hakes violated the Fourteenth Amendment by
failing to provide him with adequate medical care. The district court granted summary
judgment to the defendants on the Estate’s federal constitutional claims and declined to
exercise supplemental jurisdiction over the remaining state-law claims.
Although the district court’s articulation of the appropriate legal standard could
have been more precise, we agree with the district court that the Estate’s constitutional
NONPRECEDENTIAL DISPOSITION
To be cited only in accordance with Fed. R. App. P. 32.1

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claims fail under the objective reasonableness inquiry articulated in Kingsley v.
Hendrickson, 576 U.S. 389, 395–97 (2015) and affirm.
I. BACKGROUND
We construe the record in the light most favorable to the Estate, the nonmoving
party, and construe all reasonable inferences from the evidence in its favor. Bostic v.
Murray, 160 F.4th 831, 836 (7th Cir. 2025).
A. Factual History
On July 30, 2019, Anthony Mouradian was arrested and booked into the Jackson
County jail located in Black River Falls, Wisconsin. From the time he was arrested
through his booking and intake, Mouradian repeatedly expressed suicidal thoughts and
stated plans to self-harm. Based on his words and behaviors, the jail placed Mouradian
on suicide watch. The sergeant on duty for Mouradian’s booking, Thomas Sharp, then
emailed the jail psychologist, Dr. Ashley Hakes, concerning Mouradian. Sergeant Sharp
also contacted Northwest Connections, a 24/7 emergency crisis line that had contracted
with Jackson County to provide mental health services, to explore involuntary or
emergency commitment pursuant to Chapter 51 of the Wisconsin Statutes. See WIS .
S TAT. §§ 51.15, 51.20 (“Chapter 51”). While on suicide watch at the jail, Mouradian was
required to wear protective clothing, a smock gown, and remain in a padded cell
without toilet or water access. Jail officers monitored Mouradian every 15 minutes.
Two days later, and after meeting with the jail’s social worker, Mouradian
continued to express suicidal thoughts and announce his plans to self-harm.
Accordingly, the jail scheduled Mouradian to meet with Dr. Hakes. Dr. Hakes assessed
Mouradian on August 2, 2019, and, in what became her usual practice, prepared notes
along with an email summary of her session. Dr. Hakes shared these notes with various
jail officials and instructed them to keep Mouradian on suicide watch.
On August 9, 2019, following her session with Mouradian, Dr. Hakes released
him from suicide watch and requested that the jail’s advanced nurse practitioner
promptly meet with Mouradian for medication implementation and management.1
After she released Mouradian from suicide watch, Dr. Hakes regularly met with him to
assess his mental health and recommend actions to the jail regarding his overall safety
1 As a psychologist, Dr. Hakes is not licensed to prescribe medication. See App. Dkt. 20, Dr. Hakes
Appellate Br., at 15 n.1; District Court Dkt. 120-11, Dr. Hakes Contract with Jackson County jail.

