Hice et al v. Turn Key Health Clinics LLC et al

IN THE UNITED STATES DISTRICT COURT FOR THE
WESTERN DISTRICT OF OKLAHOMA
LISA M. HICE, 	)
LEANN D. HOFF, 	)
as Co-Administrators of the 	)
Estate of Marvin G. May, 	)
Deceased, 	)
)
Plaintiffs, 	)
)
v. 	) 	Case No. CIV-24-119-JD
)
TURN KEY HEALTH CLINICS, 	)
LLC et al., 	)
)
Defendants. 	)
REPORT AND RECOMMENDATION
On January 25, 2022, Decedent Marvin G. May was booked into the
Custer County Jail as a pretrial detainee. Doc. 1, at 4. Upon booking, Mr. May
was 74 years old with a recorded past medical history of diabetes mellitus, high
blood 	pressure, 	and 	cardiovascular 	disease. 	Id. 	Before 	and 	during 	his
detention, Mr. May suffered from various ailments including dementia, a
worsening 	bed 	sore, 	chronic 	obstructive 	pulmonary 	disease 	(COPD),
incontinence, and difficulty walking. Id. at 6; Doc. 158, at 10. On March 18,
2022, Mr. May fell out of his bunk and was transported to the emergency room
where he was pronounced dead. Doc. 1 at 9. The Co-Administrators of his
Estate 	brought 	this 	action 	under 	42 	U.S.C. 	§ 	1983 	alleging 	Defendants
deprived 	Mr. 	May 	of 	medical 	care 	in 	violation 	of 	his 	rights 	under 	the
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Fourteenth Amendment of the U.S. Constitution and Oklahoma law. Id. at 1;
see generally Doc. 1. United States District Judge Jodi W. Dishman referred
this 	matter 	to 	the 	undersigned 	Magistrate 	Judge 	for 	initial 	proceedings
consistent with 28 U.S.C. § 636(b)(1)(B), (C). Doc. 3.
Before the Court is Defendant Stacia Unruh, Licensed Practical Nurse
(LPN)’s Motion for Summary Judgment, Doc. 140. Plaintiffs filed a response in
opposition, Doc. 158, and LPN Unruh replied, Doc. 178. So, the matter is at
issue.1 The undersigned recommends the Court deny LPN Unruh’s motion for
summary judgment.
I. 	Legal standards.
A court shall grant summary judgment “if the movant shows that there
is no genuine dispute as to any material fact and the movant is entitled to
judgment as a matter of law.” Fed. R. Civ. P. 56(a). “An issue of fact is material
if under the substantive law it is essential to the proper disposition of the
claim.” Savant Homes, Inc. v. Collins, 809 F.3d 1133, 1137 (10th Cir. 2016)
(internal quotation marks and citation omitted). A dispute about a material
fact is genuine “if the evidence is such that a reasonable jury could return a
1 	Citations to a court document are to its electronic case filing designation
and pagination. Except for capitalization, quotations are verbatim unless
otherwise indicated.
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verdict for the nonmoving party.” Anderson v. Liberty Lobby, Inc., 477 U.S. 242,
248 (1986); see also Doe v. Univ. of Denver, 952 F.3d 1182, 1189 (10th Cir. 2020)
(explaining that a dispute over a material fact is genuine “if a rational jury
could find in favor of the nonmoving party on the evidence presented” (citation
omitted)). In applying this standard, the Court “‘review[s] the facts and all
reasonable inferences those facts support[ ] in the light most favorable to the
nonmoving party.’” Doe, 952 F.3d at 1189 (second alteration in original)
(quoting 	Evans 	v. 	Sandy 	City, 	944 	F.3d 	847, 	852 	(10th 	Cir. 	2019)). 	“In
reviewing the facts, at summary judgment, the party who bears a burden of
proof on an issue bears the burden of production rather than the burden of
persuasion.” Markley v. U.S. Bank Nat’l Ass’n, 59 F.4th 1072, 1080 (10th Cir.
2023).
II. 	Background.
Defendant Turn Key Health Clinics, LLC (Turn Key) contracted with the
Custer County Sheriff’s Office (Custer County) and the Board of County
Commissioners 	of 	Custer 	County 	to 	provide 	certain 	medical 	care 	and
treatment to inmates and detainees at the Custer Couty Jail. Doc. 140, at 5.
