CHIMENTI v. PENNSYLVANIA DEPARTMENT CORRECTIONS (DOC), 2:15-cv-03333

Background

Plaintiffs are DOC inmates (lead: Chimenti, Leyva, Maldonado) with chronic Hepatitis C who allege DOC and certain medical providers denied or delayed curative direct-acting antiviral drugs (DAADs).
Plaintiffs challenge a November 2016 DOC Hepatitis C Protocol that rationed DAADs by fibrosis stage, allegedly denying treatment to >98% of infected inmates for cost reasons despite DAADs being the community standard and highly effective.
Chimenti alleges prolonged denial/delay from 2013–2016, worsening liver disease (stage 4 cirrhosis), unnecessary biopsy insistence, and eventual DAAD treatment only in October 2016.
Plaintiffs seek classwide injunctive relief to require DOC to adopt community-standard Hepatitis C treatment and individual damages for constitutional violations; proposed class ≈5,400 inmates.
Procedural posture: Motions to dismiss by DOC and Medical Defendants. Parties agreed to dismiss some defendants/claims; court considered remaining § 1983 Eighth Amendment deliberate-indifference claims and several malpractice and state-constitutional claims.

Issues

Issue	Plaintiff's Argument	Defendant's Argument	Held
Whether DOC policy denying/ rationing DAADs states Eighth Amendment deliberate-indifference claim	DOC’s protocol denies medically necessary, community-standard DAADs to most inmates solely for cost, creating excessive risk of serious harm	Cost-based rationing or disagreement with treatment decisions does not, as a matter of law, establish deliberate indifference	Denied dismissal: allegations that DOC rationed DAADs based solely on cost and that DAADs are the only recommended treatment sufficiently plead deliberate indifference
Whether individual DOC officials (Wetzel, Noel, others) are plausibly liable under § 1983	Committee members formulated/implemented protocol and knowingly denied treatment, causing harm	Officials lacked personal culpability or were following evolving protocols; qualified immunity protects them	Denied dismissal as to key DOC officials: facts allege personal involvement and deliberate indifference; qualified immunity not resolved at pleading stage
Whether private medical contractors (Correct Care, Wexford) and certain medical directors (Cowan) are liable under § 1983	Contractors participated in care and committee; contributed to policy and implementation	Monell/Natale bars respondeat-superior; must plead corporate policy/custom causing violation; no such allegations here	Granted dismissal for Correct Care, Wexford, and Dr. Cowan: complaint fails to allege their own policy or causation sufficient for § 1983 liability
Whether treating prison medical disagreements (choice of drug/timing) amount to constitutional violation	Denial of DAADs (the only recommended cure) and requirement of unnecessary biopsy show more than mere disagreement	Many cases show mere disagreement or provision of alternative care is not deliberate indifference	Court found allegations here go beyond disagreement because protocol allegedly foreclosed standard-of-care DAAD treatment and caused worsening conditions; claim survives pleading stage

Key Cases Cited

Estelle v. Gamble, 429 U.S. 97 (1976) (Eighth Amendment deliberate indifference standard for denial of medical care)
Farmer v. Brennan, 511 U.S. 825 (1994) (deliberate indifference requires knowledge of and disregard for substantial risk to inmate health)
Monell v. Department of Social Services, 436 U.S. 658 (1978) (municipal liability under § 1983 requires an official policy or custom)
Bell Atlantic Corp. v. Twombly, 550 U.S. 544 (2007) (plausibility pleading standard)
Ashcroft v. Iqbal, 556 U.S. 662 (2009) (legal conclusions not accepted as true on a motion to dismiss)
Mayer v. Belichick, 605 F.3d 223 (3d Cir. 2010) (documents integral to complaint may be considered on a Rule 12(b)(6) motion)
Roe v. Elyea, 631 F.3d 843 (7th Cir. 2011) (administrative cost may be considered but not to the exclusion of reasonable medical judgment)