Source: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-almd-2_14-cv-00601/USCOURTS-almd-2_14-cv-00601-34/pdf.json

Nature of Suit Code: 446
Nature of Suit: Americans with Disabilities Act - Other
Cause of Action: 42:12102 Americans with Disabilities Act ("ADA")

---

IN THE DISTRICT COURT OF THE UNITED STATES FOR THE

MIDDLE DISTRICT OF ALABAMA, NORTHERN DIVISION

EDWARD BRAGGS, et al., )

)

 Plaintiffs, )

) CIVIL ACTION NO.

 v. ) 2:14cv601-MHT

) (WO)

JEFFERSON S. DUNN, in his )

official capacity as )

Commissioner of )

the Alabama Department of )

Corrections, et al., )

)

 Defendants. )

PHASE 2A CLASS CERTIFICATION OPINION

The plaintiffs in this putative class-action 

lawsuit are dozens of state prisoners and the Alabama 

Disabilities Advocacy Program (ADAP). The defendants 

are officials of the Alabama Department of Corrections 

(ADOC): the Commissioner and the Associate Commissioner 

of Health Services.1 They are sued in their official 

capacities only.

 

1. ADOC itself is also a party, but with respect 

to only claims under the Americans with Disabilities 

Act (ADA), 42 U.S.C. § 12131 et seq., and § 504 of the 

(continued...)

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In Phase 2A of this case, with which this opinion 

is concerned, ADAP and a subset of individual named 

plaintiffs assert the following claims: 

constitutionally inadequate mental-health treatment in 

Alabama prison facilities and involuntary medication 

without due process. They rely on the Eighth and 

Fourteenth Amendments, as enforced through 42 U.S.C. 

§ 1983. Plaintiffs seek declaratory and injunctive 

relief. Jurisdiction is proper under 28 U.S.C. § 1331 

(federal question) and § 1343 (civil rights).2 The case 

 

Rehabilitation Act of 1973, codified at 29 U.S.C. 

§ 794, which are nearly settled and therefore not 

discussed in this opinion. See Joint Status Report 

(doc. no. 968) at 5 (“Plaintiffs and Defendants ADOC 

have agreed in substance to a settlement that resolves 

the Phase 2A ADA issues. These parties continue to 

work to resolve the Plaintiffs’ claims for attorneys 

and monitoring fees for these issues.”). To the extent 

that the parties are not successful in reaching a final 

resolution of these claims, they have reserved them for 

later adjudication. See Phase 2 Order on Remaining ADA 

Claims (doc. no. 981).

2. This case has twice been bifurcated for the 

administrative convenience of the court and the 

parties. The claims in Phase 1, which the parties 

settled with a consent decree approved by the court, 

involve ADA claims alleging discrimination on the basis 

(continued...)

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is proceeding on two parallel tracks consisting of 

ADAP’s claims and the individual named plaintiffs’ 

claims.

In August 2016, more than two years after this case 

was filed and after extensive discovery, the individual 

plaintiffs formally moved for certification of a Phase 

2 class, while ADAP pursued its claims separately as an 

association whose constituents include the mentally ill 

prisoners in ADOC’s custody.3

 

of and non-accommodation of physical disabilities. See

Dunn v. Dunn, -- F.R.D. --, 2016 WL 4718216 (M.D. Ala. 

Sept. 9, 2016) (Thompson, J.). The claims in Phase 2B, 

which are set to go to trial after the Phase 2A claims 

(should they survive summary judgment), involve Eighth 

Amendment claims related to medical and dental care.

3. As the court explained to the parties during 

the briefing process, it will, at this time, decide the 

motion only as to the Phase 2A claims, although the 

motion was filed for both Phase 2A and Phase 2B. 

Plaintiffs describe the class they seek to certify for 

purposes of Phase 2A as a mental-health subclass of a 

larger health care class they seek to have certified. 

As this case has been bifurcated into mental-health 

care and medical/dental care phases, the court will 

consider whether the mental-health class certified here 

should be considered a subclass of any future health 

care class when considering whether to certify such a 

class.

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For reasons that follow, the motion for class 

certification filed by the individual plaintiffs 

(hereinafter referred to simply as plaintiffs) will be 

granted in part and denied in part, and two classes 

certified. The court has narrowed the scope of the 

mental-health care Eighth Amendment class, and winnowed 

down the involuntary-medication due-process claim to 

the portion suitable for class certification.

I. Rule 23(c)(1)(B)

Federal Rule of Civil Procedure 23(c)(1)(B) 

requires a certification order to “define the class and 

the class claims, issues, or defenses”; therefore, a 

court must consider the propriety of certification in 

relation to a specific putative class definition and 

specific putative class claims.

Plaintiffs seek certification of a Rule 23(b)(2) 

class consisting of “all persons with a serious mental 

health disorder or illness who are now, or will in the 

future be, subject to Defendants’ mental health care 

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policies and practices in ADOC facilities.” Pls.’ 

Reply Br. (doc. no. 890) at 57.4

The first claim plaintiffs seek to bring on behalf 

of this class is that defendants are violating the 

 

4. Defendants note that plaintiffs initially 

sought certification of a class of all prisoners 

subject to defendants’ mental-health care policies and 

practices. Plaintiffs have clarified that they seek 

certification of a narrower class, limited to prisoners 

with serious mental illnesses. Because there is some 

case law to suggest that healthy prisoners cannot raise 

Eighth Amendment health care claims, the court will 

employ the class definition limited to prisoners 

(current or future) with serious mental illness, in an 

exercise of its discretionary authority to “reshape the 

boundaries and composition of the class” based on a 

“determination that reformulating the class will better 

serve the purposes of Rule 23 and the underlying 

policies of the substantive law than would denying 

certification altogether.” Shelton v. Bledsoe, 775 

F.3d 554, 564 (3d Cir. 2015) (quoting Tobias Wolff, 

Discretion in Class Certification, 162 U. Pa. L. Rev. 

1897, 1925 (2014)). In doing so, the court notes that 

the effect of this choice of a narrower class 

definition on the progress of the case and on any 

eventual relief will be virtually nil. Plaintiffs’ 

Eighth Amendment claim does not concern the adequacy of 

mental-health care being provided to prisoners who are 

not seriously mentally ill. (Plaintiffs do contend 

that defendants fail to recognize many prisoners’ 

serious mental illnesses. The interests of class 

members in this category will be addressed at trial, 

because one of the practices plaintiffs challenge is 

(continued...)

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Eighth Amendment by failing to provide constitutionally 

adequate mental-health care to prisoners with serious 

mental illnesses. Specifically, they allege that 

defendants have been deliberately indifferent to a 

substantial risk of serious harm posed to the putative 

class members by a number of policies and practices 

(both separately and in combination). Although these 

policies and practices, according to both parties’ 

experts, sometimes contribute to each other, it is 

helpful to parse them in order to ensure that the 

putative class can properly challenge them.

Plaintiffs take the position that they need not 

demonstrate the suitability for class-wide adjudication 

of any particular policy or practice, and that they 

need only demonstrate that the overarching claim of 

inadequate mental-health care is appropriate for 

certification. But, as in Parsons v. Ryan, a similar 

recent case, the court must dive somewhat deeper. 289 

 

defendants’ failure to adequately screen prisoners for 

mental illness.)

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F.R.D. 513, 522-23 (D. Ariz. 2013) (Wake, J.)

(certifying a state-wide class of prisoners challenging 

systemic deficiencies in both medical and mental-health

care). Although the court agrees that plaintiffs have 

brought only one Eighth Amendment “claim,” this claim--

as it has been formulated by plaintiffs--turns on 

evaluating the risk of harm posed by particular 

policies and practices. The court will need to ensure, 

therefore, that these policies and practices are common 

to the class, and that representatives have been put at 

risk by them. Defendants, for their part, seek to 

atomize the claims of plaintiffs by focusing on the 

minutiae of unimportant distinctions, failing to see 

the forest for the trees (and leaves).

The court is thus left with the task of reaching an 

appropriate middle ground, and defining the policies 

and practices at issue in a way that recognizes themes 

articulated in the allegations and the voluminous 

quantity of record evidence the court has reviewed, 

while ensuring that defendants are not left to face a 

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singular amorphous contention that the mental-health

care they are providing is not good enough. Despite 

plaintiffs’ protestations, the headings in their

complaint do an admirable job in this respect, and the 

court has drawn heavily upon them in formulating the 

following list.

The eight policies and practices at issue in 

plaintiffs’ Eighth Amendment claim are:

(1) Failing to provide adequate numbers of and 

sufficiently qualified mental-health staff.

(2) Failing to provide adequate levels of custodial 

staffing to avoid regular security-related 

interruptions to or interference with the 

provision of mental-health care.

(3) Failing to identify mental illness or recognize 

the severity of mental illness, at initial 

screenings, in future classification and 

placement decisions, and in response to 

referrals.

(4) Failing to prescribe and manage psychotropic 

medication and its side effects appropriately.

(5) Failing to provide more than cursory

psychotherapeutic care and counseling.

(6) Failing to protect prisoners who are suicidal 

or engage in self-harm by inadequately 

monitoring and treating them and providing 

inadequate follow-up care.

(7) Placing prisoners in segregation without regard 

to its harmful effects on their mental health.

(8) Disciplining prisoners based on behavior that 

results from mental illness.

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In addition, plaintiffs seek to raise on behalf of 

the class due-process claims related to involuntary 

medication. These, too, require some disaggregation. 

Plaintiffs seek to challenge three discrete policies or 

practices:

(1) Denying substantive due process to prisoners 

subject to involuntary-medication orders by 

beginning or continuing to require them to be 

medicated absent a recent finding that they 

pose a danger to themselves to others.

(2) Denying procedural due process to prisoners 

subject to involuntary-medication orders by 

failing to provide them adequate notice of 

hearings and other protections provided for in 

the applicable regulation.

(3) Denying substantive and procedural due process 

to prisoners who are not subject to 

involuntary-medication orders by coercing

consent.

For the reasons set forth below, the court will 

certify two classes, as follows.

With respect to plaintiffs’ Eighth Amendment 

challenge to the eight policies and practices 

enumerated above, the court will certify a class of 

“all persons with a serious mental-health disorder or 

illness who are now, or will in the future be, subject 

to defendants’ mental-health care policies and 

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practices in ADOC facilities, excluding the work 

release centers and Tutwiler Prison for Women.” 

Plaintiffs (and defendants) have agreed that prisoners 

at the work release centers should be excluded from the 

class definition; the court will explain below, in the 

context of its discussion of commonality, why it has 

also decided to exclude the female prisoners at 

Tutwiler.

With respect to plaintiffs’ challenge to the policy 

or practice of denying procedural due process to 

prisoners subject to involuntary medication orders by 

failing to provide them adequate notice of hearings and 

other protections provided for in the applicable 

regulation, the court will also certify a class of “all 

persons with a serious mental-health disorder or 

illness who are now, or will in the future be, subject 

to defendants’ formal involuntary medication policies 

and practices.” The court has decided, in an exercise 

of its discretion to manage this litigation, not to 

certify for class-wide litigation plaintiffs’ 

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substantive due-process challenge to the policy or 

practice of requiring involuntary medication without a 

recent finding of dangerousness--which turns at least 

in significant part on an inherently individualized 

determination--or their challenge to the policy or 

practice of obtaining consent through coercion. 

However, the individual plaintiffs who have brought 

these claims will proceed to trial; ADAP, through its 

associational standing, may represent the interests of 

unnamed prisoners who are subject to these policies and 

practices.

II. Evidentiary Burden

In Wal-Mart Stores, Inc. v. Dukes, 564 U.S. 338 

(2011), the Supreme Court explained that “Rule 23 does 

not set forth a mere pleading standard. A party 

seeking class certification must affirmatively 

demonstrate his compliance with the Rule--that is, he 

must be prepared to prove that there are in fact

sufficiently numerous parties, common questions of law 

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or fact, etc.” 564 U.S. at 350. A court should only 

certify a class if it “is satisfied, after a rigorous 

analysis that the prerequisites of Rule 23(a) have been 

satisfied.” Comcast Corp. v. Behrend, 133 S. Ct. 1426, 

1432 (2013).5

The Supreme Court has been clear that what the 

party seeking certification must “affirmatively 

demonstrate,” and what the court must find, is that the 

requirements for class certification are met--not that 

the class will prevail on its claims. As the Court put 

it in Amgen Inc. v. Connecticut Ret. Plans & Trust 

Funds, 133 S. Ct. 1184, 1196 (2013), it “totally 

misapprehend[s] the essential point” of this case law 

to suggest that certification is improper unless 

plaintiffs are able to prove that the common question 

“will be answered in their favor.” All they need to 

 

5. While a few circuits have held that parties 

seeking certification must demonstrate their compliance 

with Rule 23 by a preponderance of the evidence, this 

is not the law in this circuit; the court further notes 

that its conclusions as to the appropriateness of class 

certification would not differ under this standard.

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offer evidence to show--for purposes of certification--

is that there exists a common question, the answer to 

which will be “apt to drive the resolution of the 

litigation.” Wal-Mart, 564 U.S. at 350.

III. Daubert

The parties have raised Daubert objections to each 

other’s experts. For purposes of the Phase 2A pretrial 

motions, however, the only objections that must be 

resolved are those to plaintiffs’ mental-health expert, 

Dr. Kathryn Burns.6 Although the court has carefully 

 

6. Defendants have also raised Rule 26 objections 

to the report offered by Dr. Burns. The court 

addressed these objections (like those plaintiffs made 

regarding defendants’ expert reports) by requiring both 

parties’ experts to supplement their reports with 

additional citations in order to facilitate the court’s 

review. The outstanding objections to the 50-page 

report offered by Dr. Burns do not hold water.

In some cases, defendants’ objections are to 

opinions which Dr. Burns, as a highly-experienced 

mental-health practitioner and administrator of a state 

prison system’s mental-health services, has plainly 

based on her own experience, such as her opinion that 

certified registered nurse practitioners “have less 

training, knowledge, skill and judgment, which is why 

(continued...)

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considered all of the evidence in the record, it need 

not resolve plaintiffs’ objections to defendants’

experts until trial, because class certification is 

appropriate even assuming that defendants’ expert 

evidence is admissible. The court therefore assumes--

for purposes only of this opinion--that it is. 

Defendants do not raise Daubert objections to the 

 

they are considered mid-level clinicians and are 

required by law to have a collaborative relationship 

with a physician.” Burns Report (doc. no. 868-2) at 

14. Defendants also object to instances in which Dr. 

Burns gives a few examples of a particular phenomenon 

she observes, but notes that she saw many more. 

However, she identifies in her report all of the 

prisoners she interviewed and those whose records she 

reviewed, and she produced to defendants her notes; 

notably, defendants’ experts relied on their notes to 

inform plaintiffs which specific records they relied 

upon in reaching their conclusions. Moreover, 

defendants were free to ask her for additional examples 

during her day-long deposition.

In her lengthy report, Dr. Burns satisfied her 

obligation to explain “the basis and reasons” for her 

opinions, and to disclose to defendants “the facts or 

data” she considered in reaching her opinions. Fed. R. 

Civ. P. 26(a)(2)(B).

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reports of plaintiffs’ other Phase 2A experts, Dr. 

Craig Haney7 and Eldon Vail.8

 

7. Although defendants have not raised any Daubert

objections to Dr. Haney, their expert does criticize 

his reliance on statements by prisoners he interviewed 

in reaching his conclusion. However, Dr. Haney’s 

reliance on these statements was reasonable in light of 

the fact that he considered them among other sources of 

information, including observations, documents produced 

by defendants and MHM, testimony of ADOC and MHM 

employees, and medical records. The court notes that 

other courts have recognized that experts’ 

“consideration of [] inmates’ declarations and 

grievances as one of several sources informing his 

opinion is a valid methodology and does not render his 

opinion inadmissible.” Gray v. Cty. of Riverside, 2014 

WL 5304915, at *20 (C.D. Cal. Sept. 2, 2014) (Phillips, 

J.) (discussing evidence regarding prison medical care, 

as part of a class-certification evaluation).

Also, Dr. Haney explained in his deposition that 

the medical records he reviewed were in “disarray” and 

“weren’t helpful in conveying information” because they 

were “very difficult to read” and “had a lot that was 

missing from them,” that reviewing more of them would 

therefore have been only “marginally useful,” and that,

although his “expectation was that the records would 

actually have been a very useful source of 

information,” he “was disabused of that notion when 

[he] began to look at them.” Haney Depo. (doc. no. 

840-2) at 81-82, 187-88.

Moreover, as Dr. Haney points out, his opinions 

concern systemic and widespread deficiencies; although 

heavy reliance on any one prisoner’s self-report about 

his own mental-health care could potentially be 

(continued...)

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suspect, Dr. Haney found that the self-reports of 

numerous prisoners corroborated each other and were 

supported by other evidence; he appropriately relied on 

this evidence to reach the broader conclusions on which 

this case will turn. See Haney Report (doc. no. 868-4) 

at 28-29 (“[T]here was a remarkable amount of 

consistency in the data on which I relied--consistency 

in the observations that I made from facility to 

facility and consistency in what prisoners after 

prisoner told me, both about the damaging conditions of 

confinement to which they are exposed and the egregious 

treatment, or lack thereof, that they receive. ... 

Moreover, the prisoners’ observations were corroborated 

by the aggregate system-wide data that I have examined, 

as well [as] the deposition testimony of ADOC and MHM 

officials with oversight responsibilities....”); see

also Haney Depo. (doc. no. 840-2) at 58-59 (“[N]o one 

particular prisoners giving me one particular opinion 

about something led me to conclude anything. ... 

[T]his particular gentleman’s expression to me, the 

expressions from other people to me about the 

mistreatment, was corroborated not only by other 

prisoners at other institutions, many of them, but also 

by the chief psychiatrist of the entire system. If 

this is the only person who told me this, then it would 

not have been something I would have put in my report 

or relied on. But it was ... apparently such a 

consistent theme that it bubbled up to the top of the 

system and became a concern by people in the system, 

running the system. So I felt confident in the fact it 

was a problem in the system.”).

8. Defendants did insert a very brief Daubert

argument regarding Vail into a footnote. Because it is 

so peripherally raised, this objection is addressed 

(continued...)

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1. Standard

After the Supreme Court outlined a gatekeeping 

analysis for scientific expert testimony in Daubert v. 

Merrell Dow Pharmaceuticals, Inc., 509 U.S. 579 (1993),

and made that analysis applicable (with necessary 

modifications in the precise questions asked) to other 

technical expert testimony in Kumho Tire Co., Ltd. V. 

