In a September 6, 2012 unpublished ruling, the Eleventh Circuit Court of Appeals affirmed a jury verdict that found Corizon Health, Inc., formerly Prison Health Services (PHS), had a policy or custom of refusing to send prisoners to hospitals. The appellate court also held it was reasonable for the jury to conclude that PHS delayed treatment in order to save money.

At issue was the appeal of Corizon, which had a contract to provide medical services to prisoners at Florida’s Lee County Jail when the company was still known as PHS. The appeal followed a jury verdict that awarded $1.2 million to former prisoner Brett A. Fields, Jr., who also received $189,051 in attorney fees and costs.

When Fields, 24, entered the jail on July 6, 2007 to serve time on two domestic violence misdemeanor charges, he was by all accounts healthy except for a bump about half the size of a tennis ball caused by a spider bite. Medical staff sent him to an isolated part of the jail and he was treated for a staph infection.

On July 14, the lesion remained open and Fields complained. He again complained on July 24 that the medication he was prescribed was “not helping the open wound.” The reason for that was because Fields had MRSA, and standard antibiotics were ineffective. He was then sent to an area of the jail that dealt with MRSA infections, where he continued to receive “lax treatment.”

Fields felt his back grow sore and numb on August 6, 2007. “At first, as the young and healthy are apt to do, Mr. Fields swiped all concerns away,” the Eleventh Circuit wrote.
The next day he experienced uncontrollable twitching affecting his legs, and dealt with the pain for six hours. A little after midnight Fields could no longer stand the pain, and he and his cellmate hit the cell’s emergency call button “hundreds of times.” A nurse finally showed up, but she told Fields she could do nothing until a doctor examined him in the morning. When Fields and his cellmate kept pushing the emergency button to get help, a guard ordered them to stop.

On the morning of August 8, 2007, Fields dragged himself to the shower. He collapsed when his legs gave out as he tried to return to his cell. When he was unable to get up, other prisoners summoned help; guards and nurses appeared, and Fields was hoisted into a wheelchair and taken to the medical unit.

A nurse examined him, noting he complained he could not walk. Physician’s Assistant Joseph A. Richards, Jr. also examined Fields and found he had no reflex or pain reaction in his legs or feet. Although he realized it was a medical emergency, Richards merely gave Fields some Tylenol and, upon a nurse’s recommendation, placed him in a medical cell.

Fields explained his symptoms and begged every nurse that came by his cell that day for help. “Like clockwork, or maybe as if by pact, all the nurses agreed on the same approach: they did nothing,” the Eleventh Circuit noted.

Shortly after midnight on August 9, 2007, Fields tried to use the bathroom for the first time in days. Nurse Bettie Joyce Allen responded to Fields’ pleas for help after he felt his intestines protruding from his rectum as he crawled to the toilet. Allen “jerked Mr. Fields’ body, obtained some K-Y Jelly, and pushed the intestines back in.”

Allen called Fields a liar when she was done because she said he should feel pain if he had not used the restroom when she moved his legs. Fields told her he was numb from the waist down. He was then moved to an observation room, but Allen said she did not examine him further. It was not until later that morning that Fields was seen by Dr. Noel Dominguez, who immediately ordered him to be taken to an emergency room. It was another two hours, however, before an ambulance was called.

Emergency room doctors ordered an MRI, which revealed an abscess was compressing Fields’ spine. Within hours it was removed by surgery. By then permanent nerve damage had resulted and Fields was partially paralyzed from the waist down. An expert witness agreed that an abscess that compresses the spine must be removed within 24 hours for a patient to stand a good chance of recovery from paralysis.

Fields subsequently filed suit against PHS, Allen and Richards, and a jury awarded $700,000 in economic damages and $500,000 in punitive damages against PHS on March 17, 2011. The jury found the company had a custom or policy of refusing to treat prisoners in order to save money. [See: PLN, Aug. 2011, p.24; April 2010, p.19].

On appeal, the Eleventh Circuit found Allen’s definition of emergency, which the rest of PHS’s staff also followed, was restricted to life-or-death situations. The jury could reach this conclusion based on the nurses’ failure to respond to emergency call buttons, refusal to treat Fields until a doctor examined him, and evidence that other prisoners with partial paralysis were placed in observation cells to await a doctor.

The Court of Appeals held that paralysis is a serious emergency that constitutes a serious medical need. The fact that PHS supervisors yelled at nurses because they sent prisoners to the hospital allowed the jury to conclude that delayed treatment was to save money by reducing costs. Thus, the jury could also conclude PHS had “implemented a policy while knowing that the policy would exacerbate [an] inmate’s paralysis,” making the company deliberately indifferent to prisoners’ serious medical needs.

The testimony at trial indicated that Fields’ paralysis could have been avoided had PHS treated him in a timely manner. Indeed, “The doctors at trial testified that no medical justification existed for not sending Mr. Fields to a hospital and that any person with medical training would have known that Mr. Fields required medical help.” As such, the Eleventh Circuit affirmed the lower court’s judgment and the $1.2 million jury award. Fields was represented by Ft. Lauderdale attorney Gregg M. Lauer. See: Fields v. Corizon Health, 490 Fed.Appx. 174 (11th Cir. 2012) (unpublished).

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