Technical Update vol. 30 no. 34 - Medical Care in County Jails

Providing appropriate medical care in a county jail is more than a healthcare responsibility; it's a legal obligation. Allegations of delayed, inadequate, or improperly coordinated medical care continue to be among the most common sources of claims against correctional facilities. Even when medical services are provided by a contracted healthcare provider, counties retain responsibility for ensuring inmates receive adequate care.

Many claims center on allegations that deputies and medical staff failed to work together to ensure an inmate received appropriate medical attention. Common examples include failing to properly monitor inmates on suicide watch or withdrawal protocols, inadequate communication regarding medical concerns, or failing to recognize when an inmate's condition requires additional evaluation.

WHAT IS "DELIBERATE INDIFFERENCE"?

A key issue in many jail medical claims is whether staff acted with “deliberate indifference” to an inmate's serious medical needs. Under both federal civil rights law and Colorado law, claims often focus on two questions:

• Was the inmate's medical condition sufficiently serious?
• Did staff recognize a substantial risk of harm and fail to take reasonable steps to address it?

The courts generally apply a relatively low threshold when determining whether a medical condition is serious enough to require attention. Once a potential medical issue is identified, the actions taken by deputies, supervisors, and medical providers are often examined closely. Communication, documentation, and timely follow-up become critical in defending these claims.

LESSONS FROM A RECENT CLAIM

A recent CAPP claim demonstrates how quickly a routine inmate interaction can evolve into a complex and costly lawsuit. Following a use-of-force incident, medical staff evaluated the inmate on multiple occasions and determined additional treatment was not necessary. Several days later, the inmate suffered a previously undetected internal injury that ultimately resulted in death.

The lawsuit alleged excessive force, failure to intervene, inadequate training, and deliberate indifference to medical needs. Although multiple parties were involved, the claim resulted in a multi-million-dollar settlement, with the majority of the financial responsibility paid through CAPP.

Cases like this reinforce that medical liability claims rarely involve a single decision. Instead, they often focus on the totality of events, including communication between personnel, documentation, observation practices, and the consistent adherence to established policies.

REDUCING MEDICAL LIABILITY

Counties can reduce medical liability by focusing on consistent oversight and clear operational practices:

• Monitor and evaluate contracted medical providers.
• Make appropriate housing decisions during booking and incarceration.
• Perform and document required cell checks.
• Maintain written medical policies and ensure they are followed.
• Promptly communicate and document significant medical concerns.

Regular training helps deputies recognize changes in an inmate’s condition, respond appropriately, and understand when additional medical evaluation is needed. These practices support better care and strengthen the county’s position if a claim arises.

WHAT THIS MEANS FOR COUNTIES

Medical liability claims remain among the most significant sources of exposure for county jails. Even when healthcare is provided by a contracted medical provider, counties remain responsible for ensuring that appropriate care is delivered. Strong communication, thorough documentation, consistent cell checks, and adherence to written policies help protect inmates while reducing liability exposure and claim costs for both the county and CAPP. Counties should regularly review medical protocols, evaluate contracted providers, and provide ongoing staff training to reinforce expectations. For questions regarding jail liability or loss prevention resources, please contact the CTSI Loss Control Team at 303.861.0507.