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and protection. Dr. Hakes requested that the jail accommodate Mouradian by providing
him with specific items or permitting him to participate in activities aimed at improving
his mental health condition. Dr. Hakes also made recommendations concerning
Mouradian’s housing within the jail. From August through November, Dr. Hakes and
Mouradian met on a regular basis. In mid-November, during one of their sessions,
Dr. Hakes provided Moradian with the first two chapters of a book exploring positive
psychology for long-term incarceration. The following week, Mouradian refused to
meet with Dr. Hakes. During this time, Mouradian had also learned that the State
offered him a plea of five years in prison to resolve his pending state charges.
Starting in late December 2019 through mid-February 2020, Mouradian began
sporadically refusing his mental health sessions with Dr. Hakes. Dr. Hakes noted
Mouradian was depressed and attempted to assist with his mood. Dr. Hakes
recommended that the jail change Mouradian’s cell placement and that the jail’s
advanced nurse practitioner reevaluate him to determine whether a medication
adjustment was appropriate. After receiving another chapter of the positive psychology
for long-term incarceration book from Dr. Hakes, Mouradian again refused his mental
health session. Around this time, Dr. Hakes believed Mouradian was not responding to
her attempted intervention methods.
The day before Mouradian’s plea hearing in his criminal case, in February 2020,
Dr. Hakes was scheduled to meet with Mouradian, however, he refused. Considering
the timing of the canceled session with the upcoming court proceeding, Dr. Hakes
advised jail staff to “be cognizant of any changes in [Mouradian’s] presentation[.]”
The next day, February 21, 2020, Mouradian attended his plea hearing. After
defense counsel informed the court that Mouradian had been “looking around his cell
for something to hang himself with” the night before, the state court judge continued
the hearing to March 13, 2020. Once notified of Mouradian’s actions the night before his
plea hearing, Dr. Hakes immediately emailed jail officials requesting that Mouradian be
placed on suicide watch because of his “high suicide risk.” The jail complied with
Dr. Hakes’s directive.
Dr. Hakes then met with Mouradian on February 28, 2020, and referred him to
Northwest Connections for an assessment because Mouradian’s persistent suicidal
thoughts, his intent to self-harm, and the potential for further harm concerned her. A
crisis worker with Northwest Connections assessed Mouradian that same day and
recommended emergency detention. The jail agreed, completing a standard law
enforcement emergency detention form pursuant to Wisconsin Statute § 51.15.

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Mouradian was temporarily detained and placed under the supervision of Sacred Heart
Hospital.
On March 2, 2020, Dr. Hakes emailed Sacred Heart, communicating Mouradian’s
history of depression and suicidal ideation. The next day, Jackson County Circuit Court
determined the jail’s allegations that Mouradian posed a substantial probability of
physical harm to himself were sufficient to warrant emergency detention. W IS . S TAT.
§ 51.20 (7); see also WIS . S TAT. § 51.15 (1). On March 5, 2020, Dr. Hakes emailed the jail’s
social worker and Sacred Heart to recommend Mouradian be placed at a mental health
hospital, which could provide him with more intensive programming until he became
sufficiently stable to return to the jail.
Mouradian was transferred to the Winnebago Mental Health Institute on March
13, 2020 for stabilization. That same day, Mouradian was prescribed fluphenazine, in
addition to the current slate of medications the jail’s advanced nurse practitioner
ordered him to take. He also signed a 90-day settlement agreement with the county,
agreeing to a specific treatment plan that included meeting with Dr. Hakes weekly and
taking his medication as prescribed. Jackson County Circuit Court stayed Mouradian’s
commitment determination pending successful completion of the terms of the
settlement agreement.
Mouradian was under emergency detention for eighteen days before he was
discharged from the Winnebago Mental Health Institute. Upon discharge, Winnebago
Mental Health Institute deemed Mouradian suitable to return to the jail. Mouradian
was diagnosed with major depressive disorder. Mouradian returned to the jail without
any heightened precautions. Dr. Hakes did, however, recommend that Mouradian be
placed in a two-man cell upon his return. She also encouraged the jail’s advanced nurse
practitioner to assess Mouradian to ensure he would receive the medication prescribed
for him at the Winnebago Mental Health Institute. After a mental health session with
Mouradian on March 20, 2020, Dr. Hakes observed that he was better than he had ever
been. Dr. Hakes also recorded that Mouradian reported decreased suicidal ideation
during their session on March 27, 2020.
On April 10, 2020, during her session with Mouradian, Dr. Hakes learned that
Mouradian was having negative effects from the new medication prescribed at the
Winnebago Mental Health Institute. Dr. Hakes emailed the jail’s advanced nurse
practitioner that same day, expressing Mouradian’s desire to stop taking the medication
and requested a reevaluation. Dr. Hakes also recommended that the jail allow
Mouradian to work a laundry job. From her perspective, the laundry job would be