Carmichael, 526 U.S. 137 (1999), the Eleventh Circuit 

explained that the purpose of this analysis is “to 

ensure the reliability and relevancy of expert 

testimony ... [and] to make certain that an expert, 

whether basing testimony upon professional studies or 

personal experience, employs in the courtroom the same 

level of intellectual rigor that characterizes the 

practice of an expert in the relevant field.” United 

States v. Frazier, 387 F.3d 1244, 1260 (11th Cir. 2004) 

(en banc) (quoting Kumho Tire, 526 U.S. at 152). The 

appeals court went on to explain that under Federal 

 

below in the context of a related objection to Dr. 

Burns.

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Rule of Evidence 702, courts are to “engage in a 

rigorous three-part inquiry,” considering “whether: (1) 

the expert is qualified to testify competently 

regarding the matters he intends to address; (2) the 

methodology by which the expert reaches his conclusions 

is sufficiently reliable as determined by the sort of 

inquiry mandated in Daubert; and (3) the testimony 

assists the trier of fact, through the application of 

scientific, technical, or specialized expertise, to 

understand the evidence or to determine a fact in 

issue.” Id. (citation and internal quotation marks 

omitted). The proponents of the expert testimony 

(here, plaintiffs) bear the burden of establishing that 

these three requirements are met. See id.

Ordinarily, “[t]he safeguards outlined in Daubert

are less essential in a bench trial”; a judge need not 

gatekeep for herself. M.D. v. Abbott, 152 F. Supp. 3d 

684, 709 (S.D. Tex. 2015) (Jack, J.) (citing Gibbs v. 

Gibbs, 210 F. 3d 491, 500 (5th Cir. 2000)), appeal 

dismissed (Apr. 5, 2016). However, the Eleventh 

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Circuit and others have held that when a court relies 

on expert testimony to find that a Rule 23 requirement 

has been met, the court must conduct a Daubert analysis 

and conclude that the expert’s opinions satisfy its 

standard. Sher v. Raytheon Co., 419 F. App’x 887, 

890-91 (11th Cir. 2011); see also In re Blood Reagents 

Antitrust Litig., 783 F.3d 183, 187 (3d Cir. 2015); 

Ellis v. Costco Wholesale Corp., 657 F.3d 970, 982 (9th 

Cir. 2011). Some courts have noted, however, that the 

Daubert analysis conducted for purposes of class 

certification may be narrower than that conducted for 

purposes of a trial on the merits, because “the inquiry 

is limited to whether or not the expert reports are 

admissible to establish the requirements of Rule 23.” 

Fort Worth Employees' Ret. Fund v. J.P. Morgan Chase & 

Co., 301 F.R.D. 116, 126 (S.D.N.Y. 2014) (Oetken, J.).

Assessing an expert’s qualifications is generally 

the most straightforward of these tasks. Defendants do 

not challenge Dr. Burns’s qualifications, and as 

discussed below, the court finds that she is 

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exceedingly well-qualified to opine on the matters she 

addresses in her report.

As for the court’s assessment of an expert’s 

methodology, the court is to determine “whether the 

reasoning or methodology underlying the testimony is 

... valid and ... whether that reasoning or methodology 

properly can be applied to the facts in issue.”9 

Daubert, 609 U.S. at 592-93. The traditional factors a 

court may consider, where appropriate, are “(1) whether 

the expert’s theory can be and has been tested; (2) 

whether the theory has been subjected to peer review 

and publication; (3) the known or potential rate of 

error of the particular [expert] technique; and (4) 

whether the technique is generally accepted in the 

[expert] community.” Frazier, 387 F.3d at 1262. 

However, the court of appeals has emphasized that, 

 

9. Notably, this is not an all-or-nothing inquiry. 

“Even if a part of an expert’s testimony is based on 

unreliable methodology, the court should allow those 

parts that are reliable and admissible.” Lohr v. 

Zehner, 2014 WL 3175445, at *1 (M.D. Ala. July 8, 2014) 

(continued...)

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particularly in cases like this one, involving 

non-scientific expert evidence, “[t]hese factors are 

illustrative, not exhaustive; not all of them will 

apply in every case, and in some cases other factors 

will be equally important.... Sometimes the specific 

Daubert factors will aid in determining reliability; 

sometimes other questions may be more useful. As a 

result, ‘the trial judge must have considerable leeway 

in deciding in a particular case how to go about 

determining whether particular expert testimony is 

reliable.’ Kumho Tire, 526 U.S. at 152. Exactly how

reliability is evaluated may vary from case to 

case....” Frazier, 387 F.3d at 1262; see also United 

States v. Brown, 415 F.3d 1257, 1267-68 (11th Cir. 

2005) (explaining that “the question of whether 

Daubert’s specific factors are, or are not, reasonable 

measures of reliability in a particular case is a 

matter that the law grants the trial judge broad 

 

(Thompson, J.) (citing United Fire and Cas. Co. v. 

Whirlpool Corp., 704 F.3d 1338, 1342 (11th Cir. 2013)).

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latitude to determine” (internal citations omitted)); 

Ruiz v. Johnson, 37 F. Supp. 2d 855, 889-92 (S.D. Tex. 

1999) (Justice, J.), rev’d on other grounds and 

remanded sub nom. Ruiz v. United States, 243 F.3d 941 

(5th Cir. 2001) (explaining that an expert’s evaluation 

of the quality of the medical care provided by a prison 

system is “not the type of testimony that necessarily 

implicates Daubert’s requirement of scientific 

methodology”). To the extent that an expert witness 

relies “solely or primarily on experience, ... the 

witness must explain how that experience leads to the 

conclusion reached, why that experience is a sufficient 

basis for the opinion, and how that experience is 

reliably applied to the facts.” Morris v. Fla. 

Transformer, Inc., 455 F. Supp. 2d 1328, 1331 (M.D. 

Ala. 2006) (Thompson, J.) (citing Fed. R. Evid. 702 

advisory committee’s note).10

 

10. Although Dr. Burns does rely on her experience 

to a significant extent in reaching some of the 

opinions she offers (specifically, with respect to the 

competencies of providers with different levels of 

(continued...)

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As for helpfulness, “the court must ensure that the 

proposed expert testimony is relevant to the task at 

hand, ... i.e., that it logically advances a material 

aspect of the proposing party’s case.” Allison v. 

McGhan Med. Corp., 184 F.3d 1300, 1312 (11th Cir. 1999) 

(citations and internal quotation marks omitted). 

Additionally, for expert evidence to be helpful to the 

finder of fact, it must offer insight “beyond the 

understanding and experience of the average citizen.” 

United States v. Rouco, 765 F.2d 983, 995 (11th Cir. 

1985). Although the relevance standard for expert 

evidence is higher than the liberal admissibility 

policy set forth in Rules 401 and 402, see Allison, 184 

 

qualifications, and the risks posed by relying on them

to serve assessment and treatment functions), she does 

not rely solely or even primarily on her experience; 

she also explains at some length the ways her 

preexisting views regarding the effects of reliance on 

underqualified and unsupervised providers were borne 

out by the evidence she gathered during her inspections 

and in reviewing documents. Moreover, the court 

concludes that, to the extent that Dr. Burns relies on 

her own experience in reaching these conclusions, she 

has adequately explained why her experience supports 

her opinions in this case.

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F.3d at 1309-10, Daubert itself makes clear that a 

court can deem expert evidence sufficiently helpful to 

be admissible but nonetheless conclude that it is 

insufficient to create a genuine dispute of material 

fact for purposes of summary judgment. 509 U.S. at 

595-96; see also Hirsch v. CSX Transp., Inc., 656 F.3d 

359, 362 (6th Cir. 2011) (same).

One final note bears mention. Here, because 

plaintiffs rely on the expert evidence of Dr. Burns 

with respect to their opposition to summary judgment 

and in support of their motion for class certification, 

the court is required first, to consider the 

admissibility of her opinions under Rule 702, and then 

to determine whether they, in conjunction with 

plaintiffs’ other evidence, are sufficient both to 

create disputes of material fact regarding the merits 

of plaintiffs’ claims for purposes of Rule 56, and to 

demonstrate the requirements of certification under 

Rule 23. As the court has explained previously, these 

analyses are “quite distinct” and “must be kept 

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25

separate.” Morris, 455 F. Supp. 2d at 1332 (quoting 

Rudd v. General Motors Corp., 127 F. Supp. 2d 1330, 

1336 (M.D. Ala. 2001) (Thompson, J.)). In this section 

of the opinion, the court will address only Rule 702 

admissibility. Later in this opinion, it will address 

the role that this evidence plays in establishing 

compliance with Rule 23. Finally, in the court’s 

simultaneously issued opinion on summary judgment, it 

has addressed at some length why this evidence creates 

material disputes of fact as to the merits of 

plaintiffs’ claims.

2. Dr. Burns

As a preliminary matter, although defendants do not 

question Dr. Burns’s qualifications, the court notes 

that they are quite impressive.11 Defendants’ mental-

 

11. Of course, sterling qualifications are, on 

their own, insufficient to defeat a Daubert challenge. 

See Quiet Tech. DC-8, Inc. v. Hurel-Dubois UK Ltd., 326 

F.3d 1333, 1351-42 (11th Cir. 2003) (“[W]hile an 

expert’s overwhelming qualifications may bear on the 

(continued...)

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26

health expert, Dr. Patterson, has himself recently 

recognized her to be a “top nationally recognized 

expert[] in the field of correctional mental health.” 

Rep. on Suicides Completed in the California Dep’t of 

Corr. and Rehab. at 1, Coleman v. Brown, No. 

2:90-cv-520 (E.D. Cal. March 13, 2013), ECF No. 4376. 

She currently serves as the Chief Psychiatrist of the 

Ohio Department of Rehabilitation and Correction (as 

she did for a period of four years in the late 1990s). 

She has also long been familiar with the provision of 

mental-health care in Alabama’s prisons, as she served 

as an expert in previous litigation that successfully 

obtained a remedial settlement, Bradley v. Harrelson.

See Order Approving Settlement Agreement, Bradley v. 

Harrelson, No. 2:92-cv-70 (M.D. Ala. June 27, 2001) 

(Albritton, J.), ECF No. 412. 

As to Dr. Burns’s methodology, defendants 

essentially present two different arguments: that she 

 

reliability of [her] testimony, they are by no means a 

guarantor of reliability.”)).

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27

did not see enough firsthand ( of 15 major facilities, 

102 prisoners), and that she (admittedly) did not 

randomly select prisoners to interview.12 In other

prison cases, a number of courts have rejected Daubert

attacks on experts (offered by both plaintiffs and 

defendants) on the grounds that their samples were 

non-random, and that they did not consider enough 

prisoners at enough facilities in order to extrapolate 

conclusions about the system as a whole. In Ruiz, 37 

F. Supp. 2d at 890-92, the court rejected the 

 

12. Defendants also note that Dr. Burns criticized 

an audit conducted by MHM on the grounds that it 

involved only 10 facilities, and the non-random review 

of the records of 144 prisoners. This, they say, 

undermines her own findings as well. But the court is 

not convinced that this criticism substantially 

undercuts her conclusions; plaintiffs have taken the 

entirely reasonable position that, because the purpose 

of an audit (to track changes in the quality of care 

being delivered over time) fundamentally differs from 

that of an expert inspection (to aid the court in 

determining whether deficiencies in the mental-health

care system create a substantial risk of serious harm 

to mentally ill prisoners), different methodologies are 

appropriate. In any event, even if Dr. Burns’s

criticism of MHM’s methodology were applicable to her 

own work as an expert, it would hardly establish that 

(continued...)

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28

defendants’ arguments that “in the absence of 

statistical proof of violations ..., the plaintiffs 

have not and cannot show system-wide violations,” 

explaining that although “[s]tatistical procedures can 

increase the court’s confidence in making inferences 

from a given set of data, ... this is an issue of 

weight, rather than admissibility of a given 

methodology. Statistical models are simply not the 

only method for making general inferences from specific 

data.”

As for non-random sampling, as the court put it in 

the context of the claims in Ruiz, “[t]he fact that 30 

records show excessive use of force does not change 

because the records were selected non-randomly.” Id. 

at 891. See also Coleman v. Wilson, 912 F. Supp. 1282, 

1303 (E.D. Cal. 1995) (Karlton, J.) (rejecting a 

similar objection to expert declaration that the 

defendants contended were “unreliable insofar as they 

 

the methodology she did employ was not sufficiently 

reliable to survive a Daubert challenge.

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29

are based on medical files ‘pre-selected’ by 

plaintiffs’ counsel”). Another court recently 

discussed at some length the use of non-random sampling 

by prison experts. In Dockery v. Fisher, 2015 WL 

5737608, at *5 (S.D. Miss. Sept. 29, 2015) (Barbour, 

J.), the court recognized that non-randomized 

qualitative research methods are both “accepted and 

mainstream in the scientific community,” and, in the 

view of some experts, “more applicable to a proper 

evaluation of the delivery of health care at a prison.” 

The court quoted plaintiffs’ expert as explaining that 

“[w]hen sampling from people (patients, staff) and 

documents in qualitative research, random samples are 

to be avoided. Instead, the gold standard for sampling 

is ‘judgment sampling’ or ‘purposeful sampling.’ 

Instead of using random number generators to select 

samples, a judgment sample is chosen based on the 

expertise and judgment of a subject matter expert with 

knowledge of the system or process being assessed. The 

goal is to obtain a sample which is as broad, rich, and 

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30

representative of the diversity of operational 

conditions as possible. ... Judgment samples are 

appropriate because ensuring that all potential 

observational units in a population and sampling time 

frame have equal probability of selection is often not 

the most desired or beneficial strategy. Rather, we 

look to the subject matter experts to guide which 

areas, times of day, or segments of the population are 

most important to study and understand.” Id. at *6 

(citation and internal quotation marks omitted). The 

court also recognized the potential merit of 

defendants’ arguments against this methodological 

approach, but concluded that this went to the weight to 

be given the expert evidence, rather than its 

admissibility. Id.; see United States v. Monteiro, 407 

F. Supp. 2d 351, 366 (D. Mass. 2006) (Saris, J.) (“It 

may well be that other methods ... may prove to be the 

best method of analysis. However, Daubert and Kumho 

Tire do not make the perfect the enemy of the reliable; 

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31

an expert need not use the best method of evaluation, 

only a reliable one.”).

In another recent case about the adequacy of prison 

health care, Jama v. Esmor Correctional Services., 

Inc., 2007 WL 1847385, at *26-27 (D.N.J. June 25, 2007)

(Debevoise, J.), the court rejected a Daubert challenge 

to an expert on the grounds that he had reviewed only 

the 78 medical request forms submitted by the nine

plaintiffs, who were among 1600 detainees housed at the 

facility at issue. Plaintiffs argued that his use of 

“convenience” rather than random sampling was 

unreliable and that “his sample size [was] too small to 

generate reliable statistics,” but the court agreed 

with defendants that these challenges went to the 

weight of his evidence rather than to its 

admissibility. The court and others recognized that 

this sort of sampling is particularly reasonable when 

it is part of a multifaceted review that considers not 

only the records and statements of individuals but also 

other sources such as deposition transcripts and other 

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32

documents that allows an expert to “draw general 

conclusions.” Id.; see also Parsons, 2014 WL 3721030, 

at *4.

Defendants cite a number of cases for the 

proposition that because Dr. Burns cited in her report 

only 29 examples of different individual prisoners 

receiving inadequate care or classification, the size 

of her sample was insufficient to allow her to draw 

conclusions about systemic inadequacies.13 These cases 

are, however, distinguishable from the case at bar. In 

Wal-Mart, the court concluded that 120 anecdotal 

affidavits describing instances of discrimination at 

235 out of 3,400 stores were insufficient to 

“demonstrate that the entire company operates under a 

general policy of discrimination.” 564 U.S. at 358 

(citation and internal quotation marks omitted.) The 

individual prisoners whose care Dr. Burns discusses 

 

13. Dr. Burns has since supplemented the report to 

include citations explicitly referencing another 29 

examples with respect to 14 additional prisoners, for a 

total of 58 instances and 43 prisoners.

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33

make up a significantly larger and more representative 

portion of the class than did the affiants in Wal-Mart, 

and, more important, the evidence about them is being 

used for an entirely different purpose. In Wal-Mart, 

the affidavits represented only one in approximately 

12,500 class members; here, ADOC recognizes as mentally 

ill by placement on the caseload about 3,500 prisoners, 

meaning that the 43 prisoners Dr. Burns cites (even 

setting aside her representation that these are but 

illustrative examples drawn from notes that include 

others) represent in the vicinity of one in 80 class 

members. Moreover, while the Wal-Mart affiants related 

only to one in every 15 or so stores, Dr. Burns drew 

from about two-thirds of a much smaller number (15) of 

major correctional facilities.

Moreover, and critically, the Court in Wal-Mart had 

already rejected the plaintiffs’ expert evidence, 

concluding that it did not establish that the company 

operated under a policy of discrimination; in the 

Court’s discussion of the affidavits, it was simply 

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34

explaining that they did not, on their own, suffice to 

support the inference that such a policy existed. With 

respect to all of Dr. Burns’s opinions, by contrast, 

she cites other evidence to establish the existence of 

a policy or practice (such as statements by prison 

mental-health practitioners or internal documents). In 

some cases, the existence of the policy or practice is 

effectively undisputed; for example, defendants do not 

disagree that a certain number of practitioners with 

certain qualifications provide mental-health care to 

prisoners. What they dispute, and what Dr. Burns cites 

these prisoners to show, is that these policies and 

practices place prisoners at a substantial risk of 

serious harm.14

 

14. Another one of defendants’ citations, Henderson 

v. City and County of San Francisco, 2006 WL 3507944, 

at *10 (N.D. Cal. 2006) (Walker, J.), is 

distinguishable for the same reasons. In that case, 

plaintiffs were attempting to show that a sheriff had a 

practice of “routinely exonerat[ing] deputies of 

wrongdoing.” Plaintiffs had presented “almost no 

evidence” of this fact, but were given an opportunity 

to file a supplemental brief based on new discovery. 

They submitted 18 grievances selected by the plaintiffs 

(continued...)

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The court will address the remainder of defendants’ 

case law--offered in support of their contention that 

Dr. Burns lacks a sufficient basis for her 

conclusions--more briefly. Although Lloyd Noland Hosp. 

& Clinic v. Heckler, 762 F.2d 1561, 1568 (11th Cir. 

1985), recognized the obvious point that a “sample size 

 

from more than 200 filed by prisoners over a one-year 

period in which over 6,000 prisoners were housed in the 

facility; the grievances described only 14 alleged 

incidents, and in five of those cases, the prisoners 

were satisfied with the responses they had received. 