The contract requires Turn Key to provide twelve hours of weekly “on-site
nursing services by a Registered Nurse [(RN)] or a [LPN].” Id. at 5-6. The
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contract also requires that a physician or mid-level provider provide a weekly
patient clinic either in-person or via telemedicine. Id. at 6. Turn Key was
responsibly for ensuring 24/7 availability of an on-call physician or mid-level
provider. Id.
Defendant LPN Unruh works as a Turn Key employee at the Jail. Id.;
Doc. 158, at 6. There is no RN at the Jail. Doc. 158, at 6.
On January 25, 2022, Mr. May was transferred to the Jail from the
Canadian County Jail. Doc. 140, at 6. Detention officers performed a COVID-
19 screen and Mr. May reported nausea. Id.
On January 27, 2022, Defendant LPN Unruh conducted a Medical
Intake on Mr. May. Id. She recorded his vital signs, including his temperature,
blood pressure, respirator rate, pulse, and oxygen saturation. Id. She reviewed
his medical history, evaluated his general appearance, behavior, level of
consciousness, breathing, and his mobility. Id. She also completed a Prison
Rape Elimination Act (PREA) risk assessment. Id. Defendant LPN Unruh
noted his gait was “stable” and made no note that Mr. May needed a cane or
wheelchair at that time. Doc. 158, at 9; Doc. 155, Ex. 12, at 3.2
2 	Plaintiffs reference the exhibits attached to their response to Defendant
Sheriff’s motion for summary judgment, Doc. 155, interchangeably in their
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On February 2, 2022, Mr. May’s cellmate notified Defendant Warnke
that Mr. May had not eaten in several days and refused to shower. Doc. 155,
Ex. 17 (Jail Incident Report). The inmate filed a sick call request form seeking
help for Mr. May, noting that: “this old man marvin may hasnt eaten in 9 days
or showered he needs real medical attention asap,” Doc. 155, Ex. 33, at 1.
Similarly, in a grievance form, the inmate wrote: “weve told staff and they aint
done shit this old man marvin hasn’t eaten or showerd in days he needs real
medical help . . .” Doc. 155, Ex. 34. To each, Jail Officer Angie Schmidt
responded: “We’re going to move him to booking til the nurse comes in
tomorrow so that we can watch him.” Doc. 155, Ex. 33, at 2 & Ex. 34, at 1. That
same day, Officer Warnke had Mr. May moved to his own cell in the “booking
area,” “to be monitored for his behavior and eating habits.” 	Doc. 155, Ex. 17.
She recorded that “[h]e [(Mr. May)] is to be offered a protein shake with every
meal & charted on ODIS if he eats his meals or drinks his share per Lt.
Stanford.” Id.3 Defendant LPN Unruh scheduled Mr. May for a telehealth visit
responses 	to 	Defendants’ 	motions 	for 	summary 	judgment. 	For 	ease 	of
reference, the undersigned will refer to the exhibits attached to Doc. 155 where
the same arguments are made or where identical evidence is cited amongst the
parties.
3 	Lieutenant 	Martha 	Stanford, 	a 	non-defendant, 	supervised 	Officer
Warnke. Doc. 155, Ex. 20, at 4.
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with Defendant Advanced Practice Registered Nurse (APRN) Tamara Carey
the next day. Doc. 140, at 6-7.
On February 3, 2022, APRN Carey conducted a Chronic Care Provider
visit with Mr. May via telemedicine. Doc. 140, Ex. 2, at 35-36. APRN Carey
assessed 	Mr. 	May’s 	condition, 	obtained 	his 	medical 	history, 	changed 	his
medication prescriptions, and scheduled a follow-up appointment for 90 days
later. Id. Defendant LPN Unruh “assisted with some of it.” Doc. 155, Ex. 15, at
3.
On February 11, 2022, Defendant LPN Unruh examined a wound on Mr.
May’s right hip, entered a Wound Care Note, and reported the wound to APRN
Carey who ordered that antibiotic ointment be applied daily. Doc. 158, at 11;
Doc. 140, Ex. 2, at 37, 40 & Ex. 3, at 12. On February 13, 2022, Officer Michael
McCowen noted that Mr. May “defecated on himself” and that his feces “got . . .
in his sore” and he “cleaned around [the] wound best [he] could.” Doc. 155, Ex.
25, at 4 (Jail Entry Report). Defendant LPN Unruh looked at Mr. May’s sore
again on February 14, 2022. Doc. 140, at 7. After February 14, 2022, Defendant
LPN Unruh made no further notes in Mr. May’s file and never saw him again.