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beneficial to Mouradian because it would allow him to leave his cell, it was an actual
activity to get him moving, and it would allow him to write letters and listen to the
radio in between his running of the laundry loads.
On April 14, 2020, ten days before his rescheduled plea hearing, Mouradian was
observed wrapping a towel around the bars of his cell and looking around his cell, as if
he might be searching for a place to tie something and self-harm. One of the jail officials
on duty emailed the jail supervisors advising them to “keep an extra eye out on
Mouradian.” After consulting with Dr. Hakes about the jail’s observations, supervisors
directed the night shift to enlarge the camera view of Mouradian’s cell/bunk area to
ensure proper observation of him throughout the night. Dr. Hakes also emailed jail
officials questioning the benefit of returning Mouradian to Winnebago Mental Health
Institute. The next day, the jail’s advanced nurse practitioner met with Mouradian and
discontinued his prescription for fluphenazine. On April 24, 2020, Mouradian pled no
contest to his pending state charges. In compliance with his settlement agreement with
Jackson County, Mouradian continued to meet with Dr. Hakes consistently.
In May 2020, the jail’s social worker followed up with Dr. Hakes, requesting an
update on Mouradian. Dr. Hakes acknowledged that Mouradian was compliant with
the terms of the 90-day settlement agreement filed pursuant to Chapter 51. When
Dr. Hakes questioned the possibility of extending the settlement agreement, the jail’s
social worker informed Dr. Hakes that no extension was possible unless Mouradian
failed to comply with the terms of the settlement agreement. On May 7, 2020, Jackson
County Circuit Court dismissed Mouradian’s 90-day settlement agreement, and his case
was closed.
Almost a week after his Chapter 51 case was closed, Mouradian declined a
session with Dr. Hakes. On May 20, 2020, Dr. Hakes met with Mouradian and later
described the session as productive and noted Mouradian’s active participation.
Dr. Hakes concluded improvements were soon to come.
Approximately seven days later, on May 27, 2020, Officers Lucas Johnson and
Linda Keller were scheduled to work the night shift at the jail, which ran from 6:00 P.M.
to 6:00 A.M. the next morning. Officer Johnson was assigned the floor-officer role and
Officer Keller the control-room officer role. Under the jail’s protocols, the control-room
officer’s duties included “locking and unlocking jail doors to facilitate officer and
inmate movements inside the jail, answering radio traffic from dispatch and from
officers within the jail, answering incoming phone calls to the jail,” and monitoring the
camera feeds on monitors. The camera feeds showed the control-room officer when to

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lock and unlock doors to facilitate officer and inmate movement around the jail. The
night shift officers were also responsible for performing timely wellness checks of all
inmates in each cell block.
Officer Johnson, as the floor-officer, performed a cell check on Mouradian and
the other inmates around 1:21 A.M. on the morning of May 28, 2020. About five minutes
later, at 1:27 A.M., Mouradian was captured on the jail’s camera feed putting a blanket
over his head and moving towels around the opening of his cell door to seal it.
Approximately 30 minutes later, Mouradian is seen on the camera feed placing a
towel through the opening between the bars of his cell door. Minutes later, the camera
records Mouradian tying his towel in a way that, when connected with his bed sheet,
created a noose. Mouradian then bends down to place the noose around his neck and
waves goodbye to the camera. Mouradian tragically hung himself in clear view of the
jail’s camera feed. During this time, Officer Johnson was preparing to assume control-
room officer duties, and Officer Keller was preparing to assume floor-officer duties.
Officer Keller left the control room around 2:13 A.M. After reaching Mouradian’s
cell and observing the noose, Officer Keller attempted to assist Mouradian by calling for
help to Officer Johnson. Both officers assisted in removing Mouradian from his cell.
Mouradian was later transported to the hospital where he was pronounced dead.
B. Procedural History
On March 15, 2023, the Estate brought claims under 42 U.S.C. § 1983 and state
law against Jackson County and various jail personnel in their official capacities, and
Dr. Hakes, individually. Eventually, the defendants moved for summary judgment,
which the district court granted.
This appeal followed.
II. DISCUSSION
We review de novo a district court’s ruling on a motion for summary judgment.
Breyley v. Fuchs, 156 F.4th 845, 847 (7th Cir. 2025) (citation omitted). A party is entitled to
summary judgment when “there is no genuine dispute as to any material fact and the
movant is entitled to judgment as a matter of law.” F ED. R. C IV. P. 56(a). “Parties
genuinely dispute a material fact where the evidence is such that a reasonable jury
could return a verdict for the nonmoving party.” Stockton v. Milwaukee County, 44 F.4th
605, 614 (7th Cir. 2022) (citation modified). “A party who fails to produce evidence

