UNITED STATES DISTRICT COURT

NORTHERN DISTRICT OF FLORIDA

TALLAHASSEE DIVISION

ALBERTO SANCHEZ,

Plaintiff,

v. CASE NO.: 4:20-cv-360

THE FLORIDA DEPARTMENT OF 

CORRECTIONS, an agency of the 

State of Florida,

CORIZON, LLC, an out-of-state 

corporation registered and doing 

business in Florida,

CENTURION OF FLORIDA, LLC, a 

Florida limited liability company,

JORGE L. ALVAREZ, S.M.D.,

ALEJANDRO A. RADI, M.D., and

CHRISTOPHER E. HADDAD, M.D.,

Defendants.

_________________________________/

SECOND AMENDED COMPLAINT

Plaintiff, Alberto Sanchez, by and through the undersigned counsel, pursuant 

to Rule 15(a)(1) of the Federal Rules of Civil Procedure, hereby files this First 

Amended Complaint against the Florida Department of Corrections (“FDC”), 

Corizon, LLC (“Corizon”), and Centurion of Florida, LLC (“Centurion”), Jorge L. 

Alvarez, S.M.D. (“Alvarez”), Alejandro A. Radi, M.D. (“Radi”), and Christopher E. 

Haddad, M.D. (“Haddad”), and alleges as follows:

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INTRODUCTION

1. This is a civil rights action for monetary damages. Plaintiff is an inmate 

incarcerated in Defendant FDC’s prison system. Plaintiff is suing Defendants for 

deliberating depriving him of medically necessary treatment for hepatitis C. 

Specifically, Plaintiff sues FDC for intentionally discriminating against him on the 

basis of disability in violation of the Americans with Disabilities Act (“ADA”) and 

the Rehabilitation Act (“RA”), and Corizon, Centurion, Alvarez, Radi, and Haddad

for their deliberate indifference to Plaintiff’s serious medical needs in violation of 

the Eighth Amendment to the United States Constitution.

JURISDICTION AND VENUE

2. This Court has jurisdiction over the claims asserted herein pursuant to 

28 U.S.C. § 1331 in that this is a civil action arising under the U.S. Constitution. 

3. Venue is proper in the Northern District of Florida, Tallahassee 

Division, as Defendant FDC is headquartered with its principle place of business in 

Tallahassee, Florida and a substantial part of the events or omissions giving rise to 

Plaintiffs claims occurred in the Northern District of Florida. See 28 U.S.C. § 1391.

4. The claims alleged herein are brought within the applicable statute of 

limitations.

5. Plaintiff has complied with all conditions precedent and has fully and 

properly exhausted all administrative remedies prior to filing this action.

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THE PARTIES

6. Plaintiff is an inmate incarcerated in Defendant FDC’s prison system.

He has been incarcerated since February 20, 2014. Throughout his incarceration, 

Plaintiff has been housed at, and was denied treatment for his HCV at, numerous

prisons owned and operated by Defendant FDC, including Central Florida Reception 

Center (“CFRC”), Apalachee Correctional Institution (“Apalachee CI”), Gulf 

Correctional Institution (“Gulf CI”), Columbia Correctional Institution (“Columbia 

CI”), and Reception and Medical Center (“RMC”).

7. Defendant FDC is an agency of the State of Florida that owns and 

operates correctional facilities throughout the State, including every prison where 

Plaintiff was housed and denied treatment for his HCV throughout his incarceration, 

and receives federal funds to operate its agency. Defendant FDC is headquartered in 

Tallahassee, Florida. Defendant FDC is responsible for the medical care of all 

individuals confined in its prison system. Further, Defendant FDC is responsible for 

overseeing the operations of its contractors, including Defendants Corizon and 

Centurion. Defendant FDC discriminated against Plaintiff—a qualified individual 

with a disability due to his infection with chronic HCV—by deliberately depriving 

him of medically necessary treatment for his chronic HCV.

8. Defendant Corizon is an out-of-state corporation, registered and doing 

business in Florida. From October 2012 until May 2016, Defendant Corizon 

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contracted with FDC to provide healthcare services to inmates confined in certain 

FDC prisons, including CFRC, Apalachee CI, Gulf CI, Columbia CI, and RMC, 

where Plaintiff was housed and denied treatment for his HCV. From the beginning 

of Plaintiff’s incarceration in February 2014 until May 2016, Defendant Corizon was 

responsible with FDC for Plaintiff’s medical care.

9. Defendant Centurion is a Florida limited liability company and 

provider of correctional healthcare services. In February 2016, Defendant Centurion 

contracted with FDC to provide healthcare services to inmates confined in FDC 

prisons, including CFRC, Apalachee CI, Gulf CI, Columbia CI, and RMC, where 

Plaintiff was housed and denied treatment for HCV. In May 2016, Defendant 

Centurion took over as FDC’s healthcare vendor for the prisons previously covered 

under Corizon’s contract. In June 2017, Defendant Centurion became FDC’s sole 

healthcare provider. Since May 2016, Defendant Centurion has been responsible 

with FDC for Plaintiff’s medical care.

10. Defendant Alvarez is a licensed medical doctor certified to practice in 

an Area of Critical Need who was employed as the Site Medical Director at 

Apalachee CI at all times relevant hereto. Defendant Alvarez refused to treat 

Plaintiff’s HCV despite being aware of Plaintiff’s serious medical condition and 

disability. Defendant Alvarez is sued in his individual capacity.

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11. Defendant Radi is a licensed medical doctor who was employed and 

served as a Gastroenterologist at RMC at all times relevant hereto. Defendant Radi

refused to treat Plaintiff’s HCV despite being aware of Plaintiff’s serious medical 

condition and disability. Defendant Radi is sued in his individual capacity.

12. Defendant Haddad is a licensed medical doctor with a specialty in 

emergency medicine who was employed and served as the Chief Health Officer at 

RMC at all times relevant hereto. Defendant Haddad refused to treat Plaintiff’s HCV 

despite being aware of Plaintiff’s serious medical condition and disability. 

Defendant Haddad is sued in his individual capacity.

13. The actions of Defendants Corizon, Centurion, Alvarez, Radi, and 

Haddad, as alleged herein, were performed under color of state law and constitute 

state action.

14. At all times relevant hereto, Defendant FDC had a non-delegable duty 

to provide constitutionally-adequate medical care to all prisoners in Florida.

