Bowman v. Corrections Corp. of America
| Decision Date | 21 November 2003 |
| Docket Number | No. 00-6719.,No. 00-6720.,00-6719.,00-6720. |
| Parties | Patricia BOWMAN, Plaintiff-Appellee/Cross-Appellant, v. CORRECTIONS CORPORATION OF AMERICA, Defendant-Appellant/Cross-Appellee. |
| Court | U.S. Court of Appeals — Sixth Circuit |
ARGUED: James F. Blumstein, Vanderbilt University Law School, Nashville, Tennessee, for Appellant.
John W. Chandler, Jr., Memphis, Tennessee, Patrick A. Ruth, Ruth, Howard, Tate & Sowell, Nashville, Tennessee, for Appellee.
ON BRIEF: James F. Blumstein, Vanderbilt University Law School, Nashville, Tennessee, Andree Sophia Blumstein, Sherrard & Roe, Nashville, Tennessee, Tom Anderson, Anderson Law Firm, Jackson, Tennessee, for Appellant.
John W. Chandler, Jr., Memphis, Tennessee, Patrick A. Ruth, Ruth, Howard, Tate & Sowell, Nashville, Tennessee, Joseph Howell Johnston, Nashville, Tennessee, for Appellee.
Before: BOGGS, Chief Judge; and SUHRHEINRICH and SILER, Circuit Judges.
Anthony Bowman was an inmate at the South Central Correctional Center (SCCC) who had a long history of medical problems associated with sickle cell anemia. Over the course of his incarceration at SCCC, Anthony experienced numerous infections, and was hospitalized repeatedly. During one such episode, on January 3, 1996, Dr. Coble, the medical director at SCCC, admitted Anthony to the SCCC infirmary, having diagnosed him with "an early pneumonia," and on January 4, 1996, Anthony was transferred to the Nashville Memorial Hospital where he died a day later, at the age of twenty-eight.
Anthony's mother, Patricia Bowman, on behalf of her son and his two children (collectively Bowman) filed a civil rights complaint under 42 U.S.C. § 1983, naming as defendants, among others, the Corrections Corporation of America (CCA), Kevin Myers, the warden of CCA's South Central Facility, and Dr. Robert B. Coble, the physician with whom CCA contracted for medical services for inmates housed within SCCC. The complaint alleged that the defendants had violated her son's constitutional right to adequate medical care while incarcerated. The case went to trial and the jury found that the defendants had not acted with deliberate indifference towards Anthony's serious medical condition. The district court entered judgment in accordance with the jury verdict, but granted Bowman's motion for judgment as a matter of law in part, holding that CCA's medical policy, as reflected in its agreement with Dr. Robert B. Coble, is unconstitutional. On this basis, the district court enjoined CCA and all parties acting in concert with it from enforcing its contract with Dr. Coble and additionally granted the plaintiff's motion for sanctions, but only to the extent of awarding attorney's fees in relation to a particular evidentiary dispute in which CCA failed to supplement properly its discovery responses as to the number of referrals it had made to medical specialists on behalf of inmates. Bowman also moved for an award of attorney's fees under 42 U.S.C. § 1988 as a "prevailing party" in a § 1983 case. The district court awarded Bowman attorney's fees and costs, but only on a pro-rated basis for the issues upon which she had "prevailed" against the defendants.
CCA appeals both the district court's injunction and its award of attorney's fees under 42 U.S.C. § 1988 to Bowman. Bowman cross-appeals the district court's partial denial of her motion for a judgment as a matter of law or for a new trial, on her claims for compensatory and punitive damages against CCA, Dr. Coble, and Myers for their alleged violations of Bowman's son's Eighth Amendment right to be free of "cruel and unusual punishment." We affirm the district court's denial of Bowman's motion for judgment as a matter of law or a new trial because there was evidence to support the jury's verdict and the district court did not abuse its discretion in making the various evidentiary rulings objected to by Bowman. We reverse the district court's holding with respect to the unconstitutionality of CCA's medical policy and the injunction awarded on that basis, because this issue is moot as to Bowman and she had no standing upon which to bring such a claim for prospective relief. Finally, we vacate the district court's award of attorney's fees to Bowman, because Bowman is no longer the prevailing party.
