In a case with enormous implications for Oklahoma jail detainees, the state Supreme Court ruled on March 11, 2025, that a jail’s subcontracted medical providers are “employees” for the purposes of the Oklahoma Governmental Tort Claims Act (GTCA), O.S.Supp.2014, §152(7)(b)(7), and are therefore immune from liability.

That ruling ended an attempt by the Estate of Brenda Jean Sanders to hold officials liable for her death at the Creek County Jail in November 2016. The suit that Sanders’ Estate filed was initially dismissed by a state trial court which found that the jail’s contracted medical provider, Turn Key Health Clinics, LLC, was immune under GTCA. The state Court of Civil Appeals, Division II, reversed that decision, and Defendants appealed. The state Supreme Court then vacated the appellate ruling.

First, the Court found that the trial court’s dismissal was not a final appealable order because the Estate could have amended its complaint, though it did not do so. That made the appeal untimely. The governing state statute, 12 O.S. §2012(G), provides an exception for untimely appeals only “in cases of excusable neglect,” the Supreme Court noted, “but no exception expressly exists in §2012(G) for an interlocutory order ripening into a ‘final judgment of dismissal’ by mere lapse of time.”

The Court then exercised its authority to recast the appeal as a petition for a writ of prohibition to prevent enforcement of the trail court’s dismissal order. But it agreed with the trial court’s initial ruling, finding that Turn Key was immune under GTCA. In its analysis, the Court acknowledged that its own case law expressly held that “[a] private entity … is not an ‘entity designated to act in behalf of the state or a political subdivision’ merely because it contracts with a public trust to provide services which the public trust is authorized to provide,” quoting Sullins v. Am. Med. Response of Okla. Inc., 2001 OK 20, 23 P.3d 259. But the Court found an exception to that rule in 51 O.S. §152(7)(b)(7), which provided that “licensed medical professionals under contract with city, county, or state entities who provide medical care to inmates or detainees in the custody or control of law enforcement agencies” are “employees of the state” for GTCA purposes. 

As a result, the writ of prohibition was denied, leaving the trial court’s dismissal in effect. Before the Supreme Court, Plaintiff was represented by attorneys Charles L. Richardson and Colton L. Richardson of Richardson Richardson Boudreaux in Tulsa. See: Sanders v. Turn Key Health Clinics, 2025 OK 19.

Another Jail Death, Another Suit

Meanwhile, pending the outcome of Sanders’ case, another suit over another jail death had been stayed in the federal court for the Middle District of Oklahoma. That case dates to 2018, when Michelle Ann Caddell was incarcerated at the Tulsa County Jail, where Tum Key Health Clinics was contracted to provide medical care. 

Beginning in June 2019, Caddell submitted multiple sick-call requests, complaining of vaginal discharge and pain in her hip and thigh. She was seen over the next month by a doctor who ordered tests, results of which indicated an elevated white blood cell count and heavy bacterial growth. Yet Caddell was only given Tylenol. Over the following month she repeatedly complained of excessive vaginal bleeding as well as pain with bowel movements. The Turn Key physician overseeing her care, Dr. Gary Myers, denied her request for more pain relievers and accused her of “abusing the [sick call] system.”

In late September 2019, Caddell was finally examined by an obstetrician, who ordered a pap smear. The test indicated cancerous cells. Yet a follow-up that was ordered was never conducted. Caddell did not receive any treatment or see a doctor for almost the entire month of October; by that time “she was soaking through a [menstrual] pad from heavy bleeding every 20 minutes and began discharging tissue from her vagina,” as her Estate’s complaint later recalled.

She was then sent to a hospital, which diagnosed Stage 3 cervical cancer and gave her morphine for her extreme pain. Caddell was released from the jail’s custody on November 5, 2019—presumably so the County and Trn Key would not be responsible for the cost of her cancer treatment—and she died 10 months later. Representing her estate, Yolanda Lucas filed suit in the federal district court, but it granted Defendants’ motion to dismiss, finding no constitutional violation because Caddell had not been denied any medical treatment. That court also dismissed state-law claims, finding that Dr. Myers was immune under the GTCA. 

But as PLN reported, the U.S. Court of Appeals for the Tenth Circuit partially reversed that decision in January 2023. “Treatment with Tylenol and accusing Ms. Caddell of fabrication was not only woefully inadequate but also plainly inconsistent with the symptoms presented,” the Court wrote. “More to the point, Dr. Myers entirely failed to monitor her afterwards to determine if his treatment plan, if it even can be described as such, was working.” The Estate’s constitutional claims were then remanded to the district court. [See: PLN, Sep. 2024, p.1.]

What the Tenth Circuit Found

The Tenth Circuit said that Caddell’s Estate had “plausibly alleged deliberate indifference sufficient to defeat a motion to dismiss” against Dr. Myers. The Defendants conceded that Caddell had a serious medical condition, and the appellate court held that Dr. Myers could be found liable for failing to properly treat that condition, as well as for serving as a gatekeeper who prevented Caddell from receiving treatment or denied access to other providers. The Court found that the district court had incorrectly decided that a “complete denial of care” was necessary to show deliberate indifference; the question was not whether some care was provided, but whether it was proper and sufficient. 

The Court of Appeals determined that Dr. Myers was aware of Caddell’s condition but, despite the abnormal medical test results, had dismissed them as “normal” and did not order follow-up testing. Further, he prescribed only Tylenol and denied Caddell additional painkillers, as well as accusing her of abusing the sick call system. For over two months, despite Caddell’s serious symptoms, he did not see her or provide any treatment. The Tenth Circuit held this went beyond malpractice, and Dr. Myers could be held liable for being deliberately indifferent both personally and as a gatekeeper. 

With respect to Turn Key and Sheriff Vic Regalado, Caddell’ s Estate argued that they were liable under Monell v. Dep’t of Soc. Svcs., 436 U.S. 658 (1978), due to their “cost-cutting policies of under-prescribing and under-administering medication, as well as, delaying transferring inmates to offsite care.” The Tenth Circuit disagreed, noting those allegations “lack[ed] specific facts” and were conclusory as to whether a cost-cutting policy existed and had contributed to Caddell’s deficient medical treatment, or violated her equal protection rights. 

Importantly, with regard to the GTCA, the federal appellate court held that it was premature at the motion-to-dismiss stage to determine whether immunity under that statute applied to private, contracted medical staff at a jail, and remanded that issue to the district court. Caddell’s estate was represented on appeal by attorney Lawrence R. Murphy, Jr. See: Lucas v. Turn Key Health Clinics, 58 F.4th 1127 (10th Cir. 2023). 

On March 12, 2025, the day after the Supreme Court’s ruling, the Estate dismissed its claims against Turn Key Health. Claims against the County, Sheriff Regalado and Turn Key Nurse Practitioner Shirley Hadden were also dismissed on April 28, 2025. The case remains pending against Dr. Myers, and PLN will update developments as they are available. See: Lucas v. Regalado, USDC (N.D. Okla.), Case No. 4:20-cv-00601.  

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