A split federal appeals panel drilled into a lower court’s decision to cap off a lawsuit from Cook County jail detainees who accused the county and Sheriff Tom Dart of violating their Fourteenth Amendment rights through allegedly inadequate dental care.
The lawsuit from Montrell Carr, detained at the county jail while awaiting trial, dates back more than six years and stems from a 2007 staff reduction that eliminated an on-site oral surgeon. Quintin Scott joined as a named plaintiff in an amended complaint filed in July 2018. After U.S. District Judge Martha Pacold refused to certify a class, Carr settled his claim. Scott also voluntarily settled — for $7,500 — but unlike Carr preserved the right to appeal the certification denial and pursue an incentive award.
Scott did just that before the U.S. Seventh Circuit Court of Appeals. Judge Diane Wood wrote the majority opinion, filed April 29; Judge Candace Jackson-Akiwumi concurred. Judge Thomas Kirsch dissented.
Before the appeals panel, the county argued Scott lacked standing to lead a class action and, even if he did, courts aren’t allowed to grant incentive awards. The majority rejected those positions, noting the county relied on U.S. Supreme Court cases from 1881 and 1885.
“Preventing the settling plaintiff from appealing would undermine judicial economy,” Wood wrote, as other potential class members could assume the claims. “Along the same lines, the Supreme Court has held that defendants cannot moot an appeal from a denial of class certification by simply buying off the individual claims of the named plaintiffs.”
The majority also found Judge Pacold improperly denied certification by misapplying a 2020 U.S. Seventh Circuit Opinion, McFields v. Dart.
Wood acknowledged “medical care, by its nature, is individualized” but that reality cannot universally defeat class allegations of substandard care. She noted Scott submitted written grievances from 11 other detainees who detailed their experiences of “significant delays in receiving oral surgery” and also said the county, during discovery, showed jail dentists made 2,800 referrals to Stroger Hospital from February 2014 through July 2017, while jail staff scheduled 2,186 detainee transports to Stroger’s oral surgery clinic from January 2013 though early October 2019.
While each dental issue is distinct to individual detainees, Wood said the lawsuit arises from the allegation common to every potential class member: the county’s refusal to staff an oral surgeon caused unreasonable delays in treatment. The McFields plaintiffs challenged Cook County’s paper triage policy for prioritizing medical complaints. Wood said the panel’s refusal to certify that class rested on the fact each potential class member had their own written complaint form with individualized disclosures.
Judge Pacold, Wood wrote, “did not grapple with (or even recognize) the salient differences between the paper triage policy challenged in McFields and the policy challenged here.” The lack of a staff surgeon potentially affected every inmate, the majority said, and the record showed jail dental staff “practically begging” for a surgeon. Further, the proposed class “is narrowly defined to limit the effect of any variation between its members,” such that it would only include detainees who received an on-site dental exam, a surgery referral and a delay in that surgical appointment.
The majority vacated the denial of certification and remanded the complaint for further proceedings.
In his dissent, Judge Kirsch agreed Scott had standing for the appeal. But Kirsch said Judge Pacold didn’t abuse discretion in denying certification. He wrote “there is not nearly as much daylight between this case and McFields as the majority supposes,” framing both lawsuits as a jail policy resulting in systemic delays for dental care.
“Gross and systemic deficiencies only exist (in Scott’s lawsuit) if there are individual claims of inadequate medical care, which depends on factors such as the detainee’s underlying dental issue, the degree of pain, and how long each detainee waited before receiving treatment,” Kirsch wrote. “The conclusion that each proposed class member had ‘a serious medical issue’ impermissibly reads additional language into the proposed class.”
Kirsch said dentists may make surgical referrals for a variety of reasons, such as non-urgent wisdom tooth extractions. He said denial of certification wouldn’t prevent individualized litigation.
The Cook County Sheriff’s Press Office issued a statement in response to a request for comment from The Cook County Record: “The allegations made in this lawsuit pertain to medical care and staffing decisions made by Cermak Health Services, which is overseen by Cook County Health and established by County Ordinance."