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Case 108-cv-01339-DCN Doc # 99 Filed 04/07/10 1 of 20. PageID # 3382 UNITED STATES DISTRICT COURT NORTHERN DISTRICT OF OHIO EASTERN DIVISION ANGELA LOWE, Individually as Administratrix of the estate of SEAN LEVERT c/o David Malik, Esq. 8437 Mayfield Road Chesterfield, OH 44026, v. Plaintiff, CUYAHOGA COUNTY/ BOARD OF COMMISSIONERS 1219 Ontario Street, 4 th Floor Clevel, Ohio 44113, GERALD T. MCFAUL CUYAHOGA COUNTY SHERIFF Cuyahoga County Corrections Center 1215 West 3rd Street Clevel, Ohio 44113, MIDWEST MEDICAL STAFFING, INC. 5273 Broadview Road Parma, OH 44134, DR. EMMANUEL O. TUFFUOR Midwest Medical Staffing, Inc. 5273 Broadview Road Parma, OH 44134, DR. DONALD KELLON Midwest Medical Staffing, Inc. 5273 Broadview Road CASE NO 108-CV-01339 JUDGE Donald C. Nugent FOURTH AMENDED COMPLAINT AND JURY DEMAND

Case 108-cv-01339-DCN Doc # 99 Filed 04/07/10 2 of 20. PageID # 3383 Parma, OH 44134 DR. L. ALVARADO Midwest Medical Staffing, Inc. 5273 Broadview Road Parma, OH 44134 KENNETH KOCHEVAR Cuyahoga County Corrections Center 1215 West 3rd Street Clevel, Ohio 44113 CHRISTINE DUBBER Cuyahoga County Corrections Center Health Care Services 1215 West 3rd Street Clevel, Ohio 44113 JANE LAWRENCE Cuyahoga County Corrections Center Health Care Services 1215 West 3rd Street Clevel, Ohio 44113 CHRISTINE MAIN Cuyahoga County Corrections Center Health Care Services 1215 West 3rd Street Clevel, Ohio 44113 CYNNAMON ALI Cuyahoga County Corrections Center Health Care Services 1215 West 3rd Street 2

Case 108-cv-01339-DCN Doc # 99 Filed 04/07/10 3 of 20. PageID # 3384 Clevel, Ohio 44113, JOHN RICHARD JANOSKO Cuyahoga County Corrections Center Health Care Services 1215 West 3rd Street Clevel, Ohio 44113, JOE-ANNA COOPER Cuyahoga County Corrections Center Health Care Services 1215 West 3rd Street Clevel, Ohio 44113, JOHN JANE DOES 5-10 (Names addresses unknown undiscoverable at this time), Defendants. I. INTRODUCTION 1. Sean Levert was a successful R & B singer, husb, father who was killed as a result of the failure of Defendants to provide medical care in the Cuyahoga County Jail. In March, 2008, Sean was sentenced to prison for a nonviolent crime. He entered the jail after sentencing informed Defendants that he was taking Xanax for a medical condition presented his bottle of prescription pills. It was well known that if a patient on Xanax is denied his medication then he is subject to severe withdrawal symptoms including terrifying hallucinations, disorientation, palpitations, nausea, terrible seizures. These foreseeable symptoms are routinely avoided by tapering the patient off of the medication. Defendants terminated Mr. Levert s medication without any tapering failed to prevent or properly 3