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sufficient to establish an element essential to that party’s case on which they bear the
burden of proof cannot survive a summary judgment challenge.” Lee v. Milwaukee
County, 175 F.4th 877, 883 (7th Cir. 2026) (citation omitted).
We can also “affirm summary judgment on any ground supported in the record,
provided the parties adequately addressed the issue in the district court and the non-
moving party had an opportunity to contest it.” See Arwa Chiropractic, P.C. v. Med-Care
Diabetic & Med. Supplies, Inc., 961 F.3d 942, 946 (7th Cir. 2020).
A. Legal Frameworks
Under the Constitution, “[i]ncarcerated persons have a constitutional right to
receive adequate medical treatment, including mental health treatment and protection
from self-harm.” Pittman ex rel. Hamilton v. Madison County, 108 F.4th 561, 566 (7th Cir.
2024) (citation modified). The scope of this constitutional right depends on the
incarcerated individual’s classification within the criminal justice system. Id. (citation
omitted).
1. Eighth Amendment
For convicted prisoners, the Eighth Amendment’s Cruel and Unusual
Punishment Clause protects against “deliberate indifference to serious medical needs of
prisoners” by “prison doctors” and “prison guards.” Estelle v. Gamble, 429 U.S. 97, 104
(1976). “To determine if the Eighth Amendment has been violated in the prison medical
context, we perform a two-step analysis, first examining whether a plaintiff suffered
from an objectively serious medical condition, and then determining whether the
individual defendant was deliberately indifferent to that condition.” Petties v. Carter,
836 F.3d 722, 727–28 (7th Cir. 2016) (citing Farmer v. Brennan, 511 U.S. 825, 834 (1994)).
This subjective standard is closely linked to the language of the Eighth Amendment,
which prohibits the infliction of “cruel and unusual punishments.” Miranda v. County of
Lake, 900 F.3d 335, 350 (7th Cir. 2018) (emphasis omitted).
2. Fourteenth Amendment
Pretrial detainees, those who have not been convicted of anything, may not be
punished prior to an adjudication of guilt in accordance with due process. Id. Thus, the
Supreme Court explained the appropriate standard for a pretrial detainee’s medical
care claims is found not in the Eighth Amendment but in the Fourteenth Amendment’s
jurisprudence. Kingsley, 576 U.S. at 396–400; see also Bell v. Wolfish, 441 U.S. 520, 534–36

