Lawsuits for medical neglect in Nevada jails and prisons


COVID-19 UPDATE: People incarcerated in Nevada jails and prisons are at constant risk of catching and transmitting coronavirus. These inmates have a constitutionally-protected right to health care. And they may file civil rights lawsuits against their correctional centers and medical staff for showing "deliberate indifference" to their "serious medical needs." Inmates may be able to recover financial damages for their medical neglect and effect important policy changes.

Nevada prisoners have an Eighth Amendment right to adequate medical care, dental care, and mental health care. Inmates suffering from healthcare neglect or medical malpractice may bring a Section 1983 lawsuit against their jail or prison for violating their civil rights.

In order to prevail on a constitutional claim for medical neglect in jail or prison, an inmate ("plaintiff") would need to prove that:

  • the inmate had a serious medical need, and
  • the jail or prison displayed deliberate indifference

Plaintiffs in 1983 cases may recover compensatory damages to pay for their:

Depending on the case, the court may also order punitive damages as well as a reimbursement of attorneys' fees.

In this article, our Las Vegas Nevada personal injury attorneys discuss:

Jail cell and inmate hands sticking through the bars
Inadequate health care for inmates qualifies as "cruel and unusual" punishment.

1. Required health care for Nevada inmates

The Eighth Amendment of the U.S. Constitution obligates jail and prisons to provide adequate health care.1 This comprises regular medical, dental care as well as mental health care (when necessary).2

Note that inmates are entitled to adequate care no matter whether the providers are government employees or private practitioners under contract with the government.3

1.1. Nevada jails

Jails are local detention facilities that house people who either:

  • have been arrested,
  • are awaiting trial (and do not bail out), and
  • serving Nevada misdemeanor sentences

NRS 211 delegates the administration of jail inmates' health care to county sheriffs. Jails are required to provide treatment to inmates for:

  • injuries incurred during arrest or while in custody;
  • treatment for infectious, contagious, or communicable diseases; and
  • examinations as required by law or by court order. 

Inmates must pay for their own treatment if their injuries occurred while they committed a public offense, while they were arrested (if convicted), if they self-inflicted their injuries, or if their injuries or illnesses were preexisting prior to being in custody.4

1.1.1. CCDC

CCDC exterior
The CCDC has faced allegations of inadequate health care.

The biggest jail in Clark County is the Clark County Detention Center (CCDC) in downtown, Las Vegas. The CCDC contracts with NaphCare, Inc. to provide medical and mental health services at both the CCDC's main facility and its North Valley Complex (NVC).

NaphCare is paid to provide medical and medication management, mental health care, and drug detoxification treatment. It also coordinates women's health care, emergency and radiological services, dialysis, and other services.

NaphCare is required to complete a thorough health assessment of any inmate that is in custody for 10 days. And they must supply inmates who are discharged with a reasonable amount of medication and information on community resources to continue their health care.5

1.2. Nevada prisons

Prisons house people who have been convicted of a Nevada felony and are serving their sentences, which are typically a year or longer.

NRS 209 delegates the administration of prison inmates' health care to Nevada's Department of Corrections Medical Division. The Division's Medical Director and Medical Administrator manage the department's medical, dental, clinical mental health, and pharmacy services. The Medical Division also has a Nursing department and Central Pharmacy.

Nevada's larger prisons have medical clinics, dental clinics, and infirmaries. Two prisons have on-site acute care infirmaries. Primary care is provided in the prisons. Outside surgeons, cardiologists, and gastroenterologists periodically go to the prisons to provide care there. When off-site care is necessary, inmates are taken to community hospitals.

On average, the prisons' healthcare staff have 600 patient care contacts each day.6

2. Nevada inmate injuries from medical neglect

Medical care is especially vital in jail and prison since statistics indicate that inmates have higher-than-average rates of illness as compared to the general population.7 However, Nevada's jail and prison healthcare is woefully inadequate:

inmate hands gripping jail bars
Nevada prisons pay below average health care costs per inmate.

In 2015, Nevada spent less than $3,500 on healthcare per inmate, which pales next to the $5,720 per inmate average. Of the 43 states surveyed in a recent Pew research study, Nevada ranks the fourth-lowest in healthcare staffing, with only 24.5 full-time staff for every thousand inmates. (Inadequate medical staffing is most pressing in rural areas.)8 And Nevada prison inmates pay a copay of $8 for healthcare, making Nevada second only to Texas as the most expensive state for inmates.9

A recent audit of the CCDC shows that its medical provider NaphCare often failed to provide medications to inmates being discharged and did not provide sufficient mental health treatment.10

2.1. Inmate grievances

Jail and prison inmates may file grievances about inadequate medical care. Just some of the complaints that Nevada prison inmates have made include the following:

  • Blindness due to not receiving insulin for diabetes, cataract surgery, or glaucoma treatment
  • No medical care for heart disease
  • No medical care for Hepatitis C
  • No medical treatment for tumors and suspicious moles
  • No medical care for five days after suffering an assault from cellmates, resulting in a permanently disabled tongue
  • No medical care after being beaten by prison employees, resulting in a dislocated shoulder
  • Dental malpractice, resulting in a broken jaw
  • No medical care from injuries resulting from handcuffs that were too tight
  • No medical care for a torn meniscus
  • No medical care for diabetes

Furthermore, many inmates face retaliation by prison workers as well as doctors for filing grievances to begin with. So many inmates suffer without seeking medical care for fear of being assaulted, sequestered, or denied food. [11

3. Suing for medical neglect in Nevada jails and prisons

Nevada inmates who have suffered medical neglect can bring a Section 1983 lawsuit claiming they were denied their Eighth Amendment constitutional right to adequate medical care. In order to prove medical neglect, the inmate ("plaintiff") would need to show the following:

  1. The inmate has a serious medical need,
  2. The prison/jail acted with deliberate indifference to the inmate's medical need12

The plaintiff has the burden to prove these elements by a "preponderance of the evidence." This is the legal way of saying that it is more likely than not that the jail/prison committed medical neglect.13

3.1. Serious medical need

A medical condition qualifies as a "serious medical" when the failure to treat the condition can cause the inmate further significant injury or the unnecessary or wanton infliction of pain. A condition does not have to be life-threatening in order to be a serious medical need: Substantial pain, injury, or function loss is sufficient.14

Examples of serious medical needs may include:

inmate behind jail bars
Inmates often do not report injuries out of fear of retaliation.
  • broken bones
  • torn ligaments
  • infection disease
  • cancer
  • deep cuts
  • chronic disease
  • chronic pain
  • an infected tooth that needs extraction
  • suicide attempts

Note that mild injuries or discomfort do not rise to the level of a serious medical need. Plaintiffs' attorneys often rely on expert medical witnesses to testify as to the seriousness of the plaintiffs' medical needs.

3.2. Deliberate indifference to the inmate's serious medical need

There are several ways detention facilities may become aware of an inmate's health care emergency, including:

  • the ailing inmate informs a jail/prison employee or doctor
  • a fellow inmate informs a jail/prison employee about the patient's condition
  • a doctor discovers the medical need during an examination or by reviewing health records
  • a jail/prison employee observes the sick inmate in distress or in deteriorating health

Once the detention facility becomes aware that an inmate may have a serious medical need, it is obligated to investigate the matter further and provide treatment if necessary. A jail/prison acts with "deliberate indifference" when it is aware of the inmate's medical situation and recklessly disregards the substantial risk of harm that the inmate faces.15

Examples of deliberate indifference to an inmate's serious health care needs may include:

  • delaying or denying access to health care
  • denying access to a specialist when necessary
  • failing to follow doctors' orders, such as administering medicine
  • failing to fully examine the inmate and review the healthcare records in order to formulate the most appropriate treatment
  • the jail/prison deciding on treatment by considering only non-medical factors, such as money or convenience16

Note that defendant(s) cannot be held liable for medical neglect merely for being negligent. The plaintiff has to show that the defendant(s) acted recklessly, which is a higher standard than negligence.17

Typical evidence that can help demonstrate "deliberate indifference" includes eyewitness testimony, medical records, and surveillance video.

4. Possible defendants in medical neglect of inmate cases

Depending on the facts of the case, inmates may sue some or all of the following parties for health care neglect:

inmate on the floor of a jail cell
Inmates suffering medical neglect can sue their jail or prison.
  • The jail/prison
  • The individual guards or other detention officials that showed deliberate indifference to the inmate's condition
  • The medical staff that showed deliberate indifference to the inmate's condition
  • The medical group that employed the doctors who showed deliberate indifference to the inmate's condition

5. Remedies for medical neglect of inmates in Nevada

Plaintiffs who suffered healthcare neglect while in jail or prison may try to recover compensatory damages to pay for their:

  • doctors' bills (that are not covered by the jail or prison)
  • pain and suffering,
  • lost wages (if applicable)
  • loss of future earnings (if applicable)

If the court finds that the actions of the jail or prison officers to be particularly egregious, the court may order punitive damages. In many cases, punitive damages are much higher than compensatory damages. The court may also order that the defendants pay the plaintiff's attorneys' fees.