During 1990, the State of Tennessee issued a request for proposals from private companies to manage the South Central Correctional Center (SCCC)1. The proposals were to include a detailed budget of projected costs for operating the SCCC, including the cost of providing medical care to SCCC inmates. Tennessee required the companies submitting proposals to state how much they would charge Tennessee on a per inmate per day (PIPD) basis to manage the SCCC and their estimated profit for doing so. On January 24, 1992, following negotiations regarding the SCCC budget and CCA's profit margin, CCA entered into a three-year contract with the State of Tennessee, acting through the Tennessee Department of Corrections (TDOC), to house state prisoners at CCA facilities, including SCCC. The contract contained an option to renew for two additional years.
As part of the contract process, CCA estimated its medical expenses for the treatment of prisoners. This expense category included hospital expenses incurred during the first seventy-two hours up to four thousand dollars per hospitalization, referrals to medical specialists, prescription drugs and laboratory tests. CCA's initial projection was $500,000 per year for these expenses (projecting an average of $1.34 PIPD in 1992, gradually rising over the years to an average of $1.48 in 1997). However, during 1992, 1993, and 1994, CCA's actual expenses for these services and products averaged $1,000,000 per year ($3.75 PIPD in 1992, $3.16 PIPD in 1993, and $2.41 PIPD in 1994). In response to being so dramatically over budget, CCA negotiated a contract with Dr. Coble to be the exclusive provider of medical services at SCCC. Dr. Coble was, among other things, to "determine the existence of medical emergencies," and therefore determine when it was necessary to send a patient to the hospital or for a medical referral. This contract was executed on October 6, 1994, and effectively created a managed health-care system at SCCC. The contract automatically renewed itself on an annual basis and could be terminated by either party upon 60 days notice.
Unlike CCA's previous agreements with other physicians, this contract provided a "capitation plan," which provided Dr. Coble with a financial incentive to reduce the PIPD costs for CCA. Dr. Coble received a minimum salary under the contract, but was able to earn up to an additional $100,000 annually by reducing CCA's costs.2 The way in which the incentive system worked is laid out in the contract and can be understood as follows:
According to CCA's contract with Dr. Coble, he was to be paid a flat rate of $9.40 per inmate under his care, every month. However, twenty percent of that figure was "withheld" so that Dr. Coble's minimum salary was actually eighty percent of $9.40 or $7.52 per inmate, per month. Every six months, CCA would calculate the amount being spent PIPD. If the amount being spent was equal to or more than $3.07, which was the average amount being spent by CCA PIPD at the time of contract negotiations with Dr. Coble, no further money would be distributed to Dr. Coble. If, however, the amount being spent PIPD was less than $3.07, Dr. Coble would receive a "proportionate return" of the amount withheld, up to the full $9.40 per inmate. Finally, Dr. Coble would receive an additional five percent bonus if he was able to keep the PIPD cost below $2.47.
From the very beginning, it is undisputed that Dr. Coble received the maximum amount of income that he could under his contract with CCA, since he was able to reduce CCA's non-personnel medical expenses at SCCC below the lowest level set forth in the capitation plan provision of his contract. Furthermore, it is agreed that during Dr. Coble's tenure, the total amount CCA spent on inmate medical services at SCCC remained approximately the same per year at $1,000,000 from 1994 through 1997, despite the fact that the population of inmates increased from 1311 in October 1994, to approximately 1506 in 1997,3 and the fact that, after August 1995, TDOC began to charge CCA for prisoners sent to the DeBerry Special Needs Facility for specialty consultations, when it had not previously done so. By June 1995, CCA's PIPD cost was reduced to as little as $1.46, and appears to have remained close to that amount thereafter.
The evidence suggests that this remarkable reduction in costs resulted primarily from less specialty referrals and less money spent on prescription drugs. For example, the physician at SCCC before Dr. Coble referred SCCC inmates to medical specialists 1,886 times the year prior to October 1994, while Dr. Coble referred SCCC inmates to medical specialists only 506 times the following year. Similarly, the cost of prescription drugs provided to SCCC inmates was reduced by approximately thirty-nine percent from 1994 to 1997.4
Anthony Bowman was an inmate at SCCC, who had been incarcerated for violating the conditions of his parole, following a conviction for passing forged checks. Throughout his life he had suffered from a form of sickle cell anemia known as "acute chest syndrome," a genetic blood disorder in which sickled red blood cells clog the capillaries of the lungs and prevent the normal exchange of carbon dioxide for oxygen. In the last years of his life, he experienced frequent crises and his medical records reveal that he was seen almost daily by medical personnel at SCCC.
On January 1, 1996, Anthony arrived at the medical department at SCCC in a...
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