FACTS

Background Information on Hepatitis C

15. Hepatitis C is a blood borne disease caused by the hepatitis C virus 

(“HCV”). The virus causes inflammation that damages liver cells and is a leading 

cause of liver disease and liver transplants. 

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16. HCV can be either acute or chronic. In people with acute HCV, the 

virus will spontaneously clear itself from the blood stream within six months of 

exposure. Chronic HCV, on the other hand, is defined as having a detectable HCV 

viral level in the blood at some point six months after exposure. Fifty (50) to eighty 

(80) percent of infected people will develop chronic HCV.

17. Liver inflammation caused by chronic HCV can significantly impair 

liver function and damage its crucial role in digesting nutrients, filtering toxins from 

the blood, fighting infection, and conducting other metabolic processes in the body. 

Liver inflammation can also cause fatigue, weakness, muscle wasting, skin rashes, 

and arthritis.

18. People with chronic HCV develop fibrosis of the liver, a process by 

which healthy liver tissue is replaced with scarring. When scar tissue begins to take 

over most of the liver, this extensive fibrosis is termed cirrhosis. Scar tissue cannot 

perform the job of normal liver cells, so fibrosis reduces liver function and results in 

the same symptoms mentioned above, but with greater intensity. Fibrosis can also 

lead to liver failure and hepatocellular carcinoma (liver cancer).

19. The amount of liver scarring a patient has is usually measured on the 

METAVIR scale. On this scale, a person can be classified F0 (no fibrosis), F1 (mild 

fibrosis), F2 (moderate fibrosis), F3 (severe fibrosis), or F4 (cirrhosis).

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20. Among those with chronic HCV, the majority will develop progression 

liver disease and approximately 20% will develop cirrhosis in a 20-year timeframe. 

Patients with rapid fibrosis liver progression may reach cirrhosis within as short a 

timeframe as one year.

21. Cirrhosis causes additional painful complications, including 

widespread itching, kidney disease, jaundice, fluid retention with edema, internal 

bleeding, varices (enlarged veins that develop in the esophagus or intestines, which 

can burst), easy bruising, ascites (fluid accumulation in the legs and abdomen), 

encephalopathy (mental confusion and disorientation), lymph disorders, increased 

risk of infection, seizures, and extreme fatigue. Most of these complications can 

occur before cirrhosis. If they go untreated, some can cause death, often from 

infection, bleeding, and fluid accumulation.

22. Abdominal ascites can require paracentesis, a procedure wherein a 

needle is inserted into the abdomen to drain the fluid. Without this periodic 

procedure, the fluid accumulation can decrease the available space for the patient’s 

lungs, thus causing shortness of breath and difficulty breathing.

23. Moreover, once an HCV patient’s liver has cirrhosis, it may not be 

reversible. Some patients with cirrhosis may have too much scar tissue in the liver, 

even if the liver can heal to some degree once the virus is eliminated by treatment. 

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If scar tissue persists, the patient may still experience the complications of cirrhosis, 

including liver cancer.

24. Chronic HCV is, as a matter of law, a serious medical need. See 

Mitchell v. Nobles, 878 F.3d 869, 876 (11th Cir. 2017).

25. Plaintiff’s disabling condition was chronic HCV. In other words, 

Plaintiff’s “disability” was chronic HCV, as defined under the ADA and RA.

General Prevalence of HCV

26. Approximately 2.7 to 3.9 million Americans have chronic HCV.

27. In 2000, the United States Surgeon General called HCV a “silent 

epidemic,” and estimated that as much as two percent of the adult U.S. population 

had HCV.

28. In 2013, HCV caused more deaths than sixty other infectious diseases 

combined, including HIV, pneumococcal disease, and tuberculosis.

29. Approximately 19,000 people die of HCV-caused liver disease every 

year in the United States.

30. HCV is the leading indication for liver transplants in the United States.

HCV in Prison

31. The prevalence of HCV in prison is much higher than in the general 

population. It is estimated that between 16% and 41% of the United States’ jail and 

prison population has HCV. Thus, incarceration is a risk factor for HCV.

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32. Defendant FDC has reported to the media and researchers that 5,000 to 

5,272 of its approximately 98,000 inmates have HCV. As of August 8, 2016, 

Defendant FDC listed 4,797 inmates as having HCV in its internal records. As of 

late-2017, it was estimated that FDC had knowledge of at least 7,000 inmates who 

were infected with HCV.

33. In fact, because it is estimated that between 16% and 41% of 

incarcerated people have HCV, it is likely that between 14,700 and 40,184 FDC 

inmates have HCV. The true number is likely at the higher end of that spectrum 

because of the high prevalence of HCV in Florida: Between 2009 and 2013, rates of 

acute HCV in Florida increased by 133%.

Standard of Care for HCV

34. For many years, there were no universally safe and effective treatments 

for HCV. The standard treatment prior to 2011, which included the use of interferon 

and ribavirin medications and sometimes required injections, had a long treatment 

duration (up to 48 weeks), failed to cure most patients, and was associated with 

numerous side effects, including psychiatric and autoimmune disorders, flulike 

symptoms, gastrointestinal distress, skin rashes, and severe anemia. Moreover, not 

all drug regimens worked for all types of HCV, and many could not be given to 

patients with other comorbid diseases.

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35. In 2011, however, the Food and Drug Administration (“FDA”) began 

approving new oral medications, called direct-acting antiviral (“DAA”) drugs, 

which have proven to work more quickly, cause fewer side effects, and treat chronic 

HCV much more effectively. At first, they were designed to work in tandem with 

the old treatment regimen. But beginning in 2013, the FDA began to approve DAA 

drugs that can be taken alone.

36. As of late-2013, DAA drugs became available for HCV patients.

37. These DAA drugs have far fewer side effects, dramatically greater 

efficacy, a shorter treatment duration (12 weeks), and are administered orally 

(commonly a once-daily pill) rather than by injections. They have truly 

revolutionized the way HCV is treated.

38. Most importantly, 90 to 95% of HCV patients treated with any of these 

DAA drugs are cured, whereas the old treatment regime only helped roughly one 

third of patients.

39. For HCV, a “cure” is defined as a sustained virologic response (SVR)—

i.e., no detectable HCV genetic material in the patient’s blood—for three months 

following the end of treatment.

