Prison Medical Abuse Case Pending Before the United States Supreme Court

The United States unfortunately has one of the highest prison populations in the entire world. With our large prison population, especially in the midst of the COVD-19 pandemic, health issues in prison are very common. But what happens when a detainee awaiting trial has a serious health problem that is ignored by a prison official? What kind of recourse can this person seek. The case Strain v. Regalado is pending before the United States Supreme Court asks the question of how a pretrial detainee can prove a prison official disregarded their health concern.

The legal standard for claims against jail medical staff for pretrial detainees is the subject of a 4-3 circuit split. The Fifth, Eighth, Tenth, and Eleventh Circuits require pretrial detainees to plead and prove that jail defendants who denied them medical care subjectively knew that their deficient treatment would pose a substantial risk of serious harm. However, the Second, Seventh, and Ninth Circuits do not require pretrial detainees to plead and prove such a high standard. The Tenth Circuit held that pretrial detainees medical care claims are governed by a subjective standard.

However, the United States Supreme Court has held that the relevant standard for assessing a pretrial detainee’s excessive force claim is objective not subjective. Some courts require the plaintiff to prove the defendant’s subjective state of mind to establish fault whereas others find objective evidence sufficient.

What happened in the Strain case?

On December 11ith 2015, Thomas Pratt was booked in Tulsa County Jail. The next morning, he reported to jail authorities that he was experiencing alcohol withdrawal and submitted a require for detox medication. He was admitted into the medical ward. Over the following four days, jail records documented that he was experience tremors, panic attacks, hallucinations, sweats, nausea, vomiting and appeared disoriented. The three jail officials named as respondents In this case personally observed these symptoms, but they did not send Pratt to a hospital or other facility for treatment, but rather kept him in the jail’s medical ward with limited resources. Respondent Patricia Dean, a nurse, performed an assessment on Pratt and noted that he was experiencing “constant nausea, frequent dry heaves and vomiting,” “severe” tremors, “acute panic states as seen in severe delirium or acute schizophrenic reactions, “drenching sweats,” confusion about “place/or person” and “continuous hallucinations.” However, she did not contract a doctor, check his vitals, or perform any additional medical assessments. Respondent Curtis McElroy, a medical doctor, documented a large cut on Pratt’s forehead and a pool of blood in his cell, and was aware of Pratt’s multiple symptoms, but still did not send him to the hospital. Respondent Kathy Loehr, a mental health counselor, also failed to seek additional care for Pratt despite all his symptoms pointing to an obvious brain injury.

On the fourth night of Pratt’s stay, an officer found Pratt lying in his bed not moving. He was finally rushed to the hospital. Pratt, who was 35 years old at the time, suffered cardiac arrest, a seizure disorder, renal failure, paralysis, and a brain injury. Pratt remains unable to work, requires assistance with everyday activities, cannot live safely on his own, and has been homeless. His disability is permanent, and he will be disabled for the rest of his life.

Despite Pratt’s horrific injuries and permanent disability, the district court dismissed his Fourteenth Amendment claim on the ground that Pratt did not satisfy the subjective component of the deliberate indifference test, specifically, that he did “not establish that defendants intentionally denied or delayed access to treatment or intentionally interfered with the treatment once prescribed.” The district court reasoned that the subjective component required a showing that the prison official knew that the detainee faced a substantial risk of harm and disregarded that risk by failing to take reasonable measures to abate it. The Tenth Circuit also held that the defendants were not liable under the subjective standard.

The Supreme Court should grant cert and review this case. It is a gross miscarriage of justice to allow a person who is not even convicted and awaiting trial to suffer a traumatic brain injury with no recourse against those responsible. Showing subjective knowledge of deficient medical treatment is a standard that is too difficult to prove in even extreme cases of medical neglect in prisons. If this standard becomes the prevailing view more pretrial detainees will suffer subpar medical treatment without any consequences to those responsible.

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