This left nine complaints about “any kind of force,” 

much less unjustified force. The court quite 

reasonably concluded that this was insufficient, on its 

own, to create a dispute of material fact as to the 

“existence of a pervasive custom of excessive force.”

The first key difference between Henderson and this 

case is that in Henderson, the court was presented with 

(a few) examples of documents plaintiffs simply 

asserted reflected excessive force, whereas here, far, 

far more voluminous evidence has been filtered through 

the expert judgment of Dr. Burns and resulted in her 

opinions. Moreover, even the facts on which Dr. Burns 

relied are easily distinguishable from the evidence 

deemed insufficient in Henderson: for one thing, Dr. 

Burns considered numerous different forms of evidence, 

including interviews, record reviews, inspections of 

facilities, internal documents, and testimony by 

mental-health care providers and administrators; for 

another, she considered facts regarding far more 

individuals--over a hundred, in fact.

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36

[may be] too small” to draw certain conclusions from 

it, the issue in that case was worlds away: whether the 

Secretary of Health and Human Services had improperly 

relied on a study--which stated that “no broad 

conclusions can be drawn about the nature and extent of 

medical malpractice in this country” on the basis of 

the study--to reach a conclusion as to that very issue. 

Moreover, defendants suggest no basis for comparing the 

suitability of the sample size in the study at issue 

(or, indeed, what that sample size was) to that 

employed by Dr. Burns.

Dukes v. Georgia, 428 F. Supp. 2d 1298, 1317 (N.D. 

Ga. 2006) (Forrester, J.), stands for the similarly 

unremarkable proposition that an expert may lack 

“sufficient data and information” to reach a 

conclusion. But the expert at issue in that case does 

not appear to have sampled anything; he simply 

speculated, without much basis, about whether a lab 

technician should have identified a strain of yeast. 

The case is hardly on point. Gilliam v. City of 

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Prattville, 667 F. Supp. 2d 1276, 1298 (M.D. Ala. 2009)

(Fuller, J.), concluded that, even if an unqualified 

expert had been qualified, his testimony would not have 

been reliable for numerous reasons, including that he 

had not examined the autopsies of the individual about 

whose death he was testifying and had offered no data 

or explanation to support his theory as to the cause of 

death or to refute other theories. Again, not on 

point. Finally, in United States ex rel. Wall v. Vista 

Hospice Care, Inc., 2016 WL 3449833, at *12 (N.D. Tex. 

June 20, 2016) (Lynn, J.), the court was required to 

determine how many false claims had been submitted by 

physicians, which in turn required assessments of 

“individual physicians’ judgment regarding individual 

patients.” The court concluded (contrary to the view 

of at least one court in this circuit) that statistical 

sampling and extrapolation could not be used by experts 

to establish liability in such a case. Defendants 

apparently believe this case is relevant because 

mental-health care providers (obviously) exercise some 

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38

judgment in caring for individual prisoners. This case 

is readily distinguishable, for two reasons: First, Dr. 

Burns has not engaged in statistical sampling or 

attempted to offer a precise quantitative assessment of 

whether specific instances of mental-health care were 

or were not adequate. Second, because it is the 

Commissioner and Associate Commissioner, not the 

mental-health practitioners who provide care, who are 

the defendants, this case does not turn on assessments 

of the case-specific “subjective clinical judgment” of 

mental-health staff, but rather on whether, in 

staffing, funding, and overseeing the operation of the 

mental-health care system, defendants have been 

deliberately indifferent to an objective risk of 

serious harm to mentally ill prisoners.

Defendants also cite a concurring opinion in EEOC 

v. Freeman, 778 F.3d 463, 469-70 (4th Cir. 2015) (Agee, 

J.), which expresses the judge’s serious concern that 

the EEOC “continues to proffer expert testimony from a 

witness whose work has been roundly rejected in our 

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39

sister circuits.” This expert had attempted to offer 

statistical evidence in support of a disparate impact 

theory. His work “contained a plethora of analytical 

fallacies”: although he had a complete data set, he 

opted to “ignor[e]” years of relevant data from more 

than half of the years and locations at issue, 

resulting in “an egregious example of scientific 

dishonesty.” Even within the subset of available data 

he did consider, he had “cherry-picked” the data that 

supported his conclusions. Dr. Burns, by contrast, is 

not endeavoring to offer statistical evidence, and 

opted for a sampling method that other courts have 

recognized as appropriate for an expert in her field, 

and that was especially reasonable in light of the 

restrictions on her ability to gather data.15 She has 

 

15. Plaintiffs’ experts explained that, in contrast 

to their experience working on other similar cases, 

they had been provided an unusually limited level of 

access to information, and especially to medical 

records. See Haney Report (doc. no. 868-4) at 12 

(“[A]lthough I had a wealth of information on which to 

rely and base my opinion--certainly enough information 

to reach and support the conclusions that are stated in 

(continued...)

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40

considered all of the data she obtained in reaching her 

conclusions. Had Dr. Burns been provided access to, 

and had it been feasible to review, a dramatically 

larger sample, and had she then opted to base her 

assessments only on a small subset of those records and 

interviews, the concerns of defendants might be better 

founded.

With respect to defendants’ contention that Dr. 

Burns did not tour all of defendants’ facilities, the 

court agrees with another court recently to consider 

this very issue that “otherwise admissible testimony 

based on investigation of some facilities but not all 

is still probative to some extent and any limitation 

goes to the weight of the opinions.” Parsons, 2014 WL 

3721030, at *4. Moreover, as Judge Wake noted in that 

case, the number of tours plaintiffs’ experts were 

 

the remainder of this Report--my fact-finding was 

limited in some unprecedented respects,” including 

“having access to prisoner files only during the 

relatively brief time that they could be reviewed 

on-site.”).

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41

allowed to complete, as well as the length of time they 

were allowed to spend in each facility and the number 

of prisoners whose records they were allowed to review 

and whose interviews they were permitted to conduct was 

circumscribed by defendants during the course of an 

extremely lengthy and contentious discovery mediation. 

See id. (“Defendants’ strenuous objections to the 

burdensome nature of the multiple prison tours, [and] 

the Court’s reduction of that burden by limiting the 

number of tours ... weigh[s] against complete exclusion 

of the opinions.”) The fact that Dr. Burns also 

reviewed policies and quality assurance documents 

relevant to other facilities, and that she reviewed the 

depositions of those responsible for providing or 

overseeing care at other facilities, further weighs in 

favor of considering her opinions even as to facilities 

she did not personally visit.16

 

16. Defendants also raise, in a brief footnote, a 

Daubert challenge to plaintiffs’ correctional expert, 

Eldon Vail. The scope of this challenge is limited to 

the contention that “[b]ecause Mr. Vail did not visit 

(continued...)

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As a last methodological point, defendants take 

issue with Dr. Burns’s failure to review the entirety 

of the medical records of all of the prisoners she 

 

and has no knowledge regarding ADOC’s staffing policies 

at [a number of] facilities, he is not qualified under 

Daubert or Federal Rule of Evidence 702 to offer an 

opinion as to them.” ADOC’s Opp. to Class Cert. (doc. 

no. 810) at 8 n.3.

Defendants point to Vail’s negative answer to the 

question “Are you aware of anything the Alabama 

Department of Corrections does at Bullock Correctional 

Facility to make sure that there are an adequate number 

of correctional staff present, given the number of 

inmates incarcerated at that facility?” as evidence 

that has no knowledge of staffing policies at that 

facility. But his “no” answer does not indicate that 

he had no basis for an opinion about staffing at that 

facility; it indicates only that he did not know of the 

existence of measures defendants take to ensure 

adequate staffing levels; in light of his other 

evidence that many ADOC facilities are severely 

understaffed, he appears to believe that no such 

measures are taken or that they are unsuccessful.

In fact, Vail testified in his deposition that he 

did review, for purposes of extrapolating his findings, 

records stating the “number of inmates,” “number of 

staff,” and “design capacity” at each of the facilities 

in the system. Vail Depo. (doc. no. 810-1) at 96. 

Although defendants are certainly free to cross-examine 

Vail at trial if they believe that his reliance on 

these data resulted in inaccurate conclusions, they are 

an adequate basis for his expert opinion for purposes 

of Daubert.

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43

interviewed, and contend that this reflects a failure 

to confirm prisoners’ self-reports. First of all, 

defendants concede that she did review the records of 

many of those she discusses specifically in her report. 

Furthermore, she may well have been able to reach 

reliable conclusions with respect to some issues 

without reviewing medical records. For example, to the 

extent that she disagreed with the classification of a 

severely mentally ill prisoner as an outpatient, she 

could well have both assessed the apparent severity of 

that prisoner’s illness and determined that he was 

currently classified (and housed) as an outpatient 

without reviewing any documents. As another example, 

Dr. Burns described in her report observing prisoners 

who had been prescribed certain antipsychotics who 

exhibited movement disorders that are characteristic 

side effects of these medications. She is a 

psychiatrist who is capable of recognizing such a 

visible disorder without reference to records. 

Finally, although bald reliance on the totally 

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44

uncorroborated statement of a single mentally ill 

individual might in some instances be questionable, Dr. 

Burns often describes statements by prisoners from her 

interviews as confirmatory of information she obtained 

from other sources, including directly from MHM. This 

is, therefore, not a basis to exclude her opinion, 

although defendants are free to cross-examine her on 

this point in order to undermine her conclusions at 

trial. See Allison, 184 F.3d at 1311 (explaining that 

Daubert analysis is “not intended to supplant the 

adversary system”).

In sum, the court concludes that Dr. Burns’s

methodology is sufficiently reliable, and that her 

opinions are based on a sufficient quantity, and range 

of sources of, data, to be admissible as expert 

evidence under Daubert and Federal Rule of Evidence 

702.

As for helpfulness, defendants insist that there is 

a “fit” problem between Dr. Burns’s report and the 

claims in this case, because her reports states that 

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45

various policies and practices subject prisoners to a 

“risk of harm”; they object to her failure to use the 

catchphrase from the case law, “substantial risk of 

serious harm.” But as Dr. Burns herself pointed out in 

her deposition, she has offered evidence helpful to the 

court in making this ultimate legal determination. She 

has described in some detail the harms that she 

believes will, and in some instances did, result from 

defendants’ policies and practices; it is the court’s 

task to determine whether these harms are “serious,”

based on case law. Indeed, as Dr. Burns is not a legal 

expert and would not be applying this case law, any 

assessment she made as to the seriousness of these 

harms would not be very helpful.17 See Burkart v. 

 

17. Defendants cite four cases that they contend 

support their position that there is not a sufficient 

“fit” between Dr. Burns’s opinions and the issues in 

this case. In these cases, however, the expert 

evidence at issue was totally unhelpful, whereas here 

the expert evidence is quite helpful but not sufficient 

on its own, absent some additional legal analysis by 

the court, to support liability. These cases all 

involve experts who, in one way or another, “fail[] to 

recognize ... the range of behavior between clearly 

(continued...)

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46

 

unlawful and perfectly lawful.” Boca Raton Cmty. 

Hosp., Inc. v. Tenet Health Care Corp., 582 F.3d 1227, 

1233 (11th Cir. 2009); see also Corwin v. Walt Disney 

Co., 475 F.3d 1239 (11th Cir. 2007) (concluding that 

the district court had not abused its discretion in 

excluding portions of expert reports in a copyright 

case, when the experts had opined that there was a 

“striking similarity”--an element of the cause of 

action--between the ideas in a painting and a theme 

park, but this opinion was unhelpful because only the 

expression of an idea, and not the idea itself, could 

be copyrighted, and the experts had offered no opinions 

as to the expressions of ideas in the painting and 

theme park); Williamson Oil Co. v. Philip Morris USA, 

346 F.3d 1287, 1323 (11th Cir. 2003) (concluding that 

the district court had not abused its discretion in 

excluding portions of an expert report in which the 

expert asserted that there had been “an illegal price 

fixing conspiracy,” but “did not differentiate between 

legal and illegal pricing behavior, and instead simply 

grouped both of these phenomena under the umbrella of 

illegal, collusive price fixing,” explaining that 

“[t]his testimony could not have aided a finder of fact 

to determine whether appellees’ behavior was or was not 

legal”); United States v. Aegis Therapies, Inc., 2015 

WL 1541491, at *6-9 (S.D. Ga. Mar. 31, 2015) (Wood, J.) 

(excluding an expert report in a case about improper 

Medicare billing because the expert report offered 

opinions in binary fashion (yes or no) as to whether 

each of 102 incidents of care were provided with the 

expectation that they would result in “significant 

improvement,” when the legally relevant question was 

whether they would result in “material improvement,” a 

different and lower standard). In these cases, the 

expert reports were unhelpful to the triers of fact 

because they merely identified an undifferentiated 

category of acts (of various kinds), some of which were 

lawful and some of which were unlawful; a given act’s 

(continued...)

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47

Washington Metro. Area Transit Auth., 112 F.3d 1207, 

1213 (D.C. Cir. 1997) (“Each courtroom comes equipped 

with a ‘legal expert,’ called a judge....”).

Similarly, it is up to the court to determine 

whether the risk is sufficiently “substantial” to 

constitute an Eighth Amendment violation.18 Dr. Burns 

has offered evidence going to the incidence of the 

harms she has described; although her statements to 

this effect are not statistically precise, they are 

 

inclusion in that category gave the factfinder no 

information about its status as lawful or unlawful. 

The equivalent report in this case would be one merely 

identifying policies the expert believes should be 

changed, without offering information that would help 

the court determine which of the policies created a 

substantial risk of serious harm and which did not.

18. Defendants also forget that an Eighth Amendment 

violation can be established on the basis of a 

combination of conditions resulting jointly in a 

deprivation of adequate mental-health care. Whether or 

not the risk of harm from any particular challenged 

policy or practice is sufficiently substantial on its 

own to establish the objective component of an Eighth 

Amendment violation, plaintiffs may establish that some 

or all of them, together, do violate the Constitution. 

See Laube v. Haley, 234 F. Supp. 2d 1227, 1245 (M.D. 

Ala. 2002) (Thompson, J.) (citing Wilson v. Seiter, 501 

U.S. 294, 304 (1994)).

(continued...)

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nonetheless very helpful. For example, she relies on 

chart reviews, interviews with prisoners, depositions 

of providers, and MHM quality assurance documents to 

conclude that for prisoners at a number of the 

facilities she toured, “virtually the only treatment 

being provided is psychotropic medication,” that any 

individual psychotherapy being provided was infrequent 

and brief,19 and that very few or no outpatient therapy 

groups were being offered. Burns Report (doc. no. 

868-2) at 38-39. In this instance, the incidence of 

 

19. Defendants respond to individual prisoners’ 

allegations that virtually no therapy is provided by 

citing medical records which sometimes show frequent 

contacts with mental-health professionals. But what

plaintiffs complain of, and what Dr. Burns found in her 

inspections, was that prisoners were not receiving 

psychotherapy, not that they were having no contact 

whatsoever with mental-health professionals. Although 

this distinction may be harder to conceptualize with 

respect to mental-health care than to medical care, Dr. 

Burns explains that it is an important one. To offer 

an illustrative (if certainly imperfect) analogy, no 

one would dispute that to a prisoner with kidney 

failure, there is a world of difference between being 

“seen” by a nurse at the cell door who asks whether he 

is suffering from some of the symptoms of kidney 

(continued...)

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49

harm is in her opinion extremely high. As another 

example, Burns opines that mental-health staff continue 

to prescribe certain long-acting antipsychotic 

injections even when they cause serious side effects 

such as severe restlessness, painful muscle spasms, and 

irreversible movement disorders; she reached this 

conclusion based on chart reviews and interviews with 

and observations of prisoners. Although her report 

does not reveal exactly what percentage of mentally ill 

prisoners are prescribed these medications, she does 

helpfully inform the court that “[m]any of the inmates 

interviewed displayed these types of movement 

disorders, but their prescriptions were continued 

rather than changed to medications less likely to cause 

these problems.” Id. at 42. In addition, she provides 

six examples of prisoners who suffered in this 

particular manner. Id. at 42-43. As a third example, 

Dr. Burns opines that prisoners with mental illness are 

 

failure and gives him some dietary suggestions, and 

receiving dialysis treatment.

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50

significantly underidentified; she believes that this 

underidentification stems from a deficient screening 

process that relies on unqualified and unsupervised 

staff to conduct evaluations. Although she does not 

state exactly what proportion of the prisoners with 

mental illness in ADOC custody she believes have not 

been identified, she does offer a number of statistics 

from other state prison systems; there is a range, but 

even the most conservative comparator statistics 

suggest substantial underidentification. Id. at 24-26.

As a final iteration of this argument, defendants 

contend that Dr. Burns is merely opining as to what 

care she thinks is good care or what care should be 

provided, and that this is not what the Constitution 

requires defendants to provide. Although defendants 

are quite correct that expert opinions as to desirable 

prison conditions are insufficient to establish 

constitutional minima, see Rhodes v. Chapman, 452 U.S. 

337, 348 n.13 (1981), their argument badly misconstrues 

the evidence Dr. Burns is offering. Although she does 

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express some opinions about how care should be provided 

(based, for example, on the fact that certain types of 

practitioners are “unqualified” to provide care without 

supervision, see Burns Report (doc. no. 868-2) at 16), 

she then goes on to explain how the failure to provide 

care in this way causes harm to prisoners. For 

example, she presents evidence, discussed above, to 

support her conclusion that these unqualified and 

unsupervised staff frequently fail to diagnose mental 

illness.

The court concludes that Dr. Burns’s expert 

evidence will be helpful to the court in assessing 

whether the mental-health care provided to prisoners in 

Alabama falls below the constitutional floor, because 

she will bring to bear her experience, and the results 

of her investigation in this case, to help the court to 

understand the seriousness of the risk of harm posed by 

the challenged policies and practices. See Coleman, 

912 F. Supp. at 1304 (rejecting a challenge that the 

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magistrate judge had “improperly relied on expert 

testimony to establish constitutional minima”).

