Not many lawyers handle cases involving inadequate medical care for inmates in jails and prisons. But our firm handles these cases often. In my experience, inmates seem to be at a higher risk of medical neglect, especially if housed in a facility where the government has contracted with a private corporation to provide healthcare. I recently came across some media coverage about the case of Maurice Monk, a 45-year-old man who died while in the Santa Rita Jail in Alameda County, California.
I am not affiliated with that case and am unfamiliar with California law. The purpose of this post is to shed light on a broader topic, not offer legal advice or insight into the Monk case. The allegations in that case are strikingly similar to dozens of potential cases that find their way to my law firm each year. Allegations of callous indifference, failure to provide medications, delay in providing consults with specialists, and understaffing (both quantitively, e.g., not enough nurses on a shift, and qualitatively, e.g., having CNAs instead of LPNs, RNs, etc.).
Medical care in correctional settings must not fall below the acceptable standards of care. There’s a proper way to deal with cancer, diabetes, cardiovascular disease, and mental health and an improper way. Whether a person is living free and going into their family doctor’s office, a recent arrestee who has not yet posted bail, or a convicted prisoner serving a 10-year sentence, they’re all human and deserving of adequate medical care. Whereas in the outside world, people are free to choose if, when, and whom they see to report or request medical care. On the inside, detainees and prisoners depend completely on the medical staff. They can request, complain, and even beg for care, but they truly have no control over whether they’ll get it timely or meaningfully.
The issue is not whether inmates are entitled to world-class healthcare. They’re not. The issue is whether inmates—including those accused of wrongdoing but still presumed innocent—are entitled to a minimum level of reasonable healthcare. And they are. In my practice, I often explain that there are two parallel legal considerations in cases involving correctional healthcare: whether medical negligence occurred no different than if my client were not an inmate and whether my client’s constitutional rights as an inmate were violated.
Yes, people detained or imprisoned have a constitutional right to adequate healthcare. For those convicted of a crime and serving a sentence, the right is found in the Eighth Amendment’s prohibition against cruel and unusual punishment. The right is found in the Fourteenth Amendment for those accused of committing a crime but not yet convicted, but the legal analysis is the same. Either way, the question is one of deliberate indifference. Meaning was there an objectively serious medical condition that a health care provider was subjectively aware of but then indifferent to.
In the Monk case, there have been reports that, among the allegations, are that correctional guards and agents of Wellpath, the private corporation contracted to provide healthcare to inmates in the Santa Rita Jail, “did nothing more than stare at him and throw food and medications into his cell like he was an animal in a pen at a zoo. Despite the obvious crisis, not a single guard or nurse thought enough about Mr. Monk to call for help.” There are also allegations that jailers and medical staff visited his cell several times over a period of days, each time he was facedown in the bed, naked from the waist down, not responding to any verbal commands before eventually they found him dead (but it’s alleged he died well before he was found that way).
I have fielded and handled similar cases. In fact, the average person (even a lawyer) would be shocked with the frequency of how often I field prospective cases just like this. Unfortunately, we cannot handle all of them. We just don’t have the resources. But other lawyers are encouraged to start taking on these cases.
There are typically three types of defendants: (a) the government or agency responsible for providing the healthcare, (b) the private company who successfully bid to contract to provide those healthcare services that the government otherwise would, and (c) employees or agents of either or both who fail to act reasonably or act with deliberate indifference. In future blog posts, I’ll address these in more detail. Still, for present purposes, I think I’ll start by pointing out some of the frustrations when suing the government—even with the most legitimate and meritorious claims.
In most jurisdictions, claims against the government or their agents that are rooted in ordinary negligence principles, including medical negligence, are “capped.” Meaning there’s a maximum amount of money a claimant can recover. This is often tied to a limited waiver of sovereign immunity (a legal principle that people cannot sue the government unless the government gives them permission).
For instance, in Florida, the cap is $200,000 for any one person. Fla. Stat. § 768.28(5)(a). That means that even in the most horrifying case of medical negligence where a jury decides the government or an agent thereof caused millions of dollars in damages (i.e., caused someone to lose their eyesight, delayed cancer diagnosis lead to death, etc.), the maximum they can actually recover is still just $200,000. Beyond that would require an act of the Florida Legislature through a claims bill, which feels as uncommon as winning the lottery. In Georgia, in tort actions against the state, “no person shall recover a sum exceeding $1 million…regardless of the number of state government entities involved.” O.C.G.A. § 50-21-29(a).
There’s often a cap on attorney fees, too. In Florida, for example, “[n]o attorney may charge, demand, receive, or collect, for services rendered, fees in excess of 25% of any judgment or settlement.” Fla. Stat. § 768.28(8). Whereas a personal injury attorney might charge 33.3%-40% for other claims, they can only charge 25% for negligence claims against the government or government agents.
Together, these things can serve as deterrents to lawyers otherwise qualified to handle such claims but don’t.