SAN FRANCISCO (CN) — Male prisoners at Santa Rita Jail in Dublin, California argued in federal court Wednesday afternoon that Wellpath Management, the contracted medical provider at the jail, was deliberately indifferent when it provided them substandard medical care to save money.
Wellpath provided primary care, specialty care and appropriate referrals to outside providers and specialties when medically necessary for Santa Rita inmates — some of whom now make up the 12 individual plaintiffs suing Wellpath under the Monell doctrine, which allows an individual to hold a government agency responsible for violating their rights or causing harm.
Arguing Wednesday before U.S. District Judge Jacqueline Scott Corley against summary judgment for the Monell violations, the plaintiffs said Wellpath operates its program based on a practice of cost-cutting rather than providing constitutionally sound medical care in the jail.
“Those specific Monell violations and constitutional violations include for sanitation, for access to imaging, including the repeated failure to perform CT scans or MRIs in cases of head injury that is contrary to normal,” said Richard Brody, counsel for the plaintiffs.
Corley, a Joe Biden appointee, told Brody that for a Monell claim to succeed he needed to prove that a Wellpath policy or custom led to the substandard care.
“What is the practice that a jury could find that led to negligent care?” she asked.
“There’s not a specific written policy that’s involved. What we’ve alleged is pursuant to [Section] 1983 that there are customs and practices in place which are actionable under 1983,” Brody replied.
Section 1983 of Chapter 42 of the United States Code authorizes redress for violations of constitutional and statutory rights by people acting under the authority of a governmental entity.
Brody said that cost factors stopped Wellpath from providing adequate treatment to patients, providing the example of one of the 12 plaintiffs, who had an infected knee but did not get proper culturing done on the infection. Brody said that culturing an infection or performing MRIs are done at outside labs and medical facilities that cut into Wellpath’s profits.
“So we’re looking at the group of 12 plaintiffs. And in that group of 12 plaintiffs, we have found a consistent pattern of delay or denial of care. And in those instances, the common connection is that the care for which there was a denial of care, or delays all involve outside costs,” Brody said.
Corley noted that court papers showed one of the 12 plaintiffs was transferred out for culturing of an infection, contradicting Brody’s claim.
“If they have a policy of not culturing, how did he get cultured?” Corley asked.
Brody replied that it took repeated complaints and negative changes in that plaintiff’s health, and that Wellpath did not intervene early enough.
Corley was unconvinced, and again asked Brody for proof of a Wellpath policy or custom encouraging substandard care.
“The custom and practice is the delay and denial,” Brody said.
“How can I say there was a custom or practice of delay unless you show as to all the inmates that are treated there over the time, how many have suffered this delay? You can’t just pick out 12,” Corley said.
Peter Bertling, counsel for Wellpath, said that the plaintiffs would be better off suing individual providers rather than Wellpath.
“Wellpath is not vicariously liable for their deliberate indifference unless a Monell violation can be shown,” Bertling said.
Individual doctors using their best judgment make the final decisions on patient care, not Wellpath, Bertling told Corley.
“There is no evidence in this case that Wellpath was ever submitted any type of request for referral that they denied,” Bertling said, before noting that court papers show that Wellpath has referred patients to hospitals and labs for treatment. “There are no memos that they’re employing saying, ‘look, this might cost us some money. And we suggest that you really think long and hard before you make any kind of referral.’ There’s nothing like that.”
Corley took the matter under submission and told Bertling she would issue a ruling within a week.
The plaintiffs originally sued in 2019, claiming the kitchen at the jail was overrun with pests contaminating their food. Corley denied their request for a preliminary injunction in 2021, noting that the county had taken steps to eliminate pest problems in the kitchen.
The plaintiffs then amended their complaint, adding the claims about substandard medical care.