Opinion ID: 183790
Heading Depth: 3
Heading Rank: 3

Heading: The Plaintiffs' Specific Claims

Text: In 1991, during an incarceration prior to Dr. Elyea's term as Medical Director, Mr. Roe was diagnosed with hepatitis C, though his records suggested infection since the 1970s. See Trial Ex. 5 (Grievance of Mr. Roe at 2, Mar. 11, 2004); Doc. 1-279. [7] He was released from custody in 2002. During Dr. Elyea's term, Mr. Roe was incarcerated for two months in 2003 and a little more than eight months, from January 19, 2004 to October 1, 2004. He again was incarcerated from July 2007 until his death in June 2008. During his 2002 incarceration, Mr. Roe had liver enzyme testing and genotype testing. His lab results showed his ALT and AST levels at more than twice normal. [8] They further revealed that his HCV genotype was 3a, and thus, according to the FBOP guidelines in place in 2003, he would have been a candidate for the shorter twenty-four-week course of antiviral therapy. Labs were repeated in 2003 and 2004, each showing elevated liver enzyme levels. Indeed, including the 2002 test, four of the five tests included in the record showed not only ALT levels greater than twice normal, but also an AST/ALT ratio of greater than one, [9] which the Guidelines identify as an indicator of underlying liver disease even when ALT levels are within the normal range, see Trial Ex. 3 at 42. During his 2004 incarceration, Mr. Roe was misdiagnosed and treated briefly for tuberculosis. See Doc. 1-283 (noting the repeated test results). Tuberculosis is a contraindication for antiviral therapy according to the Guidelines. After repeat testing revealed the incorrect diagnosis, Mr. Roe's tuberculosis treatment was discontinued on March 6, 2004, just under seven months from his scheduled release date. During and prior to his 2004 incarceration, Mr. Roe was not considered a candidate for biopsy or antiviral therapy. He also received no treatment following his release. When he returned to prison in 2007, after Dr. Elyea's term had ended but while his policy was still in place, he again received no further testing until one week before trial, when his liver was biopsied. He was, according to the court, visibly quite ill with a distended abdomen at the trial. R.88 at 9. He died three months later, apparently from cirrhosis. R.63-64.
At the time of trial, Mr. Walker had been incarcerated since 1995 and had a scheduled release date in 2011. He was diagnosed with hepatitis C in October 2003, but received no treatment until 2007, after the lawsuit had begun. From 2003 through 2005, several lab reports indicated at least minimal elevation in his ALT and AST levels; at times, the elevation was considerably higher than twice normal levels. See, e.g., Docs. 1-166, 1-176, 1-228. In December 2003, he filed a grievance concerning his lack of treatment. The Health Care Unit Administrator, Dave Huffman, responded that, in order to qualify for treatment, Mr. Walker had to be on the Hepatitis C chronic clinic for 1 year and meet specific lab test results.... After 1 year, if he meets the criterion, treatment will be started because he will still have more than 1 year left to serve. Doc. 1-156. Mr. Walker again grieved the lack of treatment in June 2004, and his grievance was again denied because he did not meet set IDOC treatment criteria. [10] Mr. Walker testified that, although his enzymes were checked periodically, he received no treatment for his HCV infection until he was deposed in connection with the present action in 2007. He was given a liver biopsy and a week later began a course of treatment, after which the virus was undetectable in his body. R.110 at 30. He also testified that, prior to receiving treatment, he suffered from a number of symptoms, including nose bleeds, headaches and pain, all of which had stopped after treatment. Id. at 31-32.
While Dr. Elyea was IDOC Medical Director, Mr. Stasiak was incarcerated from August 2003 through December 2004. He testified that he was diagnosed with hepatitis C in January 2004 and made numerous requests for a liver biopsy and treatment. He complained of symptoms he attributed to his infection, but one medical progress note stated that his claimed symptom of abdominal pain was not due to Hepatitis [and was] possibly musculoskeletal in nature. Doc. 1-128. Mr. Stasiak's enzyme levels were taken numerous times from January through December of 2004, with results varying from more than twice normal to within the normal range. [11] Mr. Stasiak complained to his prison physician that he was not receiving treatment for his HCV infection in February 2004. At that time, the physician noted his out date was only ten months away, and, therefore, he would not meet criteria for treatment during his incarceration. Doc. 1-125. In July 2004, a separate note indicated liver enzyme levels 1. Minimum stay is needed at least of 1 year. Doc. 1-130 (emphasis in original). Mr. Stasiak received no treatment prior to his release.
During Dr. Elyea's tenure, Mr. Stephen was incarcerated for seven months in 2004, seven months from 2005-2006 and two months in 2007. He was diagnosed with hepatitis C during his 2004 incarceration. Throughout his periods of incarceration in 2004 and 2005-2006, his relevant liver enzyme levels were checked numerous times and were always above twice normal. [12] Medical progress notes written in July 2004 noted that, despite his highly elevated enzyme levels, liver biopsy and treatment cannot be accomplished. He needs to stay at least 12-15 months here. Doc. 1-63 (emphasis in original). No medical records were submitted from Mr. Stephen's 2007 incarceration. According to his trial testimony, he suffered a number of symptoms, including abdominal pain and swelling. After his release, he subsequently was scheduled for treatment outside of prison and, at that time, had three liters of fluid removed from his abdomen. R.110 at 73.