Yanez v. Walker

District Court, W.D. Virginia·Decided December 20, 2024·No. 5:24-cv-00025·Unknown

Opinion

ATHARRISONBURG, VA_ FILED December 20, 2024 LAURA A. AUSTIN, CLER IN THE UNITED STATES DISTRICT COURT BY: S/K. Lokey FOR THE WESTERN DISTRICT OF VIRGINIA DEPUTY CLERK HARRISONBURG DIVISION

Tammy Yanez, ) ) Plaintiff, ) ) v. ) Civil Action No. 5:24-cv-00025 ) Christine Walker ez a/, ) ) Defendants. )

MEMORANDUM OPINION This matter is before the court on Defendants Crystal Caruso-Wilson, Sara Henson, and Allison Palmer’s motion to dismiss under Federal Rules of Civil Procedure 12(b)(1) and 12(b)(6). (kt. 21.) The motion is fully briefed and is ripe for review. For the reasons stated below, the court will deny Defendants’ motion. I. Background This case arises out of the death of Brittney Shillingburg while she was incarcerated at the Rappahannock-Shenandoah-Warren County Regional Jail (“RSW”). (Compl. § 4 (Dkt. 1).) Plaintiff Tammy Yanez, as administrator of Shillineburg’s estate, brought this action against Defendants Christine Walker, LPN, Crystal Caruso-Wilson, LPN, Sara Henson, LPN, and Allison Palmer, CNA, all medical staff working at RSW at the time of Shillingburg’s death. (id. at 1.) Yanez raises a 42 U.S.C. § 1983 claim against all four Defendants for violation of

the Fourteenth Amendment, (id. ¶¶ 34–50), as well as a state-law claim for medical negligence brought under a wrongful death right of action, (id. ¶¶ 51–61). The facts are taken from Yanez’s complaint and, at this stage, are presumed to be true. See Ashcroft v. Iqbal, 556 U.S. 662, 678 (2009); Adams v. Bain, 697 F.2d 1213, 1219 (4th Cir. 1982).

On October 18, 2022, Shillingburg was admitted to RSW as a pretrial detainee. (Compl. ¶¶ 7, 35.) Shillingburg had been previously diagnosed with Congenital Adrenal Hyperplasia (“CAH”), a genetic disorder which results in adrenal insufficiency. (Id. ¶¶ 5, 8.) The disorder requires continuous glucocorticoid replacement therapy, often offered in the form of hydrocortisone. (Id. ¶ 6.) Failure to provide this medication can result in adrenal crisis and

eventually death. (Id. ¶¶ 5, 32.) RSW had documented Shillingburg’s condition during a prior incarceration at that facility and performed a health screening upon her intake on October 18. (Id. ¶¶ 7–8.) Shillingburg arrived at the facility with 42 tabs of hydrocortisone in her possession. (Id. ¶ 9.) Despite this, RSW did not offer Shillingburg any hydrocortisone from the date of her admission through the morning of October 21, 2022. (Id.) When RSW did offer the

medication, it offered it “floated,” or crushed into a powder and suspended on the surface of a liquid. (Id. ¶ 10 & n.1.) Staff at RSW claimed that it was “jail policy” to offer medication in this form. (Id. ¶ 10.) Because Shillingburg refused to take her medication floated, she did not take her medication until the evening of October 25, 2022. (Id.) During this time, Shillingburg’s family became aware that she was not taking her medication due to the jail’s policy of floating. (Id. ¶ 11.) They informed her doctor, who called - 2 - RSW on the morning of October 25 to voice his concern that Shillingburg was not taking her medication. (Id.) Specifically, her doctor noted that “he was concerned about her living, as this med [wa]s a life sustaining med.” (Id.) Walker answered and documented the call, including a request from Shillingburg’s doctor to speak with one of the doctors at RSW. (Id.)