40. In response to the revolutionary DAA medications, the American 

Association for the Study of Liver Diseases (“AASLD”) and the Infectious Disease 

Society of America (“IDSA”) formed a panel of experts to conduct an extensive, 

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evidence-based review of the testing, management, and treatment of HCV. The 

results of that review have been published in a comprehensive document called the 

HCV Guidance, which is updated regularly and is available at 

www.hcvguidelines.org. 

41. The HCV Guidance set forth the medical standard of care for the 

treatment of HCV, which is well-established in the medical community.

42. In 2014, the AASLD/IDSA panel, through the HCV Guidance, 

recommended treatment with DAA drugs for all persons with chronic HCV. The

recommendation reflected the continuing medical research showing the safety, 

tolerability, efficacy, and dramatic benefits of the DAA drugs.

43. Treatment with DAA drugs has been the standard of care for the 

treatment of HCV since 2014.

44. Under this standard of care, treatment with DAA drugs is expected to 

cure nearly all infected persons.

45. The benefits of immediate treatment include immediate decrease in 

liver inflammation, reduction in the rate of progression of liver fibrosis, reduction in 

the likelihood of the manifestations of cirrhosis and associated complications, a 70% 

reduction in the risk of liver cancer, a 90% reduction in the risk of liver-related 

mortality, and a dramatic improvement in quality of life. 

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46. Treatment must be provided timely to ensure efficacy. Delay in 

treatment increases the risk that the treatment will be ineffective.

Public Health Benefits of Treatment in Prison

47. Providing expanded HCV screening and DAA treatment in Florida’s 

prisons would greatly reduce the number of new HCV cases in the community. 

Curing the disease while people are in prison would prevent inmates from 

transmitting it when released, and testing would diagnose numerous individuals who 

were unaware they were infected, thus allowing them to seek treatment once 

released.

48. Studies have shown that providing DAA treatment to everyone with 

chronic HCV increases long term cost-savings. One study even found that restricting 

DAA treatment access until patients were in the later stages of fibrosis actually 

results in higher per-patient costs because, while it may be initially less expensive to 

delay administering DAAs, over the course of treatment, the follow-up care 

outweighs the initial costs.

49. Thus, early DAA treatment has the potential to both drastically reduce 

the incidence of HCV in the general population and also to reduce the costs 

associated with serious complications from untreated HCV, such as liver transplants 

and liver cancer.

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Policy and Practice of Not Providing Treatment 

to Inmates with Chronic HCV

50. From late 2013, when DAAs first became available, until 

approximately October of 2017, Defendant FDC and its medical contractors—

including Defendants Corizon and Centurion—had a policy and practice of refusing 

to provide treatment for chronic HCV.

51. Defendant FDC enforced such policy and practice despite knowing that 

the failure to provide DAA drugs to inmates with HCV subjects those inmates to an 

unreasonable risk of pain, liver failure, cancer, permanent damage to their health, 

and even death. By doing so, Defendant FDC has caused the unnecessary and wanton 

infliction of pain and an unreasonable risk of serious damage to the health of inmates 

infected with HCV, including the Plaintiff.

52. From October 2012 until May 2016, Defendant Corizon served as the 

FDC’s contracted healthcare vendor. 

53. Corizon and its high-level officials responsible for medical policy in 

Florida prisons knew about DAAs when they were first available in 2013. They also 

knew that the medical standard of care to treat chronic HCV was treatment with 

DAAs. They also knew that thousands of FDC prisoners had HCV and were not 

receiving DAAs, or any other treatment for their HCV.

54. Yet, during its entire tenure in Florida, for three years, Corizon treated 

just five patients with DAAs.

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55. From October 2012 until May 2016, Defendant Corizon had a policy 

and practice of refusing to provide treatment for chronic HCV. 

56. Defendant Corizon enforced such policy and practice despite knowing 

that the failure to provide DAA drugs to inmates with HCV subjects those inmates 

to an unreasonable risk of pain, liver failure, cancer, permanent damage to their 

health, and even death. By doing so, Defendant Corizon has caused the unnecessary 

and wanton infliction of pain and an unreasonable risk of serious damage to the

health of inmates infected with HCV, including the Plaintiff.

57. Centurion replaced Corizon as the FDC’s contracted healthcare vendor 

in May of 2016.

58. Centurion and its high-level officials responsible for medical policy in 

Florida prisons knew that the medical standard of care to treat chronic HCV was 

treatment with DAAs. They also knew that thousands of FDC prisoners had 

untreated HCV. They also knew that prisoners with chronic HCV and cirrhosis 

should be prioritized for DAA treatment.

59. Yet, for a year and a half, from May 2016 until September 2017, 

Centurion treated just six patients with DAAs. 

60. At all times relevant hereto, Defendant Centurion had a policy and 

practice of refusing to provide treatment for chronic HCV.

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61. Defendant Centurion enforced such policy and practice despite 

knowing that the failure to provide DAA drugs to inmates with HCV subjects those 

inmates to an unreasonable risk of pain, liver failure, cancer, permanent damage to 

their health, and even death. By doing so, Defendant Centurion has caused the 

unnecessary and wanton infliction of pain and an unreasonable risk of serious 

damage to the health of inmates infected with HCV, including the Plaintiff.

62. Despite knowing that DAAs were the standard of care for the treatment 

of chronic HCV since 2014, Defendant FDC and its medical contractors—including 

Corizon and Centurion—failed and/or refused to provide DAAs to Plaintiff and 

thousands of other, HCV-infected inmates throughout the state, in contravention of 

the prevailing standard of care and with deliberate indifference to the serious medical 

needs of inmates with chronic HCV in Florida. This policy of refusing to treat HCV 

was implemented because of the cost of the treatment.

63. It wasn’t until FDC, and by extension FDC’s medical contractor 

Centurion, was court-ordered1 to begin providing DAAs to HCV-infected inmates 

that Plaintiff and thousands of other inmates received medically necessary treatment

for their chronic HCV.

1 See Hoffer v. Jones, 290 F. Supp. 3d 1292 (N.D. Fla. 2017) (granting preliminary injunction); 

see also Hoffer v. Inch, 382 F. Supp. 3d 1288 (N.D. Fla. 2019) (granting permanent injunction). 

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64. As a result of FDC and its medical contractors’ (including Corizon and 

Centurion) failure and/or refusal to provide DAA drugs, over 100 inmates died of 

untreated HCV and hundreds more suffered irreparable liver damage.