Lastly, defendants attack Dr. Burns’s

qualifications as well as her methodology with respect 

to one fairly narrow issue: her ability to offer an 

opinion regarding the adequacy of correctional 

staffing. As for her qualifications, they note that 

she admitted that she has never been responsible for 

staffing a correctional facility with custody staff or 

received any training in doing so. As for her 

methodology, they note that she testified in her 

deposition that she did not perform (as part of her 

assignment in this case) any sort of staffing analysis 

or review for adequacy the numbers of correctional 

officers in any facility for any shift. The court is 

not convinced by the argument regarding methodology; it 

seems clear that an expert might reliably assess a 

staffing level to be too low and therefore likely to 

cause harm without determining what staffing level 

would be appropriate. However, the court is more 

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troubled by the fact that although Dr. Burns is an 

esteemed expert in correctional mental health, 

plaintiffs have not demonstrated that her experience 

entitles her to opine on this separate, albeit related, 

issue. (Plaintiffs’ response, that she has been 

involved in “evaluating and informing internal 

operations of correctional systems” through her role as 

a correctional mental-health administrator, is not 

convincing.) The court will therefore not rely on her 

opinion on this specific issue for purposes of the 

pretrial motions.20 That all said, plaintiffs have in 

fact offered another expert, Eldon Vail, who is an 

experienced correctional administrator; defendants have 

not raised a Daubert challenge to his qualifications to 

address this issue, and the court has already rejected 

their contention that he lacks an adequate basis for 

his conclusions. His opinion on the inadequacies of 

correctional staffing and their effects on delivery of 

 

20. If, at trial, plaintiffs can convince the court 

that Dr. Burns is qualified to testify on this topic, 

(continued...)

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mental-health care is more detailed and better 

supported than Dr. Burns’s opinion on this point,

though essentially in accord; the court will therefore 

consider his evidence instead of hers.

IV. Analysis

Federal Rule of Civil Procedure 23 “establishes the 

legal roadmap courts must follow when determining 

whether class certification is appropriate.” Valley 

Drug Co. v. Geneva Pharm., Inc., 350 F.3d 1181, 1187 

(11th Cir. 2003). The party seeking certification 

bears the burden of demonstrating that all of the 

requirements of Rule 23 have been met. Id.

In order for any certification motion to succeed, 

the putative class representatives must show that 

“(1) the class is so numerous that joinder of all 

members is impracticable; (2) there are questions of 

law or fact common to the class; (3) the claims or 

defenses of the representative parties are typical of 

 

it will consider her opinion.

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the claims or defenses of the class; and (4) the 

representative parties will fairly and adequately 

protect the interests of the class.” Fed. R. Civ. P. 

23(a). In addition, a class must clear one of three 

additional hurdles: because the named plaintiffs in 

this case seek certification of a Rule 23(b)(2) class, 

they must also show that “the party opposing the class 

has acted or refused to act on grounds that apply 

generally to the class, so that final injunctive relief 

or corresponding declaratory relief is appropriate 

respecting the class as a whole.” Fed. R. Civ. P. 

23(b)(2).

The court’s role at the class-certification stage 

is not to decide the underlying claims, but rather to

determine whether the requirements for certification 

are met. See Eisen v. Carlisle & Jacquelin, 417 U.S. 

156, 177-78 (1974). “Merits questions may be 

considered to the extent--but only to the extent--that 

they are relevant to determining whether the Rule 23 

prerequisites for class certification are satisfied.” 

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Amgen, 133 S. Ct. at 1194-95 (citation omitted). A 

party seeking class certification must “affirmatively 

demonstrate his compliance with the Rule”; that is, 

plaintiffs must offer evidence sufficient to satisfy 

the court that the various requirements of Rule 23 have 

been met. Wal-Mart, 564 U.S. at 350.

Commonality, in particular, “cannot be determined 

without a precise understanding of the nature of the 

underlying claims,” and a careful consideration of the 

evidence offered in support of the common thread, but 

“[o]f course, this does not mean that the plaintiffs 

must show at the class certification stage that they 

will prevail on the merits” of those claims. Parsons 

v. Ryan, 754 F.3d 657, 676 & n.19 (9th Cir. 2014) 

(citing, inter alia, Messner v. Northshore Univ. 

HealthSystem, 669 F.3d 802, 811 (7th Cir. 2012) (“[T]he 

court should not turn the class certification 

proceedings into a dress rehearsal for the trial on the 

merits.”)).

Having articulated the framework for its analysis, 

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the court will proceed to consider each requirement for 

certification in turn.

1. Standing

“[A]ny analysis of class certification must begin 

with the issue of standing”; only once the court finds 

that the named plaintiffs have standing may it consider 

whether they have “representative capacity, as defined 

by Rule 23(a), to assert the rights of others.” 

Griffin v. Dugger, 823 F.2d 1476, 1482 (11th Cir. 

1987). To show Article III standing, the named 

plaintiffs must show that they have been injured, that 

their injuries are fairly traceable to the defendants’ 

conduct, and that a judgment in their favor would 

likely redress their injuries. See Mulhall v. UNITE 

HERE Local 355, 618 F.3d 1279, 1286 (11th Cir. 2010).

As defendants acknowledge, their arguments that the 

named plaintiffs lack standing to pursue the claims for 

which they seek certification “directly intersect[] and 

coincide[] with [their argument in their] pending 

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Motion for Summary Judgment”--that is, defendants argue 

that they lack standing because their claims are moot, 

unexhausted, precluded or barred by the statute of 

limitations.21 Defs.’ Opp. to Class Cert. (doc. no. 

807) at 104. The court has engaged in an extensive 

discussion of all of these arguments in the course of 

its opinion denying defendants’ motion for summary 

judgment. It rejected all of them except to the extent 

that it agreed that a few of the named plaintiffs’ 

claims have become moot as a result of their releases 

from prison. As these plaintiffs have been dismissed 

from the case, they will not be certified as class 

representatives. Otherwise, defendants’ arguments that 

the named plaintiffs lack standing to bring the claims 

they seek to have certified are rejected for the 

reasons set forth in the summary-judgment opinion.

 

21. Oddly, they also argue that the named 

plaintiffs lack standing because their claims fail on 

the merits. But that is simply not how standing--a 

preliminary inquiry into whether a litigant is in an 

appropriate position to raise a claim--works.

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2. Rule 23(a)

A. Numerosity

Rule 23(a)(1)’s requirement of numerosity is 

satisfied if joinder--the usual method of combining 

similar claims--would be impracticable. Although there 

is no strict threshold, classes containing more than 40 

members are generally large enough to warrant 

certification. See, e.g., Cox v. Am. Cast Iron Pipe 

Co., 784 F.2d 1546, 1553 (11th Cir. 1986); see also

Rubenstein, Newberg on Class Actions § 3.12 (5th ed.).

“Moreover, the fluid nature of a plaintiff 

class--as in the prison-litigation context--counsels in 

favor of certification of all present and future 

members.” Henderson v. Thomas, 289 F.R.D. 506, 510 

(M.D. Ala. 2012) (Thompson, J.) (citing Kilgo v. Bowman 

Transp., Inc., 789 F.2d 859, 878 (11th Cir. 1986) 

(affirming a certified class of 31 present members as 

well as future members who could not be identified); 

Green v. Johnson, 513 F. Supp. 965, 975 (D. Mass. 1981) 

(Freedman, J.) (finding numerosity after considering 

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“the fact that the inmate population at these 

facilities is constantly revolving”)); see also

Pederson v. Louisiana State Univ., 213 F.3d 858, 868 

n.11 (5th Cir. 2000) (“[D]istrict courts must not focus 

on sheer numbers alone.... [T]he fact that the class 

includes unknown, unnamed future members also weighs in 

favor of certification.”); Reid v. Donelan, 297 F.R.D. 

185, 189 (D. Mass. 2014) (Ponsor, J.) (certifying a 

class of detained plaintiffs and explaining that the 

numerosity threshold may be relaxed “when a party seeks 

only declaratory or injunctive relief, since the 

inclusion of future members increases the 

impracticability of joinder” (citing McCuin v. Sec’y of 

Health & Human Servs., 817 F.2d 161, 167 (1st Cir. 

1987)); Rubenstein, Newberg on Class Actions § 3.15 

(5th ed.) (explaining that the inclusion of future 

class members “may make class certification more, not 

less, likely” and citing two decisions certifying 

classes of prisoners, Hill v. Butterworth, 170 F.R.D. 

509, 514 (N.D. Fla. 1997) (Paul, J.) (“This Circuit has 

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held [that when] the alleged class includes future 

[members], necessarily unidentifiable[,] ... the 

requirement of Rule 23(a)(1) is clearly met, for 

joinder of unknown individuals is clearly 

impracticable.” (citation and internal quotation marks 

omitted)); Clarkson v. Coughlin, 145 F.R.D. 339, 346 

(S.D.N.Y. 1993) (Sweet, J.) (“The class action device 

is particularly well-suited in actions brought by 

prisoners due to the fluid composition of the prison 

population. ... Class actions therefore generally tend 

to be the norm in actions such as this.” (citations 

and internal quotation marks omitted))).22

Plaintiffs have submitted evidence to show that in 

February 2016, there were 3,416 prisoners on the 

mental-health caseload (and argue that this figure 

 

22. Recognition of prisoners’ relatively limited 

“access to the legal system ... has [also] led courts 

to certify classes in cases ... involv[ing] issues of 

common concern to inmates even when the potential class 

size is small and somewhat undefined.” Bradley v. 

Harrelson, 151 F.R.D. 422, 426 (M.D. Ala. 1993) 

(Albritton, J., adopting recommendation of Carroll, 

M.J.) (citation and internal quotation marks omitted).

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significantly understates the number of seriously 

mentally ill prisoners in the State). This exceeds the 

customary numerosity threshold by a factor of 85. 

Defendants nonetheless have a bone to pick. They

contend that “this number ... says nothing about how 

many individuals can claim an actual injury traceable 

to the State’s policies and procedures.” Defs.’ Opp. 

to Class Cert. (doc. no. 807) at 141. There are a 

number of problems with this argument.

First, courts look at numerosity in a fairly 

straightforward fashion: by assessing the 

practicability of joinder, in light of the number of 

people who fall within the definition of the class. 

Movants for class certification do not need to present 

evidence showing--one by one, many times over--that 

individual putative class members can proceed on the 

class claims; requiring as much would largely defeat 

the efficiency benefits of class-wide adjudication, and 

is unnecessary in light of the commonality requirement. 

See Rubenstein, Newberg on Class Actions § 3:11 

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(“[W]here joinder is impracticable, judicial economy 

weighs in favor of representative litigation of common 

issues for similarly situated plaintiffs.”). Instead, 

they need to show that the class representatives can 

proceed on claims which are common to the class.

Plaintiffs’ evidence regarding the size of the 

mental-health caseload goes directly to--indeed, 

conclusively resolves--the question whether more than 

40 or so prisoners in ADOC custody have serious mental 

illnesses. And, again, the fact that the class 

contains as-yet-unknown future members also counsels 

strongly in favor of finding that Rule 23(a)(1) has 

been satisfied.

Second, even if the court were required to consider 

how many prisoners “can claim an actual injury 

traceable to the State’s policies and procedures,” 

rather than how many prisoners in ADOC custody have a 

serious mental illness, the court would reiterate that 

the actual injury being claimed in this case is 

exposure to the substantial risk of serious harm 

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stemming from those policies and procedures. If, as 

plaintiffs claim, defendants provide inadequate numbers 

of mental-health care providers and thereby subject all 

prisoners with serious mental illnesses to a 

substantial risk of serious harm, then all class 

members can claim an actual injury--even those who have 

not yet suffered serious harm.

Finally, and for the sake of thoroughly responding 

to a thoroughly unconvincing argument, the court notes 

that plaintiffs have indeed presented evidence (some of 

it not subject to any direct rebuttal) to show that 

numerous individuals have in fact already suffered a 

range of serious harms. The reports of their experts 

are filled with examples of prisoners who the experts

opine have suffered serious harm after receiving care 

that was inadequate due to the failure of defendants to 

provide enough funding, staffing, and oversight.23 A 

 

23. Indeed, in light of the impracticability of 

joinder in a prospective-relief case involving current 

and future prisoners, the number of named plaintiffs 

(continued...)

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selection of these concrete harms includes: being 

denied necessary treatment other than psychotropic 

medication, being maintained on certain psychotropic 

medications despite suffering serious side effects and 

the availability of alternative medications, frequently 

missing doses of psychotropic medications or having 

them inappropriately or abruptly discontinued, being 

denied follow-up care after attempting to commit 

suicide, and being held in segregation without regard 

to the psychological deterioration it is causing.

Having addressed all of defendants’ objections, the 

court finds that plaintiffs have met the numerosity 

requirement for the Eighth Amendment class.

The court also finds that the plaintiffs have met 

the numerosity requirement for the procedural

dueprocess class. Plaintiffs have submitted undisputed

evidence showing that about 70 to 80 individuals were

subject to involuntary-medication orders as of March 

 

who have survived summary judgment would arguably be 

sufficient, on its own, to establish numerosity.

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2016; therefore, this class--of prisoners subject to 

involuntary-medications orders--meets the presumptive 

numerosity threshold discussed above.

B. Commonality

i. Eighth Amendment Claim

Rule 23(a)(2) requires named plaintiffs seeking 

class certification to show that “there are questions 

of law or fact common to the class.” In Wal-Mart, the 

Supreme Court explained that “this does not mean merely 

that they have all suffered a violation of the same 

provision of law. ... [Rather,] [t]heir claims must 

depend upon a common contention ... [which] must be of 

such a nature that it is capable of classwide 

resolution--which means that determination of its truth 

or falsity will resolve an issue that is central to the 

validity of each one of the claims in one stroke. What 

matters to class certification ... is not the raising 

of common ‘questions’--even in droves--but, rather the 

capacity of a classwide proceeding to generate common 

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answers apt to drive the resolution of the litigation.” 

564 U.S. at 350 (citation and internal quotation marks 

omitted). In short, commonality requires a showing 

that there is “some glue” holding the claims together. 

Id. at 352. However, plaintiffs seeking to demonstrate 

commonality under Rule 23(a)(2) need not show that 

common questions “predominate” over individual 

questions as required under Rule 23(b)(3); indeed, 

“even a single common question will do.” Wal-Mart, 564 

U.S. at 359 (citations and alterations omitted).

In Wal-Mart, the plaintiffs failed to satisfy the 

commonality requirement because they had not offered 

“significant proof” of a policy of discrimination that 

applied across the corporation’s numerous stores.24 Id.

 

24. It is worth emphasizing the critical difference 

between the common policy the plaintiffs did have 

enough evidence to demonstrate in Wal-Mart--a policy of 

delegating discretion to supervisors--and the policies 

and practices at issue here. The court explained in 

Wal-Mart that this was a “very common and presumptively 

reasonable way of doing business--one that [it had] 

said should itself raise no inference of discriminatory 

conduct.” 564 U.S. at 355 (citation and internal 

quotation marks omitted). In contrast, the policies 

(continued...)

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at 353. Here, plaintiffs have identified eight

different specific policies or practices, and offered 

significant proof that they are common to the class of 

prisoners in Alabama with serious mental illnesses.25 

 

and practices at issue here are very far from “a policy 

against having uniform [] practices.” Id.; see also

Parsons, 754 F.3d at 681 (“[This case] involves uniform 

statewide practices created and overseen by two 

individuals who are charged by law with ultimate 

responsibility for health care and other conditions of 

confinement in all [state] facilities, not a grant of 

discretion to thousands of managers.”); Logory v. Cty. 

of Susquehanna, 277 F.R.D. 135, 143 (M.D. Pa. 2011) 

(“Unlike Dukes, where commonality was destroyed where 

there was no common mode of exercising discretion that 

pervade[d] the entire company, here there is a solid 

[prison] policy that applied directly to all potential 

class members” (internal citation and quotation marks 

omitted)). Moreover, it goes without saying that (as 

one example) the practice of providing prisoners with 

mental-health staff who are stretched far too thin and 

unqualified to provide the care for which they are 

responsible is certainly not a “presumptively 

reasonable” way of operating a prison system and should 

not be very common.

25. As another court recently explained, drawing on 

the imperfect but helpful analogy of what constitutes a 

policy or custom for purposes of municipal liability 

under Monell v. Department of Social Services, 436 U.S. 

658 (1978), the common policy or practice “need not be 

formal or officially adopted.” Dockery v. Fischer, --

F. Supp. 3d --, 2015 WL 5737608, at *8 (S.D. Miss. 

Sept. 29, 2015) (Barbour, J). A common policy can be 

(continued...)

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This is all plaintiffs need to do for purposes of class 

certification; they need to show that the policies and 

practices they challenge are common, not (yet) that the 

common policies and practices are unconstitutional. 

Put differently, they need to demonstrate the existence 

of common questions with common answers, not what those 

common answers are. See Amgen, 133 S. Ct. at 1194-95 

(holding that merits questions are only to be 

considered to the extent they are relevant to Rule 23 

determination).

 

“express[ly] adopt[ed]” by legislative, executive, or 

administrative act, but it can also be “based on the 

defendant’s deliberate indifference”--that is, based on 

a showing that the defendants have “failed to respond 

to a need ... in such a manner as to show ‘deliberate 

indifference’ to the risk that not addressing the need 

will result in constitutional violations.” Id. at 

*8-10 (quoting Lightfoot v. District of Columbia, 273 

F.R.D. 314, 320-21 (D.D.C. 2011) (Kollar-Kotelly, J.), 

and citing Young v. Nationwide Mut. Ins. Co., 693 F.3d, 

532, 542-43 (6th Cir. 2012)). In this case, plaintiffs 

have offered evidence of common policies and practices 

that run the gamut from those that have been expressly 

adopted (such as the mental-health staffing levels 

defendants set by contract) to others which constitute 

a failure to act that evinces deliberate indifference 

(such as the practice of failing appropriately to 

(continued...)

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The court will proceed as follows: First, it will 

discuss what must be shown to demonstrate that the 

policy or practice is common, generally and in the 

context of an Eighth Amendment substantial-risk-of-harm 

claim such as the one brought here. Second, it will 

discuss the evidence plaintiffs have offered to show 

that policies and practices they have challenged are 

indeed common to the class. Third and last, the court 

will address defendants’ arguments that dissimilarities 

among class members defeat commonality.

As a general matter, a policy or practice need not 

affect every member of a class in order to be “common.” 

See Rubenstein, Newberg on Class Actions § 3.23 (5th 

ed.) (“[T]he Fifth Circuit has held that questions 

affecting ‘most,’ ‘a substantial number,’ or ‘a 

significant number’ of the class members will qualify 

as ‘common’ questions. This question has rarely been 

addressed outside the Fifth Circuit though courts that 

 

monitor or provide follow-up care for prisoners in 

crisis).

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have addressed it have adopted the Fifth Circuit’s 

approach.”).

