The American Civil Liberties Union (ACLU) of Colorado filed a federal class action lawsuit last week challenging the Colorado Department of Corrections’ systematic denial of life-saving treatment to more than 2,200 prisoners suffering from chronic Hepatitis C.
“Colorado has an immense public health crisis in its prisons. At least one in every nine prisoners suffers from Hepatitis C, and complications from the disease kill nearly as many Coloradans in custody every year as drug and alcohol abuse, homicide, and suicide combined,” said ACLU of Colorado Legal Director Mark Silverstein. “Highly-effective treatment is available that could prevent deaths and fight the spread of the virus, but DOC’s cruel and arbitrary standards deny that treatment to all but a select few prisoners, in violation of established medical standards and the Eighth Amendment.”
Hepatitis C is a life-threatening, communicable disease that attacks the liver, causing diminished liver function, cirrhosis, and liver failure. It is the most deadly infectious disease in the U.S., killing more Americans than the next 60 infectious diseases combined. Even in the initial stages of the disease, Hepatitis C can cause serious symptoms, including chronic fatigue, severe depression, arthritis, as well as an increased risk of heart attacks, diabetes, nerve damage, jaundice, and various cancers.
Breakthrough medications approved by the FDA over the last four years cure Hepatitis C in more than 90 percent of cases. The clinical standard of care, endorsed by a consensus of medical experts and associations, including the American Association for the Study of Liver Diseases and the Infectious Diseases Society of America, calls for administering these breakthrough medications to all persons with chronic Hepatitis C, even in the earliest stages of the disease.
In the Colorado Department of Corrections, however, prisoners suffering from Hepatitis C are not even considered for treatment until they have sustained measureable liver damage. Even then, they are required to enroll in alcohol and drug therapy that can take up to two and a half years to complete, a requirement that, according to the ACLU complaint, has no medical justification.
A DOC committee meets four times a year to choose a select few prisoners from a candidate pool, based on a yearly quota, to receive treatment.
The ACLU’s complaint alleges that DOC officials are deliberately allowing the vast majority of prisoners who are not selected for treatment to suffer and die from untreated Hepatitis C. In support, it quotes an email written last year by DOC Chief Medical Officer Susan Tiona to then-Senator Pat Steadman. At the time, DOC was planning to provide Hepatitis C treatment to 20-25 prisoners a year. With this plan, Dr. Tiona wrote, the DOC “should be effective in eliminating Department-wide deaths from Hepatitis C within the next decade” and “eliminating all additional complications from Hepatitis C by 2035.”
DOC now plans to treat up to 70 prisoners in the fiscal year beginning July, 2017. Even at that rate, it will take more than 10 years just to treat the 735 prisoners that are currently eligible under DOC’s unjustifiably restrictive criteria, according to the ACLU complaint. Meanwhile, DOC refuses to even consider treatment for more than 1500 additional prisoners who have not yet sustained enough liver damage to meet their criteria.
“Despite the availability of a cure, DOC plans to leave thousands of prisoners untreated, to continue releasing those untreated prisoners back to the community with a communicable disease, and to accept years of additional deaths and serious medical complications from untreated Hepatitis C,” said Silverstein. “Not only is that dangerous for public health, it is a cruel way to save some money in the short term that may end up costing taxpayers a lot more in the long term.”
Similar class action lawsuits are pending against departments of corrections in Massachusetts, Pennsylvania, Minnesota, Missouri, Tennessee, Florida, and Virginia.
The ACLU of Colorado lawsuit was filed last week in federal district court. In addition to Silverstein, attorneys representing the prisoners include ACLU staff attorneys Sara Neel and Arash Jahanian and a team of ACLU cooperating attorneys at the firm of Fox Rothschild, LLP, led by partner Christopher Beall.
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