65. Defendant FDC and its medical contractors, including Corizon and 

Centurion, also unjustifiably delayed providing treatment to HCV-infected inmates, 

even though the standard of care requires treatment as early as possible. Delayed 

DAA treatment increases the risk that the treatment will be ineffective. If treatment 

is delayed until a patient develops decompensated cirrhosis, a liver transplant may 

provide the only cure.

66. At all times relevant hereto, Defendant FDC categorically withheld 

treatment from FDC inmates with HCV but did not categorically withhold treatment 

from inmates with other similar diseases or conditions (such as HIV) or from other 

inmates without similar diseases or conditions.

67. Defendants FDC, Corizon, and Centurion had a policy under which 

inmates with chronic HCV were not provided lifesaving medications for their 

serious medical need and disability, while inmates with other medical needs and 

disabilities had access to lifesaving medications.

68. Defendants FDC, Corizon, and Centurion refused to provide FDC 

inmates, including the Plaintiff, with the necessary treatment for their HCV, and the 

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only treatment recommended under the prevailing standard of care, because of the 

cost of the treatment.

69. Defendant FDC discriminated against Plaintiff and other HCV-infected 

inmates on the basis of disability.

Defendants Deliberately Deprived Plaintiff of 

Medically Necessary Treatment for His Chronic HCV

70. Plaintiff has been incarcerated in the Florida prison system since

February 20, 2014. He has a history of HCV since approximately 2010, which was 

diagnosed by FDC staff during a prior incarceration. At his initial intake health 

screening in or about February 2014, Plaintiff informed the medical staff at CFRC 

that he had HCV. Thereafter, a blood draw was performed by medical staff, which 

confirmed Plaintiff’s diagnosis with HCV. Plaintiff was subsequently referred to the 

Chronic Illness Clinic for his chronic HCV for “monitoring.”

71. From the time Plaintiff came into FDC custody until May 2016, 

Defendant Corizon was the FDC’s medical contractor and was responsible with FDC 

for Plaintiff’s medical care.

72. However, for more than two years, Plaintiff was denied HCV treatment 

by Defendants Corizon and FDC. 

73. Corizon knew that Plaintiff had chronic HCV, knew that patients with 

chronic HCV should be provided DAA treatment, but denied Plaintiff DAA 

treatment without medical justification.

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74. Plaintiff was denied HCV treatment from February of 2014 until May 

of 2016 because Defendants Corizon and FDC had a policy, practice, and custom of 

not providing DAA medication to inmates with HCV, in part to save costs and to

make larger profits.

75. FDC knew Plaintiff was being denied treatment, and of Corizon’s 

policy and practice, yet failed to take any corrective action. 

76. Since May of 2016, when Centurion took over Corizon’s contract, 

Centurion has been responsible with FDC for Plaintiff’s medical care.

77. Centurion denied Plaintiff DAA treatment from May of 2016 until 

November of 2017 because Defendant FDC and its new contractor Centurion 

continued the policy, practice, and custom of not providing DAA medication to 

inmates with HCV.

78. It wasn’t until FDC was sued in federal court that the FDC’s contractor, 

Defendant Centurion, began providing DAA treatment to Plaintiff.

79. Plaintiff was denied HCV treatment from May of 2016 until October of 

2017 because Defendants Centurion and FDC had a policy, practice, and custom of 

not providing DAA medication to inmates with HCV, in part to save costs and to 

make larger profits.

80. FDC knew Plaintiff was being denied treatment, and of Centurion’s 

policy and practice, yet failed to take any corrective action.

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81. Between May of 2016 and July of 2017, Plaintiff was primarily housed 

at two prisons—Apalachee CI and RMC.

82. While at Apalachee CI, Plaintiff was regularly seen in the Chronic 

Illness Clinic, and in particular, the gastrointestinal clinic, for his chronic HCV.

83. Defendant Alvarez was one of Plaintiff’s medical providers at 

Apalachee CI, where he saw Plaintiff on numerous occasions in the gastrointestinal 

clinic as a result of Plaintiff’s diagnosis with chronic HCV. 

84. According to Plaintiff’s FDC medical records, Dr. Alvarez became 

aware of Plaintiff’s HCV no later July of 2015. While under Dr. Alvarez’s care, 

Plaintiff received multiple lab tests to monitor his HCV and test his liver function.

85. Based on Plaintiff’s lab test results, which contained signs to suggest 

that Plaintiff had advanced fibrosis or even cirrhosis as early as July of 2015, Dr. 

Alvarez knew or should have known that Plaintiff required DAA treatment.

86. Nonetheless, Dr. Alvarez failed to recommend request, or provide 

DAAs to Plaintiff while Plaintiff was in his care. 

87. Plaintiff was enrolled in the gastrointestinal clinic for his chronic HCV

while housed at RMC.

88. Defendants Radi and Haddad were Plaintiff’s medical providers at 

RMC, where they saw Plaintiff on multiple occasions between approximately 

September of 2016 through October of 2017 in the gastrointestinal clinic between 

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approximately September of 2016 through October of 2017 as a result of Plaintiff’s 

diagnosis with chronic HCV.

89. According to Plaintiff’s FDC medical records, Defendants Radi and 

Haddad became aware of Plaintiff’s HCV in mid-2016. While under Defendants 

Radi and Haddad’s care, Plaintiff received multiple lab tests to monitor his HCV and 

test his liver function.

90. Based on Plaintiff’s lab test results, which showed signs to suggest that 

Plaintiff had developed cirrhosis, Defendants Radi and Haddad knew or should have 

known that Plaintiff required DAA treatment.

91. Nonetheless, Defendants Radi and Haddad failed to recommend

request, or provide DAAs to Plaintiff while Plaintiff was in their care. 

92. Throughout his incarceration, Plaintiff regularly inquired about the 

condition of his liver and requested treatment for his HCV. All of Plaintiff’s requests 

were denied. Moreover, Plaintiff was not adequately informed of the severity of his 

liver disease and the substantial health risks associated with chronic HCV. 

93. From February 2014 until October 2017, Plaintiff was only given 

routine blood draws to monitor his HCV. He was not provided DAAs or any other 

treatment for HCV even though treatment with DAAs was required under the 

standard of care since 2014.

