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Fifth Circuit: 12-Hour Delay in Treating Texas Prisoner’s Stroke Wasn’t Deliberate Indifference

by David M. Reutter

On May 5, 2023, the U.S. Court of Appeals for the Fifth Circuit affirmed dismissal of a Texas prisoner’s civil rights complaint that alleged prison staff delayed and impeded his access to emergency medical care after the onset of his stroke symptoms. The Court found the prisoner brought claims of malpractice that fell short of a deprivation of constitutionally secured rights.

The prisoner, Albert L. Thompson, Jr., suffered a brain stem stroke at approximately 10:30 a.m. on January 11, 2017. Fifteen minutes later, he told his prison’s medical staff about his symptoms, which included trouble swallowing. But when nurses took his vitals, they found nothing unusual. They declared he was faking and ordered him to leave the clinic.

His condition worsened. Another prisoner called his sister to inform her of the situation. She repeatedly called prison officials over four hours. Meanwhile Thompson was threatened with disciplinary action if he returned to the clinic again, after going to complain of a ‘stiffening’ face. He returned a third time anyway, but a nurse who examined him again found nothing abnormal. Thompson was placed in a holding cell for another hour and a half without treatment.

After Thompson returned to the clinic, his sister called 911. An ambulance arrived at the prison at 8:40 p.m. Emergency medical technicians (EMTs) insisted on examining Thompson despite prison officials’ claims that he had been treated and was faking. The EMTs determined that Thompson required hospitalization and departed without him around 9:15. At 10:50 p.m., Thompson was transported to a hospital via prison van.

At the hospital, he was diagnosed with a brain stem stroke and severe dehydration—he had been unable to swallow liquids for more than 24 hours. He remained hospitalized for several weeks. In his pro se federal civil rights complaint, Thompson alleged the 12-hour delay in emergency medical care resulted in central post-stroke pain, neuropathic nerve issues on his right side, facial disfigurement on his left side, and a fall due to dehydration, among other consequences. The District Court for the Southern District of Texas dismissed the complaint as frivolous, finding Thompson received adequate care after transport to the hospital and that his claims prior to that amounted to negligence, not to a constitutional tort. Thompson appealed.

The Fifth Circuit found that Thompson’s pleading lacked facts to indicate that Defendants—other than three nurses—subjectively knew of a risk to his health. So they couldn’t be guilty of deliberate indifference to a serious medical need they were unaware of. As to those three nurses, there was “no indication in the pleadings that medical staff continued to recognize a risk of harm to Thompson following … evaluations [of him], or that staff would have declined medical care had they recognized his condition as requiring activation of emergency protocols.” The Court recognized that under the alleged facts, “medical staff likely should have identified Thompson’s emergency medical issue but failed to do so.”

With that, the district court’s order was affirmed except for denial of Thompson’s motion to unseal the Martinez report and the accompanying medical records. While the district court has discretion to seal records, it failed to “balance the public’s common law right of access against the interests of disfavoring nondisclosure,” the Fifth Circuit said. Thompson waived his privacy interest “with the competent and specific intent that his confidential information be openly shared with the public.” Since the district court gave no reasons to continue to seal those records after that waiver, the case was sent on a limited remand to address the motion to unseal medical records. See: Thompson v. Tex. Dep’t of Crim. Justice, 67 F.4th 275 (5th Cir. 2023).  

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Related legal case

Thompson v. Tex. Dep’t of Crim. Justice