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Appeals court upholds class action status for thousands of Missouri inmates with hepatitis

Thomas Hawk | Flickr

Updated at 4:35 p.m. with comments from the ACLU — A U.S. appeals court has upheld a federal judge’s decision to include thousands of Missouri Department of Corrections inmates with hepatitis C in a class-action lawsuit that could change how the disease is treated inside the state’s prisons.

The American Civil Liberties Union and the MacArthur Justice Center sued the stateon behalf of three inmates with the virus in 2016. The plaintiffs allege that the state didn’t treat their condition properly or quickly enough and only gave treatment to the people with the most serious symptoms. Those actions, they argue, violate the U.S Constitution and constitute cruel and unusual punishment.

Last year, U.S. District Judge Nannette Laughrey granted class certification to the lawsuit, filed on behalf of Department of Corrections inmates who have or will be diagnosed with the virus. That means the court’s decision would apply not only to the three plaintiffs but to an estimated thousands of Missouri inmates with chronic hepatitis C.

The Eighth Circuit Court of Appeals on Thursday upheld that decision, which the state had appealed. Lawyers from the state’s Attorney General’s Office said in court that the health of inmates is so varied that there was no way the inmates could constitute a class.

But that argument “misunderstood the nature of the class’s claims,” the appeals court ruled. 

Because all inmates are exposed to the same potential risk, the patient’s ultimate treatment or health outcomes is a moot point, the court said.

“Whatever the merits of the defendants’ arguments, they do not clearly relate to whether class certification is appropriate,” the court wrote.

Chronic hepatitis C is a virus that causes inflammation of the liver. It can eventually lead to cirrhosis, or significant liver scarring, which can in turn cause patients pain, bruising and organ failure. Drugs called direct-acting antivirals can cure hepatitis, but the treatment can cost more than $80,000.

The outcome of the lawsuit could affect scores of inmates, said Tony Rothert, legal director of the ACLU of Missouri.

"The court found a a minimum there are 2,000 people with chronic HCV who are not being treated in the Missouri Department of Corrections," he said. "We think there are closer to 5,000."

Representatives of the Attorney General's Office could not be reached for comment.

Health experts estimate hepatitis C affects 1 percent of the population, but 15 percent of prison inmates.

Although the case has been certified as a class action, the plaintiffs will still have to prove their case in court. They aren’t seeking monetary damages, but instead want the Department of Corrections to provide all inmates who qualify with antiviral drugs.

Read the full decision here: 


Follow Sarah on Twitter: @petit_smudge

Sarah Fentem is the health reporter at St. Louis Public Radio.