Moreover, “class members can assert such a single 

common complaint even if they have not all suffered 

actual injury; demonstrating that all class members are 

subject to the same harm will suffice.” Baby Neal ex 

rel. Kanter v. Casey, 43 F.3d 48, 56 (3d Cir. 1994) 

(emphasis in original) (citing Hassine v. Jeffes, 846 

F.2d 169, 177-78 (reversing the denial of certification 

of a class of prisoners challenging the risks posed by 

unsafe prison conditions)). As another district court 

recently explained in a jail-conditions case, “the 

Fifth Circuit, like the Third, [has] expressly 

disagreed with the proposition that a policy must 

injure each class member to provide the foundation for 

class wide relief.” Jones v. Gusman, 296 F.R.D. 416, 

465-66 (E.D. La. 2013) (Africk, J.) (citing M.D. ex 

rel. Stukenberg v. Perry, 675 F.3d 832, 847-48 (5th 

Cir. 2012)). Instead, in M.D., the court of appeals 

explained that a valid claim for class-wide relief 

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could be “based on an allegation that the [defendant] 

engages in a pattern or practice of agency action or 

inaction--including a failure to correct a structural 

deficiency within the agency, such as insufficient 

staffing--with respect to the class,” even if 

plaintiffs do not contend that every member of the 

class has suffered an actual injury. 675 F.3d at 

847-48 (internal citation and quotation marks omitted).

This case law supports a finding of commonality 

here, because being subjected to a substantial risk of 

serious harm is an actionable constitutional injury, 

even when a prisoner’s physical or mental condition has 

not yet been detrimentally impacted. See Parsons, 754 

F.3d at 681-83 (citing numerous cases, both within and 

outside the Eighth Amendment context, in which courts 

have found the commonality requirement satisfied, 

post-Wal-Mart, based on a systemic policy or practice 

that allegedly exposed the members of the class to an 

unconstitutional risk of harm); see also Dockery, 2015 

WL 5737608, at *16-17 (recognizing as common questions 

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“whether [the challenged] conditions and health care 

have either subjected prisoners to an 

unconstitutionally unreasonable risk of harm or, 

conversely, were sufficient to provide humane 

conditions of confinement”); Scott v. Clarke, 61 F. 

Supp. 3d 569, 587 (W.D. Va. 2014) (Moon, J.) 

(“Plaintiffs allege that the policies and practices at 

FCCW--e.g., the defective sick call process; FCCW’s 

refusal to refer or undue delay in referring prisoners 

for specialized care; the failure to maintain 

continuity in the provision of prescribed, potentially 

life-sustaining medications; etc.--reflect substandard 

medical care on the part of the Defendants. Whether 

these policies and practices place the Plaintiffs and 

other current and future FCCW prisoners at a

substantial risk of serious harm to which the 

Defendants are deliberately indifferent implicates 

questions of fact and law common to the entire putative 

class.”); Jones, 296 F.R.D. at 465-67 (“Whether certain 

conditions at OPP either by themselves, or through a 

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mutually enforcing effect, put inmates at a substantial 

risk of harm is amenable to a common answer. ... 

Similarly, whether OPP officials have been deliberately 

indifferent to any such risk can be demonstrated in a 

manner that is applicable to all class members. ... 

Class Plaintiffs’ Eighth and Fourteenth Amendment 

medical and mental-health care claims [likewise] 

warrant certification. ... Class Plaintiffs have 

identified discrete and particularized practices 

including, for example, medication and suicide 

prevention practices, as well as staffing inadequacies, 

that are mutually enforcing causes of OPP's deficient 

conditions. ... Accordingly, a class action is an 

appropriate vehicle for these claims.” (citations and 

internal quotation marks omitted)); Hughes v. Judd,

2013 WL 1821077, at *9, *23-24 (M.D. Fla. Mar. 27, 

2013) (Pizzo, M.J.) (finding commonality and certifying 

a class with respect to a Fourteenth Amendment

risk-of-harm claim challenging a sheriff’s failure to 

address a high level of violence among juvenile 

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detainees and practice of using pepper spray in 

response to this violence), report and recommendation 

adopted as modified on other grounds, 2013 WL 1810806 

(M.D. Fla. April 30, 2013) (Merryday, J.); M.D. v. 

Perry, 294 F.R.D. 7, 45 (S.D. Tex. 2013) (Jack, J.)

(finding commonality and certifying a class with 

respect to a Fourteenth Amendment risk-of-harm claim 

challenging a policy or practice of allowing 

caseworkers in a foster care system to carry excessive 

caseloads that posed a risk of harm to children).

The fact that not every mentally ill prisoner is 

subjected to precisely the same level of risk also does 

not defeat commonality. Indeed, the last time a judge 

in this court heard a “systemic attack on the way that 

mental health care is provided to acutely and seriously 

mentally ill inmates in the Alabama prison system,” it 

explained that “[t]hough there certainly may be some 

factual differences between the individual class 

members and the nature and severity of their illness, 

such individual differences do not defeat certification 

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76

because there is no requirement that every class member 

be affected by the institutional practice or condition 

in the same way.” Bradley v. Harrelson, 151 F.R.D. 

422, 426 (M.D. Ala. 1993) (Albritton, J.); see also

Parsons, 754 F.3d at 678-80 (“[A]lthough a presently 

existing risk may ultimately result in different future 

harm for different inmates--ranging from no harm at all 

to death--every inmate suffers exactly the same 

constitutional injury when he is exposed to a single 

statewide ADC policy or practice that creates a 

substantial risk of serious harm. ... Even if some 

inmates are exposed to a greater or idiosyncratic risk 

of harm by the policy and practice of not hiring enough 

staff to provide adequate medical care to all inmates, 

that single policy and practice allegedly exposes every 

single inmate to a serious risk of the same basic kind 

of harm.” (internal citations omitted)).

Plaintiffs have offered more than adequate evidence 

to establish the existence of the common policies and 

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77

practices they challenge.26 This evidence, discussed in 

the court’s opinion on summary judgment, could not be 

more different from the indefinite and speculative 

evidence offered by the expert in Wal-Mart, of a 

“culture” of discrimination manifested in millions of 

discretionary decisions. 564 U.S. at 353-54. Here, 

the experts point to very concrete policies and

practices--such as using unsupervised and unqualified 

nurses to conduct intake screenings, or placing 

prisoners with serious mental illness in prolonged 

segregation--that undisputedly occur or that plaintiffs 

have offered considerable evidence (often in the form 

of admissions by MHM administrators) to show are 

 

26. The court notes that, in addition to the expert 

evidence discussed here, plaintiffs have offered 

evidence regarding care they and a couple of dozen 

putative class members have received, in order to 

further illustrate the commonality of the policies and 

practices they challenge. The evidence regarding the 

named plaintiffs will be discussed below, in the 

context of the typicality analysis. Although 

illustrative, the court need not and does not base its 

decision regarding commonality on the declarations of 

the unnamed class members; plaintiffs’ expert evidence 

is more than sufficient.

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widespread. See Parsons, 754 F.3d at 678 (“The 

putative class and subclass members thus all set forth 

numerous common contentions whose truth or falsity can 

be determined in one stroke: whether the specified 

statewide policies and practices to which they are all 

subjected by ADC expose them to a substantial risk of 

harm. ... These policies and practices are the ‘glue’ 

that holds together the putative class and the putative 

subclass; either each of the policies and practices is 

unlawful as to every inmate or it is not.”). The only 

genuine debate in this case is as to the effects of 

these policies and practices--that is, whether or not 

they pose a substantial risk of serious harm. But this 

is not a question for the class-certification stage.

Instead of rehashing plaintiffs evidence in a 

second opinion, the court will simply note that 

plaintiffs’ expert, Dr. Haney, reiterates at the 

conclusion of his report that the problems that he 

discussed in his reports were widespread and systemic. 

Unlike the expert in Wal-Mart, his conclusions are

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79

based not on untethered theorizing, but on a large 

quantity of concrete evidence. He explains as follows:

“[T]he observations that I made about 

various ADOC facilities were remarkably 

consistent throughout my tours--that is, with 

only minor variations, virtually the same kinds 

of problems surfaced in each of the facilities 

that I inspected. Moreover, there was 

remarkable consistency in what prisoner after 

prisoner in these separate facilities told me 

(as documented in [the lengthy appendix to his 

report]). It did not seem to matter whether 

the prisoners I interviewed were selected 

randomly for brief cell-front interviews, 

selected for individual, confidential 

interviews after having been seen cell-front, 

picked randomly from the facility’s prisoner 

roster for individual confidential interviews, 

or suggested by counsel for Plaintiffs--they 

all told essentially the same kind of grim and 

often tragic stories. In addition, because 

many of them had been housed in other ADOC 

facilities, they were in a position to confirm 

that the problems--the mistreatment and 

neglect--that they were encountering at their 

present facility were not unique to that place 

but rather existed in facilities throughout the 

ADOC.

“In addition, these consistent accounts, 

and my own broad conclusion about systemic 

deficiencies throughout the Alabama prison 

system, are corroborated in many important 

respects by the candid observations and 

conclusions reached by an entirely different 

group of people--namely, mental health 

officials (employed by ... MHM [ADOC’s mental 

health contractor]) charged with system-wide 

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oversight responsibilities and the provision of 

mental health services in Alabama’s 15 major 

prisons. Their stated opinions provide strong 

support for my own observations about the 

system-wide magnitude of the very serious 

problems that I encountered.”

Haney Report (doc. no. 868-4) at 158-59.

As discussed at much greater length in the court’s 

opinion denying summary judgment, Dr. Burns, 

plaintiffs’ other mental-health expert, concurs, 

concluding that the “deficiencies in ADOC--inadequate 

staffing levels, qualifications, identification and 

classification, treatment and oversight of the mental 

health care--deny prisoners care for their serious 

mental illness leading to needless pain, suffering, 

self-injury, suicide and punishment for symptoms of 

untreated mental illness. These are systemic problems 

that can and should be addressed through changes to the 

mental health care delivery system.” Burns Report 

(doc. no. 868-2) at 52.

Even Dr. Patterson, defendants’ own expert, 

recognizes that a number of the policies and practices 

being challenged are pervasive, including that the 

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81

“staffing of the facilities is insufficient and a 

significant number of the mental health staff are 

unlicensed practitioners” who had not received any 

documented supervision. Patterson Report (doc. no. 

679-9) at 47. Moreover, he recognizes that other 

policies and practices, and concrete harms, stem from 

this source. For example, he observes “certain 

deficiencies in adequately identifying inmates during 

the reception and intake processes that are in need of 

mental health services, and therefore the numbers of 

inmates in need of mental health services are ... 

underestimated and reflect the need for increased 

numbers of and properly trained and credentialed mental 

health staff, as well as the need for supervision by 

registered nurses during the intake process to identify 

those inmates in need of further evaluation for mental 

health services.” Id. at 47.

Dr. Patterson is not merely suggesting that he 

found a few--or even a lot--of prisoners who were not 

identified; he is explaining that there is a consistent 

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82

pattern of failure attributable to a very specific set 

of decisions about system-wide staffing. He agrees, 

then, that insufficiency of mental-health staffing is a 

pervasive problem, and that this causes prisoners not 

to be identified as in need of treatment, across the 

board. (Of course, not every mentally ill prisoner is 

missed; rather, every mentally ill prisoner is at risk

of being missed.) It is thus undisputed--by the 

parties’ experts if not by the parties--that at least 

one of the policies or practices challenged by 

plaintiffs is common to the class.27

 

27. Indeed, a decision about system-wide staffing 

seems quite obviously to be a common policy or 

practice. It is an express policy, which applies to 

all prisoners in the system. The adequacy of staffing 

levels cannot be evaluated meaningfully with respect to 

any particular prisoner. See M.D., 675 F.3d at 848 n.7 

(suggesting that staffing levels are the type of 

condition that is generally applicable to a class of 

plaintiffs, in noting that “it is not clear how several 

of the State’s alleged failures, such as its failure to 

... employ a sufficient number of caseworkers, can be 

considered [a] ‘day-to-day, case-by-case operational 

failure[]’”); Parsons, 754 F.3d at 679 (“[T]he 

plaintiffs allege that they are placed at risk of 

serious harm by a policy and practice of severe 

under-staffing across all ADC medical care facilities. 

(continued...)

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Whether this policy or practice of understaffing 

subjects mentally ill prisoners to a substantial risk 

of serious harm is one question (of a number of them) 

apt to drive the resolution of this litigation. Unlike 

in Wal-Mart, the plaintiffs here have offered 

considerable evidence to show that this policy or 

practice is one of the reasons (indeed, the primary 

reason) that they are at serious risk of receiving 

inadequate care. This evidence is not merely of a 

“common pattern or practice,” as in an oft-repeated 

violation, but rather of a “common answer to the 

crucial question why” prisoners have been put at a 

 

As a result of this statewide policy and practice, they 

allege, the quality and availability of care across all 

ADC facilities is constitutionally deficient. This 

allegation presents questions of law and fact common to 

all members of the putative class. ... The question 

whether ADC's staffing policies pose a risk of serious 

harm to all ADC prisoners can thus be answered as to 

the entire class ‘in one stroke.’ Wal-Mart, 131 S. Ct. 

at 2551. Either ADC employs enough nurses and doctors 

to provide adequate care to all of its inmates or it 

does not do so; there is no need for an 

inmate-by-inmate inquiry to determine whether all 

inmates in ADC custody are exposed to a substantial 

risk of serious harm by ADC staffing policies.”).

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substantial risk of serious harm, Wal-Mart, 564 U.S. at 

352: because ADOC provides inadequate numbers of and 

insufficiently qualified mental-health staff, resulting 

in, among other things, a failure to identify or 

recognize the acuity of mental illness in many 

prisoners. Plaintiffs here have done exactly what 

defendants accuse them of failing to do. Instead of 

attempting to distill “constellation of disparate but 

equally suspect practices” from varying experiences of

class members, they have “identif[ied] the policy or 

custom they contend violated the [law] and then 

establish[ed] that the policy or custom is common to 

the class.” Lightfoot, 273 F.R.D. at 326; see also

Parsons, 754 F.3d at 673 (agreeing with the district 

court that “the problems identified in the provision of 

health care are not merely isolated instances but, 

rather, examples of systemic deficiencies that expose 

all inmates to a substantial risk of serious harm,” 

because the evidence of the existence of a number of 

specific common policies and practices “suggests that 

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85

the root cause of the injuries and threats of injuries 

suffered by Plaintiffs is the systemic failures in the 

provision of health care generally”); Jones, 296 F.R.D. 

at 466 (“The facts and law also demonstrate that Class 

Plaintiffs’ Eighth and Fourteenth Amendment medical and 

mental health care claims warrant certification. These 

claims do not allege amorphous systemic deficiencies. 

Class Plaintiffs have identified discrete and 

particularized practices including, for example, 

medication and suicide prevention practices, as well as 

staffing inadequacies, that are mutually enforcing 

causes of OPP’s deficient conditions. Accordingly, a 

class action is an appropriate vehicle for these 

claims.” (citations and internal quotations marks 

omitted)).

Rather than discussing each of the remaining 

policies and practices at length, the court will merely 

discuss another example. With respect to the policy or 

practice of “placing prisoners in segregation without 

regard to its harmful effects on their mental health,” 

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the pertinent question is whether defendants treat 

mentally ill prisoners alike in segregating them, not

whether this creates a substantial risk of serious harm 

to such prisoners. Although Dr. Morgan disagrees with 

Dr. Haney regarding the effects of this practice, and 

opines that the mental-health monitoring and treatment 

provided to prisoners in segregation is adequate, he at 

no point offers any evidence to suggest that the 

question--whether or not these policies and practices 

create a substantial risk of serious harm--cannot be 

adjudicated on a class-wide basis.28

 

28. Likewise, Dr. Morgan’s opinions as to the 

effects of understaffing or the efficacy of the 

assessment and classification system go to plaintiffs’ 

claims on the merits--that is, whether defendants’ 

policies place plaintiffs and putative class members at 

a substantial risk of serious harm. His opinions do 

not, however, undermine plaintiffs’ evidence that 

defendants’ policies and practices pose a common 

question capable of class-wide resolution; nothing Dr. 

Morgan says runs counter to the conclusion that these 

policies either do or do not create a substantial risk 

of serious harm to seriously mentally ill prisoners 

throughout the system.

Indeed, Dr. Morgan often relies heavily--sometimes 

entirely, to the exclusion of any consideration of the 

(continued...)

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This distinguishes the case at bar from Sher v. 

Raytheon Co., wherein the Eleventh Circuit reversed a 

grant of class certification and remanded for 

reconsideration because the district court had not 

“evaluat[ed] and weigh[ed] conflicting expert 

testimony,” and “decline[d] to declare a proverbial, 

yet tentative winner” between these experts, at the 

class-certification stage. 419 F. App’x 887, 890 (11th 

Cir. 2011). In Sher, a case about release of toxins 

into groundwater, the plaintiffs attempted to show that 

they met the requirements for certification under Rule 

 

actual treatment provided to any particular prisoners--

on the existence of a formal system-wide policy to 

conclude that the mental-health care being provided 

throughout the system is adequate. See Morgan Report 

(doc. no. 865-1) at 19 (“[B]ased on my review of ADOC 

mental health policy, it is my opinion that the ADOC 

has a clearly defined mental health services system 

applicable to all inmates, including inmates on the 

mental health caseload, and these policies and 

procedures are consistent with national standards of 

practice.”). Whether or not Dr. Morgan’s bald reliance 

on these policies supports his conclusions is a matter 

for trial, but it certainly reflects his view that the 

Eighth Amendment claim in this case can be resolved 

with respect to all class members in one fell swoop.

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23(b)(3) by presenting an expert who said that he could 

map the underground area affected and create a 

mathematical model to show how much the value of each 

surrounding property had diminished without requiring 

any individualized consideration; defendants’ experts, 

by contrast, concluded that the identified area 

included properties with no contamination and that the 

mathematical model would not obviate the need for 

individualized determinations of value diminution. Id. 

at 889. Because the experts disagreed about whether 

the plaintiffs met the requirements of Rule 23, such 

that class-wide resolution was appropriate, it was 

necessary to “declare a ... winner.” Id. at 890; see

also Ellis, 657 F.3d at 983-84 (holding that the 

district court should have resolved a dispute between 

the parties’ experts as to whether gender disparities 

in promotion existed across the country or only in 

certain areas, because plaintiffs would be unable to 

show a common policy or practice unless they could show 

consistent nationwide discrimination). Here, Dr. 

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Morgan does not suggest that some identifiable subset 

of mentally ill prisoners is not at risk of placement 

in segregation (if he did, the court would need to 

weigh his evidence to determine whether plaintiffs had 

shown commonality); instead, Dr. Morgan simply 

disagrees that the practice of placing mentally ill 

prisoners in segregation places them at a substantial 

risk of serious harm.

