Samuel v. Centene Corp.

1

HARRY SAMUEL, CHRISTOPHER ROBERT DESMOND, and ARTHUR GOVAN, individually and on behalf of others similarly situated, Plaintiffs, v. CENTENE CORPORATION, CENTURION OF DELAWARE LLC, VITALCORE HEALTH STRATEGIES, ACTING COMMISSIONER TERRA TAYLOR, FORMER COMMISSIONER CLAIRE M. DEMATTEIS, FORMER COMMISSIONER MONROE B. HUDSON, JR., MEDICAL DIRECTOR DR. AWELE MADUKA-EZEH, and BUREAU CHIEF MEDICAL RECORDS, Defendants.

Civil Action No. 23-1134-JLH-SRF

United States District Court, D. Delaware

July 26, 2024

REPORT AND RECOMMENDATION

Sherry R. Fallon United States Magistrate Judge

Presently before the court in this civil rights case are four motions to dismiss for failure to state a claim upon which relief can be granted under Federal Rule of Civil Procedure 12(b)(6) and two motions to strike, as follows:

MOVANT(S)

MOTION

D.I. #

RECOMMENDED DISPOSITION

VitalCore Health Strategies (“VitalCore”)

Motion to Dismiss under Fed.R.Civ.P. 12(b)(1) and 12(b)(6)

D.I. 21^[1]

GRANT-IN-PART

Centurion of Delaware LLC (“Centurion”)

Motion to Strike Class Allegations

D.I. 23

DENY

Centurion

Motion to Dismiss under Fed.R.Civ.P. 12(b)(6)

D.L 25^[2]

GRANT-IN-PART

Centene Corporation (“Centene”)

Motion to Dismiss under Fed.R.Civ.P. 12(b)(6)

D.I. 27^[3]

DENY

Terra Taylor, Claire M. DeMatteis, Monroe B. Hudson Jr., Dr. Awele Maduka-Ezeh, and Michael Records (collectively, the “DOC Defendants”)

Motion to Dismiss under Fed.R.Civ.P. 12(b)(1) and 12(b)(6) or, alternatively, Strike Class Allegations

D.I. 53^[4]

GRANT-IN-PART

I. BACKGROUND

Plaintiffs Harry Samuel, Christopher Robert Desmond, and Arthur Govan individually and on behalf of all others similarly situated (collectively, “Plaintiffs”), brought this putative action against defendants VitalCore, Centurion Centene, and the DOC Defendants (collectively “Defendants”) on October 11,2023. (D.I. 1) Plaintiffs, who are incarcerated in Delaware correctional facilities, contend that their rights under the Eighth and Fourteenth Amendments of the U.S. Constitution were violated by Defendants' failure to provide them with adequate medical care from April 1,2020 through the present (the “Class Period”). (Id. at ¶¶ 1-4,156)

On November 14, 2019, the Delaware Department of Corrections (“DOC”) issued a request for bids to operate the prison healthcare system. (Id. at ¶ 94) The following week, Centene created Centurion, a wholly owned subsidiary, to bid on the contract. (Id. at ¶ 95) The DOC selected Centurion's bid, and Centurion assumed contractual responsibility for providing healthcare services to Delaware inmates on April 1, 2020. (Id. at ¶¶ 105,108) The complaint alleges that Centene centralized oversight of its medical programs, operated a unified corporate compliance program, and treated Centurion's revenues as its own. (Id. at ¶¶ 98-102)

From April 1, 2020 to the end of Centurion's contractual term on June 30,2023, Centurion allegedly understaffed the prison healthcare system, failed to adequately supervise its staff, retained staff who were not qualified for their positions, and delayed and denied health care to inmates in contravention of its contractual obligations. (Id. at ¶¶ 118-23, 131-32) The complaint provides examples of Centurion's systemic failure to provide adequate and timely healthcare to the three named Plaintiffs and other inmates. (Id. at ¶¶ 26-82)

Samuel began to experience severe bleeding and sought emergency care from Centurion staff on November 29, 2022. (Id. at ¶ 27) He was seen by a staff member the following day but received no treatment for his symptoms. (Id. at ¶ 28) When Samuel's symptoms worsened on January 1, 2023, a staff member referred him to a Centurion physician assistant. Five days later, Samuel was diagnosed with diverticulosis and was prescribed over-the-counter fiber tablets and a stool softener. (Id. at ¶¶ 30-32) The following month, Samuel was taken to the infirmary on an emergency basis for extensive blood loss, and he was ultimately transported to BayHealth Emergency Department. (Id. at ¶¶ 33-35) The examining physician indicated that Samuel required surgery and needed to see a specialist, but Centurion failed to provide him with a specialist consultation and/or surgery prior to the expiration of its contract on June 30,2023. (Id. at ¶¶ 35-36)

On September 15, 2022, Govan began to experience prostate and urinary problems which were confirmed by blood work results. (Id. at ¶ 41) He received a referral for specialist healthcare on September 26, but he was never taken to a urologist. (Id. at ¶¶ 42-44) Govan received another urology referral in May of 2023, but he did not see a urologist before the June 30, 2023 expiration of Centurion's contract. (Id. at ¶¶ 45-46)

