A jury could find that a private company that provides medical services at prisons was “deliberately indifferent” to the need to train its licensed practical nurses, says an appellate court in reinstating a negligence death suit filed on behalf of an inmate who died of an infection despite his repeated complaints he was ill.

When Tyler Butler, 25, arrived at the Hopkins County Detention Center in Madisonville, Kentucky, to serve a short sentence on a misdemeanor offense, he complained he had a staph infection, according to Friday's ruling by the 6th U.S. Circuit Court of Appeals in Cincinnati in Cindy Shadrick, administratrix of the estate of Tyler Butler, deceased, v. Hopkins County, Kentucky, et al.; Southern Health Partners Inc.

He was not medically assessed by the licensed practical nurses, who were employees of Chattanooga, Tennessee based-Southern Health Partners, which has health care contracts with 198 jail facilities in 10 states.

Three days later, Mr. Butler was found dead in his cell. An autopsy disclosed he had died of sudden cardiac arrhythmia due to sepsis, a complication of an untreated staph infection.

His mother, Cindy Shadrick, filed suit, charging negligence and that the company's failure to train and supervise its nurses violated Mr. Butler's constitutional right to adequate medical care.

The U.S. District Court in Owensboro, Kentucky, granted Southern Partners summary judgment dismissing the case, which was reinstated by the appeals court panel in its 2-1 ruling.

Nurses who worked at the prison testified that they had not received any training on Southern Partner's policies, said the majority ruling. “A reasonable jury could find that “(Southern Partners) was deliberately indifferent to the need to train and supervise (licensed practical) nurses to provide adequate medical care to inmates, especially in view of the obvious risk that the Constitution could be violated without such training and supervision,” said the ruling.

“The undisputed facts establish that Butler's urgent need for medical treatment was apparent the moment he walked through (Hopkins County Detention Center's) door, yet (Southern Partners') staff did not provide it in spite of Butler's requests for help and the urging of jail deputies to attend to Butler.

“Not only were the (Southern Partner) nurses aware of facts alerting them that Butler faced a substantial risk of serious harm if he did not receive timely and proper medical care, there is evidence they … recklessly disregarded it,” said the ruling, in remanding the case for further proceedings.

The minority opinion said, “The evidence submitted by Shadrick does not create a jury question regarding whether (Southern Partners) consciously decided to adopt a policy that it knew would cause its employees to violate inmates' constitutional rights.”