The ACLU initiated the lawsuit after commissioning a medical report to investigate conditions at Ely. The investigation, conducted by Dr. William Noel, found “a pattern of gross medical abuse” that threatened the health and safety of the 1,000 prisoners housed at the facility. According to Dr. Noel, “the medical care provided at Ely State Prison amounts to the grossest possible medical malpractice, and the most shocking and callous disregard for human life and human suffering, that I have ever encountered in the medical profession in my thirty-five years of practice.” [See: PLN, June 2008, p.18].
Under the terms of the proposed settlement agreement, the State of Nevada and all named defendants denied having engaged in any culpable conduct but agreed to the appointment of a neutral, expert medical monitor, Dr. Ronald Shansky, for a period of not less than two years. The monitor will evaluate the state’s compliance with the terms of the settlement in six areas: medications, chronic care, sick call, intra-system transfers, off-site medical services and infirmary care.
The monitor will review pertinent documents related to medical treatment, and will interview staff and a sufficient number of prisoners to assess ongoing conditions at Ely.
The monitoring will end after two years, but only if the state has achieved substantial compliance in each of the six areas cited in the settlement. Disputes regarding the extent of compliance and the need for continued monitoring will be subject to binding mediation before a mediator agreed to by both parties.
The ACLU’s lawsuit involved no claim for monetary damages; thus, according to the notice approved by the court, the settlement will not preclude damage claims by individual Ely prisoners. On the other hand, there may be a preclusive effect with respect to medical care-related claims for declaratory or injunctive relief filed before – although, depending on the specific circumstances of the individual prisoner, possibly not after – the lawsuit is dismissed following approval of the settlement.
The terms of the settlement agreement will be implemented via a plan of action based in part on standards established by the National Commission on Correctional Health Care as set forth in the Commission’s 2008 publication, “Standards for Health Services in Prison.”
In the area of medications, the plan of action calls for the monitor to evaluate and propose any necessary changes to the timely dispensing and administration of medications at Ely. The monitor will consider, for example, whether and to what extent increased oversight and accountability mechanisms may be needed to ensure the safe and timely administration of medication. In consultation with the monitor, the defendants will set up a medication dispensing system that complies with the monitor’s recommendations. They shall develop and implement written protocols to help ensure there are no lapses in medication, whether due to a prisoner’s transfer, a need to refill or renew a prescription, or other reasons.
The defendants will ensure that patients refusing medication are provided in-person counseling regarding the consequences of incomplete adherence to a prescribed course of treatment. They will develop protocols for the treatment of acute pain that do not involve placement of the patient in the infirmary, and shall ensure that medication is administered at a medically appropriate time and in a medically appropriate manner, taking dietary considerations into account.
In terms of chronic care, the plan of action calls for the defendants, in consultation with the monitor, to ensure that a health care treatment plan is developed for each chronically ill patient. The treatment plan will include, at a minimum, a written initial evaluation with a plan to achieve good disease control, short and long-range goals that are reviewed and updated at least annually via a face-to-face assessment, regular check-ups at least once every three months, a yearly check-up with a physician if necessary, and laboratory work or other diagnostics as appropriate for the prisoner’s medical condition.
In the area of sick call, the plan of action calls for the defendants to implement any changes proposed by the monitor. Nurses and other practitioners will be properly supervised and perform only functions within the scope of their licenses, a medical doctor will be available at least two days a week, sick call will be available every day of the week in all areas of the prison, and medical kites will be picked up on a daily basis from each unit and triaged no later than 24 hours after receipt.
For intra-system transfers, the plan of action calls for all prisoners entering Ely to be medically screened by a registered nurse or higher-level medical practitioner within 12 to 24 hours of admission. The screening will take place in a confidential setting and ensure that a patient’s HIV status is not inadvertently disclosed.
Concerning off-site services, the defendants will ensure that, when necessary, patients are provided timely access to an outside specialist.
With regard to infirmary care, the defendants shall ensure that all infirmary patients are within sight or sound of health care staff at all times, and that security staff do not provide any routine medical care.
Following a fairness hearing, the settlement was approved by the district court on October 28, 2010, and the plaintiffs were awarded $325,000 in attorney fees and costs. See: Riker v. Gibbons, U.S.D.C. (D. Nev.), Case No. 3:08-cv-00115-LRH-VPC.
Additional source: www.nevadaappeal.com
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Related legal case
Riker v. Gibbons
|Cite||U.S.D.C. (D. Nev.), Case No. 3:08-cv-00115-LRHVPC|