by David M. Reutter
Twice in July 2022, the federal court for the District of Arizona spanked Centurion of Arizona, healthcare provider for the state Department of Corrections (DOC), issuing injunctions to correct mismanagement of prisoner medication.
On July 1, 2022, the Court issued a preliminary injunction requiring the state to keep a state prisoner hospitalized for treatment of his Valley Fever, after his medications were inconsistently administered by Centurion. That order came just two weeks after another injunction the Court issued on June 17, 2022, finding Centurion mismanaged medication for another state prisoner’s gastroesophageal reflux disease (GERD) and ordering surgery for him.
The first case was brought by Christopher Brightly, a prisoner serving a sentence for aggravated DUI. He was first transported to a hospital emergency room with spinal meningitis in June 2019. The disease had been caused by Valley Fever, a fungal infection of the lungs becoming more common as climate change dries out the southwestern U.S.
When Brightly was discharged three weeks later, he was placed on anti-fungal medication to stave off a relapse of Valley Fever. He returned to the Arizona State Prison Complex in Tucson, just as DOC changed over to Centurion from its previous healthcare provider, Corizon Health.
Brightly then allegedly experienced problems getting his medication. Doses were missed. Others were provided in half the prescribed quantity. With the aid of Tucson attorney Stacy E. Scheff, he filed suit in the Court in March 2021, seeking to force DOC and Centurion to put him in a hospital so he could get the medication he needed, when he needed it.
His first two requests for an injunction were denied on August 12, 2021, and January 4, 2022. After that, Brightly got better at recording instances when he did not receive his medication or received only half doses. He was hospitalized again for 22 days on March 2, 2022, and for one more day on April 8, 2022. Beginning April 22, 2022, Brightly was moved to three prisons over 49 days, missing more medication. He returned to a hospital on June 7, 2022, transferring to the DOC unit at Florence Anthem Hospital 20 days later.
Taking up Brightly’s third request for an injunction, the Court found it met the requirements laid out in Winter v. Natural Res. Def. Council, Inc., 555 U.S. 7, 24 (2008): His case is “likely to succeed on the merits” and he is “likely to suffer irreparable harm without an injunction”; also “the balance of equities” tips in his favor, since “possibly his life is at stake,” the Court said, while it will merely “cost Centurion more money to comply with [an injunction],” so that’s “not a close call”; and finally an injunction “is in the public interest,” which the Court said is clearly not served “by forcing Plaintiff to miss or receive underdosed medications.”
Moreover, Brightly met the additional burdens placed on prisoner injunctions by the Prison Litigation Reform Act (PLRA), 42 U.S.C. § 1997e: Transfer to a skilled nursing facility was unlikely to “affect public safety,” the Court said, given his non-violent conviction and his “feeble and bedridden” condition; and the order is “narrowly tailored” to mitigate the harmful medication disruptions caused by Centurion’s lapses and DOC’s frequent moves.
Granting the injunction, the Court said that until Centurion could provide a Medical Plan for Brightly that the Court approved, Defendants were also temporarily restrained from discharging him from the hospital to anyplace except a skilled nursing facility. See: Brightly v. Corizon Health, Inc., USDC (D. Ariz.), Case No. 4:21-cv-00127.
The second case was also brought by attorney Scheff on behalf of another client, Arron Shawn Bossardet, who is serving a life sentence for murder in DOC. However, his case has a longer procedural history; dating back to 2017, it includes court-ordered sanctions against Corizon Health for discovery violations in 2019. [See: PLN, Aug. 2019, p.50.]
Bossardet has suffered GERD with worsening symptoms over the last 20 years. One of those symptoms, a hiatal hernia, was diagnosed in July 2020. Surgery was recommended then and again the following November. After a surgical consult confirmed this necessity in January 2021, the procedure was canceled by Centurion staff on April 6, 2021. Bossardet then filed that November for an injunction to get the surgery.
In reply, Centurion Associate Medical Director Dr. Murray Young told the Court that prescription alternatives to surgery would be effective. But the Court was unpersuaded, since Bossardet often did not receive his prescribed medications or received only half doses. Moreover, Young was not a specialist and had never examined Bossardet. Noting Young’s “minor discrepancies” in documenting the prisoner’s medications, the Court said they “raise questions regarding the accuracy of Dr. Young’s record review and his familiarity with medications used in GERD treatment.” Therefore his opinion was not considered “competent counter to the recommendations of two treating specialists who have conducted thorough examinations of and testing on Plaintiff.”
Whereas “Centurion has now twice refused to follow the specialists’ recommendations, and these denials were based on determinations made by non-treating, non-specialist physicians,” the Court said, Plaintiff “establishes that he is currently suffering painful and worsening symptoms of GERD that affect his daily activities and interrupt his sleep.”
“Absent specialist-recommended surgery, Plaintiff continues to suffer,” the Court continued, and “his present pain and suffering are sufficient to support irreparable injury.”
Finding all other factors needed, the Court granted the preliminary injunction, giving Centurion seven days to schedule surgery. See: Bossardet v. Centurion Healthcare, USDC (D. Ariz.), Case No. 4:21-cv-00179.
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