Illinois Must Pay Damages for Prison Hepatitis Policy

CHICAGO (CN) - The estate of a man who died in prison from liver disease can keep a $40,000 judgment, the 7th Circuit ruled. Reduced from over $2 million, it is the only award remaining from a more-than $8 million jury verdict to four men with hepatitis C who claimed that the Illinois Corrections Department failed to properly treat them, which amounted to cruel and unusual punishment.

The suit, brought by four inmates, claimed that the department's former medical director, Dr. Willard Elyea, had established a policy that deliberately ignored prisoners' health care needs.

Hepatitis C is an incurable viral disease that can cause fatal cirrhosis of the liver. Since sharing needles is one way to transmit the disease, it is a common condition among prisoners. With medication the virus can be neutralized in 90 percent of cases, according to the National Center for Biotechnology Information.

Elyea's guidelines required that all candidates for anti-viral therapy have at least two years remaining on their sentence after the diagnosis. The doctor claimed that policy was created to ensure that inmates did not receive an incomplete course of therapy.

Though the court declined to certify the suit as a class action, an Illinois jury awarded over $2 million in damages to each plaintiff, totaling $8,080,000. A federal judge vacated the award as to three of the plaintiffs and reduced the award to $40,000 for the remaining plaintiff, Edward Roe. The 7th Circuit affirmed the decision on Friday.

Roe was diagnosed with hepatitis in 1991 while incarcerated. He returned to prison three more times, each for less than a year, dying in prison in 2008. Neither side disputes that Roe's death was the result of liver disease.

Though tests repeatedly indicated highly elevated liver enzymes, and Roe showed visible signs of illness, prison medical officials denied treatment, citing the guidelines.

On appeal, Elyea argued that Roe failed to demonstrate injury and causation, citing his failure to seek treatment while not in custody and consumption of alcohol - Roe's second trip to prison was due to a felony-level charge of driving under the influence. The court rejected the argument, noting that Roe was unable to afford the treatment because his applications for public assistance were pending.

While in custody, Roe was misdiagnosed and treated for tuberculosis. Though TB treatment is incompatible with hepatitis C anti-viral medication, the court saw no reason for denying Roe a pretreatment workup and liver biopsy.

The 7th Circuit also denied qualified immunity to Elyea, finding that his policies violated clearly established constitutional rights.

"Dr. Elyea was motivated by administrative convenience rather than patient welfare," Judge Kenneth Ripple wrote for the court's three-judge panel, adding that guidelines are not unilaterally unconstitutional.

"Often, as is the case in Illinois, outside contractors provide day-to-day care, and a carefully crafted protocol can ensure the maintenance of legally and medically acceptable standards of care throughout the system," Ripple wrote.

"In the prison context, however, such protocols must ensure that prison officials fulfill their responsibility to provide constitutionally adequate care to each individual inmate with reference to his particularized medical need."

Roe's estate received only the $40,000 judgment, having failed to appeal the remitter of his damages within the 14-day window provided by the District Court.

Anthony Stasiak, Timothy Stephen and Jonathan Walker were also plaintiffs in the suit. Because individual error, not prison policies, had led to their mistreatment, the court ruled they were ineligible for damages.

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