Finally, the court can order the jail or prison to provide the necessary medical treatments the inmate requires.18

6. Defenses to Nevada lawsuits for medical neglect of inmates

Defendants in a 1983 lawsuit for healthcare neglect may try to advance the following arguments to avoid liability:

  • The plaintiff did not have a serious health care need;
  • The defendant(s) did not know ... and reasonably could not have known ... that the plaintiff had a serious medical need;
  • The defendant(s) did not demonstrate deliberate indifference; and/or
  • The medical treatment ... or lack of treatment ... that the plaintiff received falls within acceptable professional standards of care

Defendants may try to argue that they have "qualified immunity in Nevada" that protects them from liability from Section 1983 claims. But if the plaintiff can show that the defendant did not act in good faith, then any immunity privileges should not apply.19

7. Statute of limitations for medical neglect of inmate lawsuits in Nevada

Inmates usually have a statute of limitations of two (2) years following the injury to bring a Section 1983 lawsuit in Nevada.20

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Call a Nevada attorney...

If you or a loved one suffered from medical neglect in a Nevada jail or prison, call our Las Vegas personal injury attorneys at 702-DEFENSE (702-333-3673) to consult for free. We may be able to file suit against the correctional system and fight for the largest settlement possible.

Also see our article on suing for police misconduct in Nevada.

Injured in California? See our article about suing for medical neglect of inmates in California

Legal References: 

  1. U.S. Constitution's Eighth Amendment ("Excessive bail shall not be required, nor excessive fines imposed, nor cruel and unusual punishments inflicted."); Estelle v. Gamble, 429 U.S. 97, 103 (1976). 
  2. Hoptowit v. Ray, 682 F.2d 1237, 1253 (9th Cir. 1982); see NRS 211.140 & NRS 209.4889.
  3. West v. Atkins, 487 U.S. 42, 57-58 (1988); Richardson v. McKnight, 521 U.S. 399 (1997).
  4. NRS 211.
  5. Audit Report Clark County Detention Center Inmate Medical Care Contract April 2016.
  6. State of Nevada Department of Corrections Medical Division.
  7. Id.
  8. Ben Botkin, Nevada gets low marks for inmate health spending, Las Vegas Review-Journal (November 6, 2017).
  9. Nick Wing, Prisons And Jails Are Forcing Inmates To Pay A Small Fortune Just To See A Doctor, Huffington Post (August 19, 2017)
  10. Audit Report Clark County Detention Center Inmate Medical Care Contract April 2016.
  11. Nevada Prisoner Abuse Documentation; see Doty v. County of Lassen, 37 F.3d 540 (9th Cir. 1994)("Doty's mild stress-related ailments are the type of routine discomfort that may result merely from incarceration and the concomitant separation from one's family. A serious medical need requires an ailment of a greater magnitude or with a cause separate from confinement. Since Doty was not suffering from a serious medical need, no constitutional violation occurred.").
  12. Estelle v. Gamble, 429 U.S. 97 (1976). ("An inmate must rely on prison authorities to treat his medical needs; if the authorities fail to do so, those needs will not be met. In the worst cases, such a failure may actually produce physical torture or a lingering death, the evils of most immediate concern to the drafters of the Amendment. In less serious cases, denial of medical care may result in pain and suffering which no one suggests would serve any penological purpose. The infliction of such unnecessary suffering is inconsistent with contemporary standards of decency as manifested in modern legislation codifying the common law view that it is but just that the public be required to care for the prisoner, who cannot, by reason of the deprivation of his liberty, care for himself. We therefore conclude that deliberate indifference to serious medical needs of prisoners constitutes the unnecessary and wanton infliction of pain, proscribed by the Eighth Amendment. This is true whether the indifference is manifested by prison doctors in their response to the prisoner's needs or by prison guards in intentionally denying or delaying access to medical care or intentionally interfering with the treatment once prescribed.") Note that although the Estelle decision set out the "deliberate indifference" standard, the majority did not feel that Gamble's particular claim could stand against medical staff (as opposed to prison administration). The court noted that medical negligence and malpractice was not tantamount to constitutional violation and that those claims were covered by state tort law.").
  13. Martin A. Schwartz, George Cheny Pratt, Section 1983 Litigation: Jury instructions, Volume 4, 2017 Supplement.
  14. Clement v. Gomez, 298 F.3d 898, 904 (9th Cir. 2002).
  15. Farmer v. Brennan, 511 U.S. 825, 836 (1994).
  16. See, e.g., Estelle v. Gamble, 429 U.S. at 104; Toussaint v. McCarthy, 801 F.2d 1080, 1112 (9th Cir. 1986); Jones v.  Johnson, 781 F.2d 769, 771 (9th Cir. 1986).
  17. Estelle v. Gamble, 429 U.S. 97 (1976).
  18. 42 U.S.C. § 1988.
  19. See, e.g., Harlow v. Fitzgerald, 457 U.S. 800 (1982).
  20. NRS 11.190.

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