Jails required to provide health care can delay or offer only modest help. Is it illegal?

Medical staff can avoid treatment till an inmate's release. Prisoners’ lawyers say that's breaking the law.

  • Joseph Darius Jaafari/PA Post

For a moment, Nakila Viney smiled while talking about her husband, Eric.

“He always was, just, so happy, which is exactly why I knew something was wrong when he wasn’t cracking jokes,” she said, referring to her phone calls to Eric while he was incarcerated.

She stopped smiling, grabbed for a tissue and continued, “I’m confused how anyone could watch someone like that die. And not do anything. How can you treat another human being like that?”

Eric was arrested in July on drug trafficking charges. When medical staff at the Montgomery County Correctional Facility examined him, Eric told them he had hyperthyroidism, a severe medical condition that affects a body’s metabolism and can result in organ failure.

The medical staff made note of it. But over three weeks of Eric’s pre-trial confinement, the jail’s medical doctor only saw him  a handful of times, according to a lawsuit filed against the county and the jail’s medical provider, PrimeCare Medical, Inc.

During that time, Eric’s weight fluctuated, gaining and losing over 20 pounds. When his eyes turned yellow – a sign of liver failure – Eric was not rushed to a hospital. Instead, the lawsuit says, it was another two days before the jail sent Eric to an intensive care facility. He was put on life support for 100 days, and later died from complications due to his illness.

In her lawsuit, Nakila and her lawyer argue that the jail and PrimeCare’s practices amount to deliberate indifference, a legal terminology that says the jail’s medical staff knew there was something wrong with Eric but decided to do nothing.

“They simply ignored his worsening symptoms,” the lawsuit says. PrimeCare denied the charges in a response to the complaint filed yesterday. The company said Viney’s treatment “conformed to the applicable standard of care.”

Courtesy of Nakila Viney

Nakila Viney takes a photo with her husband, Eric (left), and children. Eric died in 2018 from hyperthyroidism. Nakila is suing Montgomery County, saying that the jail ignored her husbands medical condition.

Montgomery County’s Warden, Julio M. Algarin, did not respond to an email or phone call requesting comment.

The legal hurdle for deliberate indifference is higher than the bar set for proving medical malpractice. By law, jails are required to provide adequate medical care to all inmates, regardless of their condition. But the main differentiator for judges to assess if malpractice or neglect occurred is often predicated on time.

For lawyers who specialize in representing prisoners’ medical suits, delaying treatment is a common complaint and grounds for a lawsuit.

“Sometimes what is necessary is for the medical care to be timely,” said Su Ming Yeh, interim executive director of the Pennsylvania institutional Law Project, a nonprofit organization that represents inmates in civil suits. “Timeliness is a part of adequate medical care.”

But county correctional facilities rarely house inmates for long periods of time, making it more difficult for plaintiffs to prove indifference.

“Prisoners in jails are there for an undetermined amount of time,” said Nicholas Scharff, former chief of clinical services at the Pennsylvania Department of Corrections. “So, if somebody needs a hip replacement, but he’s going home in, you know, a week or two, it’s not deliberate indifference for the provider to say this can wait till you get out.”

In other instances, because jails simply don’t have the resources to provide adequate care, inmates wait till they are transferred to a state prison. In one instance, as originally reported by PA Post, an inmate with cancer was denied treatment in the Lebanon County jail; she could only start receiving treatment after she was transferred to state prison in Muncy.

“There is a formal agreement between the state and the counties that if a patient is beyond the capacity of a jail to care for, they can be transferred to a state facility where they can be cared for. And that is appropriate and necessary,” Scharff said.

Lack of resources may make it challenging for jails to provide adequate care, but it’s no excuse for poor care, said Amy Fettig, director of the ACLU’s National Prison Project. Unfortunately, she said, there is little practical oversight of how inmates receive health care. As a result, organizations like hers must take a stand for inmates who have little recourse against their jailers.

“You have to remember, who’s watching them, right?” she said. “The law is only as good as its enforcement. And unfortunately, in this country, we’re relying on private attorneys to enforce that law and that standard.”

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