Jail’s 26-Day Delay In Providing Palliative Care States a Claim For Deliberate Indifference

April 24, 2017

The Seventh Circuit Appellate Court reversed dismissal of a deliberate indifference claim. Lula Dixon, mother and administrator of the estate of Kevin Dixon, filed suit following Kevin’s death. Kevin first complained of pain while detained at Cook County’s jail in October 2008. He was seen on December 10, 2008 and received a CT scan the next day, which revealed a tumor next to his trachea. He received a pulmonary consultation 8 days later, and the pulmonologist reviewed the scan, ordered a new scan for January 2, 2009, and scheduled a follow up for January 6. However, Kevin’s health quickly declined in the meantime. By December 30, Kevin was experiencing intense abdominal pain, difficulty breathing, difficulty moving his legs, and inability to use the toilet. When he was taken to the infirmary, the jail’s physician, Dr. Katina Bonaparte, lacked records of Kevin’s earlier test results and consultation. Allegedly, the jail’s record-keeping was deficient and inmate medical files were not updated in a timely manner. Allegedly as a result of the lack of records, Dr. Bonaparte concluded that Kevin was malingering and ordered a psychiatric consultant. Kevin was later returned to his cell with just over the counter pain relief, despite another CT scan which revealed the tumor. Three days later, January 5, he was brought back to the infirmary with severe weakness, bladder and bowel incontinence, and pressure sores on his buttocks. The physician who saw him on arrival transferred him to Stroger Hospital, where he remained until he received a compassionate release from Cook County custody and went home. He died of lung cancer at home in March 2009.

The lawsuit focused on the 26-day delay for Kevin to receive palliative care from the time the jail became aware of his tumor. The plaintiff did not allege that Kevin could have been cured with faster treatment, merely that he suffered during the 26-day period when he was transferred back and forth between the jail infirmary and his cell and was treated as if he was faking his illness. Plaintiff alleged that the jail’s medical records policy – which caused significant delays in entering records into the record-keeping system – caused the delays in providing pain relief and palliative care to Kevin. The Court agreed and found that a predictable result of the poor record keeping was that medical staff were prevented from providing proper care and treatment. In addition the facts alleged involving Kevin’s case, Plaintiff relied on a Department of Justice report condemning the inadequacy of Cook County’s medical care system, a statement from the Chief Medical Officer at Cermak, and the opinion of an expert who headed the DOJ’s investigation of the Cook County system. Based on these allegations, the Court held that a reasonable jury could find that pervasive systemic deficiencies in the detention center’s healthcare system were the moving force behind Dixon’s injury.

Plaintiff also alleged that the actions of a nurse and Dr. Bonaparte in late December stated a claim for deliberate indifference to Kevin’s medical needs. The Court agreed, holding that 6 days (from December 30 to January 5) of intense pain cannot be considered de minimis and stated a claim, even though Kevin’s condition was incurable.

Dixon v. County of Cook

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