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Alabama Jail Guards Face Liability for Inaction to Methadone Withdrawal Symptoms

by David M. Reutter

In an unpublished opinion, the Eleventh Circuit Court of Appeals affirmed the denial of qualified immunity to guards in a civil rights action alleging they were deliberately indifferent to a pretrial detainees health issues stemming from methadone withdrawal.

The lawsuit was filed by Whitney Foster, who was booked into Alabama’s Madison County Jail (MCJ) on April 4, 2014. The guards and medical staff at MCJ were aware Foster had been taking 80 milligrams of methadone per day at a methadone clinic.

Within a week of her incarceration, Foster began showing visible signs of methadone withdrawal, as well as elevated blood pressure. Nursing staff with MCJ’s medical vendor, Advanced Correctional Healthcare (ACH), “did nothing to help her.” Instead, guards and nurses accused Foster of “faking” as she slurred her speech, bit her tongue, and exhibited limited control of her body.

By April 21, her condition became “desperate,” and she continued to deteriorate until sent to a hospital on April 23. The complaint alleged that the nine defendant guards and nurses “harassed and ridiculed” her “rather than provide her comfort or adequate medical care.”

On April 22, Foster was found on the floor under her bunk, and a doctor ordered her sent to a hospital “due to signs of a stroke.” She remained in the hospital for three weeks and continues to suffer limited use of her arms and legs, and the repeated stokes and seizures she suffered at MCJ caused permanent neurological deficits and cortical blindness.

She alleged her need for medical care “was such that it would have been obvious to even a layperson that she needed to be sent to a hospital.” Foster further alleged that the guards should have recognized she was not receiving adequate treatment and took action to assist her in receiving the care she needed. The district court denied the motion to dismiss filed by the guards and MCJ’s administrator, Jerry Morrison.

While it is “generally true that a lay correctional officer cannot be liable for medical staff’s diagnostic decisions or be expected to second guess close decisions in most circumstances,” the Eleventh Circuit said it has recognized a “prisoner’s medical situation may in some cases be so obviously dire that correctional officers may be held liable regardless of whether medical personnel are also aware of the situation.” The court found the alleged facts “paint a picture” of a person suffering from extremely concerning symptoms such that her situation was “obviously dire.”

The Eleventh Circuit then turned to the claim against Morrison. Foster sought to hold him liable in his supervisory and policymaking role as MCJ administrator. At the heart of that claim was an allegation that ACH’s contract capped outside medical care costs at $200,000 per quarter and any amount under that was allowed to be taken as profit.

The complaint alleged Morrison and others established an “explicit or implicit agreement, plan and policy of delaying or denying necessary medical treatment to avoid liability for inmate medical bills.” Guards were allegedly trained to defer to ACH personnel even in cases of emergency medical needs and were disciplined if they contacted outside medical personnel.

It was further alleged that ACH “put cost control over inmate health and safety,” and that Morrison was “on notice that their plan was harmful to the health of detainees and jailees.”

The Eleventh Circuit found these allegations were sufficient to support a claim for relief and order denying qualified immunity. The district court’s order denying the defendants qualified immunity was affirmed. See: Foster v. Maloney, 785 Fed. Appx. 810 (11th Cir. 2019) 

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Related legal case

Foster v. Maloney