Nelson v. Prison Health Services, Inc.

• Decision Date: 30 December 1997
• Docket Number: No. 96-682-Civ-T-24 B.,96-682-Civ-T-24 B.
• Citation: 991 F.Supp. 1452
• Parties: Donald NELSON, as Personal Representative of the Estate of Diane Nelson, deceased, Plaintiff, v. PRISON HEALTH SERVICES, INC., American Service Group, Inc., Everett S. Rice, as Sheriff of Pinellas County, Florida, and Everett S. Rice, Individually, County of Pinellas, State of Florida, Diane Jackson, Clare Lu Safer, Sandra Spikes, Karyl Hayes, Dana Ostrov, Defendants.
• Court: U.S. District Court — Middle District of Florida

991 F.Supp. 1452

Donald NELSON, as Personal Representative of the Estate of Diane Nelson, deceased, Plaintiff, v. PRISON HEALTH SERVICES, INC., American Service Group, Inc., Everett S. Rice, as Sheriff of Pinellas County, Florida, and Everett S. Rice, Individually, County of Pinellas, State of Florida, Diane Jackson, Clare Lu Safer, Sandra Spikes, Karyl Hayes, Dana Ostrov, Defendants.

No. 96-682-Civ-T-24 B.

United States District Court, M.D. Florida, Tampa Division.

December 30, 1997.

COPYRIGHT MATERIAL OMITTED

Charles R. Scully, Law Offices of Charles R. Scully, St. Petersburg, FL, Sabato P. DeVito, Jr., Sabato DeVito, P.A., Springhill, FL, for Donald Nelson.

James Orrin Williams, Jr., Williams & Leininger, P.A., West Palm Beach, FL, for Prison Health Services, Inc., America Service Group, Inc., Sandra Spikes, Karyl Hayes and Dana Ostrov.

Robert A. Santa Lucia, Williams, Brasfield, Wertz, Fuller, Goldman, Freeman, & Lovell St. Petersburg, FL, for Everett S. Rice and Pinellas County.

Wallis M. Carson, Carson, Guemmer & Nicholson, Tampa, FL, James Orrin Williams, Jr., Williams & Leininger, P.A., West Palm Beach, FL, for Diane Jackson.

Charles D. Bavol, Bavol, Bush & Sisco, P.A., Tampa, FL, James Orrin Williams, Jr., Williams & Leininger, P.A., West Palm Beach, FL, for Clare Lu Safer.

ORDER

BUCKLEW, District Judge.

Before the Court is the Motion to Dismiss filed by Defendant Everett S. Rice as Sheriff of Pinellas County, Defendant Everett S. Rice, individually, and Defendant Pinellas County (Doc. No. 37, part 1, filed May 22, 1997). Plaintiff filed a response in opposition on June 9, 1997 (Doc. No. 41). Also before the Court are Defendant Dana Ostrov's Motion for Summary Judgment (Doc. No. 52, filed September 30, 1997), Defendant Sandra Spikes' Motion for Summary Judgment (Doc. No. 53, filed September 30, 1997), Defendants Prison Health Services and America Services Group's Motion for Summary Judgment (Doc. No. 54, filed September 30, 1997), Defendant Karyl Hayes' Motion for Summary Judgment (Doc. No. 55, filed September 30, 1997) Defendant Clare Lu Safer's Motion for Summary Judgment (Doc. No. 60, filed September 30, 1997), and Defendant Diane Jackson's Motion for Summary Judgment (Doc. No. 61, filed September 30, 1997). Plaintiff filed a response in opposition to Defendant Ostrov's Motion for Summary Judgment (Doc. No. 77), a response in opposition to Defendant Safer's Motion for Summary Judgment (Doc. No. 72), a response in opposition to Defendant Jackson's Motion for Summary Judgment (Doc. No. 73), a response in opposition to Defendant Hayes, Motion for Summary Judgment (Doc. No. 74), a response in opposition to Defendant Hayes' Motion for Summary Judgment (Doc. No. 75), and a response in opposition to Defendants Prison Health Services, Inc. and American Services Group's Motion for Summary Judgment (Doc. No. 76) on October 21, 1997.

I. BACKGROUND

In 1992, the Sheriff of Pinellas County entered into a contract with Prison Health Services, a subsidiary of American Service Group. (The Court will refer to the two collectively as "PHS.") Under this contract, PHS would provide medical services at the Pinellas County Jail. The Pinellas County Jail had been operating under this Court's oversight since 1975, pursuant to this Court's decision in Davis v. Roberts, No. 75-411-CIV-T-2. As part of this oversight, this Court appointed a monitor to review the conditions of the jail and to submit annual reports on the Jail's compliance with this Court's decision in Davis. The court-appointed monitor during 1993 and 1994 was Dr. Linda Smith.

In Dr. Smith's report of March 12, 1993, she noted pervasive problems with the Jail, especially with regards to its medical facilities and treatment: "The medical services continue to be the area generating the most complaints both through the Court and directly to the court monitor." (1993 Federal Court Monitor's Report, Doc. No. 78 at 5.) The most prevalent complaint, according to Dr. Smith, centered on the Jail's medical staff's failure to respond to requests for treatment in a timely manner, and Dr. Smith's investigation "confirm[-ed] the problem." Id. at 5.¹ A related problem involved the medical staff's failure to examine inmates who complained of medical problems. See id. at 6.