Id. After February 14, 2022, officers applied the ointment, checked his blood
pressure, and gave him his medications. Doc. 155, Ex. 25 (Jail Entry Report).
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Officer Warnke testified that after February 14, 2022, she continued to
keep Defendant LPN Unruh updated about Mr. May. Doc. 155, Ex. 11, at 39.
She would tell Defendant LPN Unruh there’s not really any “change in him,”
and ask is there “anything we can do?” Id. And Defendant LPN Unruh would
answer, “No.” Id. at 39-40. Jail staff reported to Officer Warnke that Mr. May
was not showering or eating. Id. at 41. And she would encourage Mr. May to
shower and eat, “[a]nd nine times out of ten, he’d take a shower.” Id. She saw
him and spoke with him each day she worked. Id. at 14. Officer Warnke was
well-aware of Mr. May’s incontinence, because she observed it “every day [she]
worked.” Id. at 19, 41-42. She updated Defendant LPN Unruh that Mr. May
was still not eating, and unable to get around. Id. at 43-44. Officer Warnke also
did not dispute the facility’s meal log which showed Mr. May refused 118 of
132 meals offered to him. Id. at 22. And she agreed with the staff note that said
Mr. May hadn’t eaten in three weeks. Id. at 26-27. She believed Defendant
LPN Unruh was “charting and keeping in contact with [APRN] Carey.” Id. at
46.
On March 17, 2022, Officer Warnke filed a Jail Incident Report noting
Mr. May refused to “set up” for a blood pressure check, and that he told her he
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was “fine” and “okay.” Doc. 140, Ex. 2, at 55. She noticed a pair of “soiled orange
clothes,” and she encouraged him to take a shower, but he refused. Id.
On March 18, 2022, Mr. May was discovered on the floor of his cell and
became unresponsive when jail staff tried to “sit him up.” Id. at 56. The
Sheriff’s Department notes from a responder state Mr. May was “naked from
the waist down” and “cov[er]ed in dried feces.” Doc. 155, Ex. 38. The responder
further notes that “[t]he jail staff stated [Mr. May] ha[d] not ate or drank
anything in 3 weeks.” Id. Jail staff also stated that they “were unsure of the
last time [he] was seen normal.” Id. Ex. 39. Mr. May’s “pupils [were] pinpoint”
and he was “unable to speak” or “follow directions.” Id. Ex. 39. The officers
tried to revive him with an ammonia pack, but it had a “limited response.” Doc.
140, Ex. 2, at 57. Officer Warnke notified the Turn Key provider on call, who
told her “to have [Mr. May] sent to the hospital.” Id. at 57. Officers then called
for an ambulance. Id. at 56.
The Medical Examiner listed Mr. May’s probable cause of death as
“Coronavirus Disease 2019 (COVID-19) Pneumonia Sequalae.” Doc. 155, Ex, 4,
at 19. Plaintiff’s expert, Dr. Justin Berk, will testify that “the evidence does
not indicate that COVID-19 was a cause of Mr. May’s death.” Id. “Rather, Mr.
May’s profile─starvation, dehydration, lactic acidosis, nutritional deficiencies,
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hypotension—is tragically aligned with textbook examples of preventable
death due to neglect of basic medical needs.” Id.
III. 	Deliberate indifference to Mr. May’s medical needs.
Defendant LPN Unruh argues that Plaintiff has not cited evidence that
her actions involving her care for Mr. May rise to the level of deliberate
indifference. Doc. 140, at 13. Under the Fourteenth Amendment’s Due Process
Clause, pretrial detainees are entitled to the degree of protection against
denial of medical attention which applies to convicted inmates under the
Eighth Amendment. Lucas v. Turn Key Health Clinics, LLC, 58 F.4th 1127,
1136 (10th Cir. 2023) (citing Paugh v. Uintah Cnty., 47 F.4th 1139, 1153–54
(10th Cir. 2022)); Sealock v. Colorado, 218 F.3d 1205, 1209 (10th Cir. 2000)).
The deliberate indifference standard contains both an objective and
subjective component. Lucas, 58 F.4th at 1136. The objective component is
satisfied if the deprivation is “sufficiently serious.” Farmer v. Brennan, 511
U.S. 825, 834 (1994) (quoting Wilson v. Seiter, 501 U.S. 294, 298 (1991)).