Before concluding this discussion of commonality, 

the court will address defendants’ contention that 

commonality is defeated by variations between the 

conditions in different facilities and the differing 

mental-health needs of members of the class. Although 

it is true that there are some differences between the 

various men’s facilities,29 in terms of the populations 

incarcerated there and the ways that certain forms of 

 

29. Plaintiffs’ experts did conclude that adequate 

mental-health care was being provided in the open 

residential treatment unit at Tutwiler, the only 

women’s prison in the State. However, as explained 

below, prisoners housed at Tutwiler will not be 

included in the class.

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mental-health care are delivered (as an example, not 

all major facilities have residential treatment units), 

and in terms of the levels of staffing (some facilities 

have some psychiatrist coverage while others have none 

at all, and some facilities have especially severe 

shortages of custodial staff while others have somewhat 

more moderate shortages),30 this does not defeat 

 

30. Defendants particularly press this point with 

respect to plaintiffs’ contention that the failure to 

provide adequate custodial staff interferes with the 

provision of mental-health care, noting that some 

facilities are more understaffed and some less. 

However, defendants’ own expert, Dr. Morgan, despite 

recognizing the existence of some variation in the 

level of understaffing by facility, states that 

“[custodial] understaffing remains a major concern 

across the ADOC. It is my opinion that correctional 

officer understaffing should be viewed as a 

correctional crisis within the ADOC, such that this 

crisis necessitates immediate action.” Morgan Report 

(doc. no. 671-1) at 11-12. He further notes that 

“[s]taff at all eight facilities that I visited noted 

understaffing.” Id. at 13. This amounts to a 

recognition that the practice of custodial 

understaffing is common across facilities. Dr. Morgan 

disagrees with plaintiffs’ experts as to the effect of 

this understaffing on the delivery of mental-health

care. See id. at 31 (“The ADOC is significantly 

understaffed; however, this understaffing does not 

prohibit plaintiffs and other class members from 

receiving needed mental health services....”). But 

(continued...)

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commonality for two principal reasons.

First, plaintiffs’ experts have cited evidence 

showing, and concluded, that the practices at issue are

fairly consistent across the major facilities they 

inspected, including all of the major hubs for 

treatment of prisoners with mental illness; although 

there were slight variations, they did not identify any

men’s facilities as positive outliers where the system 

for providing mental-health care was appreciably 

different (or where adequate mental-health care was 

 

this question--whether the common policy or practice 

subjects mentally ill prisoners to a substantial risk 

of serious harm by interfering with the delivery of 

their mental-health care--is a merits question for 

trial. Moreover, plaintiffs have pointed to admissions 

by mental-health staff that the lack of security staff 

has resulted in recurrent delays in or cancellations of 

mental-health treatment in different units at at least 

six of the major facilities. Minutes from a meeting of 

MHM administrators in January 2015 noted “widespread 

reports among several facilities of delays in seeing 

inmates for appointments due to security 

unavailability,” and reflected a need to “[k]eep going 

up the chain of ADOC command” to address this problem. 

CQI Meeting Minutes, Pls.’ Ex. 182 (doc. no. 850-82) at 

121, MHM029619. A practice which is “widespread” and 

which requires high-level correctional intervention to 

address is common to the class.

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being provided).

Second, and perhaps more important, the named 

plaintiffs’ records clearly reflect that they are 

transferred very frequently between a large number of

different facilities; it is fair to presume that the 

other class members are too.31 In that sense, defining 

a subclass to include only those who are or will be 

housed at a subset of facilities would be a semantic 

distinction without much if any practical difference. 

The claim in this case revolves around a prospective 

risk of harm; even if some aspect of the mental-health

care at a particular facility is idiosyncratically 

better or worse, it is clear that numerous class 

members not currently housed at that facility are 

likely to be exposed to it in the future.

Another comparison to Wal-Mart is instructive. In 

 

31. Specifically, seriously mentally ill prisoners

are often transferred due to their need to be housed in 

a residential treatment unit or a stabilization unit,

which are available at only a few facilities. As a 

result, many of the putative class members are 

(continued...)

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Wal-Mart, the fact that the class members worked at 

thousands of stores across the country made it 

impossible to show the existence of a common policy of 

discrimination based on discrimination at a subset of 

the stores. 564 U.S. at 356-58. But the female 

employees of Wal-Mart were not frequently moved to 

numerous different stores in different regions of the 

country at the whim of the defendant corporation. As 

the court pointed out, a woman working in Missoula, 

Montana, would be totally unaffected by discriminatory 

promotion practices at the stores in say, New Mexico. 

When a prisoner is in ADOC custody, however, he is 

subject to involuntary transfer at any time to another 

facility in the system, and therefore subject to the 

risks of harm that attend placement at those other 

facilities. Cf. Henderson, 913 F. Supp. 2d at 1285-86 

(holding that the claims of a prisoner who was 

transferred to a different facility were not moot 

 

frequently transferred back and forth between other 

facilities and those with these specialized units.

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because there was “more than a reasonable basis to 

believe that she will be subjected to segregation in 

[the same facility] again”).

Moreover, litigation of these system-wide issues 

would not preclude sensitivity to any salient 

differences between facilities in crafting a remedial 

order in the event that the court does find liability.32 

The remedial order the Supreme Court affirmed in Brown 

v. Plata, 563 U.S. 493 (2011), for instance, ordered 

the California prison system to reduce overcrowding 

(which was resulting in unconstitutional medical care) 

to a certain percentage of design capacity across the 

State, while allowing it flexibility to adjust for the 

distinctive features and needs of different 

institutions by having some facilities be more crowded 

and some less. Coleman v. Schwarzenegger, 922 F. Supp. 

2d 882, 970 n.64 (E.D. Cal. 2009), aff’d sub nom. Brown 

 

32. Defendants would, subject to the court’s 

consideration of objections raised by plaintiffs and 

independent approval, have the opportunity to propose 

the terms of any eventual remedial order.

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v. Plata, 563 U.S. 493 (2011).

However, as noted above, the court has decided to 

define the class to exclude prisoners at Tutwiler

Prison for Women. Although there is expert evidence 

regarding the mental-health care being provided at 

Tutwiler, and although many of the same policies and 

practices apply at that facility, there is no female 

class representative; unlike male prisoners who are 

frequently transferred between facilities, there are no 

transfers between Tutwiler and the rest of the men’s 

facilities, and no named plaintiff will ever be 

incarcerated at Tutwiler. The court therefore 

concludes that it would be more appropriate for the 

adequacy of mental-health care at Tutwiler to be 

litigated by way of ADAP’s associational standing.33

 

33. There was initially a female Phase 2A class 

representative, but she passed away during the pendency 

of this litigation. If ADAP did not have associational 

standing to bring this claim on behalf of the women at 

Tutwiler, the court would consider giving plaintiffs 

the opportunity to amend their complaint to add another 

female Phase 2A class representative. See, e.g., 

Diduck v. Kaszycki & Sons Contractors, Inc., 147 F.R.D. 

(continued...)

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96

Defendants also argue that differences in the 

health care needs of class members preclude a finding 

of commonality. For this proposition, they rely on 

language from a Third Circuit decision, Rouse v. 

Plantier, 182 F.3d 192, 199 (3d Cir. 1999):

“In light of the diverse medical needs of, 

and the different level of care owed to, each 

group of plaintiffs [specifically, ‘stable’ 

versus ‘unstable’ diabetics], the District 

Court erred in holding that all members of the 

plaintiff class alleged a violation of their 

Eighth Amendment rights. Based on the evidence 

in the summary judgment record, there may be 

one or more subgroups of plaintiffs as to whom 

particular aspects of the care allegedly 

provided was not consistent with Eighth 

Amendment requirements and other subgroups as 

to whom particular aspects of the care was 

constitutionally adequate.”

But Rouse was an appeal from a denial of qualified 

immunity (rather than an appeal from a 

class-certification decision)34 with respect to class 

 

60, 62 (S.D.N.Y. 1993) (Stewart, J.) (granting a stay 

of proceedings until the plaintiffs could find a new 

class representative following the death of a 

representative).

34. Although Rouse involved injunctive-relief 

claims as well, the court was very clear that “[t]he 

(continued...)

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97

claims for damages stemming from inadequate treatment 

in the past (rather than, as here, a purely prospective 

injunctive-relief class action alleging a current 

substantial risk of serious harm). In light of the 

posture of the case, the court’s instruction to the 

district court, to focus on differences in the medical 

needs of different subsets of the plaintiff claims, is 

totally unremarkable: if the care provided in the past 

was adequate for, say, ‘stable’ diabetics, they would 

not have suffered any retrospective constitutional 

violation, and would not be entitled to any damages. 

But here, such parsing is neither necessary nor 

appropriate: there are no damages to be apportioned, 

and, more important, even if a given class member 

admits that he has not in the past received care that 

 

only issue in this appeal is whether the defendants are 

entitled to summary judgment based on qualified 

immunity,” a defense that applies only to 

individual-capacity damages claims and not to 

official-capacity claims for prospective injunctive 

relief. 182 F.3d at 196. Moreover, the court 

expressly stated that “[t]he question of class 

(continued...)

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98

violated the Constitution, he is not precluded from 

raising a prospective Eighth Amendment claim that 

defendants are currently subjecting him to a

substantial risk of serious harm. Also, as a factual 

matter, the allegations in Rouse involved much more 

fine-grained aspects of care for a particular disease 

(for example, whether monitoring of blood sugar a 

certain number of times per day was sufficient), 

whereas the allegations in this case involve 

overarching inadequacies of staffing which, plaintiffs’ 

experts have opined, contribute to a range of other 

systemic inadequacies that affect mentally ill 

prisoners irrespective of their particular diagnoses.

Finally, the court notes that it contemplated 

certifying subclasses, such as a subclass of those 

mentally ill prisoners receiving psychotropic 

medications, or a subclass of those held in 

segregation. However, the evidence in the record 

 

certification ... is not before us, and we express no 

opinion on this issue.” Id. at 199 n.3.

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99

reflects that about two-thirds of mentally ill 

prisoners receive such medication, and that mentally 

ill prisoners who are not taking medication are 

frequently urged to do so (indeed, plaintiffs have 

offered evidence to suggest that prisoners who refused 

medication have sometimes been threatened with removal 

from the mental-health caseload). The record also 

reflects that prisoners with mental illness regularly 

move into and out of these restrictive housing units. 

As a result, certifying such subclasses would be an 

exercise in legal formalism; the court is satisfied 

that, to the extent that these medication and 

segregation practices create a substantial risk of 

serious harm to prisoners when they are taking 

medication or housed in segregation, this risk extends 

to all seriously mentally ill prisoners, who are all 

fairly likely to take medication and be placed in 

segregation at some point.

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ii. Due Process Claim

The court also finds that the procedural 

due-process class satisfies the commonality 

requirement. As with the Eighth Amendment claims, 

plaintiffs presented evidence through their expert, Dr. 

Burns, showing that prisoners across the ADOC system 

have not received adequate process before being 

subjected to involuntary medication. While the parties 

agree that the ADOC’s written policy is 

constitutionally adequate under Washington v. Harper, 

494 U.S. 2010 (1990), Bui challenges whether the 

procedures are adequate in practice.35 This question 

applies to all class members, as they are all on 

involuntary-medication orders. The question can be 

answered in one stroke--namely, by determining whether 

ADOC’s involuntary-medication practices adequately 

 

35. This question largely, although imperfectly, 

overlaps with a very concrete one: Is there, or is 

there not, a practice of failing to comply with ADOC’s 

written policy on involuntary medication? The answer 

to this question is the same for every member of the 

class.

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protect due-process rights. See Hightower ex rel.

Dehler v. Olmstead, 959 F. Supp. 1549, 1557 (N.D. Ga. 

1996) (considering procedural due-process claims, among 

others, brought by a certified class of patients in a 

state hospital), aff’d sub nom. Hightower v. Olmstead, 

166 F.3d 351 (11th Cir. 1998).

C. Typicality

Although the commonality and typicality inquiries 

“tend to merge,” the typicality requirement--which is 

“somewhat of a low hurdle”--focuses the court’s 

attention on “whether a sufficient nexus exists between 

the claims of the named representatives and those of 

the class at large.” Gen. Tel. Co. of Sw. v. Falcon, 

457 U.S. 147, 158 n.13 (1982); Taylor v. Flagstar Bank, 

FSB, 181 F.R.D. 509, 517 (M.D. Ala. 1998) (Albritton, 

J.); Busby v. JRHBW Realty, Inc., 513 F.3d 1314, 1322 

(11th Cir. 2008) (citation and internal quotations 

omitted). A class representative’s claims are typical 

if they “arise from the same event or pattern or 

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practice and are based on the same legal theory” as the 

class claims; they need not be identical. Williams v. 

Mohawk Indus., Inc., 568 F.3d 1350, 1357 (11th Cir. 

2009) (citation and internal quotations omitted); see

In re Healthsouth Corp. Sec. Litig., 257 F.R.D. 260, 

275 (N.D. Ala. 2009) (Bowdre, J.). Defendants argue 

that plaintiffs have failed to identify class 

representatives able to challenge each of the policies 

and practices at issue in this case; although they 

frame this argument as going to adequacy, it actually 

sounds in typicality.

For purposes of typicality, plaintiffs need to show 

that there are named plaintiffs who have been exposed 

to the policies or practices that create the 

substantial risk of serious harm they challenge, not

that they have actually suffered the harm in the past.36

So, for example, if lack of adequate medication 

 

36. The remaining plaintiffs must also show--and 

have shown, as discussed in the court’s opinion on 

summary judgment--that they have serious mental-health

needs.

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management creates a substantial risk of a prisoner 

taking psychotropic medications suffering unnecessarily

from serious side effects, there must be a named 

plaintiff who is taking psychotropic medication; he 

need not necessarily prove, at the class-certification 

stage (or, for that matter, at trial), that he has 

already suffered from side effects.

Hence, plaintiffs need to prove that there are 

named plaintiffs who (1) receive mental-health care

from the mental-health care staff,37 (2) rely upon 

custodial staff to facilitate their receipt of

mentalhealth treatment, (3) are assessed at intake, 

during classification reviews, and in response to 

referrals, (4) need or take psychotropic medications, 

(5) require psychotherapy, (6) engage or desire to 

engage in self-harm or to commit suicide, (7) are 

placed in segregation, and (8) receive disciplinary 

 

37. More precisely, the question is not whether the 

named plaintiff does receive mental-health care, but 

whether he relies on the mental-health care staff for 

any care he does receive.

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citations based on symptomatic behavior. There is no

serious dispute,38 though, that all of the named 

plaintiffs fall within categories (1) and (3); that 

many of the named plaintiffs--including at least six

who have been housed in segregation (Hartley, Jackson, 

Johnson, McCoy, Pruitt, and Williams)--fall within 

category (2); that at least eight (Braggs, Hartley, 

Johnson, McCoy, Pruitt, Wallace, and Williams) fall 

within category (4); and that at least two (in many 

 

38. Again, defendants do argue, vehemently, that 

the named plaintiffs have not offered evidence to show 

that they, individually, have suffered past violations 

of the Eighth Amendment as a result of these policies 

and practices. (As discussed in the court’s opinion on 

summary judgment, this is both incorrect and 

irrelevant, because their claim concerns not past harm 

but a future risk of harm that they contend exists 

because they need mental-health care but can obtain it 

only from a seriously deficient system.) For the 

purpose of typicality, the named plaintiffs need only 

show that they are exposed to a particular policy or 

practice--for example, that they need mental-health

care, and that they can only obtain that care from the 

limited number of mental-health staff defendants have 

provided. Whether or not that limit is 

unconstitutionally harmful is a question for trial and 

not for class certification.

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cases, more) fall within each of the remaining 

categories.39

Although they need not do so, plaintiffs have in 

fact presented evidence that at least one of them has 

not only been exposed to but harmed by the risk created 

by each of the policies or practices at issue. Rather 

than engage in an exhaustive discussion that would 

largely rehash the extended section on individual harm 

in the court’s opinion on summary judgment, the court 

will instead mention illustrative examples.40

 

39. Defendants’ own expert, Dr. Patterson, 

recognized that at least Braggs, Hartley, Jackson, 

McCoy, and Wallace have required psychotherapeutic 

treatment; that at least Pruitt, Wallace, and Williams 

have engaged in self-harm (and that others have 

reported a desire to do so); and that at least Jackson, 

McCoy, Pruitt, Wallace, and Williams, have been housed 

in segregation. Although Dr. Patterson did mention a 

few disciplinary citations the named plaintiffs 

received, he did not discuss those citations that 

stemmed from symptomatic behavior (specifically, 

self-harm). He did opine, however, in general terms,

that the “potential harm” of delays in providing 

mental-health treatment includes “disciplinary actions 

due to inadequate treatment.” Patterson Report (doc. 

no. 679-9) at 47.

40. The court refers the reader to this section of 

its summary-judgment opinion.

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As for defendants’ policy or practice of failing to 

provide adequate numbers of and sufficiently qualified 

mental-health staff, plaintiffs have offered evidence 

to show that the inadequate staffing has adversely 

affected Hartley’s treatment: his treatment plans 

repeat problem statements and goals without documenting 

changes in his mental state, and that his treatment 

team meetings are not attended by required staff 

members. In fact, defendants’ own mental-health

expert, Dr. Patterson, agrees with plaintiffs that 

Hartley’s treatment plans, and his resulting 

mental-health care, are inadequate. He further opines 

that “Mental Health Treatment Planning” is “seriously 

deficient, at least in part because of the lack of 

adequate staffing.” Patterson Report (doc. no. 679-9) 

at 52.

Plaintiffs have also offered evidence to show that 

named plaintiffs have been exposed to and harmed by 

defendants’ failure to provide sufficient custodial 

staffing to avoid regular security-related interference 

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with the provision of mental-health care. For example, 

Jackson’s medical records indicate that a number of his 

mental-health appointments were canceled due to 

security issues arising from an insufficient number of 

ADOC officers.

With respect to the failure to identify or 

recognize the severity of mental illnesses, plaintiffs 

have offered evidence to show that although staff at a 

state mental hospital recognized, prior to Johnson’s

incarceration in 1996, that he suffered from depression

and was possibly psychotic (and potentially incompetent

to stand trial), he was not placed on the mental-health 

caseload for almost two decades, until he was placed on 

suicide watch; at that point, he was recognized to be 

suffering from paraonia and possible delusions. 

Furthermore, although he was at this point referred for

mental-health treatment, there appears to be no 

evidence that the mental-health staff ever received or 

acted upon the referral. Moreover, Dr. Burns pointed 

to McCoy as an example of a prisoner who was severely 

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ill and required residential care but was not being 

provided it due to his classification at an 

inappropriately low level.