Case 108-cv-01339-DCN Doc # 99 Filed 04/07/10 4 of 20. PageID # 3385 recognize his medical crisis. Sean suffered for days then died in a restraint chair. His wife, Angela Lowe, brings this action seeking fair compensation in the hope that she can prevent other prisoners at the Cuyahoga County Jail from suffering such injury death. II. JURISDICTION 2. Jurisdiction over claims brought under the Civil Rights Act of 1871 is conferred on this Court by 28 U.S.C. 1331, 1343 (3) (4). Jurisdiction over the state law claims is conferred by 28 U.S.C. 1367. An affidavit pursuant to Ohio Rule Civ. Proc. 10(D)(2) is attached in support of the medical claims. Venue is proper in this Division. III. PARTIES 3. Angela Lowe is the wife of Sean Levert. Mr. Levert is deceased. Ms. Lowe brings this suit individually as the Administratrix of the Estate of Sean Levert for the benefit of his next of kin heirs. Ms. Lowe Sean Levert were residents of Portage County, Ohio. Sean however, died in Cuyahoga County. Ms. Lowe was appointed Administratrix of the Estate of Sean Levert on April 29, 2008. She brings this action both in her individual fiduciary capacities. 4. Defendant Sheriff Gerald McFaul (Sheriff) is was at all times relevant to this action the duly elected Sheriff of Cuyahoga County, Ohio. Defendant is a person under 42 U.S.C. 1983 at all times relevant to this case acted under color of law. He is sued in his individual in his official capacity. He was a county policy maker with respect to policies procedures at the Cuyahoga County Corrections Center (Jail). 5. Defendant Cuyahoga County (County) is a unit of local government organized under the laws of the State of Ohio. Defendant is a person under 42 U.S.C. 1983 at all times relevant to this case acted under color of law. 4

Case 108-cv-01339-DCN Doc # 99 Filed 04/07/10 5 of 20. PageID # 3386 6. Defendant Kenneth Kochevar is was at all times relevant to this action the Director of the Cuyahoga County Corrections Center. Defendant is a person under 42 U.S.C. 1983 at all times relevant to this case acted under color of law. He is sued in his individual in his official capacity. He was a county policy maker with respect to jail policies procedures. 7. Defendant Christine Dubber is was at all times relevant to this action the Manager of Health Care Services at the Cuyahoga County Corrections Center. Defendant is a person under 42 U.S.C. 1983 at all times relevant to this case acted under color of law. She is sued in her individual in her official capacity. She was a county policy maker with respect to jail policies procedures. 8. Defendant Midwest Medical Staffing, Inc. (MMS) is a corporation was at all times relevant to this action the medical provider under contract with Cuyahoga County, providing medical, psychiatric, dental pharmaceutical services at the Cuyahoga County Corrections Center. MMS is a person under 42 U.S.C. 1983 at all times relevant to this case acted under color of law. 9. Defendant Dr. Donald Kellon was at all times relevant to this action an agent of MMS serving as a psychiatrist at Cuyahoga County Corrections Center. Defendant is a person under 42 U.S.C. 1983 at all times relevant to this case acted under color of law. He is sued in his individual in his official capacity. 10. Defendant Dr. L. Alvarado was at all times relevant to this action an agent of MMS serving as a physician at Cuyahoga County Corrections Center. Defendant is a person under 42 U.S.C. 1983 at all times relevant to this case acted under color of law. He is sued in his individual in his official capacity. 5

Case 108-cv-01339-DCN Doc # 99 Filed 04/07/10 6 of 20. PageID # 3387 11. Defendant Dr. Emmanuel O. Tuffuor was at all times relevant to this action an agent of MMS serving as the Medical Director at Cuyahoga County Corrections Center. Defendant is a person under 42 U.S.C. 1983 at all times relevant to this case acted under color of law. He is sued in his individual in his official capacity. 12. Defendant Nurse Christine Main is was at all times relevant to this action a nurse employed by the County assigned to the Cuyahoga County Corrections Center. Defendant is a person under 42 U.S.C. 1983 at all times relevant to this case acted under color of law. She is sued in her individual in her official capacity. 13. Defendant Nurse Jane Lawrence is was at all times relevant to this action a nurse employed by the County assigned to the Cuyahoga County Corrections Center. Defendant is a person under 42 U.S.C. 1983 at all times relevant to this case acted under color of law. She is sued in her individual in her official capacity. 14. Defendant Nurse Cynnamon Ali is was at all times relevant to this action a nurse employed by County assigned to the Cuyahoga County Corrections Center. Defendant is a person under 42 U.S.C. 1983 at all times relevant to this case acted under color of law. She is sued in her individual in her official capacity. 15. Defendant Nurse John Richard Janosko is was at all times relevant to this action a nurse employed by the County assigned to the Cuyahoga County Corrections Center. Defendant is a person under 42 U.S.C. 1983 at all times relevant to this case acted under color of law. He is sued in his individual in his official capacity. 16. Defendant Nurse Joe-Anna Cooper is was at all times relevant to this action a nurse employed by the County assigned to the Cuyahoga County Corrections Center. Defendant is 6

