Nurses Sued for Inmate's Horrific Rash and Suicide

     (CN) - Prison healthcare providers must face claims their alleged disregard for signs of a toxic skin disease led to a Pennsylvanian prisoner's suicide, a federal judge ruled.
     When Anna Marie Murillo was incarcerated at York County Prison on Dec. 31, 2009, she disclosed a history of depression, and was placed in mental health segregation.
     A doctor prescribed Murillo the anti-seizure drug Lamictal on April 19, 2010, and upped the dosage a week later, despite the inmate having reported that the drug was keeping her awake at night.
     After she experienced irritated eyes and facial swelling the next month, she was prescribed Benadryl, eye drops, and Tylenol, and refused to take Lamictal the next day. A physician assistant later found that Murillo was probably allergic to a medication, though she had previously indicated no allergies other than bee stings.
     On the way to the hospital that afternoon, Murillo told paramedics that she woke up with an allergic reaction, and that she had been cleaning out a vent the day before. In the emergency room, Murillo was diagnosed with a common skin infection called cellulitis.
     The treating physician ruled out Stevens-Johnson Syndrome (SJS), a life-threatening skin condition and alleged rare side effect to Lamictal, but upon Murillo's recommended that she undergo a follow-up in a day or two and return if her symptoms worsened.
     The next day, upon noting Murillo's swollen eyes and face and elevated heart rate, Nurse Practitioner George Mosonyi placed her in medical observation, and prescribed allergy meds Prednisone and Benadryl, antibiotics Keflex and Bartcim, and heartburn drug Zantac.
     Later that day, Murillo cried about her swollen eyes and tongue, and complained of a body rash to Nurse Bradley Jones, but denied having shortness of breath or eating problems.
     The next morning, May 15, 2010, Murillo's rash had spread over her entire body, with swollen and chapped lips, a swollen tongue, and an elevated temperature of 102.6 degrees.
     Mosonyi sent Murillo to the hospital for SJS, though she was discharged on her own recognizance two weeks later, and did not return to prison.
     Just over a year later, Murillo committed suicide on Sept. 2, 2011.
     Carla Navedo, a special representative of the decedent's estate, sued the nurses, PrimeCare Medical Inc., and others in May 2012, alleging violations of the Eighth Amendment and state-law claims for medical negligence, wrongful death, and survival.
     PrimeCare, Mosonyi, and Jones moved for summary judgment in June 2013.
     U.S. District Judge Yvette Kane partially denied the motion Monday, noting the plaintiff's expert's claim that although SJS requires "aggressive, high intensity, multispecialty, supportive care in, at the least, a high powered intensive care unit with frequent visits by ophthalmology," the defendants "made no effort" to constantly monitor Murillo.
     "The court therefore concludes that the expert report of Dr. Sullivan sets forth that defendants fell below the standard of care in failing to pay closer attention to decedent's symptoms or to rehospitalize her in the face of her worsening symptoms," Kane wrote.
     The plaintiffs plausibly alleged that the nurses deliberately waited for days to rehospitalize Murillo, the ruling states.
     "This delay, according to plaintiff's expert report, decreased decedent's chances of recovering from SJS," Kane wrote. "Thus, the court finds that a reasonable fact finder could conclude that, in light of instructions from the hospital and decedent's continuing pain and symptoms, defendants were aware of the risk of serious harm to decedent, their failure to return her to the hospital prevented her from receiving needed or recommended medical treatment, and they therefore exhibited deliberate indifference to her serious medical need."