The Denver Women’s Correctional Facility.

The Denver Women’s Correctional Facility.

The estate of an inmate who died from cancer in the custody of the Colorado Department of Corrections may sue workers for deliberate indifference to her medical needs, a federal court has ruled.

The deceased’s cancer “was an objectively serious medical need and the delay in receiving treatment caused substantial harm,” wrote U.S. Magistrate Judge Nina Y. Wang in a Dec. 17 order.

Gabrielle Medina was arrested in January 2018 and pleaded guilty to multiple misdemeanors and parole violations. She arrived at Denver Women’s Correctional Facility to serve her sentence in May of that year. Upon intake, Medina reportedly revealed she had cervical cancer and required radiation.

Medina sent a request in June to health employees for an update on the resumption of her cancer treatment. At that point, she had gone two months without it and her symptoms, according to the legal complaint, had gotten worse. She received neither services nor an appointment with an outside cancer center.

In October 2018, a doctor observed Medina’s cancer had advanced, but allegedly did not provide treatment, according to court records. Throughout the month, Medina complained of heavy bleeding and also suffered a seizure. A nurse at the prison advised menstrual pads and education about a healthy diet, the lawsuit described.

It was in November that Medina finally had an evaluation at a cancer center, and began chemotherapy and radiation treatment in December, seven months after arriving at the correctional facility. However, records indicated that between February and April 2019, prison nurses did not refer her for further treatment, despite worsening symptoms. By the summer, the cancer had spread throughout her body.

Although Medina received additional chemotherapy and radiation in July, she died in October 2019 at age 27.

Medina’s estate sued the warden and several personnel at the prison, alleging they showed deliberate indifference to her medical needs, violating her Eighth Amendment right against cruel and unusual punishment.

In response, several CDOC employees asked Wang to toss out the lawsuit, calling Medina’s death “a result of the unfortunately poor choices she made.” The defendants noted dozens of occasions dating to 2014 in which Medina canceled medical appointments, failed to show or did not heed advice to follow up.

“The evidence shows that Ms. Medina’s cervical cancer was diagnosed as early as 2015 and that, unfortunately, she consistently refused the offered medical treatment,” they argued in response to the allegations, adding, “it was actually Ms. Medina who disregarded an excessive risk to her own health.”

The magistrate judge declined to dismiss the claim against Leto Quarles, a prison physician who discontinued two of Medina’s pain medications following chemotherapy.

“To be sure, an inmate does not have a constitutional right to a particular course of treatment or narcotic pain medication,” she wrote. “Nor is a mere disagreement with treatment enough to demonstrate a medical provider’s deliberate indifference, even if the rendered treatment is subpar. But the allegations here go beyond a desire for a particular treatment or a disagreement with treatment,” and Quarles’s actions failed to abate Medina’s pain.

Wang agreed to dismiss the claims against several other CDOC employees, finding Medina’s estate had not shown what they could have done to address her needs. She did find the allegations sufficient to allow the lawsuit to proceed against Tiffany Neary and Jill Keegan, two nurses who were accused of failing to refer or treat Medina for her cancer, as well as Randolph Maul, the CDOC’s chief medical officer.

While medical records may prove otherwise at trial, Wang determined the allegations demonstrated an awareness of “Medina’s increasing pain and discomfort associated with her cervical cancer and that the need for medical treatment was so obvious that the delay in treatment was patently unreasonable.”

In response, the defendants listed at least half a dozen instances of Medina declining services from her nurse.

Raymond K. Bryant, an attorney with Civil Rights Litigation Group who represents Medina’s estate, acknowledged the defendants’ argument that Medina had refused her own medical care on occasion. However, he asserted most of her no-shows and cancellations were the fault of the CDOC, saying Medina was too sick to transport herself while in their care.

“The inaction of these defendants over the course of such a prolonged period of time and in the face of such extreme suffering represents more than just deliberate indifference to prisoner needs, it represents callous disregard for human life,” Bryant said. “It is a travesty that many of them still maintain responsibility for inmates in the DOC system, either as employees or private medical contractors.”

The Department of Corrections and attorneys for the defendants did not immediately respond to a request for comment.

The case is Estate of Gabrielle Medina v. Samuels et al.

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