290 F. Supp. 3d 1292
N.D. Fla.2017Background
- Three named FDC inmates with chronic hepatitis C (Hoffer: decompensated cirrhosis; McPherson and Molina: compensated cirrhosis) sued the Florida Department of Corrections (FDC) seeking class relief for all current/future inmates with chronic HCV, alleging unconstitutional denial of needed treatment.
- Direct-acting antivirals (DAAs) introduced in 2013 cure ~95% of HCV with brief, well‑tolerated courses but are expensive; FDC treated very few inmates (13 total through mid‑2017).
- FDC historically outsourced care to contractors (Corizon, Wexford, Centurion); internal testimony shows repeated refusals or failures to fund DAA treatment and aborted plans (e.g., the “Kennedy 12”).
- Plaintiffs moved for a preliminary injunction to compel FDC to screen, prioritize, and treat inmates consistent with medical guidance; the court held a multi‑day evidentiary hearing.
- The court found chronic HCV is a serious medical need, that FDC had subjective knowledge of the risk and had been deliberately indifferent (funding delays and inadequate policy implementation), and that injunctive relief was necessary to prevent irreparable harm.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether denial/delay of DAA treatment violates the Eighth Amendment | FDC's policies/practices amount to deliberate indifference to serious medical needs of HCV‑infected inmates | Funding constraints and administrative/resource limits justify delays; FDC is revising policy and made promises to treat | Court: Plaintiffs likely to succeed; FDC deliberately indifferent; injunction appropriate |
| Whether past failures moot injunctive relief | Past misconduct plus ongoing inadequate implementation create imminent risk of future harm warranting injunction | Past promises and a recent letter to contractor suggest the issue is being addressed and the case may be mooted | Court: Promises insufficient and implementation too slow; case not moot; injunction necessary |
| Scope and content of relief (policy + implementation) | Court should order concrete policy revisions, prioritization, timetables, capacity increases, and treatment timelines aligned with expert guidance | FDC seeks to prepare its own plan and argues resource/administrative burden | Court: Grants preliminary injunction directing FDC to revise policy and file a detailed plan (timelines, capacity) by specified date |
| Weight of public interest and equities | Inmates face severe irreversible harms; public health benefits from treating prison HCV | Monetary and administrative burden on FDC/government | Court: Public interest supports injunction; financial burden does not outweigh constitutional rights |
Key Cases Cited
- Wilson v. Seiter, 501 U.S. 294 (1991) (Eighth Amendment deliberate indifference framework applies to prison conditions)
- Estelle v. Gamble, 429 U.S. 97 (1976) (deliberate indifference to serious medical needs violates the Eighth Amendment)
- Farmer v. Brennan, 511 U.S. 825 (1994) (knowledge of risk standard for Eighth Amendment deliberate indifference)
- Wreal, LLC v. Amazon.com, Inc., 840 F.3d 1244 (11th Cir. 2016) (preliminary injunction standard)
- Goebert v. Lee County, 510 F.3d 1312 (11th Cir. 2007) (elements of deliberate indifference claim)
- Mann v. Taser Int'l, Inc., 588 F.3d 1291 (11th Cir. 2009) (definition of serious medical need)
- Ancata v. Prison Health Servs., Inc., 769 F.2d 700 (11th Cir. 1985) (contracting out medical care does not absolve constitutional duties)
- Cottone v. Jenne, 326 F.3d 1352 (11th Cir. 2003) (supervisory liability where policy/custom causes deliberate indifference)