Barfield v. Cook

District Court, D. Connecticut·Decided August 6, 2019·No. 3:18-cv-01198·Unknown

Opinion

UNITED STATES DISTRICT COURT DISTRICT OF CONNECTICUT

ROBERT BARFIELD, ET AL No. 3:18-cv-1198 (MPS) Plaintiffs,

v.

ROLLIN COOK in his official capacity as Commissioner of the Connecticut Department of Correction

Defendant.

RULING ON CLASS CERTIFICATION Plaintiffs Robert Barfield, John Knapp, Jason Barberi, and Darnell Tatem (together, “named Plaintiffs” or “Plaintiffs”) bring this putative class action lawsuit regarding medical care for incarcerated people infected with Hepatitis C against Rollin Cook in his official capacity (“Defendant”) as Commissioner of the Connecticut Department of Correction (“CT DOC”). Following the Court’s ruling on the Motion to Dismiss, the only claim remaining is Plaintiffs’ claim for various forms of injunctive relief against Cook in his official capacity for deliberate indifference to medical needs in violation of the Eighth Amendment under 42 U.S.C. § 1983.1

1 In the operative complaint, Plaintiffs brought suit against Commissioner Scott Semple in both his official and individual capacities. ECF No. 35 at ¶ 14. They alleged three claims against Semple in his official capacity as Commissioner of the CT DOC: (1) deliberate indifference to medical needs in violation of the Eighth Amendment under 42 U.S.C. § 1983 (Count One); (2) violation of the Americans with Disabilities Act, 42 U.S.C. § 12131 et seq. (Count Two); and (3) violation of the Rehabilitation Act, 29 U.S.C. § 701 et seq. (Count Three). They also alleged deliberate indifference to medical needs in violation of the Eighth Amendment under 42 U.S.C. § 1983 against Semple in his individual capacity (Count Four). After Cook became the new Commissioner of the CT DOC, Plaintiffs moved to substitute Cook as the official capacity defendant under Federal Rule of Civil Procedure 25(d). ECF No. 44. Absent objection, the Court granted the motion to substitute. ECF No. 48. In its ruling on the Motion to Dismiss, the Court dismissed Counts Two, Three, and Four as well as all claims brought by Davis and certain claims Plaintiffs move to certify a class consisting of “all people who are or will be prisoners in the custody of the [CT DOC], and who have or will have Hepatitis C while in custody and have not yet been cured.” ECF No. 32 at 1. For the reasons discussed below, this motion is GRANTED to the extent set forth in this ruling.

I. FACTS These facts are drawn from the operative complaint, the parties’ briefs on class certification, and the accompanying affidavits and exhibits. Hepatitis C Hepatitis C is a blood-borne disease caused by the Hepatitis C Virus (“HCV”). ECF No. 35 at ¶ 25. HCV causes inflammation that damages liver cells, and is a leading cause of liver disease and liver transplants. Id. It is transmitted through contact with infected blood and can be

transmitted through intravenous drug use, tattooing, blood transfusions, and sexual activity. Id. at ¶ 26. HCV can be either acute or chronic. Id. at ¶ 27. Acute HCV clears itself from the blood stream within six months of exposure. Id. Chronic HCV is a long-term illness that is defined as having a detectable HCV viral level in the blood six months after exposure. Id. People with chronic HCV develop fibrosis of the liver, which is a process that replaces healthy liver tissue with scarring, thereby reducing liver function. Id. at ¶ 29. When scar tissue takes over most of the liver, it is called cirrhosis. Id. at ¶ 30. Cirrhosis may not be reversible and can cause complications even after the HCV is treated. Id. at ¶ 33. Fibrosis can also lead to liver cancer. Id. at ¶ 29. In addition, chronic HCV can cause kidney disease, internal bleeding, and a host of other serious medical issues. Id. at ¶¶ 28-31, 35. It can also cause death. Id. at ¶ 31.

related to testing. ECF No. 60. Thus, only Count One remains, and only Barfield, Knapp, Barberi, and Tatem have standing to proceed. Approximately 2.7 to 3.9 million Americans have chronic HCV and approximately 19,000 people die of HCV-caused liver disease each year in the United States. Id. at ¶¶ 39, 42. The prevalence of HCV in prison is much higher than in the general population. Id. at ¶ 44. It is not clear how many people in the CT DOC system have HCV, but a recent study shows that 10- 12 percent of the population at the New Haven Correctional Center had HCV in 2015. Id. at ¶¶

45, 55, 58. Standard of Care for HCV In the past, the standard treatment for HCV, which included the use of interferon and ribavirin medications, had long treatment durations, failed to cure most patients, and was associated with many side effects. Id. at ¶ 62. In 2011, however, the Food and Drug Administration (“FDA”) began approving new oral medications called direct-acting antiviral drugs (“DAAs”). Id. at ¶ 63.While the DAAs were initially designed to work with the old treatment regimen, in 2013 the FDA began to approve DAAs that can be taken alone. Id. DAAs work more quickly, cause fewer side effects, and treat chronic HCV more effectively than the

old treatment; in fact, 90 to 95 percent of HCV patients treated with DAAs are cured, whereas the old treatment regime cured only roughly one-third of patients. Id. at ¶¶ 63-65.2 The American Association for the Study of Liver Diseases (“AASLD”) and the Infectious Disease Society of America (“IDSA”) set forth the medical standard of care for the treatment of HCV. Id. at ¶¶ 67-68. The IDSA/AASLD guidelines recommend that all people with risk factors for HCV be tested, including both those born between 1945 and 1965 and all those who were ever incarcerated. Id. at ¶ 75. The guidelines also recommend immediate treatment with DAA

2 For HCV, a “cure” is defined as a sustained virologic response—i.e., no detectable HCV genetic material in the patient’s blood—for three months following the end of treatment. ECF No. 35 at ¶ 66. drugs for all people with chronic HCV. Id. at ¶ 69. The Centers for Disease Control and Prevention (“CDC”) encourages healthcare professionals to follow this standard of care. Id. at ¶ 67. The Medicaid guidelines are consistent with this standard of care, as they eliminated any requirement that there be evidence of hepatic fibrosis before covering DAA treatments. Id. at ¶ 71.

The benefits of immediate treatment include immediate decrease in liver inflammation, reduction in the rate of progression of liver fibrosis, reduction in the likelihood of the manifestations of cirrhosis and associated complications, a 70 percent reduction in the risk of liver cancer, a 90 percent reduction in the risk of liver-related mortality, and a dramatic improvement in quality of life. Id. at ¶ 73. Delay in treatment increases the risk that treatment will be ineffective. Id. at ¶ 74. HCV Treatment at CT DOC In 1997, CT DOC and the University of Connecticut Health Center (“UCHC”) entered into a Memorandum of Agreement (“MOA”) for the provision of health care to offenders

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