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(1979). Under this standard, we explained in Pittman ex rel. Hamilton v. Madison County
that the pretrial detainee needs to show only that the defendant’s conduct was
objectively unreasonable. 108 F.4th at 570. In other words, a pretrial detainee satisfies
this standard by putting forth evidence that “reasonable officers under the
circumstances would have understood the high degree of risk involved, making the
consequences of the defendants’ conduct obvious.” Id. at 572 (emphasis omitted).
B. Analysis
On appeal, the Estate maintains that the district court erred in two ways: (1)
applying the Eighth Amendment’s subjective professional judgment standard to grant
summary judgment for Dr. Hakes and (2) finding the County Defendants’ failure to
monitor the camera feed to Mouradian’s cell on the night of his death did not violate
Jackson County jail policy for purposes of Monell liability. See Monell v. Dep’t of Soc.
Servs., 436 U.S. 658 (1978).
In response to the first error, Dr. Hakes maintains the district court properly
utilized the Eighth Amendment’s subjective standard because Mouradian was no
longer a pretrial detainee at the time of his death. Because the Estate was unable to
demonstrate her conduct fell below the professional standard, Dr. Hakes argues that the
Estate’s claim fails against her. In addressing the Estate’s second error, the County
Defendants contend that, even under the objective standard, its officers were entitled to
rely on the medical provider’s professional judgment and there is no policy or custom
requiring correctional officers to observe inmates constantly within a jail, even when
those inmates are placed on precautions or suicide watch.
We address each argument in turn.
1. Dr. Hakes
Beginning with Dr. Hakes, the Estate argues the district court erred because it
applied a subjective prong to its Fourteenth Amendment inadequate medical care claim.
The district court reasoned, “[i]n the context of a claim for inadequate medical care”
arising under the Fourteenth Amendment, “the professional judgment standard requires
essentially the same analysis as the Eighth Amendment standard.” This proposition finds
support in our caselaw prior to the Supreme Court’s decision in Kingsley. Compare
Minix v. Canarecci, 597 F.3d 824, 831 (7th Cir. 2010) (“Although the Eighth Amendment
applies only to convicted persons, pretrial detainees … are entitled to the same basic
protections under the Fourteenth Amendment’s due process clause … [so] we apply the

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same legal standards to deliberate indifference claims brought under either the Eighth
or Fourteenth Amendment.”) with Miranda, 900 F.3d at 343–44. But Pittman corrected
the “tension, if not inconsistency,” by explaining pretrial detainees “in a medical care
case need not prove a defendant’s subjective awareness of the risk of harm to prevail on
a Fourteenth Amendment Due Process claim.” 108 F.4th at 569–70.
Capitalizing on our circuit’s interpretation following Kingsley, the Estate claims
the district court’s error warrants reversal. Dr. Hakes, in response, defends the district
court’s decision, arguing that Mouradian’s status in the jail at the time of his death was
more analogous to a convicted prisoner than a pretrial detainee, triggering the Eighth
Amendment, which applies a subjective test to a medical-care claim. See Bell, 441 U.S. at
535 n.16 (“A sentenced inmate, on the other hand, may be punished, although that
punishment may not be ‘cruel and unusual’ under the Eighth Amendment.”); Kingsley,
576 U.S. at 399 (explaining that the incarcerated person “ha[d] been accused but not
convicted of a crime). Whether the Estate’s claim of inadequate medical care for
Mouradian is analyzed under the Eighth or Fourteenth Amendment ultimately makes
no practical difference to our resolution of the challenges in this appeal because the
Estate has failed to demonstrate that Dr. Hakes’s actions were objectively unreasonable.
Here, the Estate’s expert, Dr. Eugene Braaksma, testified that he “could not
comment on [] other reasonable professional[s]” and would not offer “a conclusion
about” whether a reasonable professional in Dr. Hakes’s shoes would have acted
similarly. That inability left the Estate without any evidentiary proof to challenge the
appropriateness of Dr. Hakes’s conduct. Dr. Hakes assessed Mouradian’s mental health
in over twenty near-weekly sessions over seven months, summarized each session in an
email and notes to the jail, advocated for his mental health needs and other privileges,
provided him educational materials, promptly requested re-evaluations from the jail’s
advanced nurse practitioner when his behavior prompted it, and continued to advocate
on his behalf to county officials and jail personnel.
Because the Estate has offered no evidence from which a reasonable jury could
conclude that a reasonable professional in Dr. Hakes’s shoes would have responded
differently, we affirm the district court’s grant of summary judgment for Dr. Hakes.
2. County Defendants
Next, the Estate argues the district court erred in granting the County
Defendants’ summary judgment motion because they had an independent obligation to
monitor Mouradian on the night of his suicide and their failure to do so was objectively