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94. DAA medications were available to Defendants FDC, Corizon, 

Centurion, and the Individual Defendants upon request. However, the Defendants 

did not recommend, request, or provide DAA drugs to Plaintiff until November of 

2017, after FDC was sued in federal court in Hoffer and ordered to provide DAA 

treatment to Plaintiff.

95. Whether an FDC inmate receives DAA treatment almost exclusively 

relies on the inmate’s METAVIR or fibrosis score (F0-F4). Under FDC’s guidelines, 

inmates are then prioritized for treatment based on their fibrosis score, which reflects 

the stage and progression of their liver disease. Nonetheless, until October 2017, 

Defendants FDC, Corizon, and Centurion failed to require or perform the necessary 

tests to determine the stage and progression of Plaintiff’s HCV, and thus, whether 

Plaintiff met the criteria for treatment under FDC’s guidelines.

96. It was not until late October 2017—more than seven years after FDC 

initially diagnosed him with HCV—that Plaintiff was given a FibroSure test to 

determine his fibrosis score. The results showed a fibrosis score of F4, thus

indicating that Plaintiff had cirrhosis. However, Plaintiff’s liver was cirrhotic prior 

to October 2017. In fact, all of the Defendants were well-aware of this fact, as 

demonstrated by the fact Plaintiff’s medical records throughout his incarceration are 

replete with documentation of the fact Plaintiff’s HCV was so serious, severe, and 

poorly-controlled, that Plaintiff suffered from life-threatening cirrhosis of the liver, 

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as well as other countless serious and severe resultant, related, and/or associated 

medical conditions and effects, including without limitation, severe fibrosis, 

significant or severe liver inflammation activity, varices, ascites, thrombocytopenia, 

jaundice, portal hypertension, severely abnormal blood AST and ALT levels

(elevated – as high as 421 AST/296 ALT in October 2016) and blood platelet count 

(low – as low as 38 in December 2016 and 33 in August 2017), persistent and 

extreme fatigue and low energy, increased muscle weakness, joint pain, dizziness, 

abdominal discomfort and distension, poor appetite, and nausea, beginning as early 

as 2014 and persisting throughout his incarceration. Despite Plaintiff’s clinical 

presentation, no DAA treatment was provided to Plaintiff at that time, or in the 

months and years thereafter.

97. For years Plaintiff was led to believe that he was on the “list” to be 

treated. However, Defendants FDC, Corizon, and Centurion refused and/or failed to 

provide treatment to Plaintiff from February 2014 to November 2017, in part to save 

costs and increase profits. Furthermore, the Individual Defendants failed to 

recommend, request, or provide DAAs to Plaintiff while he was in their care. 

Treatment was only provided to Plaintiff after the Court in Hoffer ordered FDC to 

begin providing DAA treatment to HCV-infected inmates. There was no medical 

reason or justification for the failure to provide Plaintiff with DAAs prior to his 

ultimate date of treatment.

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98. Throughout his incarceration, Plaintiff repeatedly and specifically 

requested medical treatment for his HCV, both verbally and through the grievance 

process. Defendant FDC refused these requests. In fact, Plaintiff was told that he did 

not qualify for treatment under FDC’s treatment guidelines. Instead, Plaintiff’s 

medical providers merely continued to “monitor” Plaintiff’s HCV from February 

2014 until November 2017, at which time Plaintiff finally received DAA treatment.

99. Plaintiff repeatedly requested an accommodation for his chronic, 

serious, severe, and life-threatening HCV—that is, treatment which could result in a 

cure for his disability. This request for DAA treatment was a request for a reasonable 

accommodation in that DAA drugs are the only recommended form of treatment 

capable of clearing HCV from Plaintiff’s body. Nonetheless, Defendants failed to

recommend, request, or provide Plaintiff with such treatment until November 2017.

100. Plaintiff’s request for DAA drugs as treatment for HCV was a 

reasonable request for a reasonable accommodation, as the Defendants were 

constitutionally required to provide such medication as treatment for HCV. 

Administering DAA drugs were necessary under the prevailing standard of care for 

treating individuals with HCV, and has been since 2014. 

101. Despite Plaintiff’s HCV-diagnosis, serious, severe, and life-threatening

HCV-related conditions symptoms, and repeated requests for treatment, Plaintiff 

was not provided DAA treatment until November 2017.

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102. Plaintiff should have received treatment with DAA drugs as early as 

2014, at the outset of his incarceration, in accordance with the prevailing standard 

of care.

103. From the outset of his incarceration in February 2014, Plaintiff suffered 

from well-known, well-documented, serious, severe, and life-threatening cirrhosis 

of the liver, and other serious complications associated with cirrhosis, due to 

Defendants’ refusal and delay in providing treatment for his HCV.

104. Defendants FDC, Corizon, and Centurion refused to provide DAA 

treatment for Plaintiff’s HCV because those Defendants had a policy and practice of 

not providing DAA drugs to HCV inmates. This policy and practice was 

implemented for non-medical reasons, including, inter alia, the cost of the treatment.

105. In other words, Defendants’ refusal to provide DAA treatment for nonmedical reasons constituted a deliberate indifference towards Plaintiff and his 

serious medical need and disability.

106. By being denied access to DAA treatment for his HCV by the

Defendant FDC, Plaintiff was denied meaningful access to prison programs, 

services, and activities, including access to medical services.

107. Plaintiff has suffered and continues to suffer from a variety of 

symptoms directly caused by or associated with HCV including, but not limited to:

persistent and extreme fatigue and low energy, increased muscle weakness, 

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dizziness, joint pain, abdominal discomfort and distension, poor appetite, and 

nausea. In fact, some days Plaintiff’s is unable to muster up enough strength to get 

out of bed. 

108. Plaintiff has also suffered and continues to suffer from a variety of 

symptoms or conditions indirectly caused by or associated with HCV including, but 

not limited to: cirrhosis, severe fibrosis, significant or severe liver inflammation 

activity, varices, ascites, thrombocytopenia, portal hypertension, jaundice, and 

severely abnormal blood AST and ALT levels (elevated – as high as 421 AST/296 

ALT in October 2016) and blood platelet count (low – as low as 38 in December 

2016 and 33 in August 2017).