Defendant LPN Unruh does not challenge the objective component of Plaintiffs’
claim, 	and 	the 	Tenth 	Circuit 	has 	“held 	that 	‘death 	[is], 	without 	doubt,
sufficiently serious to meet the objective component.’” Burke v. Regalado, 935
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F.3d 960, 992 (10th Cir. 2019) (quoting Martinez v. Beggs, 563 F.3d 1082, 1088
(10th Cir. 2009)).
The 	subjective 	component 	is 	satisfied 	if 	the 	official 	“knows 	of 	and
disregards an excessive risk to inmate health or safety.” Farmer, 511 U.S. at
837. A plaintiff “need not show that a prison official acted or failed to act
believing that harm actually would befall an inmate,” but only that the official
“merely refused to verify underlying facts that [s]he strongly suspected to be
true, or declined to confirm inferences of risk that [s]he strongly suspected to
exist.” Lucas, 58 F.4th at 1137 (quoting Farmer, 511 U.S. at 842, 843 n.8.).
“‘Whether a prison official had the requisite knowledge of a substantial risk is
a question of fact subject to demonstration in the usual ways, including
inference 	from 	circumstantial 	evidence’ 	such 	as 	whether 	‘the 	risk 	was
obvious.’” Id. (quoting Farmer, 511 U.S. at 842). “An official disregards risk
when [s]he fails to take reasonable measures to abate the risk.” Id.
A “factfinder may conclude that a prison official knew of a substantial
risk from the very fact that the risk was obvious.” Quintana v. Santa Fe Cnty.
Bd. Of Comm’rs, 973 F.3d 1022, 1029 (10th Cir. 2020) (quoting Farmer, 511
U.S. at 842). But this requires “that such risks present themselves as ‘obvious’
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to the so-called ‘reasonable man.’” Id. (quoting Mata v. Saiz, 427 F.3d 745, 752
(10th Cir. 2005)).
The 	Tenth 	Circuit 	recognizes 	two 	ways 	to 	establish 	the 	subjective
component of a deliberate indifference claim against an individual defendant:
[T]he subjective component can be satisfied under two theories:
failure to properly treat a serious medical condition (“failure to
properly treat theory”) or as a gatekeeper who prevents an inmate
from receiving treatment or denies access to someone capable of
evaluating the inmate’s need for treatment (“gatekeeper theory”).
The latter theory can apply to medical professionals when the
professional knows that his or her role in a medical emergency is
solely 	to 	refer 	the 	patient 	to 	another. 	Even 	a 	brief 	delay 	in
treatment can be unconstitutional.
Lucas, 58 F.4th at 1137 (internal citations omitted).
A. 	Objective component.
As noted, Defendant LPN Unruh concedes the objective component is
met. Doc. 140, at 13-14; see Prince v. Sheriff of Carter Cnty., 28 F.4th 1033,
1045 (10th Cir. 2022) (concluding detainee’s “ultimate harm of death was
sufficiently serious for purposes of the objective component of deliberate
indifference”); Burke, 935 F.3d at 994 (10th Cir 2019) (same).
B. 	Subjective component.
1. 	Failure to properly treat.
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On February 2, 2022, days into Mr. May’s detention, an inmate notified
Officer Warnke that Mr. May had not eaten in several days and refused to
shower. Doc. 155, Ex. 17 (Jail Incident Report). That resulted in Officer
Warnke moving Mr. May to a cell next to Defendant LPN Unruh’s office, close
to the booking area “to be monitored for his behavior and eating habits.” Id.;
Doc. 155, Ex. 33, at 2 & Ex. 34, at 1.
The next day was Mr. May’s medical visit with APRN Carey. Doc. 140,
Ex. 2, at 35-36. Officer Warnke’s Jail Incident Report notes state that Mr. May
was brought via wheelchair for the visit. Doc. 155, Ex. 18. She and Defendant
LPN Unruh “encouraged him to drink a protein shake and he refused to drink
it but [he] drank some water.” Id.
Officer Warnke’s Jail Incident Report notes state that after the visit,
APRN Carey stated Mr. May’s,
Mental condition appeared to be deteriorating rapidly and that
when she had seen him at the previous county he was transported
around via wheelchair at that facility also. [LPN Unruh and
Officer Warnke] let [APRN Carey] know that he was moved to
booking yesterday because he wasn’t eating or showering while he
was in the dorm housing. [APRN] Carey said that she wanted to
notify Adult Protective Services about his well being due to his
deteriorating mental state.