Plaintiffs have offered evidence to show that named 

plaintiffs have been exposed to and harmed by 

defendants’ practice of failing to appropriately 

prescribe and manage psychotropic medication and its 

side effects. For example, Hartley’s medical records 

reflect that he has complained of a movement disorder

caused by his antipsychotic medication, that treating 

this side effect has adversely affected his kidneys, 

and that he has requested and been denied an 

alternative antipsychotic medication which Dr. Burns 

explained would be less likely to cause a movement 

disorder.

With respect to defendants’ failure to provide more 

than cursory psychotherapeutic care and counseling, 

plaintiffs have offered evidence to show that Braggs 

has not received the regular therapy--for anxiety, 

major depressive disorder, and post-traumatic stress 

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disorder--contemplated in his treatment plans; that 

Pruitt’s repeated requests to speak to counselors have 

been rejected; and that Wallace, despite his repeated 

suicide attempts and self-harm, and diagnoses of 

bi-polar disorder and intellectual disability, has not 

consistently received group therapy. Defendants’ 

expert, Dr. Patterson, agrees with plaintiffs that 

Wallace’s care has been inadequate, due in part to the 

lack of group therapy.

Plaintiffs have offered evidence to show that named 

plaintiffs have been exposed to and harmed by 

defendants’ practice of inadequately monitoring and 

providing inadequate follow-up care to prisoners who 

are suicidal or engage in self-harm. Over the course 

of a six-month period, Pruitt was admitted to a crisis 

cell as a result of self-injurious behavior at least 

five times, for stretches sometimes lasting more than a 

week. As to inadequate monitoring of the crisis cells, 

Dr. Patterson recognized that there was no indication 

in Pruitt’s records that he was seen by a psychiatrist 

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or nurse practitioner during any of these admissions. 

He was attacked by other prisoners during two different 

admissions (disinfectant was thrown in his face and 

burning fabric was thrown onto his leg). Dr. Burns 

notes that he was not placed on the mental-health

caseload after these admissions and opines that he was 

therefore denied adequate follow-up care.

As to defendants’ placement of mentally ill 

prisoners in segregation without regard to its harmful

effects on their mental health: McCoy has repeatedly 

been placed in segregation for extended periods of 

time, including one thirteen-month stretch, even though 

he was in a psychotic state and the mental-health staff 

had advised against prolonged isolation due to 

segregation’s effect on his stability. Deterioration 

of McCoy’s mental health during segregation was also 

documented in his records. Jackson was in segregation 

between 2007 and 2014; he was frequently transferred 

from one facility’s segregation unit to another’s. 

This extended stay in segregation has broken him down

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mentally, according to his own testimony and the 

opinion of one of plaintiffs’ experts.

Plaintiffs have likewise presented evidence to show 

that Wallace and Pruitt have been harmed by defendants’ 

policy or practice of disciplining prisoners for

behavior that stems from mental illness. Wallace 

received nine disciplinary citations for instances of 

cutting his wrists, and Pruitt has also received 

disciplinary tickets for creating a hazard when he 

engaged in self-harm.

Finally, with respect to the procedural due-process 

class, plaintiffs have presented evidence showing that 

the class representative, Bui, was exposed to and 

harmed by defendants’ involuntary-medication practices. 

He has been under an involuntary-medication order since 

November 2007, and the order has been renewed 

approximately every six months. Plaintiffs have shown

that on some occasions, Bui was not present at his own 

involuntary-medication hearings; that many notices were 

given to him on the day of the hearing, or back-dated; 

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and that on several occasions, he did not have a lay 

advisor during the hearing to explain the purpose of 

the hearing or to help him present objections to the 

hearing panel’s findings.41

Rule 23(a)(3)’s typicality requirement has been 

satisfied with respect to both classes.

D. Adequacy

Rule 23(a)(4) requires that the “representative 

parties will fairly and adequately protect the 

interests of the class.” This analysis “encompasses 

two separate inquiries: (1) whether any substantial 

conflicts of interest exist between the representatives 

and the class;42 and (2) whether the representatives 

 

41. Plaintiffs’ evidence shows at least that Bui’s 

own presence and that of a lay advisor should have 

been--and was not--documented.

42. For a conflict to defeat class certification, 

it must be “fundamental,” such as when “some party 

members claim to have been harmed by the same conduct 

that benefitted other members of the class.” Valley 

Drug Co., 350 F.3d at 1189.

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will adequately prosecute the action.” Valley Drug Co. 

v. Geneva Pharm., Inc., 350 F.3d 1181, 1189 (11th Cir. 

2003) (citation omitted).43

“Adequate representation is usually presumed in the 

absence of contrary evidence,” and generally exists for 

injunctive-relief classes, because there is no monetary 

pie to be sliced up. Access Now, Inc. v. Ambulatory 

Surgery Ctr. Grp., Ltd., 197 F.R.D. 522, 528 (S.D. Fla. 

2000) (Seitz, J.).

As noted above, defendants’ argument against the 

adequacy of the named plaintiffs as class 

representatives is that the named plaintiffs have not 

 

43. Prior to the promulgation of Rule 23(g) 

regarding the adequacy of class counsel, courts 

considered that topic in the context of Rule 23(a)(4). 

Since Rule 23(g) was added in 2003, courts have been 

“slow in shifting the analysis of counsel’s adequacy 

from Rule 23(a)(4) to Rule 23(g),” but the leading 

treatise on the topic takes the position that the 

drafters of the rule intended courts to “locate their 

entire discussion of class counsel within the 23(g) 

analysis and restrict their analysis under Rule 

23(a)(4) to the topic of adequacy of the proposed class 

representative.” Rubenstein, Newberg on Class Actions

§ 3:80 (5th ed.). As defendants have also taken this 

approach, the court will adopt it here.

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themselves raised the claims they now seek to bring on 

behalf of the class; this argument goes to typicality 

rather than adequacy. In any event, as the court has 

already explained, this argument fails. Defendants 

have also reiterated in the section of their brief on 

adequacy their contentions that the named plaintiffs do 

not have justiciable claims. This argument, too, has 

already been addressed in the section on standing.

Defendants have not suggested that the named 

plaintiffs have conflicts of interest with the class, 

and the court concludes that no such conflict exists. 

As for whether they will adequately prosecute this 

action, defendants challenged two of the named 

plaintiffs based on statements in their depositions 

arguably reflecting that they do not intend to 

represent other prisoners in this case or do not 

understand their roles as class representatives. 

However, these plaintiffs have been released from 

custody; because their claims are now moot, they cannot 

serve as class representatives. The remaining named 

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plaintiffs are adequate representatives of the Eighth 

Amendment class, and Bui is an adequate representative 

of the procedural due-process class.

3. Rule 23(b)(2)

A class satisfies Rule 23(b)(2) in cases in which 

“the party opposing the class has acted or refused to 

act on grounds that apply generally to the class, so 

that final injunctive relief or corresponding 

declaratory relief is appropriate respecting to the 

class as a whole.” Fed. R. Civ. P. 23(b)(2).

“Rule 23(b)(2) has been liberally applied in the 

area of civil rights, including suits challenging 

conditions and practices at various detention 

facilities.” Bumgarner v. NCDOC, 276 F.R.D. 452, 457 

(E.D.N.C. 2011) (Boyle, J.); see also Wright & Miller, 

7AA Fed. Prac. & Proc. Civ. § 1776 (3d ed.) (discussing 

the range of civil-rights actions certified pursuant to 

Rule 23(b)(2), and explaining that “the class suit is a 

uniquely appropriate procedure in civil-rights cases”). 

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Indeed, some courts have gone so far as to say that the 

rule’s requirements are “almost automatically satisfied 

in actions primarily seeking injunctive relief.” Baby 

Neal ex rel. Kanter, 43 F.3d at 59.

As plaintiffs have repeatedly explained and offered 

evidence to demonstrate throughout the litigation of 

this case, and as this court has found in addressing 

the commonality requirement, the problems of which they 

complain and the remedies they seek are systemic.44 The 

 

44. As discussed above in the commonality context, 

the fact that some class members may have thus far 

received appropriate mental-health care and therefore 

might not yet have been harmed by the challenged 

policies and procedures does not defeat certification. 

Additionally, even if not all of the class members were 

subjected to a substantial risk of serious harm--that 

is, even if it were sure that the risk would not 

materialize with respect to some mentally ill 

prisoners--certification would still be appropriate. 

See Anderson v. Garner, 22 F. Supp. 2d 1379, 1386 (N.D. 

Ga. 1997) (Murphy, J.) (“‘[A]ll the class members need 

not be aggrieved by or desire to challenge the 

defendant’s conduct in order for one or more of them to 

seek relief under Rule 23(b)(2).’ Johnson v. American 

Credit Co. of Georgia, 581 F.2d 526, 532 (5th Cir. 

1978); Georgia State Conference of Branches of NAACP v. 

State, 99 F.R.D. 16, 35-36 (S.D. Ga. 1983) (“What is 

necessary is that the challenged conduct or lack of 

(continued...)

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Supreme Court has approved of system-wide relief in 

prison cases involving “systemwide violation[s]” 

resulting from “systemwide deficiencies.” Plata, 563 

U.S. at 532.

Defendants are quite right that a single injunction 

would not be appropriate if plaintiffs sought an order 

requiring that each named plaintiff be provided the 

specific forms of treatment he has been denied. They 

cite Wal-Mart for the proposition that Rule 23(b)(2) 

“does not authorize class certification when each 

individual class member would be entitled to a 

different injunction or declaratory judgment against 

the defendant.” 564 U.S. at 360. But Rule 23(b)(2) 

certainly does not preclude certification merely 

because the class members could bring separate claims 

regarding the adequacy of the particular treatment they 

have individually received--claims which, everyone 

agrees, could not be resolved with a single injunction 

 

conduct be premised on a ground that is applicable to 

the entire class.”)).

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or declaratory judgment--when those are not the claims 

they actually have brought in this lawsuit.

For some reason, defendants repeatedly misconstrue 

the claims in the case as demands for individual 

treatment of various kinds, and then proceed to argue 

that the individualized claims plaintiffs are not 

raising cannot be brought in the form of a class 

action.45 As the court explained at some length in its 

analysis of the applicable Eighth Amendment case law in 

its summary-judgment opinion, defendants’ position is 

unwarranted; plaintiffs are not seeking adjudication of 

demands for particular individualized treatment, and 

the challenge they are actually bringing--to systemic 

 

45. In support of this reading of plaintiffs’ 

claims, defendants cite to deposition testimony wherein 

the named plaintiffs, when asked by defense counsel 

what concrete changes they would like to see in the 

individual care they are currently being provided, 

answer that question. These statements, however, are 

not their claims. Adequate staffing levels and 

adequate amounts of residential treatment space are not 

individual forms of treatment one can request; they are 

conditions that make it possible for appropriate 

treatment to be provided when and to the extent 

necessary.

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deficiencies that create a substantial risk of serious 

harm--are well recognized.

Defendants declare that “an alleged delay in care 

at St. Clair bears no relationship of any kind to 

allegedly insufficient staffing at Hamilton, or 

allegedly insufficient intake procedures at Kilby.” 

Defs.’ Opp. to Class Cert. (doc. no. 807) at 167. This 

position is controverted by the evidence in this case. 

Plaintiffs’ experts opine that all of these problems--

and others--stem directly and ineluctably from a 

contractual arrangement that provides for inadequate 

numbers of and insufficiently qualified mental-health

staff. Fundamentally, defendants err in forgetting 

that the language of Rule 23(b)(2) focuses on the 

nature of defendants’ acts and omissions and the 

suitability of class-wide relief, and does not require 

that the class-wide relief benefit each class member in 

precisely the same way. Here, plaintiffs seek a remedy 

for defendants’ decision to starve the mental-health

care system in Alabama prisons of human and financial 

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resources, and relief would be appropriate for everyone 

subjected to the substantial risk of serious harm 

plaintiffs claim this creates--that is, prisoners with 

serious mental illness.

It would, in fact, be impossible to grant any 

meaningful relief on this claim without granting it on 

a class-wide basis. See Wal-Mart, 564 U.S. at 360 

(“The key to the (b)(2) class is the indivisible nature 

of the injunctive or declaratory remedy warranted.”

(citation and internal quotation marks omitted)). 

Although the court could order, for example, that a 

particular prisoner who currently requires psychiatric 

care be seen by a psychiatrist, it cannot order that 

adequate staffing be provided to the extent necessary 

to address any one particular prisoner’s mental-health

care needs as they develop in the future. Although 

deficiencies in the individual treatment now being 

provided could potentially (though much less 

efficiently) be addressed one by one, the risks 

defendants’ policies and practices pose to mentally ill 

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prisoners, whose needs change over time, could not. 

Moreover, any order remedying a systemic deficiency 

with respect to only one prisoner would rob Peter to 

pay Paul; the court would be playing a zero-sum game, 

shifting mental-health care resources from one prisoner 

to another.46 By the same token, there exists no 

individual remedy for the practice of filling 

residential treatment beds with segregation prisoners, 

thereby reducing the bed space available in those units 

and undermining the treatment provided there; the court 

obviously cannot order that a bed be reserved for each 

prisoner likely to require one, or order that a 

particular prisoner’s therapy in the residential 

treatment unit--but only his--not be disturbed.

Nor could the court address inadequate intake 

screenings without also addressing inadequate staffing 

levels, when the deficiencies in screening are caused 

 

46. Additionally, no relief other than class-wide 

relief could address the needs of future prisoner with 

mental illness.

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by the fact that there are not enough staff members 

qualified to conduct the screenings or supervise others 

in doing so. Moreover, as discussed above in the 

context of commonality, even ordering adequate staffing 

at a particular facility would not meaningfully redress 

the claims of prisoners currently housed at that 

facility, since the chance of a prisoner being moved to 

another one is very high.

The Rule 23(b)(2) cases to which defendants cite

are all unavailing. In Lakeland Regional Medical 

Center, Inc. v. Astellas U.S., LLC, 763 F.3d 1280 (11th 

Cir. 2014), the court affirmed the denial of 

certification in a case where the plaintiff failed to 

identify the relief it sought other than “such 

declaratory and injunctive relief as appropriate in 

order to compel and ensure defendant[’s] future 

compliance with law.” Id. at 1291 (citation omitted).47

 

47. The Lakeland court also found that the 

undisputed evidence demonstrated both that no other 

member of the putative class had ever asked for the 

sort of license the plaintiff wanted the defendant to 

(continued...)

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Here, by contrast, plaintiffs have described in 

detail the specific policies and practices in which 

they ask the court to order defendants to stop 

engaging; to the extent that they seek an order 

requiring defendants to formulate a plan for remedying 

unconstitutional conditions, rather than setting out 

the details of that plan themselves, they do so only 

out of appropriate deference to the discretion of 

prison administrators. See Parsons, 754 F.3d at 689 n. 

35 (explaining that requiring plaintiffs to articulate 

with great precision the terms of the injunction they 

seek is particularly inappropriate in “prison cases, 

given that an injunction in any such case must closely 

 

issue, and that it was very unlikely that any other 

member of the putative class would want to purchase 

that sort of license even if it were made available. 

In other words, the relief that the plaintiff asked for 

would not address the injury (if any) to the other 

members of the putative class. Here, plaintiffs have 

offered expert evidence (with which, in many instances, 

defendants’ mental-health expert actually agrees) to 

show that the policies and practices they challenge are 

generally applicable to prisoners with mental illness 

in the ADOC, and that the relief they seek would serve 

(continued...)

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track the violations established by the evidence at 

trial, that any such relief must comply with the 

[Prison Litigation Reform Act]’s extensive 

requirements, that prison officials must play a role in

shaping injunctions, that ultimate proof of some 

violations but not others might easily change the 

structure of a remedial plan, that conditions in 

prisons might change over the course of litigation, and 

that the class certification hearing is not a dress

rehearsal of the trial on the merits (let alone a dress 

rehearsal of the remedy proceedings)”); Morrow v. 

Washington, 277 F.R.D. 172, 198 (E.D. Tex. 2011) (Ward, 

J.) (“Plaintiffs have set forth facts suggesting that 

Defendants’ behavior was generally applicable to the 

class as a whole, making injunctive relief appropriate. 

The precise terms of the injunction need not be decided 

at this stage, only that the allegations are such that 

injunctive and declaratory relief are appropriate and 

 

to redress the risk these policies and practices pose 

to all such prisoners.

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that the class is sufficiently cohesive that an 

injunction can be crafted that meets the specificity 

requirements of Rule 65(d).”).

Defendants’ other cases fare no better. In Heffner 

v. Blue Cross and Blue Shield of Ala., Inc., 443 F.3d 

1330, 1345 (11th Cir. 2005), certification of a Rule 

23(b)(2) damages class was reversed because the court 

concluded that the class members were not entitled to 

relief (in the form of a refund of a deductible) absent 

an individualized showing that they had in fact relied 

on a summary plan description indicating that no 

deductible would be charged. Similarly, in Jamie S. v. 

Milwaukee Pub. Sch., 668 F.3d 481, 499 (7th Cir. 2012), 

the court reversed certification of a class in a case 

where “the intricate remedial scheme ... require[d] 

thousands of individual determinations of class 

membership, liability, and appropriate remedies,” 

explaining that certification under Rule 23(b)(2) is 

not appropriate when “the relief sought would merely 

initiate a process through which highly individualized 

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determinations of liability and remedy are made.” 

Here, by contrast, no individualized determinations are 

necessary or relevant. If the court grants relief, it 

will do so across the board, in one fell swoop. This 

relief will ensure that the statewide prison

mental-health care system, with which all class members 

interact, is not operated pursuant to policies and 

practices that subject all prisoners to a substantial 

risk of serious harm.

This is exactly the kind of case for which Rule 

23(b)(2) was intended.48

 

48. It is just as clear that the procedural 

due-process claim certified for class-wide resolution 

satisfies Rule 23(b)(2), as the relief requested here 

(an injunction requiring the provision of certain 

procedural protections, not only in policy but also in 

practice) would clearly apply to the class as a whole. 

By contrast, the failure to make constitutionally 

appropriate substantive determinations as to whether 

prisoners should be involuntarily medicated is less 

clearly susceptible to “final injunctive relief or 

corresponding declaratory relief ... respecting the 

class as a whole” under Rule 23(b)(2). Although a 

consistent refusal by those who authorize involuntary 

medication to consider some specific, discrete factor 

could arguably be susceptible to class-wide relief, 

even if further individual determinations would need to 

(continued...)

