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Ineffective Treatment of Ohio Prisoner’s Psoriasis Defeats Summary Judgment

The Sixth Circuit Court of Appeals held on July 16, 2017 that an Ohio prisoner presented sufficient evidence to survive summary judgment in a claim that prison medical officials chose a less efficacious treatment method.

Ohio prisoner Kevin Darrah was diagnosed prior to his 2006 imprisonment with Palmo-Plantar-Hyper-Keratoderma (HPK), “a severe form of psoriasis that causes debilitating pain from large and deep fissures that form on the bottom of the feet.” In December 2006, dermatologists in the medical center at the Lebanon Correctional Institution (LCI) examined Darrah and noted his HPK had been treated successfully with Soriatane, and that multiple other treatments had proven ineffective.

Darrah was prescribed Soriatane at LCI, and his medical record showed it was effective and his HPK was “much improved.” He was transferred on January 18, 2011 to Madison Correctional Institution (MCI). At that facility he did not receive Soriatane because it was not listed on the Ohio Department of Rehabilitation and Correction’s (ODRC) drug formulary (list of approved medications). LCI was not regulated by the ODRC’s central pharmacy until March 2012, which is why Darrah did not have issues receiving Soriatane there.

As MCI was regulated by the central pharmacy, medications not on the formulary required prior authorization from ODRC’s Office of Correctional Health Care through a request from an advanced-level provider. For over a year, Darrah did not receive treatment with Soriatane; rather, he was treated with an ineffective drug called methotrexate.

In September 2012, Darrah filed a civil rights complaint alleging that Dr. Krisher, Dr. Andrew Eddy, Dr. David Weil and nurse Karen Stanforth violated his Eighth Amendment right to be free of cruel and unusual punishment by denying necessary medical treatment. The district court granted the defendants’ motion for summary judgment, and Darrah appealed.

The Sixth Circuit’s ruling addressed the potential liability of the defendants, finding each could be held liable. Dr. Weil was the Chief Medical Officer at MCI. Darrah claimed that for the first three months at that facility he received no treatment for his HPK, which constituted a knowing interference with his “prescribed plan of treatment.” The appellate court said Dr. Weil’s “lackadaisical pace” of seeking a Soriatane prescription, prescribing pain medication and issuing a 26-day lay-in during that three-month period did not defeat Darrah’s claim. It also held continuing to treat Darrah for several months with methotrexate without noticeable improvement could exhibit deliberate indifference.

Nurse Stanforth, as MCI’s Health Care Administrator, could be liable for failing to fulfill the requirements of her position by not assisting with the continuity of Darrah’s treatment by an advanced-level medical provider. Dr. Krisher, a member of ODRC’s Collegiate Review Board, knew of the previous success in treating Darrah with Soriatane; thus, he could be found to have disregarded a serious risk of harm. Dr. Eddy, the ODRC’s Chief Medical Officer, could be held liable for forcing Darrah to remain on medication that was inefficient in treating his diagnosed medical condition.

“For the above-mentioned reasons, we hold that Darrah has produced sufficient evidence to establish that a genuine dispute of material fact exists as to whether Defendants Krisher, Eddy, Weil, and Stanforth were deliberately indifferent,” the Sixth Circuit wrote. It further found the defendants were not entitled to qualified immunity, as circuit precedent was “clear that neglecting a prisoner’s medical need and interrupting a prescribed plan of treatment, even for a relatively short period, can constitute a constitutional violation.”

The district court’s summary judgment order was reversed and the case remanded for further proceedings.

See: Darrah v. Krisher, 865 F.3d 361 (6th Cir. 2017). 

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Related legal case

Darrah v. Krisher