Id.
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Officer 	Warnke 	testified 	she 	was 	aware 	of 	the 	February 	3, 	2022
telemedicine visit with APRN Carey and presumed that APRN Carey called
Adult Protective Services, that Carey told Defendant LPN Unruh she wanted
to contact Adult Protective Services, and that Officer Warnke had “seen forms
come through” from Adult Protective Services. Doc. 155, Ex. 11, at 12, 23.
APRN Carey’s February 3, 2022 chronic care note from Mr. May’s visit
documented Mr. May’s COPD, and that she knew of Mr. May’s “worsening
Alzheimer’s disease.” Doc. 155, Ex. 35, at 1. “Per officer [Warnke]” she noted
Mr. May had not eaten or showered in seven days. Id. She noted that Mr. May
could not “ambulate safely alone” and scheduled another visit with her for 90
days later. Id. at 2.
Officer Warnke testified that Defendant LPN Unruh worked at the Jail
for “12 hours a week.” Doc. 155, Ex. 11, at 13. Officer Warnke testified she
regularly reported to Defendant LPN Unruh about Mr. May’s status. Id. (“I
kept Stacia Unruh updated.”).
Defendant LPN Unruh testified that after February 11, 2022, she did not
enter any other wound care notes on Mr. May because the Jail’s officers were
“monitoring the wound care” after that date. Doc. 155, Ex. 15, at 8. She clarified
that if the wound got worse, the officers were to report to her or the provider.
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Id. at 9. She did not recall ever getting a report that the wound was worsening.
Id. She testified she was never alerted of any reason she needed to go check on
Mr. May after her last treatment of him on or around February 14, 2022. Id.
at 15.
While it appears true that there are no Jail Entry Reports about Mr.
May’s wound from February 23, 2022 through March 16, 2022, Defendant LPN
Unruh’s care for Mr. May was not limited to wound care, given his many
ailments.
Officer Warnke testified that on February 14, 2022, she and Defendant
LPN Unruh encouraged Mr. May to shower (which he did), and then Defendant
LPN Unruh looked at his wound and applied the ointment. Doc. 155, Ex. 11,
at 38. After this, Officer Warnke testified she continued to keep Defendant
LPN Unruh updated about Mr. May’s condition. Id. at 39-40. When she would
ask Defendant LPN Unruh if there was anything they could do for Mr. May,
Defendant LPN Unruh would answer, “No.” Id. She knew that Mr. May was
sometimes refusing meals and was being offered protein shakes, which he also
refused at times. See Doc. 155, Ex. 18.
Officer Warnke testified that because Mr. May was in the booking area,
“anybody could walk by his cell” to check on him, but that if Defendant LPN
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Unruh had a lot of sick calls, she might have been too busy to see him. Doc.
155, Ex. 11, at 40. Officer Warnke testified Turn Key ordered the adult diapers
for Mr. May and that she recalled telling Defendant LPN Unruh that Turn Key
was “ordering adult diapers for him.” 	Id. at 42. Officer Warnke also believed
that Defendant LPN Unruh “was charting and keeping in contact with [APRN]
Carey” about Mr. May throughout his stay. Id. at 46. She believed “Unruh was
contacting a provider regarding Mr. May . . . or documenting on him.” Doc. 142,
Ex. 9, at 8.
Officer Warnke testified that Defendant LPN Unruh expressed concern
about Mr. May’s sore becoming infected. Doc. 155, Ex. 11, at 17-18. Officer
Warnke 	testified 	that 	her 	own 	knowledge 	in 	applying 	the 	antibacterial
ointment stemmed only “from what [she had] observed at . . . nursing homes,”
and she did not know if her fellow officers had any training in applying the
ointment. Id. at 18. In fact, fellow Officer Michael McCowen noted as early as
February 13, 2022, that Mr. May’s feces “got . . . in his sore.” Doc. 155, Ex. 25,
at 4.
Defendant LPN Unruh testified she was “not sure . . . whenever [Mr.
May] started defecat[ing] on himself or urinating on himself,” Doc. 142, Ex. 5,
at 11, and did not recall if he was wearing a diaper on February 10, 11, or the
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14th. Id. at 10-14, 16. She testified she did not recall knowing that Mr. May
needed to have a diaper on February 14, 2022, the day after Officer McCowen
reported feces had gotten into Mr. May’s wound. Id. at 16.