Case 108-cv-01339-DCN Doc # 99 Filed 04/07/10 7 of 20. PageID # 3388 a person under 42 U.S.C. 1983 at all times relevant to this case acted under color of law. She is sued in her individual in her official capacity. 17. Defendants John Jane Does are individuals entities who individually or in concert with the other defendants responsible for providing medical care to Sean Levert when he was housed at the Cuyahoga County Corrections Center. At this time these persons are not known to Plaintiff but will be named when they are discovered. IV. FACTS A. Sean Levert 18. Sean Levert was born in Clevel, Ohio was the son of Eddie Levert, who sang with The O'Jays. In the 1980 s Sean formed the trio LeVert with older brother Gerald Levert childhood friend Marc Gordon. The LeVert trio recorded several hits with solid rankings on the U.S. R&B charts in the 1980s early 1990s. In 1995, Sean launched a solo music career was still active as a singer at his death. He was an internationally acclaimed R & B singer. 19. Sean Levert Angela Lowe were married in 2001. They had two children from the marriage, Sean Jr. Chad. 20. Sean also had three children born before his marriage to Angela Lowe. Sean paid child support on these three children but fell behind on his obligations. In 2008, he pled guilty to nonpayment of some of his child support obligations, a nonviolent crime. Sean paid $20,000.00 toward his outsting bill before sentencing, but was nonetheless sentenced to a prison term of 22 months. 21. At the time of his sentencing, Mr. Levert was 39 years old. He was 5 4 tall weighed 260 pounds. He loved his wife children had every intention of securing release from prison resuming his family life music career. 7

Case 108-cv-01339-DCN Doc # 99 Filed 04/07/10 8 of 20. PageID # 3389 B. Conditions at Cuyahoga County Corrections Center 22. Cuyahoga County Judge Nancy Russo sentenced Sean on March 24, 2008, he entered the Cuyahoga County Corrections Center (Jail) in Clevel, Ohio. 23. When Judge Russo sentenced Sean, the Jail was overcrowded. At the time of Sean s sentencing, the Adult Bureau of Detention of the Ohio Department of Rehabilitation Corrections (ODRC) had already cited the Jail for Non-Compliance with ODRC stards. ODRC found the Jail overcrowded, lacking adequate inmate sleeping space. 24. On April 17, 2008 just days after Sean s death, the Jail was again inspected by the ODRC an Annual Jail Profile (Profile-Exhibit A) was issued. That Profile, recommended that action must be taken, as soon as possible, to insure that all Correctional Officers receive training within the first year of assignment (Chapter 109-2-09 Administrative Code). Jail Administration must develop a plan within the next six (6) months to insure that all Correctional Officers meet this requirement. C. Sean Levert s Prescription Medication 25. Sean had been prescribed Xanax by his family physician, Dr. Charles Webb to treat an anxiety disorder. Sean was prescribed two milligrams of Xanax to be taken three times daily. Sean had been taking prescription Xanax for several years before he was sentenced. 26. During sentencing, Judge Russo noted that Sean took Xanax. Judge Russo even mentioned Sean s Xanax medication in a personal note to the Sheriff. 27. Xanax is a medication in the class of drugs known as benzodiazepines. In March, 2008 it was well known that abruptly discontinuing benzodiazepines such as Xanax could lead to severe, painful terrifying withdrawal symptoms, often resulting in death. It was also known that Xanax treatment for long term users could not be safely discontinued unless the medication was 8

