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Recent Case Highlights Risk Management Tips for Correctional Healthcare Providers

A complaint was  recently filed against law enforcement officials and a correctional healthcare company in the Northern District of Texas, Wichita Falls Division, alleging that local law enforcement officials and the correctional healthcare company failed to timely respond to the medical needs of a pregnant inmate.  While  the facts of the case may  obviously be in dispute, the complaint does highlight the types of allegations correctional healthcare companies may face and  defend.  The following is a brief synopsis of the allegations in the complaint:
The Plaintiff is a female who was 34 weeks pregnant.  On June 2, 2012 she was arrested by the Wichita Falls Police Department for a possession charge and was booked into the Wichita County Jail.  At the time of her arrest, she had a pending appointment with her ob-gyn, scheduled nine days later.  She was apparently transported to the  appointment, and her ob-gyn listened to the baby’s heartbeat and opined  that the baby was doing fine.  Later that day, while back in the Wichita County Jail, Plaintiff purportedly began experiencing lower back pain, cramps, and other signs of labor.  Subsequently, jail detention officers escorted the Plaintiff to a nurses station where the nurse listened to the baby’s heartbeat and informed the Plaintiff that the heartbeat sounded fine.  Plaintiff asked the nurse if she should be concerned about what she perceived as  warning signs of labor, and the nurse told her to monitor her symptoms and report back if they worsened.
Later that evening, after lockdown, Plaintiff allegedly began experiencing increased symptoms, contractions, and severe lower back pain.  Recognizing that her symptoms had changed, Plaintiff informed the medical emergency staff at 11:00 p.m. but alleges her requests were ignored until 3:30 a.m., an approximate four hour delay.  When the Wichita County jail officials responded, Plaintiff was allegedly not examined but  escorted to a different part of the jail for further monitoring  Shortly thereafter, Plaintiff advised her pain worsened and she began to experience symptoms of active labor.  According to the complaint, Plaintiff began moaning and screaming due to the increased pain and pressure.  The jail officials allegedly ignored her signs and left her in the cell for another 45 minutes.  According to the complaint, around 5 a.m. the Plaintiff went into active labor.  The nurse who originally saw the Plaintiff the previous day walked by the cell where the Plaintiff was in active labor and allegedly dismissed her symptoms.  After that last encounter, Plaintiff’s Complaint alleges she requested an officer to help  determine if she was indeed giving birth.  The officer confirmed that the baby’s head was crowning.    Shortly thereafter, the Plaintiff delivered a baby girl who had a dark purple complexion with the umbilical cord wrapped around her neck.
The Complaint further alleges that the jail officials called emergency services but did not make any attempts to revive the baby.   Emergency services transported  the baby to the hospital which pronounced the baby dead on arrival.  The Plaintiff remained at the facility to finalize the birthing process.
The Plaintiff asserted constitutional and statutory causes of action against the jail and its sheriff.  Further, state medical malpractice claims were made against the individual defendant nurse for  failure to respond to the Plaintiff’s symptoms, and the correctional healthcare company that employed the nurse and provided correctional healthcare services to the  jail.    The Plaintiff alleges that the nurse’s failure to respond to Plaintiff’s medical needs was the proximate cause of the death of her child.  Lastly, the Plaintiff alleges that the correctional healthcare company was liable for the actions of the nurse under the theory of respondeat superior and vicarious liability.
While the Complaint makes allegations that may be disputed, this case highlights some important risk management policies and procedures for both correctional healthcare companies and the facilities that house inmates to guard against these types of allegations:
(A)  Inmate Health Records:
Correctional healthcare providers should ensure that the inmate health records contain detailed progress notes of all significant medical events, as well as any diagnoses and treatments for the inmate.  Although the case cited above does not specify whether correctional healthcare management documented every encounter i.e.  treatment, assessment, etc., if these encounters are  noted in the chart, defending the claim will likely be easier and produce greater success.
(B)  Communication:
Medical staff at facilities should advise the correctional staff of any inmate’s special needs that may affect housing, program assignments, work detail, and disciplinary measures, as well as admission to and transfer from institutions.  This communication, of course, is usually documented, but may not always be in the  inmates medical file.  The defense may be stronger  if the communication regarding any such special needs are well-documented.
(C)  Timely Response to Serious Complaints:
Because of the constitutional mandate regarding the provision of medical care to inmates, a delay in responding to serious complaints may be seen as a violation of that constitutional requirement and a breach of the standard of care.  The facilities and correctional healthcare providers should have policies and procedures in place that ensure a response to any medical needs in a timely and appropriate fashion.  Again, that response should also be documented in the inmate’s chart.
The case referenced above is Nicole Guerrero v. Wichita County, Texas, Sheiff David Duke, Correctional Healthcare Management, Inc. and Ladonna Anderson, case no. 7:14-CV-58-O, Northern District of Texas, Wichita Falls Division.