Medical neglect in jails and prisons is more than a healthcare issue; it is a profound civil rights concern. These cases involve deeply entrenched legal challenges, making expertise essential for understanding the nuances. In this Q&A, Guy Fortney, a respected civil rights attorney with Brewster & De Angelis, shares his insights into the complexities of holding jails and prisons accountable for inadequate medical care. With years of experience litigating cases involving institutional neglect, Fortney provides a candid look at the intersection of constitutional rights and medical care in Oklahoma’s correctional facilities.
Why Is It So Difficult to Hold Jails and Prisons Accountable for Medical Neglect?
Jails and prisons, as government entities, benefit from certain legal immunities that complicate accountability. Claims of negligence against these institutions are often constrained by the Oklahoma Governmental Tort Claims Act, which imposes significant limitations on recovery. For a case to succeed, it typically must be brought under federal statute 42 U.S.C. §1983, which permits lawsuits for civil rights violations committed by individuals acting “under the color of law.” §1983 case law is very nuanced and does not provide redress for all wrongs in a jail or prison.
In the medical context, an inadvertent failure to provide adequate medical care cannot be said to constitute “an unnecessary and wanton infliction of pain” or to be “repugnant to the conscience of mankind.” Thus, a complaint that a physician has been negligent in diagnosing or treating a medical condition does not state a valid claim of medical mistreatment under the Eighth or Fourteenth Amendments. Medical malpractice does not become a constitutional violation merely because the victim is a prisoner. To state a cognizable claim, a prisoner must allege acts or omissions sufficiently harmful to evidence deliberate indifference to serious medical needs. The conduct must often be intentional, meaning that the medical provider must have known the consequences of his or her failure to act and intended the result. “Deliberate indifference” is a high standard for recovery from medical neglect in jails and prisons.
Additionally, civil rights cases against individuals often involve issues of 'qualified immunity,' which are difficult to overcome.
What Are Examples of Inadequate Medical Care You've Seen in Your Cases?
Like healthcare in private settings, many times the quality of care that you receive is dependent upon the people delivering the care. Failures to attend to the medical needs of incarcerated individuals can be especially acute because they are dependent upon the jail or prison to provide humane conditions of confinement; prison officials must ensure that inmates receive adequate food, clothing, shelter, and medical care.
When an attitude of indifference arises among medical professionals attending to inmates, all manner of inadequate medical care can occur—often with devastating results for the inmate and their family.
What Types of Cases Have the Best Chance of Success?
Given the difficult and heightened burdens of proof for deliberate indifference among medical providers at jails and prisons, the best chance of success is to hire attorneys who understand this area of the law - civil rights and medical malpractice.
A successful civil rights case often survives motions to dismiss, summary judgment challenges, and appeals before ever reaching a jury. Your best chance of success comes with a team that knows and understands 42 U.S.C.§1983, your constitutional rights, and the course of litigation in this specialized area of law.
Why Is Medical Neglect in Jails and Prisons a Civil Rights Issue?
The U.S. Supreme Court has stated that deliberate indifference to serious medical needs of prisoners constitutes the “unnecessary and wanton infliction of pain,” proscribed by the Eighth Amendment. An inmate must rely on prison authorities to treat his medical needs; if the authorities fail to do so, those needs will not be met. In the worst cases, such a failure may produce physical “torture or a lingering death.”
Denial of medical care may result in pain and suffering which does not serve any penological purpose. This is true whether the indifference is manifested by prison doctors in their response to the prisoner's needsor by prison guards in intentionally denying or delaying access to medical careor intentionally interfering with the treatment once prescribed. This does not mean that every claim by a prisoner that he has not received adequate medical treatment is a violation of the Eighth Amendment.
An accident, although it may produce added anguish, is not on that basis alone to be characterized as wanton infliction of unnecessary pain. Similarly, in the medical context, an inadvertent failure to provide adequate medical care cannot be said to constitute “an unnecessary and wanton infliction of pain” or to be “repugnant to the conscience of mankind.” Thus, a complaint that a physician has been negligent in diagnosing or treating a medical condition does not state a valid claim of medical mistreatment under the Eighth Amendment. Medical malpractice does not become a constitutional violation merely because the victim is a prisoner. To state a cognizable claim, a prisoner must allege acts or omissions sufficiently harmful to evidence deliberate indifference to serious medical needs. Estelle v. Gamble.
How to Pursue Legal Action for Medical Neglect
If you believe that you or a family member has suffered a civil rights violation due to medical neglect in a jail or prison, you should contact an experienced civil rights attorney. Civil rights claims can be difficult to pursue because the failures must amount to deliberate indifference and not simply neglect or negligence. Additionally, the interplay between a civil rights action and a governmental tort claim can make the case unnecessarily complex. An experienced civil rights attorney can evaluate your case with these principles in mind.