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One of the issues that routinely leads to liability in the jail setting is the failure to provide medications that have been properly prescribed either before or during incarceration.

In Prewitt v. Roos, the United States Court of Appeals for the Ninth Circuit reviewed a case where it was alleged that jail officials had failed to properly administer pain medication and follow post-operative instructions after Prewitt’s hand surgery.i  Prewitt had hand surgery while in jail and received discharge instructions from the hospital. “There is no factual dispute that numerous doctors’ prescriptions for Prewitt’s pain medication were deliberately not followed. Nor were ‘several pillows’ provided to Prewitt to ‘lessen swelling,’ as required by his discharge instructions. As a result of the defendants’ interference with Prewitt’s prescribed medical treatment, his pain was allegedly considerably exacerbated. This interference violated Prewitt’s constitutional rights.”

The court rejected the defense that officers were following the jail’s medication dispensing schedule as an excuse for failing to follow the doctor’s orders.  The court held: “a reasonable jury could find on the summary judgment record that the defendants’ reliance on the jail’s medication dispensing schedule is an insufficient justification for the defendants to prevail, particularly in light of the competing directive in the same health care manual that prescribed medication ‘will be administered in the prescribed dosage at the prescribed time.’”

In Benge v. Scalzo, the United States District Court for Arizona applied the Ninth Circuit analysis in a case where a prisoner transferred from the State Prison system was not given the medications that were prescribed in the state prison system for psychological issues, once transferred to the Madison Street Jail.ii

“There is no dispute that Plaintiff received treatment and medication for his mental health condition while at ADC. This gives rise to at least an inference that his condition remained a serious mental health need upon his transfer to the jail. Sines [the nurse] argues that there was nothing to suggest that Plaintiff was depressed or suicidal at the jail (DSOF PP 16, 18), but Plaintiff directly disputes that assertion (Doc. # 58 at 5; PSOF PP 35-38). Further, Defendants do not deny that upon seeing a psychiatrist in December 2003, Plaintiff was prescribed medication for his mental health condition. On these facts, a jury could reasonably conclude that Plaintiff suffered from a serious mental health need.”

It should be noted that the plaintiff went without medication for 423 days before he was finally seen by a psychiatrist who prescribed a similar treatment and medication as he had been receiving while in the state prison system.

“A delay in providing medical treatment does not constitute deliberate indifference unless the delay was harmful. Hunt v. Dental Dep’t, 865 F.2d 198, 200 (9th Cir. 1989) (internal citation omitted); see also Hallett v. Morgan, 296 F.3d 732, 746 (9th Cir. 2002) (Eighth Amendment is only violated if ‘delays occurred to patients with problems so severe that delays would cause significant harm and that Defendants should have known this to be the case’). Sines contends that there exists no record of harm or suicide attempts and points to Plaintiff’s admission that he never told medical or jail staff about overdosing (Doc. # 57, Ex. 25, Pl. Dep. 38:16-19). But Plaintiff testified that when he was treated for throwing-up after he overdosed March 2003, he did not want to tell medical staff the reason he was sick because he feared being placed in a restraint chair, which was often done with suicidal inmates (id., 38:3-9). He testified that after his medication was stopped ‘cold turkey’ upon transfer to the jail, over the next few weeks he became very depressed and then attempted to take his life (Doc. # 59, Ex. A, Pl. Dep. 42:20-22, 43:24-44:9). He testified that he heard voices he believed to be his mother’s and God’s, and he described his condition as ‘almost like trauma’ (id. 52:1-3). Plaintiff testified that in his condition, he decided to follow these voices and reject plea offers and represent himself in his criminal trial (id. 52:7-16). Construing this evidence in Plaintiff’s favor, the lack of treatment caused him to suffer, led to a suicide attempt, and severely affected his decision-making abilities. This is sufficient to raise a material dispute on this prong of the Eighth Amendment claim.”

In ruling on deliberate indifference of the nurse, the court asserted: “This question is not a dispute over the course of treatment, as Defendants argue (see Doc. # 56 at 10). Rather, the dispute concerns the information that formed the basis of Sines’ decision not to recommend medication or a visit with a psychiatrist. Plaintiff’s testimony suggests that Sines ignored pertinent medical information — Plaintiff’s prior ADC treatment and medication regime. Given Sines’ medical training, he would have known the risk to Plaintiff in discontinuing psychiatric medication and treatment. See Steele, 87 F.3d at 1268-70 (jury could find deliberate indifference where psychiatrist discontinued a transfer prisoner’s psychotropic medication without reviewing the prisoner’s medical records or consulting the former prison facility medical staff). Plaintiff has raised a question of fact as to whether Sines acted with deliberate indifference.”


i Prewitt v. Roos, 160 Fed. Appx. 609 (9th Cir. 2005).

ii Benge v. Scalzo, 2008 U.S. Dist. LEXIS 40782 (Dist. Ariz. 2008).

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