Failure to Adopt Policy to Coordinate Medical Care May Constitute Deliberate Indifference

March 14, 2017

In the Seventh Circuit’s recent en banc decision in Glisson v. Indiana Department of Corrections, No. 15-1419 (7th Cir. Feb. 21, 2017), the Court held that a private medical corporation, contracted to provide medical services for the Indiana Department of Corrections (INDOC), could be held liable for its failure to enact policies and practices which would provide a formal coordination of medical care for chronically ill inmates. Nicolas Glisson suffered from liaryngeal cancer, hypothyroidism, depression, and memory issues. He had his larynx removed prior to his incarceration and was left with a permanent stoma (opening in his throat) into which a tracheostomy tube was normally inserted. He needed a voice prosthesis to speak and wore a neck brace to prevent his head from slumping forward in a way that impeded breathing. He had a gastrojejunostomy tube (G-tube) in his upper abdomen to assist with his nutritional intake. Glisson was sentenced to the INDOC after his conviction on drug charges.

Glisson’s family brought his neck brace, suction machine, mirror and light that he used for his trachoestomy to the county jail, but these items were never transferred with Glisson to the INDOC. When he arrived at the INDOC, he was seen by several medical providers, but no one coordinated his care or reviewed his medical history. He was later transferred to another facility where he again received disjointed medical care. All of the providers had little contact with Glisson and, each standing alone, were not deliberately indifferent to his care and treatment. However, no provider developed a medical treatment plan, checked his progress against his admission status, or even reviewed his medical history. Within weeks, one of the physicians noted that Glisson was cachectic, which means undernourished to the point of physical wasting and loss of weight and muscle mass. His mental and physical health further deteriorated and, after a brief hospital stay, Glisson died in prison approximately a month after he was transferred to the INDOC.

Glisson’s estate filed suit against INDOC and Correctional Medical Services, Inc. (Corizon), the INDOC’s contracted medical provider. The plaintiff argued that the INDOC and Corizon failed to develop a medical treatment plan or coordinate Glisson’s care. The plaintiff did not sue any individual medical providers, but attacked the lack of any coordination of care. The Court assumed that none of the physicians, nurses, and other medical providers who treated Glisson during his stay were, individually, deliberately indifferent to his medical needs. Rather, the Court found that an organization (private or public) may be liable under the Eighth Amendment where its institutional policies are deliberately indifferent to the quality of care provided. The Court explained that here, Corizon was admittedly familiar with INDOC Guidelines as they related to chronic disease intervention; yet, its providers failed to take any steps to integrate the growing body of evidence of Glisson’s plummeting mental and physical health. Because a jury could find that Corizon’s decision not to enact centralized treatment protocols for chronically ill inmates let directly to his death, the district court’s grant of summary judgment was reversed and the case remanded.

Glisson v. INDOC No. 15-1419

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