Case 108-cv-01339-DCN Doc # 99 Filed 04/07/10 9 of 20. PageID # 3390 tapered off in a slow deliberate fashion while the patient was monitored by appropriate medical professionals. D. Sean Levert s Experience at the Cuyahoga County Jail 28. On March 24, 2008, Sean brought his prescribed Xanax medication, with him to the Jail. The Defendants removed the medication from Mr. Levert officially inventoried the medication bottle containing 37 prescribed Xanax pills (Exhibit B). 29. At no time from the moment Mr. Levert entered the Jail until his death six days later did Defendants provide Mr. Levert any of his prescribed Xanax medication. 30. On March 25, 2008, Defendant Nurse Christine Main completed Sean s Mental Health Screening/Referral Form. She noted the prescription for Xanax, noted that he took two milligrams three times a day. 31. On March 25, 2008, Defendant Main filled out an authorization for the release of Sean s medical records Mr. Levert signed the release. The release requested Diagnosis, Medication Treatment records, Discharge Summary. The Release was faxed that day to Southpointe Dr. Charles Webb. The authorization was not faxed to the office of Mr. Levert s primary care physician, Dr. Webb. 32. On March 26, 2008, Southpointe Hospital faxed nine pages of medical records to the Jail that involved blood tests treatment in 2006 for conditions unrelated to Mr. Levert s treatment for anxiety with Xanax. The Southpointe fax did not verify the prescription for Xanax or even refer to the prescription for Xanax. 33. Neither Defendant Main nor any of the other defendants took any further action to verify Mr. Levert s prescription for Xanax. At all times relevant to this action the Defendants 9

Case 108-cv-01339-DCN Doc # 99 Filed 04/07/10 10 of 20. PageID # 3391 possessed the actual Xanax pills in Mr. Levert s prescription bottle but they did not act to provide Mr. Levert any of his duly prescribed medication. 34. On information belief, on March 25, 2008 Defendant Dr. L. Alvarado reviewed the medical intake records regarding Mr. Levert that had been prepared by Defendant Main. 35. From March 25, 2008 until Mr. Levert s death on March 30, 2008, neither Defendants Main, Alvarado nor any other Defendant diagnosed Mr. Levert as a person at risk of Xanax withdrawal. Further, Defendants failed to advise the security medical staff interacting with Mr. Levert to be alert to signs symptoms of Xanax withdrawal. 36. Between March 25, 2008 until Mr. Levert s death on March 30, 2008, Defendants Main, Alvarado the other Defendants failed to take any measures to taper the Xanax medication avoid the foreseeable withdrawal symptoms experienced by Mr. Levert. 37. Inside the Jail, Sean was given no cot or bed upon which to sleep. Sean was housed in an area that was severely overcrowded. Sean was required to sleep on a mattress on the floor of his cell. Due to the housing conditions, Sean became sleep-deprived, exacerbating his pre-existing medical conditions. 38. Soon after he arrived at the Jail, Sean Levert began to deteriorate physically. His cellmate, Bart Rol noticed Sean was sleeping sitting up, talking laughing to himself. Mr. Rol also reported that he could tell Sean was anxious, that he heard Sean request his medication. Mr. Rol eventually witnessed Sean experiencing hallucinations. 39. The hallucinations suffered by Mr. Levert were foreseeable as a known symptom of Xanax withdrawal. 40. On March 27, 2008, Sean asked Corrections Officer Eric Price, for his Xanax medication. Corrections Officer Price reported Sean s request to Defendant Nurse Cynnamon Ali. Defendant 10

