When Does Deprivation of Medicine to a Person in Jail Constitute Inadequate Medical Care?

When Does Deprivation of Medicine to a Person in Jail Constitute Inadequate Medical Care?

May Molina was a prominent civil rights activist who was known for protesting police actions.  In May 2004, Molina was arrested on a drug tip. When Molina was arrested, she told the police officers that she took thyroid and diabetes medications, but the police told her she could not bring her medications to the jail as they "were not permitted in lockup."    

About 16 hours into her detention, Molina met with her long-time attorney.  According to Molina's attorney, she could barely stand, walk, or speak.  Molina's attorney told the jail guards to get her to a hospital because she was in very poor health, and Molina repeatedly asked for her medications from her cell.  However, none of the guards on duty responded, and a few hours later, Molina was found dead in her cell.

The county medical examiner conducted a post-mortem examination on Molina's body, discovering that she had ingested six tinfoil packets and had morphine in her blood.  The county medical examiner determined that Molina died from "opiate intoxication complicated by obesity and cirrhosis of the liver."

Molina's daughter, acting as the administrator of Molina's estate instituted a 42 U.S.C.S. § 1983 action against the City of Chicago and involved officers claiming that Molina's Fourth Amendment rights were violated when she received inadequate medical care in jail. 

The administrator's expert witness concluded that "the deprivation of her medications for diabetes and thyroid caused Molina to fall into a myxedematous, or diabetic coma, which eventually led to her death."  The administrator's expert witness further stated that, "even if Molina died of a heroin overdose, she could have survived had she been taken to the hospital for medical care."   

The district court excluded the administrator's expert witness on Daubert grounds, holding that his opinion was based on insufficient data.  The district court granted summary judgment in favor of defendants, and the administrator filed an appeal.

The appellate court reversed the district court's grant of summary judgment on the denial of medical care claim.  The appellate court listed four facts that it considered as in determining whether an officer's response to Molina's medical needs was objectively unreasonable: (1) Whether the officer has notice of the detainee's medical needs; (2) the seriousness of the medical need; (3) the scope of the requested treatment; and (4) police interests, including administrative, penological, or investigatory concerns.  The appellate court further stated that "the duty to respond reasonably to an arrestee's medical needs is affected by any police policies that may endanger the well-being of those in custody.  Here, the [] policy of prohibiting detainees from taking medication in lockup unless the individual is transported to [a] [h]ospital is central to our inquiry."

The appellate court found that each of the defendants had "some notice" that Molina was in very bad health.  The appellate court stated that "the question on summary judgment is whether a jury could find that it was objectively unreasonable for each defendant to take no action to seek medical care for Molina based on what she knew at the time."  The appellate court finally found that at the summary judgment stage, expert medical testimony establishing the cause of Molina's death was not required.  Further, the court stated, "[w]here an obviously ill detainee dies in custody and the defendants' failure to provide medical care is challenged, the causation inquiry is quite broad...here, a jury could infer, based on medical records and witness testimony, that the defendants caused Molina harm when they failed to take her to the hospital after they knew she suffered from a serious medical condition."

Although there was a dispute as to whether Molina died due to the deprivation of her medications or due to a heroin overdose, the appellate court held that defendants were not entitled to summary judgment for the denial of medical care claim.  A jury could find that defendants were on notice that Molina suffered from a serious medical condition that required immediate attention.  A jury could also infer that defendants caused Molina harm.  In addition, the appellate court determined that the district court abused its discretion by excluding the expert witness' testimony.  The finding that his opinion was based on insufficient data was founded on the district court's erroneous understanding of the factual record.  Finally, the appellate court found that defendants were not entitled to qualified immunity.

Lexis.com subscribers can access the Lexis enhanced version of the Oritz v. City of Chicago, 2011 U.S. App. LEXIS 17759, decision with summary, headnotes, and Shepard's.

Non subscribers can access the free unenhanced version of the Oritz v. City of Chicago, 2011 U.S. App. LEXIS 17759, decision available from lexisONE Free Case law.

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