Plaintiff’s Condition Worsened During the Period of Delayed Treatment

109. As well-documented by Plaintiff’s medical records, from the beginning 

(i.e., February 2014) and throughout the course of his incarceration in FDC custody 

and under Defendants’ medical care and treatment, Plaintiff’s HCV and his resultant, 

related, and/or associated medical conditions and impacts—including but not limited 

to, Plaintiff’s cirrhosis, severe fibrosis, significant or severe liver inflammation 

activity, varices, ascites, thrombocytopenia, portal hypertension, jaundice, and 

severely abnormal blood AST and ALT levels (elevated – as high as 421 AST/296 

ALT in October 2016) and blood platelet count (low – as low as 38 in December 

2016 and 33 in August 2017), as well as his persistent and extreme fatigue and low 

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energy, increased muscle weakness, dizziness, joint pain, abdominal discomfort and 

distension, poor appetite, and nausea—failed to improve, and in fact worsened, and 

drastically and even acutely so at times.

110. To be sure, Plaintiff was referred and transported by FDC countless 

times throughout his incarceration for treatment at RMC due to the seriousness and 

severity of Plaintiff’s HCV and resultant, related, and/or associated medical 

conditions and impacts.

111. In fact, Plaintiff’s HCV, and resultant, related, and/or associated 

medical conditions and impacts, became so serious, severe, acute, and lifethreatening that Plaintiff had to be transported to an outside, private healthcare 

system and facility (specifically, Tallahassee Memorial HealthCare (“TMH”) in 

October 2016, for emergency treatment of his conditions, which by that time had 

worsened to the point Plaintiff became jaundiced—for which Plaintiff had been 

treated in FDC facilities by being “given an ‘antacid.’”

112. Plaintiff returned to FDC custody and facilities after being fortunate 

enough to survive this traumatic medical incident, however, Defendants FDC and 

Centurion still failed to provide Plaintiff with treatment for his chronic, serious, 

severe, and life-threatening HCV using DAAs, for over an entire year thereafter, 

until November of 2017.

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113. However, by the time Defendants FDC and Centurion finally provided 

Plaintiff with DAA treatment for his HCV, it was too late. Indeed, the treatment 

failed.

114. The irreparable damage suffered by Plaintiff may have been prevented 

if not for Defendants’ unconstitutional denial and delay of treatment for HCV. 

Plaintiff continues to suffer damages as a result of Defendants’ deliberate 

indifference to his serious medical need and disability.

115. As a result, Plaintiff has suffered serious, substantial, life-threatening, 

and permanent injuries, including irreparable liver damage, as a result of 

Defendants’ failure to provide him necessary medical care and treatment for his 

chronic HCV.

COUNT I 

TITLE II OF THE AMERICANS WITH DISABILITIES ACT (ADA) 

(Against Defendant FDC)

116. Plaintiff incorporates and re-alleges paragraphs 1 through 115 as if fully 

set forth herein.

117. This count is brought under Title II of the Americans with Disabilities 

Act (ADA), 42 U.S.C. 12101, et seq. and 42 U.S.C. §§ 12131–12134, and its 

implementing regulations.

118. The ADA prohibits public entities from discriminating against 

individuals with disabilities in their services, programs, and activities. 42 U.S.C. 

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§§ 12131–12134; see also 28 C.F.R. §§ 35.130. In other words, the ADA impose an 

affirmative duty on public entities to create policies and procedures to prevent 

discrimination based on disability. 

119. Defendant FDC is a “public entity” within the meaning of 42 U.S.C. 

§ 12131(1) and 28 C.F.R. § 35.104. 

120. Plaintiff had chronic HCV, which is a physiological disorder or 

condition that affects one or more body systems, including but not limited to the 

digestive, gastrointestinal, immune, circulatory, cardiovascular, and hemic systems, 

and is therefore a physical impairment. 42 U.S.C. § 12102(1) & (2); 28 C.F.R. 

§ 35.108(a) & (b). This physical impairment substantially limits one or more major 

life activities, including but not limited to eating, walking, bending, lifting, 

concentrating, thinking, and communicating; the operation of major bodily functions 

such as digestive, gastrointestinal, immune, circulatory, cardiovascular, and hemic 

systems; and the operation of the liver. 42 U.S.C. § 12102(2); 28 C.F.R. § 35.108(c).

121. In other words, Plaintiff’s chronic HCV caused him to have a disability 

as defined under the ADA. Stated differently, Plaintiff’s disability was chronic HCV.

122. Plaintiff has a record of having an impairment that substantially limits 

one or more major life activity, as he has a history of such an impairment. 42 U.S.C. 

§ 12102(1)(B); 28 C.F.R. § 35.108(a)(1)(ii) & (e). 

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123. Plaintiff is regarded by FDC as having an impairment that substantially 

limits one or more major life activity, as FDC perceives him as having such an 

impairment. 42 U.S.C. § 12102(1)(C) & (3); 28 C.F.R. § 35.108(a)(1)(iii) & (f). 

Defendant FDC has subjected Plaintiff to a prohibited action because of an actual or 

perceived physical impairment. 

124. Plaintiff was a qualified individual with a disability because he met the 

essential eligibility requirements for the receipt of services or the participation in 

programs or activities provided by Defendant FDC, including but not limited to 

medical services. 42 U.S.C. § 12131(2); 28 C.F.R. § 35.104.

125. By withholding medical treatment from those with HCV, but not 

withholding medical treatment from those with other disabilities or those who are 

not disabled, Defendant FDC excluded Plaintiff from participation in, and denied 

him the benefits of, FDC services, programs, and activities (such as medical 

services) by reason of his disability. 42 U.S.C. § 12132; 28 C.F.R. § 35.130(a).

126. By withholding medical treatment from those with HCV, but not 

withholding medical treatment from those with other disabilities or those who are 

not disabled, Defendant FDC subjected Plaintiff to discrimination. 42 U.S.C. § 

12132; 28 C.F.R. § 35.130(a).

127. DAAs are the only effective medical treatment available for HCV under 

the prevailing standard of care, and is the constitutionally-required treatment under 

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the Eighth Amendment. Plaintiff requested DAA treatment for his HCV, which was 

a request for a reasonable accommodation for his HCV. By denying or delaying in 

providing DAA treatment to Plaintiff, Defendant FDC refused or failed to provide 

Plaintiff a reasonable accommodation for his request for treatment of his HCV in 

violation of Title II of the ADA.

128. Defendant FDC failed to provide Plaintiff with equal access to and 

enjoyment of effective medical services. 28 C.F.R. § 35.130(b)(1). 