Case 108-cv-01339-DCN Doc # 99 Filed 04/07/10 11 of 20. PageID # 3392 Nurse Ali told Corrections Officer Price to tell Sean there was nothing she could do for him, that he would just have to wait. Defendant Nurse Ali failed to check Mr. Levert s medical record; take Mr. Levert s vital signs; perform a mental status exam, or take any other action to investigate the medical status of Mr. Levert. E. Sean Levert s Deadly Medical Crisis 41. Because he did not receive his prescription Xanax medication, Sean lapsed into acute Xanax withdrawal syndrome. Sean was seen rocking from side to side sweating profusely. Sean paced back forth. Sean yelled repeatedly that he needed his medication. Sean began hallucinating seeing imaginary people running around his cell; believing he had seen a correctional officer being stabbed; believing he heard a woman s voice; believing that his son had been murdered. 42. On March 30, 2008, Sean activated the call box on his cell, told the Correction Officer on duty that he had seen his son drowning. He was subsequently interviewed by Defendant Nurse Jane Lawrence who ordered that Sean be transferred to the psychiatric floor for observation. At approximately 325am, Sean was removed from his cell taken to the psychiatric floor. 43. Defendant Nurses John Richard Janosko Joe-Anna Cooper arrived for duty on the morning of March 30 th. Defendant Nurse Janosko is a Registered Nurse, is responsible for delegating duties to Defendant Nurse Cooper, who is a Licensed Practical Nurse. Defendant Janosko is also responsible for ensuring that inmates who are newly admitted to the psychiatric unit are interviewed. Defendant Nurse Lawrence did not inform Defendant Janosko or Defendant Cooper of Sean s hallucinations or his Xanax prescription. 11

Case 108-cv-01339-DCN Doc # 99 Filed 04/07/10 12 of 20. PageID # 3393 44. Defendants, including Defendant Nurses Lawrence, Janosko Cooper, failed to properly diagnose or treat Sean Levert s Xanax withdrawal even when his symptoms were apparent. 45. Defendants, including Defendant Nurses Lawrence, Janosko, Cooper failed to administer regular mental status exams while Mr. Levert was on the psychiatric floor. Defendant Janosko failed to interview or assess Mr. Levert at all. Defendant Cooper failed to administer proper mental health or physical evaluations. 46. Defendants, including Defendant Nurses Lawrence, Janosko, Cooper failed to regularly check Mr. Levert s vital signs when he was on the psychiatric floor. 47. Defendants Janosko Cooper failed to check Mr. Levert s chart or medical history, despite the fact that Mr. Levert had been admitted to the psychiatric floor with hallucinations bizarre behavior only hours before Defendant Janosko Cooper s shift began on March 30. 48. Defendant Nurse Cooper was called to Sean s cell on March 30 after dinner because Sean would not stop crying. Despite Sean s distress, Defendant Cooper never consulted Sean s chart or medical history never conducted a mental status exam. Defendant Cooper never took Mr. Levert s vital signs. 49. For at least an hour more, Sean continued to cry was visibly upset. Defendant Cooper spoke twice with a guard about Sean s behavior. Defendant Nurse Janosko was present during at least one of these conversations. Neither Defendant Nurses Cooper nor Janosko conducted any mental or physical assessment of Sean. Instead, Sean was locked in his cell because he was bumming out the other inmates. 12

Case 108-cv-01339-DCN Doc # 99 Filed 04/07/10 13 of 20. PageID # 3394 50. Once housed on the psychiatric floor Sean continued to hallucinate suffer from severe, classic, terrifying withdrawal symptoms for the next 21 hours. He was never seen by a physician or psychiatrist during this time. 51. Defendant Nurse Janosko did not conduct an interview or evaluation of Sean at any time, nor did he direct Defendant Nurse Cooper to do so. 52. Defendant Dr. Donald Kellon was a physician responsible for providing assessment diagnosis of psychiatric disorders at the Jail, was responsible for the mental health care of Sean Levert. Dr. Kellon failed to properly diagnose or treat Sean Levert s Xanax withdrawal syndrome. 53. At approximately 1045pm, on March 30, 2008, Sean was placed in a restraint chair by the order of Defendant Nurse Lawrence. The seizure of Sean by the use of restraints caused Sean s physical condition to worsen. 54. After Sean was placed in the restraint chair, Defendant Nurse Lawrence called Defendant Dr. Kellon. At that point, Dr. Kellon ordered that Nurse Lawrence administer an injection of haldol, ativan, benadryl. Defendant Lawrence failed to administer the injection. 55. As a direct proximate result of the acts set forth herein, Sean Levert died. Prior to death, Sean endured extended pre-death agony, pain within his body horrifying mental hallucinations. The Cuyahoga Coroner s June 4, 2008 Verdict specifically listed, Alprazolam [benzodiazepine] withdrawal as a cause of death. F. Policies, Practices Culpable Conduct 56. The risk of withdrawal syndrome in Xanax users is well known in jails. The Sheriff, County, MMS, Dr. Emmanuel Tuffuor, Dr. Donald Kellon, Dr. L. Alvarado, Christine Dubber, Kenneth Kochevar any John Doe policy makers had policies, practices, customs usages 13

