Civil Rights

Denial of Medical Care

People in the care of law enforcement and jailers have a right to receive medical care. If serious injury or death results from a denial of medical care you may have a case. The Eighth Amendment of the United States Constitution guarantees individuals the right to be free from cruel and unusual punishment. The United States Supreme Court has determined that this includes the right of people in custody, i.e. prisoners, to have access to medical care.

However, prisoners are not guaranteed the right to unqualified access to healthcare. Prisoners are entitled to adequate medical care, and the deprivation of adequate medical care may violate the Eighth Amendment of the Constitution, or for pre-trial detainees it is the Fourteenth Amendment, under certain conditions.

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Our Columbia civil rights lawyers have experience in handling denial of medical care cases resulting in injury or death. We have assisted families whose loved one have died in custody, and whose death could have been prevented if medical care was provided.

Denial of medical cases are difficult and complex because the law requires a large burden on the party bringing the lawsuit. Generally speaking, the denial of medical care is a constitutional violation if custodial officials are “deliberately indifferent” to a “substantial risk of serious harm”. Thus in order for a person in custody to successfully claim inadequate medical care violated their constitutional rights, they must prove that the poor treatment resulted in sufficiently serious harm, that the prison official responsible for the harm knew of the excessive risk to inmate health or safety, and the prison official disregarded that risk by failing to attempt to minimize the risk.

When a person in custody dies as a result of suicide, the right to medical care protected by the United States Constitution is implicated, and a cause of action may be had under 42 USC Section 1983 for violation of the prisoner’s constitutional right and seeking damages for the prisoner’s heirs.

Where Does Negligence Come In?

It is important to note that the cause of action is not one for negligence. This means that making a mistake or error is not enough, in its own, to prove a case under Section 1983.

In applying the deliberate indifference standard, a court will not find negligence or differences of opinion, as to the course of medical care or judgment, generally actionable. For example, if there is a difference of opinion between two physicians, prison authorities may rely on their own physicians and do not have to accept the position of prisoner’s or the detainee’s civilian treating physician.

There are some situations which have been recognized by courts as presenting genuine issues of deliberate indifference and not differences of medical professional opinion. These include denial of access to medical practitioners qualified to address the particular medical problem at issue, denial of access to medical personnel, denial of treatment, delay of access to medical person or delay in treatments, and delay in evaluation in light of a serious medical need.

A failure of jailers to carry out medical orders may also constitute deliberate indifference. Deliberate indifference may also be shown when a judgment is so bad it isn’t really medical because it is so grossly incompetent, inadequate, or excessive as to shock the conscious or to be intolerable to fundamental fairness, that is constitutes deliberate indifference.

Alternative Courses of Treatment

In cases involving choices between alternative courses of treatment a prisoner must show the course or treatment the doctor chose was medically unacceptable in light of the circumstances and that they chose this course in conscious disregard of an excessive risk to the plaintiff’s health. While negligence is not the standard by which these cases are determined, evidence which may support a finding of deliberate indifference may be shown by a failure to follow professional standards or prison medical care protocols, because the standards or protocols can be evidence of the practitioner’s knowledge of the risk posed by particular symptoms or conditions.

Notably prison officials may be held liable under the deliberate indifference standard where the officials deliberately ignored the medical recommendations of a prisoner’s treating physician, even if they are following generally accepted medical standards of the institution, but such standards are inappropriate for the particular patient and such is brought to the prison official’s attention.

While negligence is not the standard, some courts have also recognized that a consistent pattern of reckless or negligent conduct establishes deliberate indifference. This may include interference with professional medical judgment by nonmedical factors or personnel, systematic deficiencies in staffing, and the failure to inquire into facts necessary to make a professional and medical judgment.

Suicidal People Have Serious Medical Need

In a suicide case the death of the person in custody has occurred. Some people think that no claim to be brought, but this is not the case if the death occurred because the deceased was denied medical care related to a serious medical need.

Generally speaking, the definition of a serious medical need is one that has been diagnosed by a physician as mandated treatment or one that is so obvious that even a lay person could easily recognize the necessity of the doctor’s attention.

The courts have also recognized specific areas that are serious medical needs. Drug or alcohol withdrawal is a serious medical need. Mental health care is governed by the same deliberate indifference/serious need analysis as physical care. The courts have recognized certain deficiencies in the medical care provided to prisoners in need are actionable in a prisoner’s suicide case. These include lack of a mental health care screening upon intake and failure to transfer inmates whose conditions cannot be adequately treated at the jail or prison, as well as failure to follow up on inmates with known or obvious mental derangement.

Pre-Trial Detainees

Pre-trial detainees technically do not have 8th Amendment protection as it has no application to unconvicted detainees. Thus the treatment for pre-trial detainees is governed by the due process clause of the Fourteenth Amendment.

Prison officials demonstrate “deliberate indifference” if they display reckless disregard for the substantial risk of harm to a prisoner or pre-trial detainee. This standard requires that the official knows of and disregards an excessive risk of harm to the prisoner or pre-trial detainee. However, a prison official need not know of a specific risk from a specific source.


Proof of a defendant’s knowledge of a substantial risk of harm to a prisoner can be proved by circumstantial evidence, because it may be inferred from the very fact that the risk was obvious. Circumstantial proof may be shown through a variety of factors that may be case specific. Such a factor could include deterioration in the prisoner’s condition that would be obvious. Prison officials cannot escape liability if the evidence showed that they merely refused to verify underlying facts suspected to be true.

Prison official’s knowledge can also be proved by direct evidence. Evidence can take many forms, including medical records, observations of other prisoners or detainees, video surveillance of the actual condition or actions of the prisoner and involved prison employees, the course of conduct that occurred in the facility including complaints, medical intakes, grievances, sick call requests, records of in-facility medical treatment, records regarding adequacy treatment, as well as opinion testimony.

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