by Matt Clarke

On August 24, 2021, the U.S. Court of Appeals for the Eighth Circuit held that private companies providing health care for prisoners are not entitled to assert qualified immunity or appeal its denial.

The underlying case was filed in U.S. District Court for the Western District of Missouri by Brenda Davis and Fred Stufflebean after the death of their son, Justin A. Stufflebean, at the Buchanan County Jail (BCJ) on November 16, 2015. The 27-year-old had been held at the jail for the Missouri Department of Corrections (DOC) since his October 2015 sentencing for statutory rape.

During his sentencing hearing, Stufflebean’s physician testified that he suffered from Addison’s disease and hypoparathyroidism, endocrine disorders that “flare up” periodically, depress blood calcium levels, and can cause death in 24 to 48 hours if untreated. County Sheriff’s Deputy Brian Gross was present at the hearing and, afterward, walked Stufflebean across the street to the jail.

There, based on questions Gross answered, a fellow deputy, Dustin Nauman, entered “No” to answer intake form questions as to whether Stufflebean was:

• a medical, suicide, or mental health risk now;

• currently under a physician’s care; or

• a medical, mental health, or suicide risk during a previous incarceration at the jail.

Stufflebean had been incarcerated at BCJ after his arrest the previous year and classified then as “Special Conditions—Medical.” Nauman recorded Stufflebean’s list of medications and ailments, but not his prior classification, making a referral to the medical department instead.

During his three-day stay at the jail, Stufflebean saw several nurses and a doctor, all of whom were employed by Advanced Correctional Healthcare (ACH), the jail’s privately contracted provider of prisoner heath care. His mother dropped off his medications, but no one ensured that he got them, even after he sent in written requests.

Stufflebean was then transferred to DOC’s Western Reception Diagnostic and Correctional Center (WRDCC), telling the on-duty nurse there that he was suffering from severe symptoms of his disease, including elevated heart rate, vomiting, and weakness. She recorded he was lethargic and had a weak gait, but she did not see that he received any medication. He continued not to receive any even after multiple medical emergency calls made on his behalf by the prison’s privately contracted health care provider, Corizon Health.

During his third day at the prison, Stufflebean collapsed, had no heartbeat, and was taken to a hospital, where he died two weeks later. Meanwhile, his mother went to retrieve his belongings from BCJ and discovered among them his medications, which he had not been given at either BCJ or WRDCC.

After Stufflebean died, his parents filed a federal civil rights action under 42 U.S.C. § 1983 against the sheriff, the jail captain, ACH, Corizon Health, and other jail and medical staff, claiming they had denied their son medical care and were liable for his wrongful death. Defendants moved for summary judgment, which the district court granted to all but Corizon Health, ACH, four of their medical personnel and deputies Gross and Nauman. Those defendants then appealed to the Eighth Circuit.

Taking up the case, that Court held that, although ACH and Corizon Health were state actors for the purposes of 42 U.S.C. § 1983, they were not entitled to raise the defense of qualified immunity (QI). For one, QI has historically not been available to privately employed medical personnel, as the U.S. Supreme Court and six other circuits have held, the Court noted. Further, QI is not available to employees of “systematically organized private for-profit firms, tasked with assuming a major lengthy administrative task” for the government.

The Court noted that the main policy consideration for giving government officials QI—avoiding unwarranted timidity in the performance of public duties—simply did not apply to private companies. Marketplace pressures would presumably prevent unwarranted timidity by private company actors.

Other policy considerations—attracting qualified candidates to public service and preventing harmful distractions—were also inapplicable, the Court said. Private medical personnel were free to choose other work that did not expose them to liability for government actions, yet even so were under the risk of the distraction of litigation while in private practice.

If private prisoner medical care providers are not entitled to raise a QI defense, the Court was without jurisdiction to hear their interlocutory appeal or that of their employees. Thus those appeals were dismissed for lack of jurisdiction.

The district court had also denied QI to Deputy Gross and Deputy Nauman, saying they failed in their “ministerial duty” to record what they knew of Stufflebean’s medical condition. But the Court said Gross was not performing a ministerial duty when answering the question whether Shufflebean was a risk now. That was a “discretionary duty,” so he was entitled to QI. As for Nauman, the Court said it was presented insufficient evidence about his access to records from Stufflebean’s previous incarceration to make a call on his performance of his ministerial duty, so a jury would have to do that.

Turning to the Sheriff and jail captain, the Court agreed with the lower court that they were entitled to QI as they exercised little direct oversight over ACH. Remarkably, the Court also determined that neither was on “notice of a pattern of conduct by the subordinate [contractor] that violated a clearly established constitutional right”—despite two prior lawsuits alleging the same denial of medication.

“It is unlikely that two allegations of inadequate care by two inmates can put a supervisor on notice of systematic failures,” the Court said, and it remanded the case for further proceedings consistent with its opinion. See: Davis v. Buchanan County., 11 F.4th 604 (8th Cir. 2021).

Defendant health care providers filed for a writ of certiorari from the U.S. Supreme Court to hear an appeal of their denial of QI, but that motion was denied on January 10, 2022, leaving the Court’s decision to stand and returning the proceeding to the district court. See: Munger v. Davis, 2022 U.S. LEXIS 56.

Davis and the elder Stufflebean are represented in their suit by attorneys William W. Bird of Bird Law Firm in Liberty, Pamela Kay Blevins of the Law Office of Pam Blevins in St. Joseph, and Michelle Dee Carpenter of Kranitz & Sadoun in St. Joseph.  

Additional Source: St. Joseph News-Press

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