Louisiana State Prison (LSP) in Angola, Louisiana, was found “deliberately indifferent” to the Eighth Amendment rights of its nearly 6,400 prisoners to receive competent medical care, according to an opinion issued by a federal district court judge, which she refused to reconsider in a ruling handed down on October 8, 2021.

Men on death row at the prison filed lawsuits against the state Department of Public Safety and Corrections (DOC) alleging that they were subjected to excessive heat and time spent in solitary confinement. According to the Pennsylvania Law News, the state Department of Public Safety and Corrections (DOC) reached settlements with the men.

Class action against Angola for its medical care

A long-running class action lawsuit launched by Angola prisoners in 2015 was upheld by Chief Judge Shelly D. Dick of the United States District Court for the Middle District of Louisiana on March 31, 2021, according to her most recent ruling.

Medical Negligence At Angola State Prison

A judge issued a sweeping order requiring major changes to the prison’s medical care after hearing testimony from hundreds of prisoners as well as medical and disability experts from both sides during an 11-day bench trial. The judge also toured the prison before issuing the order requiring major changes to the prison’s medical care.

The Court stated that “[p]laintiffs have satisfied their burden of proving that Defendants have been deliberately indifferent to the inmates’ serious medical needs in the means and manner of the delivery of health care, in violation of the Eighth Amendment to the United States Constitution.” The Court further stated that “[p]laintiffs have satisfied their burden of proving that Defendants have been deliberately indifferent to the inmates’ serious medical needs in the means and manner of the delivery of health care

Medical Negligence At Angola State Prison

DOC “violated” the Americans with Disabilities Act (ADA), as amended by the Americans with Disabilities Act Amendment Act, as well as “Section 504 of the Rehabilitation Act of 1973,” according to the Court’s conclusion (RA).

The Court noted that Angola has a long history of litigation involving allegations of substandard medical care, dating back more than three decades to an investigation launched by the federal Department of Justice (DOJ) on August 8, 1989, under the Civil Rights of Institutionalized Persons Act, 42 U.S.C. 1997.169 134, on August 8, 1989.

Specific examples of medical indifference

On May 13, 1991, the Department of Justice released its findings, noting that “a number of conditions at LSP deprived inmates of their constitutional rights, including the failure to provide adequate medical and psychiatric care to inmates.”

Medical Negligence At Angola State Prison

Moreover, “serious flaws in the provision of medical care exist system-wide at LSP,” according to the Department of Justice report, such that “inmates who require medical care and attention are not receiving it.” Additionally, “deficiencies regarding…staffing, sick call procedures, delays in treatment, and safeguards to ensure receipt of proper medication and treatment” were discovered.

In 1992, a class action lawsuit was filed, and a settlement agreement was reached in 1998, which required a number of corrective steps to be implemented in the area of medical care. As a result, the Court stated that the Department of Defense (DOC) has been aware for many years that medical care in Angola is subpar, particularly in light of the provisions of the 1998 settlement demanding improvements in:
• evaluations of sick calls; Incorporating “contemporary standards of care,” for example
• creating a mortality review process as well as “a comprehensive quality assurance program;” and
• “automatic referrals” to outside medical professionals;
 “documentation of deviations” from instructions from outside providers, as well as “communication of those deviations to the outside provider”; and
• ending the practice of “disciplining inmates for malingering without first having them evaluated by an outside physician;” and
• the “provision of adequate medical leadership” (as defined above).
Unfortunately, the Court went on to say, major difficulties continue to exist.

Medical Negligence At Angola State Prison

“Plaintiffs have demonstrated organizational and structural deficiencies in the…health care system that underpin and contribute to Eighth Amendment violations,” the Court stated, adding that “the cumulative effect of leadership and organizational deficiencies demonstrate the subjective component of deliberate indifference.” The Court also noted that “the cumulative effect of leadership and organizational deficiencies demonstrate the subjective component of deliberate indifference.”

Citing mistakes

The inability of medical leadership at the institution to ensure “meaningful mortality review” was singled out by the Court as the source of the problem. Angola, the Court found, “does not conduct mortality reviews; rather, the physician who cared for the patient provides a brief narrative summary of the circumstances surrounding the patient’s death in order to make necessary corrections in patient care in order to prevent more deaths in the future. ” A serious evaluation of the death or of the treatment that occurred before the death is not carried out.”

