349 F.Supp. 278 (M.D.Ala. 1972), Civ. A. 3501, Newman v. State of Alabama

Docket Nº:Civ. A. 3501
Citation:349 F.Supp. 278
Party Name:Newman v. State of Alabama
Case Date:October 04, 1972
Court:United States District Courts, 11th Circuit, Middle District of Alabama

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349 F.Supp. 278 (M.D.Ala. 1972)

N. H. NEWMAN, and others, Plaintiffs,


STATE OF ALABAMA et al., Defendants, United States of America, Amicus Curiae.

Civ. A. No. 3501-N.

United States District Court, M.D. Alabama, Northern Division.

Oct. 4, 1972

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[Copyrighted Material Omitted]

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Joseph D. Phelps, of Hill, Robison, Belser, Brewer & Phelps, Montgomery, Ala., for plaintiffs.

William J. Baxley, Atty. Gen., and Herbert H. Henry, Asst. Atty. Gen., State of Ala., Montgomery, Ala., for defendants.

David L. Norman, Asst. Atty. Gen., and Louis M. Thrasher, Patricia G. Littlefield and Philip Fuoco, Attys., Civil Rights Div., Dept. of Justice, Washington, D. C., and Ira DeMent, U. S. Atty., M. D. Ala., Montgomery, Ala., for the United States as amicus curiae.


JOHNSON, Chief Judge.

This is a class action brought by prisoners within the Alabama Penal System who represent themselves and others similarly situated. Plaintiffs contend that as prisoners they are deprived of proper and adequate medical treatment in violation of their rights guaranteed under the Eighth and Fourteenth Amendments to the United States Constitution. They seek declaratory and injunctive relief. Defendants are the Attorney General of the State of Alabama, the Commissioner, the chairman, and other members of the Alabama Board of Corrections, and the warden, the hospital administrator and the hospital staff of the Medical and Diagnostic Center, Mt. Meigs, Alabama, the general hospital for the Alabama prison system. The case is now submitted upon the pleadings, motions, depositions, testimony taken at trial, and briefs of the parties. Jurisdiction is founded upon 28 U.S.C. § 1343.

As this Court has stated before, it is well established that prisoners do not lose all their constitutional rights. Washington v. Lee, 263 F.Supp. 327, 331 (M.D.Ala.1966), aff'd per curiam, 390 U.S. 333, 88 S.Ct. 994, 19 L.Ed.2d 1212 (1968). See Cruz v. Beto, 405 U.S. 319, 92 S.Ct. 1079, 31 L.Ed.2d 263 (March 20, 1972). Among other safeguards, the Eighth Amendment's prohibition against cruel and unusual punishment, incorporated into the due process clause of the Fourteenth Amendment, protects prisoners from unconstitutional conditions of treatment imposed by prison authorities under color of state law. See Robinson v. California, 370 U.S. 660, 82 S.Ct. 1417, 8 L.Ed.2d 758 (1962). The adequacy of medical treatment provided prison inmates is a condition subject to Eighth Amendment scrutiny. See, e. g., Hutchens v. State of Alabama, 466 F.2d 507 (5th Cir. August 15, 1972); Campbell v. Beto, 460 F.2d 765 (5th Cir., April 18, 1972). While federal courts will not hesitate to intervene when action is clearly necessary to protect a prisoner's constitutional rights, the courts traditionally have been reluctant to interfere in the normal processes of state prison administration. Consistent with this policy, the Fifth Circuit has narrowly limited the scope of review under the Eighth Amendment. Courts should not inquire into the adequacy or sufficiency of medical care of state prison inmates unless there appears to be an abuse of the broad discretion which prison officials possess in this area. See, e. g., Haskew v. Wainwright, 429 F.2d 525 (5th Cir. 1970); Roy v. Wainwright, 418 F.2d 231 (5th Cir. 1969); Granville v. Hunt, 411 F.2d 9 (5th Cir. 1969); Thompson v. Blackwell, 374 F.2d 945 (5th Cir. 1967). The Fifth Circuit has repeatedly stated, however, that there may be cases in which the deprivation of medical care will warrant judicial inquiry and action. See, e. g., Woolsey v. Beto, 450 F.2d 321 (5th Cir. 1971); Sanders v. United States, 438 F.2d 918 (5th Cir. 1971); Schack v. Florida, 391 F.2d 593 (5th Cir. 1968).

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See also, Burroughs v. Wainwright, 464 F.2d 1027 (5th Cir., July 28, 1972); Bowman v. Hale, 464 F.2d 1032 (5th Cir., July 28, 1972). When practices within a prison system result in the deprivation of basic elements of adequate medical treatment, then such practices violate constitutional guarantees and federal courts must act to provide relief. This is especially true when deprivation immediately threatens life and limb. Campbell v. Beto, supra.