Case 108-cv-01339-DCN Doc # 99 Filed 04/07/10 14 of 20. PageID # 3395 which caused prisoners to suffer, untreated, serious symptoms as a result of the termination of their benzodiazepine medications. Such policies are the moving force behind the injuries suffered by Mr. Levert in this case. By following such policies Defendants were deliberately indifferent to the serious medical need of Sean Levert in this case. 57. The Sheriff, County, MMS, Dr. Emmanuel Tuffuor, Dr. Donald Kellon, Dr. L. Alvarado, Christine Dubber, Kenneth Kochevar any John Doe policy makers were also deliberately indifferent to the serious medical need of Sean Levert by failing to train staff implement jail policies, practices, customs usages that adequately addressed the obvious known health safety risks to inmates entering the Jail while taking prescribed medications in the class of benzodiazepines, likely to go into withdrawal without proper medical treatment. 58. The Defendants acted negligently, recklessly, wantonly, willfully, knowingly, intentionally with deliberate indifference to the serious medical need of Sean Levert. 59. As a direct proximate result of Defendants actions, before his death Sean Levert suffered severe emotional distress, pain, suffering, extreme horrifying mental hallucinations. 60. As a further direct proximate result of Sean s wrongful death Sean, his survivors /or heirs have suffered permanent damages, including but not limited to, the loss of his support, services, society, including lost companionship, care, assistance, attention, protection, advice, guidance, counsel, instruction, training, education, as well as the loss of prospective inheritance. 61. As a further direct proximate result of Sean s wrongful death Sean s survivors, next of kin /or heirs have suffered permanent damages, including but not limited to, grief, 14

Case 108-cv-01339-DCN Doc # 99 Filed 04/07/10 15 of 20. PageID # 3396 depression, severe emotional distress. They have incurred funeral bills, medical bills treatment will incur additional medical bills treatment in the future. V. FIRST CAUSE OF ACTION 42 U.S.C. 1983 62. The Defendants have, under color of state law, deprived Sean Levert of rights, privileges immunities secured by the Fourteenth Eighth Amendments to the U.S. Constitution including but not limited to the right to be free from cruel unusual punishment, the right to be protected, the right to adequate medical care when incarcerated. 63. The Sheriff, County, MMS, Dr. Emmanuel Tuffuor, Dr. Donald Kellon, Dr. L. Alvarado, Kenneth Kochevar, Christine Dubber, John Doe Policymakers failed to adequately train supervise the Jail corrections officers staff in the intake, assessment correctional medical care of inmates who arrive at the jail while taking prescription drugs in the benzodiazepine class, including Sean Levert. 64. The rules, regulations, customs, policies procedures of the Defendants were inadequate unreasonable were the moving force behind the constitutional deprivations suffered by Sean Levert. 65. Although the policymakers were on notice of the obvious need to train supervise Jail staff in the area of day to day Jail operations, policies procedures relating to medical mental health assessment follow up care of inmates, the Sheriff, County, MMS, Dr. Donald Kellon, Dr. Emmanuel Tuffuor, Dr. L. Alvarado, Kenneth Kochevar, Christine Dubber, John Doe Policymakers failed to adequately train supervise the individual Jail staff in that regard. The policy makers failed to develop institute adequate reality based training programs relating to the incarceration, care treatment of individuals such as Sean who had pre-existing medical conditions. As such the Sheriff, County, MMS, Dr. Donald Kellon, Dr. Emmanuel 15