Medical Negligence At Angola State Prison

The Court also highlighted that a “malingering” policy is still in effect in Angola, despite the fact that it is rarely enforced. Under this policy, a prisoner who calls in sick must recognize that he may be subject to disciplinary action if no medical justification for the call can be found. While the regulation itself is not unlawful, the Court found that its implementation exposes an unconstitutional scenario in which the “medical department at LSP is controlled by LSP security rather than medical care providers.”

Angola’s violations

After evaluating the evidence and testimony, the Court reached its conclusions of fact and issued an injunction against the defendants for the following violations of the law:
Providing “constitutionally inadequate clinical care,” which includes insufficient “privacy in examinations” and “routine medical equipment in exam rooms,” in addition to “adequate medical records management,” “clinical hygiene and spacing,” and “episodic treatment of complaints,” is a violation of the Constitution.

  1. Failing to offer “adequate medical care with qualified providers when a sick call is received;” 3.
    Providing “access to medically necessary specialty care in a timely manner” by not “scheduling and tracking” specialty appointments, failing to “comply[ with] testing and diagnostic requirements,” failing “to execute appropriate follow-up care ordered by specialty care providers,” and “failing[ to] coordinate care” are all examples of failures.
    Fourth, failing to provide “constitutionally adequate emergency care” during the “evaluation and assessment of emergencies by qualified providers,” as well as “failing to timely treat and/or transport to a hospital for emergent care;”
    5 – Failing to provide “adequate, qualified staff in infirmary/inpatient care,” as required by the APA.
    “Medical leadership and organization in the following particulars” are not provided by the institution.

a. “lack of a meaningful mortality review;” b. “lack of a meaningful mortality review;” c. “lack of a meaningful mortality review;” d.

• “the use of correctional officers [guards] to manage medical decisions;”

the “lack of peer review,” and so on.

d. “a lack of participation by medical staff in the budgeting process.”

absence of medical monitoring, to name a few examples. and

the failure to keep correct credentialing records up to date; and the

Because of physical and architectural restrictions, the prison failed to “compliance with the ADA and RA in providing disabled inmates access to programs and services,” according to the ADA.

If no “physical modifications” have been made to provide for access to handicapped prisoners, failing to offer “adequately trained, staffed, and safe orderly assistance” is a violation of the law, as is failing to “provide proper oversight of health care orderlies.”

If LSP does not maintain a certified ADA Coordinator and advisory group to deal with ADA concerns, it will be found in violation of LSP’s own American Disabilities Act (ADA) Directives (i.e., “failing to comply with LSP’s own American Disabilities Act Directives”).

“failing to make reasonable efforts to integrate disabled inmates into the general population in accordance with the spirit of the ADA implementing regulations;”

Failing to “adequately train medical staff regarding ADA compliance” is a felony.

Failing to “appropriately evaluate and address ADA accommodation requests and disability-related grievances,” as required by law.

Failing to properly “identify and track disabilities, as well as accommodation requests, in a meaningful way;”

Not providing adequate “accommodation” for “disabled inmates in the application of discipline;” and

maintaining “blanket exclusionary policies for disabled inmates regarding access to various services, activities, and programs in violation of the Americans with Disabilities Act” (ADA).

In addition, the Court stated that it would retain jurisdiction over the parties in order to ensure that the injunctive relief contained in the order was adhered to. For example, Lewis v. Cain, 2021 United States District LEXIS 63293 (M.D. La.).

Defenders then urged the Court to review its decision or, if that was not possible, to certify the decision for interlocutory appeal. Despite the denial of the request, the Court directed that the parties move to the remedial phase of the case. For example, Lewis v. Cain, 2021 United States District LEXIS 195313 (M.D. La.).

Medical Negligence At Angola State Prison

The Writ of Mandamus filed by the Defendant was refused by the United States Court of Appeals for the Fifth Circuit on November 29, 2021. In re: Vannoy, United States Court of Appeals for the Fifth Circuit, Case No. 21-30671.

Lawyer Mercedes H. Montagnes and Nishi Lal Kumar, both of the Promise of Justice Initiative, Ronald K. Lospenatto of the Advocacy Center, Bruce W. Hamilton of the American Civil Liberties Union’s Louisiana Chapter, and Erica L. Navalance of the Capital Appeals Project, all of New Orleans, are representing the plaintiffs in their lawsuit, which is being handled by Cohen Milstein Sellers & Toll PLLC in Washington, D.C.