Plaintiffs in this case have shown by substantial evidence that the Alabama prison authorities have clearly abused their discretion in providing medical treatment to inmates. Defendants, in administering the Medical and Diagnostic Center (M&DC) and other prison medical facilities, and in otherwise performing the duty of providing for the medical needs of inmates, have fallen far short of supplying the constitutionally required level of adequate medical treatment. The medical facilities of the Alabama prison system are grossly understaffed. In addition, with the exception of the M&DC, which is recently built and generally well equipped, the physical plant and equipment provided for the care of prisoners are totally inadequate. Compounding the lack of staff and facilities, and resulting in part therefrom, is the poor administration of the medical treatment program, including the procurement and distribution of drugs and other medical supplies. Further, the record is filled with examples of correctional staff members intentionally denying inmates the right to be examined and treated by trained medical personnel, and further refusing to provide medicine and other treatment prescribed by a physician. The result is a degree of neglect of basic medical needs of prisoners that could justly be called "barbarous" and "shocking to the conscience." See, Novak v. Beto, 453 F.2d 661, 671 (5th Cir. 1971).

The almost 4000 prisoners within the Alabama Penal System are housed in five major prisons-Atmore, Holman (maximum security unit), Draper, Tutwiler (women) and the M&DC-a minimum security facility for the young, an honor farm, a pre-release center, and 13 road camps. M&DC, where the prison general hospital is located, also serves as the receiving center for approximately 175 new inmates each month as well as the permanent assignment for some 175 inmates. The hospital, whose main ward is frequently filled nearly to capacity, contains approximately 80 beds, including a tuberculosis ward and a hepatitis ward. At any given time, some 100 additional inmates will be temporarily assigned to the center from other facilities, awaiting diagnosis or treatment by a physician, or receiving treatment on an outpatient basis.

The medical staff at M&DC, in addition to providing treatment for hospital patients, must attend to the medical needs of the inmates permanently and temporarily assigned to the center. This includes the routine physical examination of all new prisoners. To provide this care, there is no full-time physician presently employed at M&DC. Services are provided by three doctors in private practice who are employed on a salary basis to work at the center for a short time each week. Services are also provided on a part-time basis by the Medical Director of the prison system who, in addition, has responsibility for the entire medical care program within the system and further maintains his own very extensive private practice. Three registered nurses, the only ones employed anywhere in the system, cover the hospital on staggered shifts during the week. There is no registered nurse on duty at night or on weekends. While nurses and doctors can be called if needed, it often takes several hours to locate them, and at least one doctor refuses to take night calls.

Most of the daily care at the M&DC is provided by nine medical technical assistants (MTA's) who received their training as medics in the armed services and who perform as licensed practical nurses, although not licensed by the

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state. They are responsible for providing 24-hour coverage, seven days a week. At night, and frequently during the day, only one MTA is on duty to serve the entire center. A dentist provides services to inmates during part of the day, three days a week. The M&DC has no hospital administrator, no dietician, no registered X-ray technician, no medical records librarian and no civilian records clerk. 1

The record is clear, from the testimony of outside experts, of physicians who have attended patients at the M&DC, and of others, that the present level of staffing at the Center is simply insufficient to provide even minimally adequate care to inmates. The case histories of inmates, described below, attest graphically to this conclusion.

The totally inadequate medical care at the M&DC is remarkably good compared with that available in other prisons within the system. The Atmore-Holman complex, located some 150 miles from the M&DC, contains approximately 1700 inmates, or almost half the state prison population. Only one part-time, retired physician is employed to treat these inmates. He conducts sick call at both Atmore and Holman for a few hours, three times a week. The evidence shows that at Atmore alone as many as 150 inmates may attend sick call on a single day. Of these, only a handful can be selected to see the doctor that day. If the regular physician becomes ill or is otherwise unable to treat the inmates, the chances of obtaining even emergency treatment are even less, since a week or more sometimes passes during which no doctor visits either prison. Dental care at Holman and Atmore is provided by one part-time dentist.

Both Atmore and Holman maintain small, overcrowded infirmaries with only rudimentary laboratory facilities. Atmore has an old X-ray machine, not recently tested for leakage, operated by an unsupervised inmate. The minor surgery room is poorly equipped (there is no sterilizer for example) and unsanitary. Neither Holman nor Atmore has means to safely restrain patients or to isolate contagious diseases. Holman has no oxygen unit and otherwise lacks equipment necessary for emergencies. The only full-time medical personnel employed to staff these...

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