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4. Rule 23(g)

In order to certify a class, the court must also 

appoint class counsel. In so doing, the court “must 

consider ... (i) the work counsel has done in 

identifying or investigating potential claims in the 

action; (ii) counsel’s experiences in handling class 

actions, other complex litigation, and the types of 

claims asserted in the action; (iii) counsel’s knowledge 

of the applicable law; and (iv) the resources that 

counsel will commit to representing the class.” Fed. 

R. Civ. P. 23(g)(1)(a). The court also “may consider 

any other matter pertinent to counsel’s ability to 

fairly and adequately represent the interests of the 

class,” Fed. R. Civ. P. 23(g)(1)(B).

Lawyers affiliated with the Southern Poverty Law 

Center, the Alabama Disabilities Advocacy Program, and 

the law firm of Baker, Donelson, Bearman, Caldwell & 

 

be made, the court concludes that this issue will more 

appropriately be litigated by Bui and ADAP than by a 

class.

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Berkowitz have represented named plaintiffs in 

litigating and negotiating the settlement of this case, 

and they now seek appointment as class counsel.49 As 

previously discussed for purposes of certification of 

the Phase 1 class in this case, the record reflects 

that these attorneys have substantial experience in 

litigating class actions and in the complex substantive 

areas of both prisoners’-rights and disability-rights 

law.

Notably, defendants take issue with the adequacy of 

only a subset of named plaintiffs’ counsel. They argue 

that the Southern Poverty Law Center (SPLC) should not 

be appointed as class counsel, but they do not make the 

same argument with respect to Baker, Donelson or ADAP, 

both of which represent the individual named 

plaintiffs.

 

49. Anil Mujumdar of the law firm of Zarzaur, 

Mujumdar & Debrosse has also participated extensively 

in the Phase 2A litigation, in representing only ADAP, 

not the named plaintiffs. Neither he nor the firm has 

requested to be appointed as class counsel.

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In any event, defendants’ arguments with respect to 

SPLC are not convincing. Although they focus on one 

possible deficiency in SPLC’s pre-filing 

investigation--namely, its failure to review the

medical and mental-health records of all named 

plaintiffs prior to filing their complaint--they ignore 

the detailed and involved investigation that SPLC and 

plaintiffs’ other counsel conducted prior to (and

since) the filing of this case. Before filing suit, 

plaintiffs’ counsel conducted a two-year investigation 

into health care in ADOC facilities, interviewed 

numerous prisoners, obtained some medical records, and 

obtained some records from defendants and their medical 

contractors through open records requests. They issued 

a lengthy report on their findings, which discussed the 

named plaintiffs in some detail. Especially in light 

of the difficulty of investigating secure institutions, 

this was plainly adequate.50

 

50. The cases defendants cite as examples of 

inadequate pre-filing investigation bear little 

(continued...)

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In addition, defendants argue that SPLC has taken 

positions in conflict with its fiduciary obligations to 

the putative class. Essentially, defendants complain 

that when, earlier this year, the Alabama legislature 

considered a proposal to invest hundreds of millions of 

dollars in building four large new prison facilities in 

the State, the president of SPLC sent a letter to a 

number of legislators opposing its passage. Whether or 

not this letter had any effect on legislative support 

for, or the eventual defeat of, the bill, nothing in it 

was in conflict with the interests of the putative 

class his organization seeks to represent.

 

resemblance to the case at bar. In these cases, 

counsel’s deficiencies were glaring; they had failed to 

conduct even the most cursory inquiry into whether the 

proposed class representatives even existed--in Ballan 

v. Upjohn Co., 159 F.R.D. 473, 488 (W.D. Mich. 1994) 

(Hillman, J.), one was a “phantom,” who “counsel had 

named ... without knowing who, let alone where, [she] 

was”--or had failed to speak at all to at least one of 

the proposed class representatives prior to the morning 

of his deposition, see Williams v. Balcor Pension 

Investors, 150 F.R.D. 109, 120 (N.D. Ill. 1993) (Zagel, 

J.).

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As defendants themselves acknowledge, it was “the 

opinion of the Commissioner [that] inmates in the ADOC 

system would benefit from the [bill], because it would 

alleviate problems caused by overcrowding and 

understaffing.” Defs.’ Opp. to Class Cert. (doc. no. 

807) at 171 (emphasis added). SPLC’s president 

expressed a different opinion, favoring a legislative 

approach that prioritized “sentencing reform,” and 

“demand[ed] that the prison system reform its 

management practices.” Id.

Defendants’ argument incorrectly presupposes either 

that the Commissioner’s view was indisputably correct, 

or else that the only legislative alternatives were the 

passage of the bill as proposed, on the one hand, and 

no action at all on the other. This, too, is not the 

case; there is a panoply of possible legislative 

approaches to any issue as complex as prison reform. 

The fact that an SPLC official expressed a preference 

for options other than the one that happened to be on 

the table at a particular moment hardly reflects an 

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abandonment of his fiduciary duty to his current or

prospective clients.

Setting aside the fact that plaintiffs’ counsel are 

free to take a different position than the 

Commissioner, it is not entirely clear how and why--

even accepting his position--the prison construction 

project would benefit the plaintiff class. According 

to the statement of the Commissioner quoted by 

defendants, the salient impact of the bill would be on 

overcrowding and understaffing.51 Moreover, as with any 

“transformation” of the size contemplated here, the 

prison construction project would presumably impact the 

delivery of health care in numerous ways--some positive 

and some negative, many hard to predict. Plaintiffs 

 

51. Confusingly, however, it also appears to be 

defendants’ contention in this litigation that 

overcrowding and custodial understaffing do not result 

in constitutionally inadequate health care. If this is 

indeed their position, the court is uncertain why they 

believe that impeding the passage of a bill designed to 

address these issues would be adverse to the interests 

of a class whose sole purpose in bringing this 

litigation--obtaining adequate mental-health 

care--would be unaided by this reform.

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note in replying to this argument that the record 

reflects that the Commissioner has also suggested that 

his proposal would allow ADOC to dramatically cut the 

cost of providing health care. The court certainly 

passes no judgment on the merits of SPLC’s perspective, 

but it does seem perfectly reasonable for lawyers 

representing clients who seek more funding for health 

care to oppose a bill the proponent of which says would 

result in less funding for health care.

5. Ascertainability

Defendants argue that the Eighth Amendment class 

certified here is not ascertainable. However, there is 

serious reason to doubt that the judicially created 

ascertainability requirement applies to Rule 23(b)(2) 

classes. Even if it does, this class meets the 

requirement.

Although the Eleventh Circuit did hold in

defendants’ primary case, Little v. T-Mobile USA, Inc., 

691 F.3d 1302, 1304 (11th Cir. 2012), that a class must 

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be “clearly ascertainable”--that is, “its members can 

be ascertained by reference to objective criteria,” 

Bussey v. Macon County Greyhound Park, Inc., 563 F. 

App’x 782, 787 (11th Cir. 2014) (citation and internal 

quotation marks omitted)--it did so in the context of a 

Rule 23(b)(3) damages class, not, as here, a Rule 

23(b)(2) injunctive-relief class. Defendants have not 

cited, and the court is not aware, of any cases within 

this circuit applying the ascertainability requirement 

to a Rule 23(b)(2) class, much less any binding 

precedent doing so.

Moreover, the circuits that have squarely addressed 

the issue have generally concluded that the 

ascertainability requirement does not apply to Rule 

23(b)(2) injunctive-relief classes. The recent 

discussion of this issue by the Third Circuit is 

detailed and persuasive.52

 

52. Notably, the Third Circuit, like the Eleventh, 

has split from some other circuits in applying a 

“heightened” ascertainability requirement to Rule 

23(b)(3) class actions. See Mullins v. Direct Digital, 

(continued...)

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In Shelton v. Bledsoe, 775 F.3d 554 (3d Cir. 2015), 

the court distinguished Rule 23(b)(2) and (b)(3) 

classes by noting that the latter “‘allows 

certification in a much wider set of circumstances,’ 

including those ‘in which class-action treatment is not 

as clearly called for,’” and explaining that because 

Rule 23(b)(3) classes are an “‘adventuresome 

innovation,’ Congress included additional ‘procedural 

safeguards,’” such as individual notice and an 

opportunity to opt-out. Id. at 560 (quoting Wal-Mart, 

131 S. Ct. at 2558, Comcast, 133 S. Ct. at 1432). In 

Rule 23(b)(2) classes, on the other hand, “‘[t]he key 

... is the indivisible nature of the injunctive or 

declaratory remedy warranted--the notion that the 

 

LLC, 795 F.3d 654, 659-72 (7th Cir. 2015) (disagreeing 

with Marcus v. BMW of N. Am., LLC, 687 F.3d 583 (3d 

Cir. 2012), and Karhu v. Vital Pharms., Inc., 621 F. 

App’x 945, 946 (11th Cir. 2015) (requiring that the 

“class definition contain[] objective criteria that 

allow for class members to be identified in an 

administratively feasible way ... [through a] 

manageable process that does not require much, in any, 

individual inquiry” (citations and internal quotation 

marks omitted))).

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conduct is such that it can be enjoined or declared 

unlawful only as to all of the class members or as to 

none of them.’” Id. at 561 (quoting Wal-Mart, 131 S. 

Ct. at 2557 (citation and internal quotation marks 

omitted). In sum, the court explained, “the identities 

of individual class members are less critical in a 

(b)(2) action than in a (b)(3) action.” Id.

As the court noted in Shelton, an advisory 

committee note to Rule 23 describes cases which are 

specifically defined in terms of their 

unascertainability as “illustrative” examples of Rule 

23(b)(2) classes: “various actions in the civil rights 

field where a party is charged with discriminating 

unlawfully against a class, usually one whose members 

are incapable of specific enumeration.” Fed. R. Civ. 

P. 23 advisory committee’s note (1966) (emphasis 

added). This court therefore agrees with the Third 

Circuit that a requirement--directly contrary to the 

express language of the advisory committee--“that the 

members of the class be capable of specific 

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enumeration[] is inappropriate for (b)(2) classes.”53 

Shelton, 775 F.3d at 561.

 

53. The court also adds the following observations. 

Requiring plaintiffs seeking certification of a Rule 

23(b)(2) class to demonstrate that they could determine 

conclusively and a priori who would and would not be a 

member of it would seriously undermine some of the most 

important functions of this type of litigation.

This is because (1) many civil rights cases involve 

challenges to discrimination on the basis of categories 

that are statutorily delineated by Congress in a 

legislative effort to protect the civil rights of 

people within them, and as discussed below, many of 

those categories are hard to assess in a perfectly 

objective fashion, and (2) other cases involve 

challenges to public entities’ failures to adequately 

assess individuals to whom they have an obligation to 

provide services.

Concluding that the requirement that a class member 

have a “serious mental illness” was not a sufficiently 

objective one would set the court atop a dangerously 

slippery slope. It would undercut Congress’s efforts 

to protect other groups, the bounds of which it defines 

in statute, such as people with disabilities. Other 

categories that have long formed the basis of civil 

rights violations (and the basis of class definitions 

in collective actions challenging those violations), 

like race, are hardly “objective.” Store records can 

reveal who bought defective products; determining who 

is or is not “Hispanic” is not so simple. Although a 

court can engage in this inquiry, it is certainly an 

individualized one.

(continued...)

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As the Third Circuit recounted, two other circuits 

have reached the same conclusion.54 In Shook v. El Paso 

 

In addition, strict application of this standard to 

cases where the violation at issue is a failure to 

identify would create a Catch-22; it would be the 

height of irony for a prison system to be able to 

defeat certification of a class seeking to challenge 

its failure to identify prisoners with mental illness 

by arguing that that very failure made the class 

unascertainable.

54. As explained in the leading treatise on class 

action law, “early circuit cases” in the Fifth, Sixth, 

and Seventh Circuits applied the ascertainability 

requirement “without considering the unique nature of 

23(b)(2) actions,” but “later district court cases in 

these circuits have adopted an intermediate position 

... under which the requirement of ascertainability is 

applied less stringently in 23(b)(2) actions.” 

Rubenstein, Newberg on Class Actions § 3:7 (5th ed.). 

It also observes that “recent decisions either ... 

eschew the implied requirement of definiteness in Rule 

23(b)(2) class actions, or follow the intermediate 

approach, and treat definiteness as flexible ...[,] 

even in circuits that have traditionally applied the 

definiteness requirement to such class actions.” Id. 

(citing, among other cases, In re Monumental Life Ins. 

Co., 365 F.3d 408, 413 (5th Cir. 2004) (recognizing 

that “a precise class definition is not as critical 

where certification of a class for injunctive or 

declaratory relief is sought under [R]ule 23(b)(2),” at 

least so long as notice and opt-out rights are not 

requested), and Kenneth R. ex. rel. Tri-City CAP, 

Inc./GS v. Hassan, 293 F.R.D. 254, 264 (D.N.H. 2013) 

(McAuliffe, J.) (holding that a Rule 23(b)(2) class 

defined as containing persons with “serious mental 

(continued...)

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Cty., 386 F.3d 963, 972 (10th Cir. 2004), the court 

explained that “many courts have found Rule 23(b)(2) 

well suited for cases where the composition of the 

class is not readily ascertainable; for instance, in a 

case where the plaintiffs attempt to bring suit on 

behalf of a shifting prison population.” The First 

Circuit has agreed. See Yaffe v. Powers, 454 F.2d 

1362, 1366 (1st Cir. 1972) (holding that “the actual 

membership of [a Rule 23(b)(2)] class need not ... be 

precisely delimited,” because individual notice to 

class members is not required); see also Floyd v. City 

of New York, 283 F.R.D. 153, 171-72 & n.115 (S.D.N.Y. 

2012) (Scheindlin, J.) (citing cases). Shelton also 

pointed out the “significant” fact that the Supreme 

Court’s recent foray into Rule 23(b)(2), Wal-Mart, 

“lacks any inquiry into ‘ascertainability.’” 775 F.3d 

at 563.

 

illness” was sufficiently ascertainable (citation 

omitted))).

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For these reasons, the court concludes that the 

class proposed in this litigation need not be 

ascertainable. That said, the court concludes in the 

alternative that even if the requirement did apply, 

plaintiffs’ proposed class definition would satisfy it.

Although defendants complain that the term 

“serious” mental illness is undefined, defendants 

themselves note in their motion for summary judgment

that there is case law in this circuit articulating 

what counts as “serious” in the arena of Eighth 

Amendment mental-health claims: an illness “that has 

been diagnosed by a physician as mandating treatment or 

one that is so obvious that even a lay person would 

easily recognize the need for a doctor’s attention.” 

Hill v. Dekalb Reg’l Youth Det. Ctr., 40 F.3d 1176, 

1187 (11th Cir. 1994) (explaining that “[t]his standard 

has been acknowledged and used by other federal circuit 

and district courts,” and concluding that it was the 

“appropriate and guiding principle”). This is a rather 

straightforward, objective standard: a prisoner would 

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be a member of this class if he has been diagnosed as

needing mental-health treatment or if he is very 

obviously mentally ill.55 Of course, because this is 

not a Rule 23(b)(2) damages class action, and class 

members will not be entitled to individual notice or 

have the right to opt out, the court need not actually 

conduct this inquiry to determine whether each prisoner 

is or is not a member of the class.

To conclude, the court will briefly address the 

other two cases defendants cite, both of which are 

unreported decisions by out-of-circuit district courts: 

Johannes v. Washington, 2015 WL 5634446 (E.D. Mich. 

Sept. 25, 2015) (Michelson, J.), and Schilling v. 

Kenton Cty., 2011 WL 293759 (E.D. Ky. Jan. 27, 2011) 

(Bunning, J.). They are wholly consistent with the 

result reached here; indeed, Johannes actually 

 

55. Indeed, the existence of prisoners who are very 

obviously mentally ill but who have not been diagnosed 

by prison mental-health staff as needing treatment 

would itself be compelling evidence of an Eighth 

Amendment violation.

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recognizes that the ascertainability requirement 

applies “less stringently” in Rule 23(b)(2) cases. 

2015 WL 5634446, at *10. These cases declined to 

certify or expressed concern about certifying what are 

known as “fail-safe” classes--classes that are defined 

in terms of the eventual merits adjudication. See

Schilling, 2011 WL 293579, at *5 (“A class definition 

is ... too general where it requires the Court to 

determine whether an individual's constitutional rights 

have been violated in order to ascertain membership in 

the class itself.”). In this case, a fail-safe class 

would be one defined to consist of all prisoners who 

have received constitutionally inadequate mental-health

care. Because plaintiffs have not proposed a fail-safe 

class, these cases suggest no reason not to certify.56

 

56. The court notes that some courts have in fact 

expressed a preference for fail-safe classes, in order 

to avoid the possibility that the class will include 

some members who have not been harmed by the challenged 

conduct. See Kenneth R., 293 F.R.D. at 264 (certifying 

a fail-safe class); Strouchler v. Shah, 286 F.R.D. 244, 

247 (S.D.N.Y. 2012) (refining a class definition to 

address an overbreadth objection, and in so doing, 

(continued...)

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* * *

The motion for class certification filed by the 

remaining named plaintiffs is granted in part and 

denied in part. The court will certify a class of all 

persons with a serious mental-health disorder or 

illness who are now, or will in the future be, subject 

to defendants’ mental-health care policies and 

practices in ADOC facilities, excluding the work 

release centers and Tutwiler Prison for Women. The 

court will also certify a class of all persons with a 

serious mental-health disorder or illness who are now, 

or will in the future be, subject to defendants’ formal 

involuntary-medication policies and practices.

 

creating a fail-safe class). The Fifth Circuit has 

both “rejected a rule against fail-safe classes,” In re 

Rodriguez, 695 F.3d 360, 370 (5th Cir. 2012), and also 

explained that Rule 23(b)(2) classes can be certified 

even when not all members of them have been harmed, see

Johnson v. Am. Credit Co. of Ga., 581 F.2d 526, 532 

(5th Cir. 1978). Bluntly put, this area of 

class-action law is a mess. See Rubenstein, Newberg on 

Class Actions § 3:6 (5th ed.).

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The court will decline to certify a class for the 

individual plaintiffs’ due-process challenge regarding 

involuntary medication without a recent finding of 

dangerousness, or for their due-process challenge 

regarding coerced consent. However, the individual 

plaintiffs with these claims will proceed to trial, and 

ADAP, through its associational standing, may represent

the interests of unnamed prisoners who are subject to 

these policies and practices.

An appropriate order will be entered.

DONE, this the 25th day of November, 2016.

 /s/ Myron H. Thompson 

UNITED STATES DISTRICT JUDGE

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