Risperdal Blamed for Inmate's Impotence

     (CN) - A Pennsylvania county must face claims that it gave a detainee permanent impotence by prescribing him a risky antipsychotic and ignoring his penile dysfunction, a federal judge ruled.
     Ten days after James Hasty was admitted to the Montgomery County Correctional Facility on pending criminal charges in September 2010, he was prescribed the antipsychotic, Risperdal, according to the complaint.
     The next day, Hasty developed priapism, a "persistent, usually painful, erection of the penis unrelated to sexual stimulation," causing "significant pain in his abdomen and genital area and abnormal urination," the complaint states.
     Hasty says he then refused medication from prison nurses for three days, as he believed that it was giving him priapism, a recognized complication of taking Risperdal.
     Indeed, in what Attorney General Eric Holder called one of the largest healthcare fraud settlements in U.S. history, Johnson & Johnson agreed in November 2013 to pay more than $2.2 billion for promoting drugs like Risperdal for uses not approved by the FDA.
     In that lawsuit, the feds alleged that Risperdal had a known connection to increased risk of strokes and diabetes, but J&J subsidiary Janssen Pharmaceuticals downplayed those hazards.
     Hasty claims in his suit that he repeatedly asked for care through the prison's medical phone request system, which merely told him to directly ask prison officers and medical staff.
     But even Hasty's direct requests were ignored and denied, according to the complaint.
     When a physician's assistant finally examined Hasty on Sept. 17, the inmate was taken to a hospital, treated, and sent to Hahnemann University Hospital days later, the complaint states.
     While there, Hasty underwent surgery "and other extremely painful and debilitating medical treatments," which resulted in permanent impotence, the inmate claims.
     He ultimately sued the county, the prison's medical director, Dr. Margaret Carillo, and the medical staff's employer, Correctional Medical Care Inc. (CMC), on July 31, 2012.
     The amended complaint asserts civil rights claims and state law medical malpractice.
     Dr. Carillo moved to dismiss for failure to state a claim and to strike Hasty's claim for punitive damages and deliberate indifference, reckless behavior, and/or willful misconduct.
     The county and medical provider, in turn, moved to dismiss in December 2012.
     U.S. District Judge R. Barclay Surrick denied the motions Feb. 28, tossing aside the defendants claim that Hasty failed to identify who authorized the allegedly unconstitutional policies.
     "Plaintiff has identified an unconstitutional policy or custom in failing to have an adequate system in place that provides emergency medical care to inmates in need and failing to train and supervise their staff in responding to those medical needs," Surrick wrote.
     He later added: "At this early stage of the proceedings, plaintiff's allegations of repeated requests for medical assistance through the telephone request system and directly to medical and other staff at the prison, coupled with the apparent but ignored medical need - symptoms of priapism - are sufficient to meet the minimum pleading requirements to establish deliberate indifference under the due process clause of the 14th Amendment."
     Although Hasty did not allege he spoke directly to Dr. Carillo, "the complaint does state a plausible claim that Dr. Carillo, as the authorized decision maker and policymaker for the prison and supervisor of the medical personnel, failed to provide an adequate system where inmates had access to emergency medical care," Surrick found.
     The judge further held that Hasty timely filed his certificates of merit within 60 days, and refused to strike the medical negligence claim.
     "Accepting plaintiff's factual assertions as true, which we must, it is reasonable to infer that, if a proper medical referral system had been in place at the prison, plaintiff would have received treatment sooner and avoided the resulting permanent disability," Surrick wrote.
     The court deferred ruling on Hasty's claim for punitive damages at this time, however.