A federal judge earlier this month refused to dismiss a constitutional rights lawsuit filed against the Jefferson County jail’s medical contractor, involving multiple personnel who allegedly failed to provide adequate care to a detainee before she died of an infection.

Abby Angelo entered the Jeffco jail on June 19, 2021 following her arrest. Nine days later, deputies found her unresponsive. Her cause of death was allegedly tricuspid valve endocarditis, a heart infection that may not have been fatal had Angelo received antibiotics or even surgery.

Angelo’s surviving child and his legal guardian sued the jail’s medical contractor, Wellpath, as well as the five nurses who interacted with Angelo in the days leading up to her death. The plaintiffs alleged the defendants were liable for failing to provide medical care in violation of Angelo’s constitutional rights, as well as negligence and wrongful death.

In a May 20 order, U.S. District Court Judge Charlotte N. Sweeney denied Wellpath’s motion to dismiss. She noted the plaintiffs were arguing two theories: First, that the defendants failed to properly treat a serious medical condition and, second, they denied access to medical professionals who could have capably addressed Angelo’s illness. The lawsuit, Sweeney determined, credibly alleged both types of violations.

“The Wellpath Defendants also state that ‘it is unclear why Plaintiffs take issue with’ the course of treatment. The issue is clear: the treatment was woefully inadequate, and Ms. Angelo died,” she wrote.

Sweeney is also handling a lawsuit involving another Jeffco jail detainee who allegedly had a life-threatening dental condition that Wellpath employees disregarded — including one of the nurses who saw Angelo. Sweeney repeatedly cited to her similar ruling declining to dismiss that case, while she analyzed the allegations underlying Angelo’s death.

According to the plaintiffs’ lawsuit, Wheat Ridge police took Angelo into custody on multiple warrants for failing to appear in court. At the jail, deputies saw Angelo’s health declining and contacted Wellpath employees for assistance. Among other things, Angelo was too weak to walk, felt sick, and had shortness of breath and low oxygen saturation levels.

One day before her death, a nurse put her on an opiate withdrawal protocol, which was not the source of her problems. The next afternoon, deputies found her dead of a heart infection, aged 29.

The plaintiffs sued licensed practical nurses Carrie Earle, Rebecca Strong and Courtney Slowey, as well as registered nurses Nicole Wolf and Esmeralda Ziegelmann. They claimed the nurses’ “wait and see” approach was an unreasonable response to Angelo’s obvious health problems.

The lawsuit also named Wellpath itself as a defendant, pointing to several other instances in Jeffco and beyond where detainees died or suffered from illness on Wellpath’s watch.

“The contract between the Jefferson County Defendants and Wellpath financially incentivizes reductions in the use of necessary off-site medical services for inmates,” the plaintiffs’ lawyers wrote. “Such a provision invites reckless risk-taking to save money.”

The Wellpath employees moved to dismiss the claims against them, as did the other defendants, Jefferson County and elected Sheriff Reggie Marinelli. Jeffco brushed aside the plaintiffs’ reference to other medically injured detainees, calling them “a handful of dissimilar adverse medical events” that were “indicative only of the fact that incarcerated individuals, like the rest of our community, may have health issues with significant and even fatal outcomes regardless of the medical care they receive.”

Sweeney largely sided against the defendants. The allegations established Angelo had concerning symptoms, which even the non-medically trained deputies recognized, but the nurses neither adequately treated them nor escalated to someone who could. Wellpath’s own protocols were also allegedly behind the inaction.

“Plaintiffs have sufficiently alleged the existence of two informal policies: financial disincentives to providing off-site care, and nurses practicing beyond their abilities, failing to escalate care, and using a ‘wait and see’ approach,” she wrote. “Plaintiffs also established causation: if the nurses had been trained to escalate care, Ms. Angelo’s death could have been avoided if she had been seen by emergency care providers.”

Sweeney further concluded Marinelli, but not the county board, could be held liable for Wellpath’s constitutional violations under the theory that the sheriff could not delegate to a third party her ultimate obligation to provide adequate medical care. Sweeney noted the claims could proceed against Marinelli on those grounds, but not because Jeffco was on notice Wellpath’s procedures would allegedly lead to a constitutional violation, as the plaintiffs suggested.

“However,” Sweeney warned Jeffco, “over time, substantiation of similar allegations across multiple lawsuits may eventually serve as sufficient notice to Jefferson County.”

The case is Estate of Angelo et al. v. The Board of County Commissioners et al.