Legal and Legislative Updates

By Deana Johnson, JD

Posted on March 3, 2010 – Not All Inmate Lawsuits are Fivolous: A Study of the Complexity of Custodial Death Litigation

When inmate litigation is addressed, reference is usually made to the volume of ludicrous pro se claims that providers working in corrections must expect. However, there is a subset of inmate litigation involving represented cases stemming from a patient’s death. Such cases usually combine both federal Section 1983 claims and state law medical malpractice allegations. For this reason, as well as the complexity of providing care in a correctional setting, inmate death litigation can evolve into protracted, specialized work. 
As the case overview below is designed to highlight, defensible care is often not enough to protect the provider sued over an inmate death: the intertwine of correctional and medical issues can work to create jury issues and increase the value even when the provider took all reasonable steps and complied with the applicable standard of care. The case overview is not based on any single piece of litigation and, instead, combines modified issues from several actual claims.

Case Overview: Inmate-On-Inmate Violence Creates Claims Against Both Correctional Staff and Medical Providers

Underlying Facts

This overview stems from the hypothetical murder of Decedent, a prison mental health patient, by his longtime cellmate (“Murderer”), another mental health patient. Their cell was located in the mental health unit of a large state prison. Both men were being followed by different psychiatrists, as well as case management and social workers. 
The men had been housed together at this prison for 17 months without incident. Murderer had not been violent toward any prison staff or other inmates and had not voiced any intent to harm others during his incarceration. Murderer had expressed on several occasions an intent to harm himself, but had not acted on these statements to the knowledge of the prison staff. He had not received a single disciplinary infraction during this incarceration. 
The crime for which Murderer was convicted and incarcerated was murder. He had killed his longtime domestic partner by repeated stabbing after a night of drinking and arguing. While Murderer had prior convictions, none of them involved violence towards others and, instead, were mostly centered around personal drug use. 
Decedent, likewise, had no history of violence during incarceration. He had been at the prison for almost five years and never had a problem with a cellmate. Decedent voiced only one complaint about Murderer: five days before the murder, Decedent told a correctional officer passing by that he was scared of his cellmate and wanted a transfer. That message was never forwarded to the prison medical staff, and Decedent never made a more formal complaint. In this hypothetical case, Decedent’s family filed suit against numerous different defendants, including corrections staff. This overview, however, centers around the claims against the two mental health doctors treating the men: namely, that they failed to recognize the danger posed by Murderer and failed to protect Decedent when he voiced a concern about his safety.

Discovery Focuses on Issues Other than the Care Provided by the Doctors

Whenever a case involves claims of medical negligence, discovery encompasses both fact and expert witnesses. After the exchange of written discovery, depositions begin. Most lawyers start with the named parties and then move on to other fact witnesses identified during the discovery process. Here, deponents would likely include the correctional officers working the unit at the time of Decedent’s complaint and the time of the murder, the deputy warden over behavioral health, the warden, the person(s) over the mental health department, the policy maker(s) for the mental health department and, of course, all providers who treated Murderer and Decedent. The two defendant psychiatrists would certainly be deposed about their care and treatment of the men. In addition, these sessions would involve close examination of numerous different prison mental health policies, including those that each doctor was alleged to have failed to follow. Most likely, some of the policies would have been in place for years, while others had just been circulated before the murder and may or may not have been reviewed by the doctors prior to the incident. 
Decedent’s counsel would almost certainly try to pit one doctor defendant against the other in order to bolster his expert’s opinions that both fell below the applicable standard of care and acted with deliberate indifference to Decedent’s needs. While juries accept opinions from expert witnesses who seem credible, they are even more likely to believe a defendant provider who accuses a co-worker of malpractice.

While the Doctors’ Care is Defensible, Other Considerations Weigh In to Encourage Settlement

Both doctors would, and should, feel confident in the care provided. In this hypothetical, both providers correctly diagnosed and medicated their patients. Both had continuous follow up with Murderer and Decedent and had no notice that violence would occur. Decedent’s doctor felt especially anxious about being named since he had never even met Murderer and had no involvement in the decision to house him with Decedent. 
These doctors’ common sense continued to raise the question of how they could have predicted such violence when Decedent and Murderer had lived together without incident for an extended time and Murderer had not done anything during his incarceration to even earn a disciplinary infraction. Neither knew that Murderer’s incarceration was due to a conviction for murder of his life partner with whom he had lived for years. 
However, the defense of the case did not rest merely on the care provided by the psychiatrists. The plaintiff’s lawyer was well versed in correctional litigation and focused instead on institutional concerns that led to the housing assignment, lack of communication between the correctional and medical staff, lapse in proof that new policies were received and reviewed and the events of the day of the murder. 
Naturally, both doctors would want to highlight the argument that closer supervision by security would have prevented the murder and that the sole complaint Decedent voiced about his safety during the entire time he lived with Murderer was to a corrections officer. That approach, however, would be dangerous since finger pointing between defendants can anger a jury and increase the value of the case. 
When there are multiple party defendants and complex claims such as presented in this overview, settlement is always an option that the courts want the parties to explore. In this scenario, settlement would be a good option because of the cost of the defense of the multiple defendants, cost of experts, concerns with accusations between defendants and jury sympathy. Of course, unlike the other hypothetical defendants, settlement would directly affect the doctors throughout the remainder of their careers since any such payment would be reported to the applicable medical licensing agency. 
Not settling, on the other hand, could result in a verdict against the providers in excess of their insurance coverage. It would take significant time away from their work both during preparation and the actual trial. A trial is an unbelievably stressful event for everyone, but even more so for the named defendant. To have to sit at a table and watch witnesses discredit your actions takes a serious and often underrated toll on people, especially medical providers who have dedicated their lives to providing care. 
There is, unfortunately, no easy answer to these competing options. The purpose of this overview was to demonstrate the complexities of such cases and to outline why settlement often occurs when, in fact, the providers rendered excellent care. While inmate death litigation may encompass only a small fraction of the overall correctional litigation, it can be a life-altering event for those who are not prepared.

Ms. Johnson is an attorney with Insley and Race, LLC, in Atlanta, Georgia. Readers may contact her at djohnson@insleyrace.com