Damages class may proceed over prison contractor’s opioid treatment policy

The 4th U.S. Circuit Court of Appeals upheld certification of a damages class alleging that a private prison healthcare contractor unconstitutionally denied treatment for opioid use disorder, but remanded for further findings on whether the plaintiffs could pursue injunctive relief.

The plaintiffs alleged that the defendant maintained a policy excluding screening and medication-assisted treatment for opioid use disorder from the medical care it provided in correctional facilities. According to the plaintiffs, the policy forced incarcerated individuals into painful and medically risky withdrawal, violating the Eighth and Fourteenth Amendments.

The 4th Circuit treated the certified classes separately. As to the injunctive relief class, the court held that the record required further development. Because standing for prospective relief depends on a real and immediate threat of future harm, the court remanded for fact-specific findings on whether the named plaintiffs faced a sufficient likelihood of future exposure to the challenged policy.

But the court affirmed certification of the damages class. It concluded that the class was ascertainable from the defendant’s own records, including diagnoses, prescriptions and withdrawal monitoring. The court also found that common questions predominated, including whether the defendant had a uniform policy excluding opioid-use-disorder treatment and whether that policy amounted to deliberate indifference to serious medical needs.

The court rejected the defendant’s argument that individualized issues defeated certification. The alleged constitutional injury was the denial of medically necessary care itself, not the precise withdrawal symptoms or damages experienced by each class member. Variations in damages did not defeat predominance, particularly where the plaintiffs offered a class-wide model tied to the duration of denied treatment.

The 31 page opinion is Spurlock v. Wexford Health Sources Inc., Lawyers Weekly No. 001-159-26.