The Sixth Circuit Court of Appeals reversed a grant of summary judgment to Southern Health Partners, Inc. (SHP) in a civil rights action alleging the company failed to train and supervise its nurses at Kentucky’s Hopkins County Detention Center (HCDC), which violated a deceased prisoner’s constitutional right to adequate medical care.

The lawsuit involved the death of Tyler Butler, 25, just three days after he was booked into HCDC on April 8, 2010 pursuant to a court order. A deputy did not want to admit him due to his sickly appearance and reported MRSA infection. SHP nurse Candace Moss, who was scheduled to change shifts in 30 minutes, was asked to make a decision on booking Butler.

Moss was shown various infections on Butler’s body, legs and groin areas. She instructed deputies to admit him, and had him placed on 72-hour detoxification for drug use and medical watch for the staph infection. Other than having his blood pressure checked three times and receiving five pills unrelated to his MRSA infection, Butler received no medical care before he was found unresponsive in his cell on April 11, 2010. An autopsy concluded his death was caused by sudden cardiac arrhythmia due to sepsis, a complication of MRSA.

Butler’s mother, Cindy Shadrick, filed suit. The federal district court granted summary judgment to SHP, and Shadrick appealed. The Sixth Circuit was presented with two questions: whether genuine issues of material fact remained on the claim that SHP failed to train and supervise its nurses and sufficient evidence existed to proceed on a negligence theory, and whether SHP was entitled to governmental immunity.

The evidence indicated that SHP did not have a training program. “The lack of training and supervision by SHP is clearly evidenced by the blanket inability of the LPN nurses who worked at HCDC to identify and discuss the requirements of SHP’s written policies governing their work,” the Court of Appeals wrote. “The nurses professed ignorance of the written medical treatment protocols and policies purportedly drafted by SHP to guide their conduct.”

“Most troubling is the admission of Angela Pleasant, SHP’s on-site nursing manager at HCDC, that she was not familiar with the SHP policies she was specifically designated to enforce,” the Court added. “Key here also is her open acknowledgement that SHP nurses followed an undocumented policy and custom of providing assistance only if an inmate asked for it, despite ... policies ... mandating that nurses take particular actions at particular times.”

The appellate court further noted that SHP President Jennifer Hairsine was “not college-educated or medically trained, and she could not explain the differences in the permitted scope of medical practice for LPNs and RNs. Rather than provide training and supervision necessary to insure that LPN nurses acted within the scope of practice, SHP expected the nurses to define that scope for the company.”

Those facts, the Sixth Circuit determined, could enable a jury to find SHP had failed to train and supervise its LPNs and was deliberately indifferent to Butler’s medical needs, and that those deficiencies were the underlying cause of his death. As such, the Court of Appeals held SHP was not entitled to governmental immunity, and the district court’s order was reversed. One appellate judge issued a dissenting opinion. See: Shadrick v. Hopkins County, 805 F.3d 724 (6th Cir. 2015).

Following remand, the case proceeded towards trial with the district court entering a lengthy order concerning the parties’ motions in limine on August 31, 2016. Among other issues, the court held the plaintiffs could not present evidence that two SHP nurses named as defendants in the case had settled the claims against them through an offer of judgment; further, the plaintiffs were prohibited from introducing evidence of other suits filed against SHP related to prisoner medical care. “However, evidence of other lawsuits may be used as impeachment if Defendant opens the door to such an inquiry by arguing that SHP was not aware of the deaths of other inmates,” the district court wrote.

The case remains pending with a trial date scheduled in April 2017. See: Shadrick v. Southern Health Partners, Inc., 2016 U.S. Dist. LEXIS 118431 (W.D. Ky. 2016). 

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