Corizon Health, LLC settled a recent class action brought against it for 1.7 million dollars related to the way the company handled prisoners with hernias.
For those who don’t know, Corizon, a private correctional healthcare provider, was under contract with the FDOC beginning in 2013 to provide healthcare services in most Florida’s prisons.
The Lawsuit claimed that Corizon allowed many incarcerated individuals to experience undue pain and suffering, and in some cases death, because of a policy of not providing surgical consultation and/or correction.
The Eighth Amendment guarantees the right of prisoners to be free from cruel and unusual punishment. In the medical context, the standard is one of deliberate indifference.
A healthcare provider or prison guard can be deliberately indifferent if the prisoner had an objective serious medical need, and the doctor, nurse or guard, appreciated the risks of the prisoner’s condition and did nothing.
The Supreme Court in Estelle v. Gamble explained deliberate indifference this way: the Eighth Amendment safeguards the prisoner against a lack of medical care that “may result in pain and suffering which no one suggests would serve any penological purpose.
Courts when looking at deliberate indifference claims perform a the two step analysis discussed above. The Seventh Circuit Court of Appeals said: the first step is examining whether a prisoner suffered from an objectively serious medical condition, and then determining whether the individual defendant was deliberately indifferent to that condition.
Typically, hernias are categorized as serious medical conditions.
A hernia happens when there is a breakdown in the soft tissue structures in the abdominal wall. The hernia derives its name based on the location of the breakdown. An umbilical hernia is a breakdown of the wall around the “belly-button”. An inguinal hernia is a breakdown or weakness in the inguinal ring; located in the groin area. Inguinal hernias are more common in men whereas femoral hernias are more common in women.
In men, the internal and external inguinal rings are around and above a tract that leads directly into the scrotum. When abdominal contents travel through the weakness in the inguinal area, the abdominal contents descend into the inguinal tract, into the scrotal sac and around the testicle. Because the inguinal tract and scrotal area are small contained spaces, the risk of incarceration (tissue becomes trapped) or strangulation (part of intestine or other tissue gets trapped and cuts off the blood supply) of the bowel is high and must be monitored by healthcare providers following patients with inguinal hernias.
Because of the location in the groin, inguinal hernias cause severe pain. The pain can increase with movement or that increases intraabdominal pressure like straining while making a bowel movement, urinating, climbing, lifting, coughing or sneezing.
When the intestinal contents travel into the scrotum, every time intraabdominal pressure is increased (i.e. a sneeze), it feels like the person is being kicked in the gonads (nuts, balls). The only treatment for an inguinal hernia is surgical repair. Without surgery, the tear or weakness in the abdominal doesn’t heal, and the patient will experience continued pain and discomfort. The risk of developing complications, which can be life threatening, increases with time.
The proper treatment for a hernia begins with referral to a general surgeon for a surgical consultation. The term general surgeon is a misnomer because a “general surgeon” is a surgeon that specializes in abdominal surgery. The standard of care or generally accepted medical practice for a patient with a hernia is to perform surgery if the patient is symptomatic. This means if the patient is experiencing continued pain, the inability to walk, work or engage in other normal life activities, or other symptoms.
The major complications associated with inguinal hernias are strangulation and incarceration.
A strangulated hernia is when a piece of bowel or other tissues gets caught in the inguinal canal and/or scrotum, and the blood supply gets “strangled off”. With no blood supply, the bowel can become gangrenous and die.
An incarcerated hernia happens when tissue becomes trapped.
Surgical Treatment for Hernias
Surgery can be performed laparoscopically or open. Typically, a mesh or other material is used cover up the defect in the abdominal wall or inguinal ring.
The Corizon Settlement
In the proposed settlement that is waiting for court approval, $1.7 million dollars will be distributed between 1788 folks.