Officer Brayan Alvarado also testified that for the “last two to three
weeks” before Mr. May’s death “the whole jail staff kind of knew” that Mr. May
“need[ed] to go somewhere,” Doc. 155, Ex. 21, at 14, i.e., “a facility that can
take care of him.” Id. He clarified that he meant a “medical facility.” Id.
And Sheriff Daniel Day testified as follows:
Q: Would that be your . . . . expectation with an individual who
seemed like they had diagnosed dementia, and they hadn’t eaten
for seven days, and they were unable to shower? Would you 	. . .
have an 	expectation that that person 	would be taken to the
hospital emergently?
. . . .
A: Yes, sir.
. . . .
Q: [A] person who has refused or who has an inability to eat for
over a week, that’s something that anyone, whether they’ve had
medical training or not, should be aware of as an emergent medical
situation. Agreed?
. . . .
A: Yes, sir.
Doc. 155, Ex. 1, at 10-11.
Defendant LPN Unruh argues that because no officer contacted her, she
thought that no further medical care was needed for Mr. May. Doc. 140, at 20.
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Also, Defendant LPN Unruh observed no signs or symptoms of COVID-19, nor
did Mr. May exhibit any. Id.
But that is not the medical care at issue. Given the record here, there is
evidence from which a reasonable juror could conclude that Defendant LPN
Unruh acted with deliberate indifference. She knew he was moved close to
booking on February 2, in fact “next to her office,” Doc. 148, at 2, because of
concern for his medical status. She knew his Alzheimer’s was worsening, given
APRN Carey’s Chronic care notes. She knew he could not walk without
assistance. She knew Turn Key was ordering adult diapers for Mr. May, she
knew he had a bed sore requiring prescription bacterial ointment with routine
applications and expressed concern about it getting infected. Doc. 155, Ex. 11,
at 17-18, 20, 38-39. And a quick look at the February 13, 2022 Jail Entry Report
would have informed her that feces did in fact get into Mr. May’s bed sore. Doc.
155, Ex. 25, at 4. This is not a case where she exercised her considered medical
judgment. During her twelve hours of weekly time at the jail from February 14
through March 17, 2022, she did not stop in next to her office to check on Mr.
May even though “anybody could walk by his cell and open the window and
look at him and see how he was.” Doc. 155, Ex. 11, at 40.
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A reasonable jury may conclude that Defendant LPN Unruh acted with
deliberate indifference to Mr. May’s medical needs by not checking in on him
in person even once over the four weeks he was there before he fell from his
bunk. The record shows that Defendant LPN Unruh failed to treat Mr. May or
provide him with proper medical care based upon her knowledge of his medical
condition. 	Lucas, 	58 	F.4th 	at 	1139 	(“[M]erely 	doing 	something 	(with 	no
reference to the underlying condition) does not necessarily insulate one from
liability.”).
2. 	Liability under the gatekeeper theory.
Similarly, there is evidence from which a reasonable juror could conclude
that Defendant LPN Unruh acted with deliberate indifference under the
“gatekeeper” theory. Defendant LPN Unruh was the only medical professional
at the Jail, present two days a week. Doc. 155, Ex. 15, at 9-11. She was not
allowed to perform patient assessments. Id. at 5. As noted above, given the
information she had about Mr. May’s worsening condition, a juror could find it
deliberately indifferent not to contact APRN Carey to update her or anyone
else who might assess him. Paugh, 47 F.4th at 1155; see also id. at 1160 (“[A]
reasonable jury could find that [the defendant] was aware that [the inmate]
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was in obvious need for medical attention, and . . . abdicated her gatekeeping
role by not relay[ing] the problem to medical staff.” (quotations omitted)).
IV. 	Recommendation and notice of right to object.
For the reasons set forth above, the undersigned recommends the Court
deny Defendant LPN Unruh’s motion for summary judgment. Doc. 140.
The undersigned advises Defendant of her right to file an objection to
this report and recommendation with the Clerk of this Court on or before April
21, 2026, in accordance with 28 U.S.C. § 636(b)(1) and Federal Rule of Civil
Procedure 72(b)(2). The undersigned further advises Defendant that failure to
make a timely objection to this report and recommendation waives the right to
appellate review of both factual and legal questions contained herein. Moore v.
United States, 950 F.2d 656, 659 (10th Cir. 1991).
This report and recommendation does not terminate the referral to the
undersigned Magistrate Judge in this matter.
ENTERED this 31st day of March, 2026.
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