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unreasonable. While we recognize the unfortunate set of circumstances surrounding
Mouradian’s death, the Estate’s argument fails.
First, the official capacity claims against Sheriff Waldera, Captain Bowe, Officer
Keller and Officer Johnson are treated as claims against Jackson County. Grieveson v.
Anderson, 538 F.3d 763, 771 (7th Cir. 2008). “Governmental entities cannot be held liable
for the unconstitutional acts of their employees unless those acts were carried out
pursuant to an official custom or policy.” Id.; see also Monell, 436 U.S. at 694. Thus, to
survive summary judgment on a § 1983 official capacity claim against Jackson County,
the Estate needed to present evidence demonstrating Mouradian suffered a
constitutional violation, and the official policy, custom, or practice caused the alleged
constitutional violation. Perkins v. Lawson, 312 F.3d 872, 875 (7th Cir. 2002); Wagner v.
Washington County, 493 F.3d 833, 836 (7th Cir. 2007) (per curiam). In other words, for the
Estate’s claims against the County Defendants to survive, the Estate must:
(1) show that [Mouradian] was deprived of a federal right;
(2) trace the deprivation to some municipal action (i.e., a policy or custom)
attributable to the municipality itself;
(3) show municipal fault; and
(4) show that the municipal action was the moving force behind the federal-
rights violation.
Lee, 175 F.4th at 884 (citation modified). Looking at these standards, we begin with the
most basic element of the Estate’s Monell claim: whether Mouradian suffered a
constitutional injury. Accepting the Estate’s position that Mouradian was a pretrial
detainee at the time of his death, the Estate was still required to show that the care
Mouradian received was objectively unreasonable—that is, insufficient to abate a
“serious risk of harm” from a reasonable officer’s perspective. Pittman, 108 F.4th at 571–
72.
On this record, we accept that Mouradian’s mental health issues rose to the level of
an “objectively serious” medical need requiring a level of treatment necessary to avoid
a substantial risk of harm and that the County Defendants were aware of this serious
medical condition. See, e.g., Lee, 175 F.4th at 885. The problem for the Estate, however, is
that it has not put forth specific, articulable evidence that would allow us to assess
whether the care the County Defendants did provide, through Dr. Hakes, was
objectively insufficient to meet this serious need. The record contains evidence that
Mouradian received a variety of mental health services while he was detained at the

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jail—crisis intervention, behavioral counseling, medication management, and housing
adjustments. As noted above, the Estate’s expert failed to identify how Jackson
County’s treatment, through Dr. Hakes, was objectively unreasonable. Without this
evidence, we have no basis to conclude that Jackson County’s actions were
constitutionally deficient. Because the Estate did not put forth specific, admissible
evidence demonstrating a genuine issue of material fact on whether the medical care
Mouradian received at the jail was objectively unreasonable, the Estate failed to meet its
burden. And without demonstrating an underlying constitutional violation, we do not
reach the “policy or custom” inquiry of Monell. Id. at 886. Accordingly, we affirm the
district court’s grant of summary judgment for the County Defendants.
C. Remaining Issues
Because the Estate has failed to demonstrate an underlying constitutional
violation, we decline to address the County Defendants’ qualified immunity defense.
See, e.g., Whitman v. Nesic, 368 F.3d 931, 936 (7th Cir. 2004), as amended (June 4, 2004).
Second, we find that the district court properly declined to exercise supplemental
jurisdiction over the Estate’s state-law claims pursuant to 28 U.S.C. § 1367(c)(3). See
Fuqua v. SVOX AG, 754 F.3d 397, 401 (7th Cir. 2014).
III. CONCLUSION
While we are sympathetic to the unfortunate events in this case, the Estate has
failed to demonstrate Dr. Hakes’s actions or the County Defendants’ actions were
objectively unreasonable. Accordingly, we AFFIRM.

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