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Spokane, Washington  Est. May 19, 1883

Even before $27 million Spokane County Jail lawsuit, NaphCare had a rocky legal history

The Spokane County Jail is seen in this August 2020 photo.  (Dan Pelle/The Spokesman-Review)

Spokane County is no stranger to big money lawsuits and settlements. Neither is NaphCare, the medical provider for the Spokane County Jail.

But lawsuits that end with eight-figure verdicts don’t happen often.

A federal jury on Tuesday awarded $27 million in damages to the family of a woman who died in the Spokane County Jail. NaphCare is appealing the decision, but the verdict could have significant ramifications for the county and its private contractor.

Cindy Lou Hill was booked into the jail on Aug. 21, 2018, on suspicion of heroin possession. Four days later, the 55-year-old was shirtless on the floor of her cell, unable to move and complaining of intense stomach pain.

Hill wasn’t brought to a doctor or sent to the emergency room. NaphCare nurse Hannah Gubitz determined Hill’s symptoms were consistent with heroin withdrawal and sent her to a medical cell.

Hill died hours later of a bacterial infection caused by a ruptured intestine.

Hill’s estate sued Spokane County and NaphCare, arguing her death could have been avoided if she’d received proper medical care. The U.S. District Court jury agreed and decided NaphCare would pay the estate $26.5 million in damages. Spokane County will pay $275,000.

“It’s massive,” said Ed Budge, the attorney for Hill’s estate. “It was absolutely the right decision. The jury recognized that a message needed to be sent.”

NaphCare’s backstory

NaphCare is an Alabama-based company founded in 1989. It provides medical services to jails and prisons.

In 2016, when Spokane County first hired NaphCare, the company said it had 51 clients in 27 states and oversaw the health care needs of 100,000-plus inmates. Some of NaphCare’s most notable customers are the Clark County Detention Center in Las Vegas and the Suffolk County House of Corrections in Boston.

NaphCare isn’t publicly traded, but Budge said during his closing argument that the company in 2021 reported gross annual revenues of $372 million.

Like many companies that provide medical services to prisons and jails, NaphCare has faced dozens of lawsuits over the years.

One of the most notable lawsuits ended in 2019 when the company was part of a $3 million settlement with the family of a man who died in a Virginia jail.

At the time of his death in 2015, Jamycheal Mitchell was a 24-year-old inmate at Hampton Roads Regional Jail.

Mitchell, who suffered from mental illness, lost nearly 40 pounds and experienced extreme swelling in both legs while in custody. The Virginia Office of the Inspector General determined that he received substandard care from NaphCare nurses before his death.

The family of Damaris Rodriguez is suing NaphCare and South Correctional Facility in Des Moines, Washington. Their lawsuit says Rodriguez, a mother of five, wasn’t given medical treatment in January 2018 even though she was experiencing hallucinations and repeatedly vomited during the four days in jail leading up to her death.

The Rodriguez family reached a partial settlement with the King County jail in October for $2 million.

NaphCare used to be the medical provider for Alabama’s largest prison – the Limestone Correctional Facility. But in 2003, Alabama dropped NaphCare after a state audit said the company provided “dangerous and extremely poor quality health care” at the facility. NaphCare called the audit “unsubstantiated” and sued for libel.

How NaphCare came to Spokane County

The Spokane County Jail had a staffing problem in 2016.

The jail couldn’t find enough nurses, so the county signed a six-month, $2.6 million contract with NaphCare.

“We didn’t really have any other choice,” then-Spokane County Detention Services Director John McGrath told The Spokesman-Review in 2017.

NaphCare helped solve the staffing problem, but the company got off to a rocky start in Spokane.

The county’s existing nurses initially worked alongside NaphCare staff. That didn’t last long. Nearly all of the original nurses left within months, although NaphCare hired a few.

Multiple nurses told The Spokesman-Review that NaphCare’s takeover and cost-cutting measures were leading to lower-quality care. NaphCare denied those accusations and county officials said the company’s arrival had improved inmate health care.

Inmates also raised concerns about NaphCare.

For example, Bryan Monnin went 40 days with an untreated broken elbow without being taken to surgery. Patricia Swiger said she went weeks without getting her prescription medication. Kurt Warren said he had MRSA for two weeks, but NaphCare nurses ignored it. The staph infection spread and eventually required surgery.

Will NaphCare keep working in the jail?

If Spokane County commissioners have concerns about NaphCare’s performance, they haven’t voiced them.

County Commissioner Al French said he couldn’t comment on NaphCare because the Hill case isn’t over – the company is appealing the jury’s decision and motioned for a new trial. Commissioners Josh Kerns and Mary Kuney did not respond to requests for comment.

Based on documents available through the county’s resolution directory, NaphCare’s contract hasn’t changed much since 2016.

NaphCare’s contract runs through June 2024, according to a September 2017 Spokane County Commission resolution. The county pays NaphCare roughly $7 million a year to provide medical services to the jail.

In a written statement, NaphCare said it intends to keep working in Spokane.

“NaphCare remains committed to our mission to improve and save lives,” NaphCare Communications Director Stephanie Coleman wrote in an email.

“We fully intend to continue our partnership with Spokane County Detention Services to provide proactive, preventive health care within the Spokane County Jail.”

Coleman suggested that NaphCare remains on solid financial footing even though the jury’s requiring the company to pay $26.5 million in damages to Hill’s estate.

“While we will move forward with the appeals process, NaphCare remains a stable company that is able to weather this storm,” Coleman wrote.