Case 108-cv-01339-DCN Doc # 99 Filed 04/07/10 16 of 20. PageID # 3397 Tuffuor, Dr. L. Alvarado, Kenneth Kochevar, Christine Dubber, John Doe Policymakers were deliberately indifferent to the serious medical needs of Sean Levert. VI. SECOND CAUSE OF ACTION WRONGFUL DEATH 66. Defendants actions caused the wrongful death of Sean Levert resulting in damages recoverable under R.C. 2125.02 VII. THIRD CAUSE OF ACTION MALPRACTICE BY PHYSICIANS 67. After Sean Levert was admitted to the Jail, Defendants Dr. Donald Kellon Dr. L. Alvarado failed to use reasonable care in terminating his Xanax prescription medicine in diagnosing treating the symptoms experienced by Sean Levert when his Xanax medication was terminated. Defendants Dr. Donald Kellon Dr. L. Alvarado breached their duty of care to Sean Levert. 68. Defendant Medical Director Dr.Tuffuor failed to insure that adequate policies were in place at the Jail to appropriately identify, diagnose treat inmates entering the jail who were at risk of experiencing a medical crisis if their medication was interrupted. 69. The conduct of Defendant Dr. Emmanuel Tuffuor, Dr. Donald Kellon Dr. L. Alvarado deviated from stard medical practice, all in violation of Ohio law. Their conduct was a proximate cause of Sean Levert s injury death. VIII. FOURTH CAUSE OF ACTION MALPRACTICE BY NURSES 70. After Sean Levert was admitted to the care custody of the Jail, Defendant Nurses Christine Main, Jane Lawrence, Cynnamon Ali, John Richard Janosko, Joe-Anna Cooper breached their duties to provide medical care to Mr. Levert consistent with stard medical practice, all in violation of Ohio law. 16

Case 108-cv-01339-DCN Doc # 99 Filed 04/07/10 17 of 20. PageID # 3398 71. The conduct of Defendant Nurse Christine Main, Defendant Nurse Jane Lawrence, Defendant Nurse Cynnamon Ali, Defendant Nurse John Richard Janosko, Defendant Nurse Joe-Anna Cooper proximately caused Sean Levert s injury death. IX. FIFTH CAUSE OF ACTION NEGLIGENCE BY MMS AND MEDICAL DIRECTOR 72. Defendants Midwest Medical Staffing (MMS), Dr. Emmanuel Tuffuor, their employees agents, owed a duty of reasonable care to Sean Levert. 73. Defendants MMS Tuffuor have a duty to provide qualified personnel to perform medical services at the Jail a duty to use reasonable care in determining the qualifications of its contractors, agents employees who provide medical services. 74. Defendants MMS Tuffuor have a duty to establish appropriate policies procedures concerning the medical treatment of inmates at the Jail. 75. Defendant MMS Tuffuor, their contractors, employees agents breached their duty of care to Sean Levert by failing to provide appropriate medical care treatment under the circumstances. 76. As a direct proximate result of the negligence of MMS, Dr. Donald Kellon, Dr. Tuffuor, Dr. L. Alvarado, Sean Levert suffered injury, pain suffering, pre-death agony, emotional psychological trauma, eventually died as a result of such injury. X. SIXTH CAUSE OF ACTION NEGLIGENT AND RECKLESS BREACH OF DUTY BY SHERIFF, JAIL DIRECTOR, HEALTH CARE MANAGER AND COUNTY 77. Defendant Sheriff McFaul, Kenneth Kochevar, Christine Dubber Cuyahoga County owed a duty of reasonable care to Sean Levert. 78. Defendants Sheriff, Kenneth Kochevar, Christine Dubber Cuyahoga County has a duty to provide qualified personnel to perform medical services at the Jail a duty to use 17

