Opinion ID: 8704897
Heading Depth: 3
Heading Rank: 1

Heading: Unity Health Care and the D.C. Central Detention Facility

Text: Ms. Konah worked for Unity as a Licensed Practical Nurse from November 2006 through September 2009. 1 Unity is a non-profit health care provider that operates a-network of clinics for medical and social services in the District. Her duty location for that entire time was the Central Detention Facility (CDF, also referred to as the D.C. Jail) in Southeast Washington, D.C. Under its contract with the District, Unity provides medical treatment to inmates at CDF, as well as at the Correctional Treatment Facility and halfway houses. Sealed Statement of Undisputed Material Facts Supp. Unity Mot. Summ. J. [Dkt. 67-5] (Unity SUF) ¶ 5. Each of the “open population” housing units at CDF is monitored by a sergeant, who sits in a glass-walled control module called a “bubble” and who supervises floor officers and inmates. Id. ¶ 10. Inmates who qualify for open population are released from the cells but must remain in the cell block. From the bubble, the sergeant controls one gate (“bubble gate”) that connects the cell block to a narrow hallway called the “sally port,” 2 and a front gate that connects the sally port to the main hallway of the jail. Id. ¶ 11; see also Def. Unity Health Care, Inc.’s Mot. Summ. J. (Unity MSJ), Ex. 22 [Dkt. 67-6], Supp. Decl. Vali Zabiheian (Zabiheian Supp. Decl.), Ex. A (Sally Port Photograph). The front gate from the main hallway is at one end of the sally port, and the bubble gate into the cell block is at the other end. Sally Port Photograph. Having a bubble gate and the front gate open at the same time is not permitted because inmates could run out into the hallway of the jail, which would be a security breach. Unity SUF ¶¶ 13, 51; see also Unity MSJ, Ex. 5 [Dkt. 67-6], Dep. of Robert Lee Jefferson, Jr. (Jefferson Dep.) at 94 (“[T]hat’s a security matter, because if I have both of them [open], that means the inmate can run out into the hallway of the jail.”). Inmates are not supposed to be in the sally port without a correctional officer present. Unity SUF ¶ 49; Jefferson Dep. at 72, 76 (“They’re not supposed to be in there unsupervised, no. .If there’s inmates in the .sally port, there should be an officer with them.... [W]e make [the inmates] get out the sally port.”). One of Unity’s duties is to administer medications to inmates, which nurses have typically done in the housing units. Unity SUF ¶¶ 7, 41. Correctional officers are required to accompany nurses at all times when they administer medication to inmates. Id. ¶¶ 7-9; Unity MSJ, Ex. 2 [Dkt. 67-6], Deposition of Lena Konah (Konah Dep.), at 95 (Q. “And are you supposed to be escorted by an officer? A. Yes.”). If an officer is not immediately available, a nurse can “just come back and wait for one.” Konah Dep. at 100. Waiting for an officer was Ms. Konah’s typical practice. Id. Insulting interactions between inmates and nurses were not uncommon at CDF. Unity SUF ¶¶ 22-26. Sometime in April 2009, a nurse — not Ms. Konah — reported that an inmate had thrown urine and feces at her. Id. ¶ 33. On April 21, 2009, several nurses, including Ms. Konah, sent a letter to Unity complaining about security practices at the jail. Id. ¶ 34; Compl. ¶¶ 26, 31; see also Unity MSJ, Ex. 18 [Dkt. 67-6], Letter dated April 21, 2009 (4/21/09 Letter) at 1. The letter described several recent incidents involving feces and “unknown liquids”, as well as the general difficulties of working around the inmates while distributing medication. 3 Unity SUF ¶ 34; see also 4/21/09 Letter at 1. The letter asked Unity to change policies regarding medication administration so that officers would “bring the inmates to the bubble or to the sick call room” in lieu of the nurses “passing medication from cell to cell.” 4/21/09 Letter at 1. The sick call rooms are located in the sally ports for nurses to use .in dispensing medication. Unity SUF 1T41. The sick call rooms have Dutch doors that enable a nurse to remain inside the room with the bottom half of the door closed while administering medications through the open top half of the door. Id.; see also Sally Port Photograph. To access sick call rooms, nurses sign out keys and return them when they are done. Unity SUF ¶42; These procedures had been in place and available for some time. Unity MSJ, Ex. 9 [Dkt. 67-6], Decl. Bianca Thompson (Thompson Decl.) ¶¶ 8-11. Ms. Konah knew the procedures, as she signed out a key and used a sick call room in March 2009. Id. ¶ 11; see also Unity SUF ¶ 43. The day after the nurses’ complaint letter, Mali Zabiheian, Unity’s Health Services Administrator and the senior management representative for Unity at the D.C. Jail, implemented a “sick call room policy.” Unity SUF ¶ 35; see Unity MSJ, Ex. 20 [Dkt. 67-6], Decl. of Yali Zabiheian (Zabiheian Decl.) ¶¶ 1, 7-8 & Ex. A (4/22/09 Zabiheian Memo) at 1. The policy stated: Effective May 1, medication administration and dispensing by the nursing and pharmacy staff will take place in the sick call rooms on the housing units. The medical staff will no longer walk on the housing units to administer medicine in open population. 4/22/09 Zabiheian Memo at 1. On April 30, 2009, during a training meeting,- all nursing staff at the Jail, including Ms. Konah, were instructed to use the sick call rooms when dispensing medicine. Unity SUF ¶ 40. According to Unity business records, during a discussion of “Medication Dispensing in Units,” all nurses were instructed to “begin using the sick call rooms when meds are administered on the open population housing units. On the lock down units, meds will still be walked cell to cell with an officer present.” Zabiheian Deck, Ex. B (Nursing Staff Meeting Record) at Bates UNITY136. Mr. Zabiheian’s memo was posted at the Jail where Unity employees clock in, in the nursing station, and in the medication room; a copy was also sent to Warden Simon Wainwright. Zabiheian Deck ¶ 8. The requirement that a corrections officer escort nurses at all times remained in place. Unity SUF ¶¶ 7, 9. Ms. Konah signed the attendance sheet for the April 30, 2009 training, and the meeting record reflects her attendance, Nursing Staff Meeting Record at Bates UNITY 132-33; she admits the signature is hers but does not remember any meeting on a new policy, see Konah Dep. at 54-59.