Dr. Smith's report for the following year revealed that medical treatment at the jail had, if anything, deteriorated:

The medical services are the most problematic area of concern under the consent decree. Most of the civil rights complaints filed with the courts are related to medical care both in the form of lawsuits and letters directly to the Federal Court Monitor. Despite a change in medical providers that occurred in November 1992, inmate medical care continues to be fraught with serious problems, and the "new" medical providers really aren't new any longer and should have resolved many of these problems long ago. Complaints addressed by the Court monitor receive responses such as "the person fell through the cracks," "we made a mistake," "it won't happen again," etc. While it is reasonable to assume that when you are dealing in a human service capacity mistakes will occur occasionally, mistakes and problems in the medical care at the Pinellas County Jail are occurring too frequently especially given the serious liability issues that could arise from these mistakes.

(1994 Federal Court Monitor's Report, Doc. No. 78 at 7.) A particular concern for Dr. Smith was "the disparity in medical care for the females.... It seems that action is only taken when a crisis occurs." Id. at 8.² Dr. Smith warned that "the medical providers need to do some serious evaluation of the care provided to the females." Id. at 9. In particular, PHS needed to reevaluate "the current way in which 82's [requests for medical treatment] are handled by the medical staff." Id. at 10.

Perhaps because of Dr. Smith's investigations and reports, PHS did evince some concern about the manner in which its nursing staff was addressing the inmates' medical needs. In an August 3, 1993, memorandum to all nursing staff, Pat Terry, PHS Health Services Administrator, stated:

A positive response [to requests for medical treatment] only is acceptable! No matter how irritating you may think the inmate or his complaint is, please consider this: One year from now, you receive a subpoena to appear in court, and you find the following responses on the '82's'[:] "You have been hording your Nitro so you don't get any more" ... "Your `mommy' has called three times regarding your pain, tell her to stop calling and I will give you Tylenol." I actually found all of the above "82's" and I certainly do not want to go to court and explain these responses.

1994 Federal Court Monitor's Report App., Doc. No. 78. In closing, Terry pleaded with her staff, "I am asking that we all act like professionals in responding, no matter what kind of day you have had or how much the inmate has irritated you. Deliberate indifference will not be tolerated." Id. (emphasis added).

Similarly, in a July 16, 1993, memorandum to the nursing staff, Fran Bell stated that "[a]ll inmates must be seen. . . . Even if they are to be seen, or have been seen recently, you still need to `see' in person, at least to inquire about the current problem." (1994 Federal Court Monitor's Report App., Doc. No. 78.) Apparently, however, these memoranda had little effect on the willingness of the Jail's medical staff to deal with treatment requests. Thus, in a December 14, 1993 memorandum, Fran Bell remonstrated: "The proper handling of 82's has been addressed several times. I have been advised that several nurses are still not doing proper assessments and referrals.... You must `see' and evaluate inmates." (1994 Federal Court Monitor's Report App., Doc. No. 78.)

There is affidavit testimony on the part of female in-mates that suggests that the nursing staff at the Pinellas County Jail were not addressing their medical needs. Georgiana Woernle, for example, has testified that after suffering a miscarriage while in the Pinellas County Jail, "I had to wait six or seven hours before they sent me to the hospital even though I was bleeding profusely. . . ." (Woernle Aff. ¶ 8.) Similarly, Adrienne Von Trager, a diabetic, has testified that "Nurse Diane Jackson told me, `you don't need insulin until you go into a seizure.'" (Von Trager Aff. ¶ 4.)

Late in the evening of March 6, 1994, Diane Nelson entered the Pinellas County Jail as a pre-trial detainee. She had been arrested around 11:00 pm. Diane Nelson had suffered a heart attack the previous October and her doctor had prescribed Procardia XL and nitroglycerine to combat her cardiac problems. She had taken her medications at 6:00 pm that evening, but upon being arrested, she had been unable to locate them, and the deputy took her to jail without them. When Diane Nelson entered the Pinellas County Jail, she was taken to the screening nurse in the medical wing of the Female Security Center (FSC). The screening nurse that night was Karyl Hayes. On a document headed "Receiving Screening," Nurse Hayes noted that Diane Nelson had a heart condition that she had had a heart attack in October of 1993. (Hayes Dep. at 18.) Under medications she wrote: "Procardia XL, 60 mg PO, BID," meaning Procardia Extra-Long Acting (sustained release), 60 milligrams by mouth twice per day. Id. at 25. On a document titled "Master Problem List," Nurse Hayes wrote "Verify/cont." for verify and continue medications. Id. at 26. Nurse Hayes noted that Diane Nelson's blood pressure of 144/98 was "slightly elevated."

Nurse Spikes worked the first shift, succeeding Nurse Hayes at screening, from 7:00 am to 3:30 pm on March 7, 1994. (Spikes Dep. at 5-6.) On the morning of March 7, Diane Nelson asked Spikes when she would receive her medications. Id. at 7. Spikes then gave her three nitroglycerine in an envelope. Id. at 22. Spikes saw the unverified medications listed on...