Inmate loses case over health care

Prisoners can’t sue for damages when they are denied health care because the state has failed to provide enough funding for medical staff or supplies, a divided federal appeals court ruled Thursday.

In the case of a Southern California inmate whose treatment for a painful dental condition was delayed because the prison was short of dentists and technicians, the Ninth U.S. Circuit Court of Appeals in San Francisco ruled 6-5 that prison employees are immune from damage claims when the cause is a lack of state funds.

“A prison medical official who fails to provide needed treatment because he lacks the necessary resources can hardly be said to have intended to punish the inmate,” Chief Judge Alex Kozinski said in the majority opinion. He noted that prisoners seeking damages must prove, under federal law, that government employees intentionally violated their rights or were “deliberately indifferent” to their needs.

Kozinski said prisoners can still sue the state and its employees for continuing to deny needed medical care. Courts in such lawsuits can order the state to provide additional services, as a three-judge court has done in a long-running case over health care in the California prison system.

But dissenting judges said court orders for future treatment won’t help inmates who have already been denied essential care.

“What good is (a treatment order) to a prisoner whose appendix has burst?” asked Judge Morgen Christen. “Without the ability to seek damages, prisoners who sustain injuries from overcrowding and underfunding will be denied any meaningful form of relief,” she said, and the state will have little incentive to improve conditions.

The inmate, Cion Peralta, sought dental care at the state prison in Lancaster (Los Angeles County), complaining of pain and bleeding gums. He was put on a waiting list, was given pain medication, and was later brought in to have his teeth cleaned. He spent 18 months on the nonemergency care list and developed periodontitis and bone loss, the court said.

At the time, the prison had three or four dentists, three or four assistants and no office technicians. The state says prisons should have one dentist for every 950 prisoners, but the ratio at Lancaster was about one for every 2,000, the court said.

Peralta sued the dentist who treated him and the prison’s chief dental and medical officers, claiming deliberate indifference to his needs. The state would have paid any damages awarded against them. But the court upheld a federal judge’s ruling dismissing the damage claims because of a lack of state resources.