Jail May Be Liable for Pregnant Inmate’s Death

PITTSBURGH (CN) - A grieving mother can proceed with a lawsuit that claims her pregnant daughter died of pneumonia in an Allegheny County jail because officials put their budget ahead of their duty to treat her, a federal judge ruled.

The county and jail warden Ramon Rustin moved to dismiss, but U.S. District Judge David Cercone refused on Dec. 16.

Despite claims that the jail actually treated 27-year-old Amy Gillespie for influenza, Cercone found that there was a "deliberate indifference to a fatal condition that easily could have been controlled and cured with proper testing, diagnosis and treatment."

"These basic measures were not undertaken as a result of adhering to a policy of withholding or minimizing the availability of medical care in order to control and contain costs," he added.

Gillespie was sentenced to 30 days in jail because getting pregnant violated the terms of her work release through the woman defenders program. Upon her entry to the Allegheny County Jail, she was approximately 13 to 14 weeks pregnant and passed her physical and mental health screening in good health. In the following weeks, however, she allegedly told her mother and a close friend that a corrections officer told her to "stick it out" when she had complained about feeling sick.

Gillespie's mother, Luann Gillespie Shultz, also said her daughter "communicated to others her fear that she and/or her baby were going to die" because of the jail's failure to treat her symptoms.

The jail infirmary eventually admitted Gillespie when she had symptoms of nausea, vomiting, aches, fever, upset stomach, and sleeplessness. There, the inmate "complained, repeatedly, about being unable to breathe and about having discharge from her lungs," according to the complaint.

While someone on the medical staff at the jail listed Gillespie's condition as a possible viral influenza, prescribing her Tylenol, IV fluid units and Benadryl, none of the staff recognized that her condition "presented a classic case of pneumonia," according to the complaint. "Upon information and belief, no effort was made by Medical Staff to obtain a sputum culture, or take x-rays to further diagnose Gillespie's condition."

Two days after she was admitted to the infirmary, an ambulance took Gillespie to the UPMC emergency room. Cultures allegedly determined that she "had no virus or immune system failure which might have contributed to such a rapid decline in [her] health," the complaint states. "Instead, these cultures reflected that Gillespie suffered from bacterial Pneumonia, a condition that is easily treated by modern medicine if diagnosed in a timely fashion."

Unable to save Gillespie, doctors put the woman on oxygen, intubated her, inserted a catheter and kept her "continuously sedated." Gillespie's mother and brother took the patient off life support less than two weeks after the date of her hospitalization.

A physician at the hospital allegedly said that the "jail didn't treat her fast enough."

In their motion to dismiss, Allegheny County and Warden Rustin said the complaint failed to identify any policy or custom that resulted in a violation of a constitutional right. They also claimed the action did not fall under the Eight Amendment because Gillespie did receive some medical care while in jail. Rustin invoked qualified immunity, claiming he lacked personal involvement.

Cercone rejected the motion, though he agreed that the government's obligation to provide medical care does not mean it is unconstitutional for "prison authorities to consider the cost implications of various procedures, which inevitably may result in various tests or procedures being deferred unless absolutely necessary."

That may not justify their conduct in this case.

"Gillespie's condition, evidenced by her subsequent death, was serious and the facts alleged and the reasonable inferences drawn therefrom are enough to nudge the Eighth Amendment claim across the line between a possible and plausible claim for relief," Cercone wrote.

Deliberate indifference can also be alleged since Gillespie's medical condition "progressed to a point where it was serious and she had corresponding serious medical needs."

"She communicated these needs to jail officials to no avail," the 11-page decision states. "The treatment, actions and inactions of the defendants were nonexistent or not objectively reasonable. She did not improve on her own or respond positively to the treatment made available by defendants. Actual testing to confirm a proper diagnosis and course of treatment only was provided after her condition developed to the point where she had to be admitted to Intensive Care."

"Up until the point where she had to be admitted to the Intensive Care Unit, the pain and suffering which Gillespie was caused to endure was done so consciously, with bad faith and malice, and out of a concern regarding the expenses that would be involved in providing proper care to Gillespie and other detainees," the judge added. "These alleged and inferred circumstances are sufficient to posit that the asserted cost-cutting/saving policy or practice both existed and was a moving force in causing Gillespie's death."

Cercone also ruled that Rustin "failed to carry his burden of showing entitlement to qualified immunity."

Shultz's complaint "is not based upon allegations of medical malpractice or negligence involving a prison employee; it is premised on the failure to treat an inmate s serious medical condition as a result of a custom, practice or policy of denying essential testing and diagnosis due to measures designed to produce cost-savings," Cercone concluded.

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