Desmond was placed in the Chronic Care Program because he suffers from chronic high blood pressure, heart disease, high cholesterol, and kidney disease. (Id. at ¶¶ 49-50) Despite his chronic conditions, Centurion staff withheld his prescribed blood pressure medication for 47 days, and he was not brought to the cardiologist on a regular basis. (Id. at ¶¶ 51-52) Desmond did not have a colonoscopy or see a dermatologist despite his elevated risks of colon and skin cancer. (Id. at ¶ 53)

Other unidentified inmates also experienced a broad range of health issues for which appropriate medical care was delayed or denied. (Id. at ¶¶ 55-82) Their conditions included hernias, joint pain, brain damage and seizures, injuries resulting from sexual assault, gastrointestinal problems, mental illness, opioid addiction, prostate issues, back injuries, stroke, heart attack, infection, asthma, kidney disease, and nerve damage. (Id.)

On January 10,2023, Centene sold Centurion to an undisclosed buyer for $236 million. (Id. at ¶¶ 23,126-29) Centurion continued its practices of understaffing, failing to supervise, and delaying and denying health care for serious conditions between January 11 and the end of its contractual term on June 30, 2023. (Id. at ¶¶ 130-32, 167-72,178,180) The DOC did not renew its contract with Centurion and instead awarded the correctional health care contract to VitalCore after an expedited bidding process. (Id. at ¶¶ 133-41) VitalCore's contract runs from May 1, 2023 to June 30, 2026. (Id. at ¶¶ 142-43)

When VitalCore assumed responsibility for inmate healthcare, it gained access to personnel records, unfilled position descriptions, grievances, records on the use of outside specialists, and records on the timing of responses to sick calls. (Id. at ¶¶ 145-48) Nonetheless, VitalCore hired Centurion's existing staff. (Id.) The alleged deficiencies in the medical care provided by Centurion continued under VitalCore. (Id. at ¶¶ 149-54)

Although Samuel received a bone scan and a colonoscopy after VitalCore's contractual term began, he was denied further treatment when those tests revealed terminal prostate and rectal cancer. (Id. at ¶¶ 38-39) Samuel passed away on April 21,2024. (D.I. 74) Despite receiving a second referral for an urgent consult with a urologist on May 11, 2023, Govan still had not seen a specialist as of the filing of the complaint on October 11, 2023. (D.I. 1 at ¶¶ 4547) As a result, Govan still does not know whether he has prostate cancer. (Id. at ¶¶ 40,47-48) Desmond still has not seen a cardiologist or dermatologist, and he has not had a colonoscopy. (Id. at ¶¶ 52-54)

The complaint also attributes liability to the DOC Defendants in their individual capacities. (D.I. 76 at 46:22-47:4) DeMatteis, Hudson, and Taylor served consecutively as Commissioners of the DOC during the Class Period and had a constitutional and statutory duty to provide medical care to inmates. (D.I. 1 at ¶¶ 84-85) DeMatteis was responsible for contracting with Centurion and made payments throughout the contractual period without seeking to terminate the contract for cause despite Centurion's alleged breaches. (Id. at ¶¶ 19, 87, 108, 125) Hudson selected VitalCore as Centurion's successor in an expedited bidding process when the term of Centurion's contract ended. (Id. at ¶¶ 87, 133-38, 141) Taylor took over for Hudson as Acting Commissioner on July 6,2023, after working as Deputy Commissioner since August of 2022. (Id. at ¶¶ 17, 125) The complaint alleges that DeMatteis, Hudson, and Taylor failed to supervise Centurion and VitalCore. (Id. at ¶ 92)

Records has served as Bureau Chief since November 8, 2021, and he served as deputy Bureau Chief prior to that date, supervising Centurion and VitalCore and overseeing the operation of the grievance system to ensure timely and proper investigation and remediation of all grievances submitted by inmates. (Id. at ¶¶ 17, 21) The complaint alleges that Records routinely denied grievances without investigating the facts or requiring Centurion and/or VitalCore to provide the recommended medical care to inmates. (Id. at ¶¶ 88-89)

Maduka-Ezeh has served as the Medical Director throughout the Class Period and was responsible for ensuring that Delaware inmates received adequate healthcare in a timely fashion. (Id. at ¶ 20) Maduka-Ezeh purportedly admitted under oath that Centurion and VitalCore failed to provide the requisite medical care or maintain adequate records, yet she took no action to terminate the contracts for cause. (Id. at ¶¶ 90-91)

n. DISCUSSION

A. Exhaustion of Administrative Remedies

VitalCore and the DOC Defendants allege that Plaintiffs failed to exhaust their administrative remedies under the Prison Litigation Reform Act (“PLRA”), 42 U.S.C. § 1997e(a), before filing this suit. (D.I. 22 at 26; D.I. 55 at 16) This argument is not persuasive. The Third Circuit has explained that, “[b]ecause failure to exhaust is an affirmative defense for the defendants to plead and prove,” plaintiffs are not required to plead or demonstrate...