The Supreme Court today hears argument about whether the family of a Southern California man can sue over poor health care the man received while in federal custody. The case Hui v. Castaneda could clarify what kind of medical care the government owes people it's detained.
Francisco Castaneda crossed illegally into the U.S. when he was 10, with his sister, two brothers, and his widowed mother. The Salvadoran immigrant worked from the age of 17, and built a family of his own in L.A.
In 2005, he got picked up on a drug possession charge. His conviction meant months in state jail, then federal custody. His sister Yanira remembers one call from a federal detention center. "He goes yeah, I think I have cancer," she says softly. "I remember I was screaming, I was like no, I couldn’t believe it."
Immigration and Customs Enforcement held Francisco Castaneda as he awaited a deportation hearing. From his first day in custody records from federal health service doctors and other professionals show Castaneda told them he had a painful lesion he worried was cancerous.
Los Angeles lawyer Conal Doyle has his own firm and works with the group Public Justice; he represents Castaneda. "One of the providers that was employed with the federal government saw him and described the lesion on the end of his penis as if you had taken a mushroom, taken off the stem and smashed it with a hammer," he says. "It was cracking and bleeding and didn't smell right and didn't look right."
Immigration officials released Castaneda after 11 months without ever testing for cancer. When doctors at UCLA-Harbor hospital amputated his penis a week after his release, cancer had spread to his lymph system.
His sister Yanira brought him home to the city of Bell, rolled a bed into her spotless, tiled living room and cared for her brother, who she called by his middle name, Alex. "He would cry at night. I would hear him cry – I don’t know if it was because of the pain," she says. Yanira is a faithful Christian. "God makes miracles. And I guess we were waiting for one. And it never happened," she says, gulping sobs.
Cancer killed Castaneda. He's one of more than a hundred detainees who have died in custody or soon after in the last 7 years. News investigations and immigrant rights groups have exposed inadequate medical care in dozens of these cases.
Immigration and Customs Enforcement won't comment on individual cases. Department of Homeland Security Secretary Janet Napolitano, who oversees ICE, has promised to improve health care practices.
Still, Loyola Law School professor Brietta Clark says courts haven't had much chance to define detainees' medical rights. "There are detention standards, medical standards that ICE has created. But they don't follow them," Clark says. "And there are no rules promulgated, there is no statute that makes them judicially enforceable."
Public Justice and Conal Doyle now represent Castaneda's family. Doyle argues public health workers' indifference to Castaneda's cancer violated his constitutional right to due process and amount to cruel and unusual punishment. "The United States has admitted liability in this case. They've admitted their negligence caused his death. And so the only issue really is whether we can pursue these individual claims against the actual medical personnel who cared for him individually," he says.
If so, Castaneda's family could win much more money, possibly millions, at trial. They'd proceed with what's called a Bivens claim. That's a claim named for a 1971 case, Bivens v. Six Unknown Named Agents of Federal Bureau of Narcotics. In that case, the Court held that people could allege Constitutional violations by federal employees even if no federal statute specifically allowed such a claim. Damages in Bivens lawsuits aren't subject to the same limits that other individual claims face under the Federal Tort Claims Act.
Doyle and UC Irvine law school dean Erwin Chemerinsky say large damages could force better public policy. "How are we going to deter prison officials from ignoring detainees' legitimate medical needs?" Chemerinsky asks rhetorically. "If there's no liability of the government officials in this circumstance, what's to keep them from ignoring these kind of problems with other inmates in the future?"
Still, Chemerinsky observes a growing hostility to these Bivens claims from conservative justices. "The Supreme Court in recent years has cut back very much on the ability to sue government officials when they violate the Constitution," he says.
Lawyers for Esther Hui and others argue Congress explicitly gave immunity to the Public Health Service for claims like these. That would limit the ways Castaneda could recover for the harm he suffered. In that case, the Federal Tort Claims Act would be the narrow path along which Castaneda could travel to recover damages. That act limits claims state-to-state; in California, the limit in damages would be about $250,000.
The Obama administration and a group of government health workers have filed friend of the court briefs backing federal employees. Both argue that claims like this could deter doctors and nurses from taking federal jobs.
Doyle says his client's claim asks nothing unusual from health professionals at detention centers. "All they need to do," he says, "is just provide basic care, and we have to prove that they were deliberately indifferent. It's a standard of criminal recklessness to hold a medical doctor liable for this kind of thing."
If the Supreme Court sides with Castaneda, his lawyers would still need to show a jury that federal employees were in fact that reckless. The court's decision in the case is expected this summer.