Case 108-cv-01339-DCN Doc # 99 Filed 04/07/10 18 of 20. PageID # 3399 reasonable care in determining the qualifications of its contractors, employees agents who provide medical services. 79. Defendants Sheriff, Kenneth Kochevar, Christine Dubber Cuyahoga County have a duty to establish appropriate policies procedures concerning the medical treatment of inmates at the Jail. 80. Defendants Sheriff, Cuyahoga County its contractors, employees agents breached their duty of care to Sean Levert by failing to provide appropriate medical care treatment under the circumstances. 81. Defendants Sheriff, Kenneth Kochevar, Christine Dubber County failed to conduct audits to ensure that services by its contractors were consistent with stard medical practice. 82. The conduct of the Sheriff, Kenneth Kochevar, Christine Dubber was negligent, reckless, wanton willful, intentional, knowing deliberately indifferent. 83. As a direct proximate result of the conduct of Defendants Sheriff, Kenneth Kochevar, Christine Dubber Cuyahoga County, Sean Levert suffered injury, pain suffering, emotional psychological trauma, eventually died as a result of such injury. XI. SEVENTH CAUSE OF ACTION LOSS OF CONSORTIUM 84. At the time of incidents complained in Plaintiff s Complaint, the Plaintiff Decedent were married. 85. That as a result of the wrongful acts of the Defendants, each of them, the Plaintiff was caused to suffer, will continue to suffer in the future, loss of consortium, loss of society, affection, assistance, conjugal fellowship. 86. All the aforesaid injuries damages were caused proximately by the wrongful acts of the Defendants. 18

Case 108-cv-01339-DCN Doc # 99 Filed 04/07/10 19 of 20. PageID # 3400 XII. JURY DEMAND 87. Plaintiff hereby dems a trial by jury of all issues triable by jury. XIII. PRAYER FOR RELIEF WHEREFORE, Plaintiff prays that this Court A. Award Plaintiff compensatory damages in an amount to be shown at trial; B. Award punitive damages against all Defendants except the County in an amount to be shown at trial; C. Equitable relief, including, without limitation, that the County the Sheriff be made to apologize to promulgate, adopt, train, maintain enforce appropriate policies to prevent future instances of the type of misconduct described herein; D. Award Plaintiff reasonable attorney s fees, costs disbursements; E. Grant Plaintiff such additional relief as the Court deems just proper. Respectfully submitted, /s/ David B. Malik /s/alphonse A. Gerhardstein David B. Malik, (0023763) Alphonse A. Gerhardstein (0032053) 8437 Mayfield Road, Suite 103 GERHARDSTEIN & BRANCH CO. LPA Chesterl, OH 44026 432 Walnut Street, Suite 400 (440) 729-8260 Cincinnati, Ohio 45202 dbm50@earthlink.net (513) 621.9100 (513) 345-5543 (Fax) /s/ Daryl T. Dennie agerhardstein@gbfirm.com Daryl T. Dennie (0067609) 75 Public Square Suite #1414 Clevel, OH 44114 (216) 622-2700 dryldennie@aol.com /s/ Dennis J. Niermann Dennis J. Niermann (007988) 8437 Mayfield Road, Suite 103 Chesterl, OH 44026 (440) 729-8260 19

Case 108-cv-01339-DCN Doc # 99 Filed 04/07/10 20 of 20. PageID # 3401 dennisj.niermann@gmail.com Attorneys for Plaintiff CERTIFICATE OF SERVICE I hereby certify that on April 7, 2010, a copy of the foregoing pleading was filed electronically. Notice of this filing will be sent to all parties for whom counsel has entered an appearance by operation of the Court s electronic filing system. Parties may access this filing through the Court s system. I further certify that a copy of the foregoing pleading the Notice of Electronic Filing has been served by ordinary U.S. mail upon all parties for whom counsel has not yet entered an appearance electronically. /s/ Alphonse A. Gerhardstein Attorney for Plaintiff 20