129. Defendant FDC utilized criteria or methods of administration that had 

the effect of subjecting Plaintiff to discrimination and that defeated or substantially 

impaired accomplishment of the objectives of medical treatment for HCV. 28 C.F.R. 

§ 35.130(b)(3).

130. DAAs were readily available to Defendant FDC during this time period 

and yet it categorically refused to provide Plaintiff with treatment that the medical 

community deems essential. 

131. Defendant FDC denied and delayed providing Plaintiff with the 

necessary treatment and reasonable accommodation for his HCV because of the cost 

of the treatment and accommodation.

132. Defendant FDC knew about the violations described herein but failed 

to correct them, thereby exhibiting deliberate indifference to the rights of Plaintiff. 

Such violations include but are not limited to:

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(a) FDC’s decision to adopt and enforce a policy of not providing 

treatment to HCV-infected inmates;

(b) FDC’s refusal to provide Plaintiff with necessary medical 

treatment for his HCV, and the only treatment available under the prevailing 

standard care;

(c) FDC’s refusal to provide Plaintiff with DAA drugs because of 

the high, unbudgeted cost of the treatment; and

(d) To the extent it lacked sufficient funds to purchase and treat 

HCV-infected inmates like Plaintiff with DAAs, FDC’s refusal or failure to 

even request adequate funding from the Florida Legislature.

133. Had Defendant FDC not delayed but instead provided Plaintiff with 

DAA treatment and the reasonable accommodation he requested throughout his 

incarceration, Plaintiff would not have suffered additional injuries, including both 

physical injuries and emotional pain and suffering.

134. Defendant FDC owed Plaintiff a non-delegable duty to ensure that his 

wellbeing would not be compromised as a result of discrimination based on his 

disability. As such, Defendant FDC is vicariously liable for the actions of any and 

all persons or entities Defendant FDC contracted out its medical services to or 

otherwise designated to care for Plaintiff.

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135. As a direct and proximate cause of Defendant FDC’s actions and 

omissions, Plaintiff has suffered and continues to suffer from harm and violation of 

his ADA rights.

WHEREFORE, Plaintiff demands judgment against Defendant FDC for 

compensatory damages, including for physical injury, disfigurement, permanent 

physical injury, and emotional pain and suffering, for all prejudgment interest 

allowable under law, for attorney’s fees and costs incurred in connection with this 

litigation, and for such other relief as this court deems appropriate. 

COUNT II 

SECTION 504 OF THE REHABILITATION ACT (RA) 

(Against Defendant FDC)

136. Plaintiff incorporates and re-alleges paragraphs 1 through 115 as if fully 

set forth herein.

137. This count is brought under Section 504 of the Rehabilitation Act (RA), 

29 U.S.C. § 701, et seq. and 29 U.S.C. § 791–794, et seq., and its implementing 

regulations. 

138. Section 504 of the RA prohibits discrimination against persons with 

disabilities by any program or activity receiving Federal financial assistance. 29 

U.S.C. § 794(a).

139. Defendant FDC is a program or activity receiving federal financial 

assistance within the meaning of 29 U.S.C. § 794.

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140. Defendant FDC excluded Plaintiff—a qualified individual with a 

disability—from participation in, and denied him the benefits of, programs or 

activities solely by reason of his disability (chronic HCV). 29 U.S.C. § 794(a); 29 

U.S.C. § 705(20); 28 C.F.R. § 42.503(a).

141. Defendant FDC subjected Plaintiff—a qualified individual with a 

disability—to discrimination. 29 U.S.C. § 794(a).

142. Defendant FDC denied Plaintiff—a qualified handicapped person—the 

opportunity accorded to others to participate in programs and activities. 28 C.F.R. § 

42.503(b)(1).

143. Defendant FDC utilized criteria or methods of administration that either 

purposely or in effect discriminate on the basis of handicap, and defeat or 

substantially impair accomplishment of the objectives of FDC’s programs or 

activities with respect to handicapped persons. 28 C.F.R. § 42.503(b)(3).

144. Defendant FDC knew about the violations described herein but failed 

to correct them, thereby exhibiting deliberate indifference to the rights of Plaintiff.

145. As a direct and proximate cause of Defendant FDC’s exclusion and 

discrimination, Plaintiff has suffered and continues to suffer from harm and violation 

of his RA rights.

WHEREFORE, Plaintiff demands judgment against Defendant FDC for 

compensatory damages, including for physical injury, disfigurement, permanent 

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physical injury, and emotional pain and suffering, for all prejudgment interest 

allowable under law, for attorney’s fees and costs incurred in connection with this 

litigation, and for such other relief as this court deems appropriate.

COUNT III

42 U.S.C. § 1983 – EIGHTH AMENDMENT MONELL CLAIM

(Against Defendants Corizon and Centurion)

146. Plaintiff incorporates and re-alleges Paragraphs 1 through 115 as if 

fully set forth herein.

147. This count is brought through 42 U.S.C. § 1983 and against Defendants 

Corizon and Centurion for violation of the Eighth Amendment’s prohibition of cruel 

and unusual punishment on inmates. 

148. At all times relevant hereto, Defendants Corizon and Centurion and 

their policymakers knew about and enforced policies, practices, and/or custom that 

exhibited deliberated indifference to Plaintiff’s serious medical needs in violation of 

the Eighth Amendment. Defendants Corizon and Centurion, acting through their 

employees and agents, intentionally delayed, failed, and refused to provide Plaintiff 

with treatment that will address his serious medical needs despite knowing that its

actions would result in Plaintiff’s continued suffering and exposure to liver failure 

and its symptoms, liver cancer, and death.

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149. Defendants Corizon and Centurion have caused the wanton infliction 

of pain upon Plaintiff, an HCV-infected inmate, by exhibiting deliberate indifference 

to his serious medical needs and condition.

150. The refusal to provide treatment by Defendants Corizon and Centurion,

acting through their employees and agents, worsened Plaintiff’s serious medical 

condition. Left untreated, Plaintiff’s medical needs posed a substantial risk of serious 

harm, and in fact, did cause actual harm. Defendants Corizon and Centurion knew 

of this substantial risk of serious harm, and the actual harm, faced by Plaintiff, and 

yet disregarded those risks and harms by failing to provide Plaintiff with the 

medication that would have alleviated those risks and harms. Thus, Defendants 

Corizon and Centurion have been deliberately indifferent to the substantial risk of 

serious harm posed to Plaintiff in connection with his chronic HCV.

