Arizona Inmates Advance in Challenge Over Health Care

     (CN) – A class may advance claims that Arizona’s prison health care system is dangerously understaffed and negligently managed, the 9th Circuit ruled Thursday.
     Led by Victor Parsons in a 2012 complaint, the inmates say that medical, dental and mental health care provided by the Arizona Department of Corrections (ADC) exposed them to substantial risk and harm, including “preventable injury, amputation, disfigurement, and death,” violating the Eighth Amendment.
     Emergency treatment and other medical care in ADC prisons is often delayed or denied, and it was difficult to secure medications and medical devices, according to the complaint. Inmates say dental care is also substandard and focused largely on extracting the offending tooth. As for basic mental health care, the inmates say some prisoners are kept in isolation units with constant illumination and given inadequate exercise and nutrition.
     U.S. District Judge Neil Wake in Phoenix refused to dismiss the case and then certified a class and a subclass of inmates. In its appeal , Arizona argued that the inmates had failed to demonstrate the “commonality and typicality” required for class certification.
     A three-judge panel sided with the inmates Thursday, crediting their “four thorough and unrebutted expert reports, the detailed allegations in the 74-page complaint, hundreds of internal ADC documents, and declarations by the named plaintiffs.”
     This evidence is more than enough at this stage in the case to show “the existence of the statewide ADC policies and practices that allegedly expose all members of the putative class to a substantial risk of serious harm,” Judge Stephen Reinhardt wrote for the court.
     “Those policies and practices, moreover, are defined with sufficient precision and specificity,” he added. “They involve particular and readily identifiable conduct on the part of the defendants, such as failing to hire enough medical staff, failing to fill prescriptions, denying inmates access to medical specialists, adopting a de facto ‘extraction only’ policy for dental issues, and depriving suicidal and mentally ill inmates access to basic mental health care.”
     Arizona houses about 33,000 inmates in 10 prisons, and has for two years hired private companies to provide health care inside.
     In 2012, then-contractor Wexford Health Services reported that, “for higher-level providers, such as physicians, psychiatrists, dentists, nurse practitioners, and management-level health care staff, the overall vacancy rate across ADC facilities exceeded 50 percent,” according to the ruling.
     Wexford also “described ‘long-standing issues, embedded into ADC health care policy and philosophy’ and noted that ADC’s health care system was ‘extremely poor,’ ‘dysfunctional,’ ‘sub-standard,’ and rife with ‘deficiencies.'”
     Corizon Inc. replaced Wexford in March 2013, the San Francisco court noted.
     The ruling rejects Arizona’s claim that the inmates had failed to meet the strict commonality requirement for class certification handed down by the Supreme Court in the 2011 decision Wal-Mart v. Dukes.
     “What all members of the putative class and subclass have in common is their alleged exposure, as a result of specified statewide ADC policies and practices that govern the overall conditions of health care services and confinement, to a substantial risk of serious future harm to which the defendants are allegedly deliberately indifferent,” Reinhardt wrote. “As the District Court recognized, although a presently existing risk may ultimately result in different future harm for different inmates-ranging from no harm at all to death – every inmate suffers exactly the same constitutional injury when he is exposed to a single statewide ADC policy or practice that creates a substantial risk of serious harm.”
     The ADC did not immediately return a request for comment.
     The plaintiffs are represented by the ACLU National Prison Project and the ACLU Foundation of Arizona.

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