Walker informed Shillingburg’s doctor that it was jail policy to float medication. (Id.) That evening, Walker attempted to administer Shillingburg’s medication again. (Id. ¶ 13.) Shillingburg refused, presumably because the medication was again floated, but agreed to take her medication in that form if the water was poured onto the crushed medication “right before taking” rather than leaving the medication “sitting in water for a long period of time.” (Id.)

Shillingburg’s doctor called RSW again on October 26, 2022. (Id. ¶ 14.) He directed that the hydrocortisone should not be floated when administered to Shillingburg. (Id.) Following this conversation, RSW’s Director of Nursing, Superintendent, and Assistant Superintendent agreed to no longer float Shillingburg’s medication. (Id. ¶¶ 14–15.) The Director of Nursing informed the nursing staff of this change. (Id. ¶ 15.) Shillingburg later began to receive her hydrocortisone in pill form. (Id. ¶ 16.)

Shillingburg also began experiencing symptoms of adrenal crisis that day. (Id. ¶¶ 17– 18.) Even “[d]uring acute illness,” adrenal crisis may be reversed by “simply increasing [the patient’s] medication by 2 or 3 times her normal dose.” (Id. ¶ 30.) If the patient is “unable to ingest the medications or if the increased dosage did not alleviate her symptoms,” transfer to a hospital for intravenous fluid and glucocorticoid administration is the next step of care. (Id. ¶¶ 30–31.) Untreated, adrenal crisis may result in death. (Id. ¶ 32.) - 3 - Throughout the day on October 26, Shillingburg reported to Henson and Caruso- Wilson symptoms consistent with adrenal crisis: She had no appetite, could not eat, felt light- headed and dizzy, and felt nauseated. (Id. ¶ 18.) Shillingburg was informed that she would be taken to see a doctor the next day. (Id.) She was not. (Id. ¶ 19.) Nor is there any indication

that Shillingburg’s condition was communicated to a medical doctor or other provider. (Id.) On October 27, Shillingburg interacted with Caruso-Wilson, Palmer, and Katharine Castillo, LPN, and informed them that she was unable to eat or drink, was exhausted, and was having difficulty standing upright. (Id.) The three staff members instructed Shillingburg to “try small sips” of water and take “small bites of food” but did not inform a doctor or other medical

provider. (Id.) They also offered her “Mylanta to see if that would help.” (Id.) On October 28, 2022, Walker was called to intake to examine Shillingburg for complaints of chest pain. (Id. ¶ 20.) Walker’s notes indicate that upon arrival, Shillingburg was “laying down and did not appear to be in any distress.” (Id.) Shillingburg did, however, report that she was “freezing,” had low energy, felt nauseated, and was having difficulty breathing. (Id.) Walker was unable to obtain Shillingburg’s vital signs during the visit. (Id.)

She did not inform any medical doctor or other provider of Shillingburg’s condition. (Id. ¶ 21.) Video footage of Shillingburg’s cell after this encounter shows Shillingburg “in significant distress and physical deterioration throughout the remainder of the day.” (Id. ¶ 22.) When a guard entered Shillingburg’s cell at 2:56 p.m. to offer her a cup of water, Shillingburg was unable to stand. (Id. ¶ 23.) Two minutes later, “Shillingburg rolled over on her back, and appeared to go limp.” (Id.) Shillingburg did not move from 3:02 p.m. to 3:38 p.m., when - 4 - guards re-entered her cell to check on her. (Id.) At that time, RSW staff began chest compressions. (Id. ¶ 24.) They continued until emergency medical services arrived and transported Shillingburg to Winchester Medical Hospital. (Id.) There, Shillingburg “went into cardiac arrest for another 30 minutes,” after which she was transferred to the Winchester

Medical Center ICU. (Id. ¶ 25.) Shillingburg remained in the ICU on “significant amounts of vasopressor support” until October 29, 2022, when her mother and brothers decided to transition her to comfort care. (Id. ¶ 26.) Shillingburg died a short time later. (Id.) The autopsy report listed Shillingburg’s cause of death as “complications of congenital adrenal hyperplasia.” (Id. ¶ 27.)

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