151. By denying Plaintiff medically-necessary treatment for his HCV, or 

unjustifiably delaying in providing such treatment, Defendants Corizon and 

Centurion imposed punishment far in excess of that authorized by law, contrary to 

the Eighth Amendment.

152. Defendants Corizon and Centurion’s denial and delay of the medically 

necessary treatment for Plaintiff’s HCV violated all standards of decency, contrary 

to the Eighth Amendment.

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153. Defendants Corizon and Centurion’s actions with respect to Plaintiff 

amounted to grossly inadequate care; medical care that can only charitably be 

described as cursory such that it amounted to no medical care at all.

154. Defendants Corizon and Centurion refused to provide treatment for 

Plaintiff’s HCV because they had a policy and practice of not providing DAA drugs 

to HCV patients, which was implemented for non-medical reasons, including the 

cost of the treatment. 

155. The constitutional violations of Defendants Corizon and Centurion, 

through the actions and omissions of their employees and agents, were directly and 

proximately caused by policies, practices, and/or customs implemented and enforced 

by Defendants Corizon and Centurion.

156. As a direct and proximate result of the policies, practices, customs, and 

deliberate indifference of Defendants Corizon and Centurion, Plaintiff has suffered 

substantial damages, including permanent physical injuries and emotional pain and 

suffering.

WHEREFORE, Plaintiff demands judgment against Defendants Corizon and 

Centurion for compensatory damages, punitive damages, attorney’s fees and costs, 

and such other relief as this court deems appropriate.

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COUNT IV

42 U.S.C. § 1983 – EIGHTH AMENDMENT CLAIM

(Against Defendants Alvarez, Radi, and Haddad)

157. Plaintiff incorporates and re-alleges Paragraphs 1 through 115 as if 

fully set forth herein.

158. This count is brought through 42 U.S.C. § 1983 and against Defendants

Alvarez, Radi, and Haddad for violations of the Eighth Amendment’s prohibition of 

cruel and unusual punishment on inmates.

159. At all times relevant hereto, Defendants Alvarez, Radi, and Haddad

acted under color of state law and intentionally deprived Plaintiff of his rights under 

the United States Constitution. Defendants Alvarez, Radi, and Haddad are sued in 

their individual capacities.

160. Plaintiff had a serious medical need as he was diagnosed with chronic 

HCV. Defendants Alvarez, Radi, and Haddad were subjectively aware that Plaintiff 

had chronic HCV and suffered from symptoms associated with chronic HCV. 

Plaintiff’s condition and serious medical need was so obvious that even a layperson 

would easily recognize the necessity for medical attention and treatment.

161. Despite qualifying and being approved for treatment, Defendants 

Alvarez, Radi, and Haddad refused to provide Plaintiff with DAAs, the only 

treatment and cure for HCV under the prevailing standard of care. 

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162. Defendants Alvarez, Radi, and Haddad intentionally refused to provide 

Plaintiff with treatment that will address his serious medical needs despite knowing 

that their actions would result in Plaintiff’s continued suffering and exposure to liver 

failure and its symptoms, liver cancer, and death.

163. Defendants Alvarez, Radi, and Haddad have caused the wanton 

infliction of pain upon Plaintiff, an HCV-infected inmate, by exhibiting deliberate 

indifference to his serious medical needs and condition. 

164. Defendants Alvarez, Radi, and Haddad’s refusal to provide treatment 

worsened Plaintiff’s serious medical condition. Left untreated, Plaintiff’s medical 

needs posed a substantial risk of serious harm, and in fact, did cause actual harm. 

Defendants Alvarez, Radi, and Haddad knew of this substantial risk of serious harm, 

and the actual harm, faced by Plaintiff, and yet disregarded those risks and harms by 

failing to provide Plaintiff with the medication that would alleviate those risks and 

harms. Thus, Defendants Alvarez, Radi, and Haddad have been deliberately 

indifferent to the substantial risk of serious harm posed to Plaintiff in connection 

with his HCV.

165. By denying Plaintiff the medically needed DAA treatment for his HCV, 

or unjustifiably delaying in providing such treatment, Defendants Alvarez, Radi, and 

Haddad imposed punishment far in excess of that authorized by law, contrary to the 

Eighth Amendment.

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166. Defendants Alvarez, Radi, and Haddad’s denial of the medically 

necessary treatment for Plaintiff’s HCV violated all standards of decency, contrary 

to the Eighth Amendment.

167. Defendants Alvarez, Radi, and Haddad’s actions with respect to 

Plaintiff amounted to grossly inadequate care; medical care that can only charitably 

be described as cursory such that it amounted to no medical care at all.

168. Plaintiff did not receive the constitutionally-required DAA treatment 

because of the cost of the treatment.

169. Plaintiff suffered damages as a direct and proximate result of 

Defendants Alvarez, Radi, and Haddad‘s constitutional violation, including 

permanent physical injuries and emotional pain and suffering.

170. WHEREFORE, Plaintiff demands judgment against Defendants 

Alvarez, Radi, and Haddad for compensatory damages, punitive damages, attorney’s 

fees and costs, and such other relief as this court deems appropriate.

DEMAND FOR JURY TRIAL

Plaintiff demands a jury trial for all counts alleged above.

[Signatures on following page]

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Respectfully submitted,

ANDREWS LAW FIRM

822 North Monroe Street

Tallahassee, Florida 32303

T: (850) 681-6416 / F: 681-6984

/s/ John M. Vernaglia

JOHN M. VERNAGLIA (FBN 1010637)

STEVEN R. ANDREWS (FBN 0263680)

RYAN J. ANDREWS (FBN 0104703)

DAVID A. WEISZ (FBN 1023229)

john@andrewslaw.com

steve@andrewslaw.com

ryan@andrewslaw.com

david@andrewslaw.com

service@andrewslaw.com

Counsel for Plaintiff

CERTIFICATE OF SERVICE

I HEREBY CERTIFY that on this 13th day of January, 2021, a true and 

correct copy of the foregoing was electronically filed in the United States District 

Court for the Northern District of Florida using the CM/ECF system, which will 

send a notice of electronic filing to all counsel of record.

/s/ John M. Vernaglia

JOHN M. VERNAGLIA 

Case 4:20-cv-00360-AW-MJF Document 69 Filed 01/14/21 Page 40 of 40