Subpoenas have been issued at your jail for an inmate claim that his continuing headaches were ignored and he was denied necessary treatment of his ‘serious medical need’. Your risk manager and legal counsel will be meeting with staff members involved in the case, including nurses involved in triaging the sick call slips. They are referring to this as a Section 1983 case…..

Although all nurses should have an understanding of nursing malpractice and the legal basis of their profession, correctional nurses have an added need to understand law. When I first entered the specialty I knew little about the importance of various constitutional amendments or civil rights legislation and my work actions. When I first heard the term “1983 Case” I made a mental note to check out that year and see what had happened that was so important. I was in nursing school in 1983. That was a long time ago and I didn’t remember much that was going on. However, 1983 is not a year but a section of US Civil Rights Act of 1871. This act was created to protect those who were being harassed by the Ku Klux Klan following the Civil War. Section 1983 of this act is the means through which US citizens can bring forward a civil claim that their constitutionally protected rights have been violated.

Section 1983 legal claims include false arrest, unreasonable searches, equal protection, and excessive force. For correctional nursing practice, Section 1983 claims involve abridgement of the 8^th or 14^th Amendment to the constitution as it relates to health care provision of prisoners or detainees. In Estelle v Gamble (1976) the Supreme Court ruled that denial of adequate medical care constituted “cruel and unusual punishment” as was protected against by the 8^th amendment to the constitution. Jail detainees are not yet prisoners being ‘punished’ and technically are not addressed in the 8^th amendment. However, Bell v Wolfish (1979) established this same need of adequate healthcare for unconvicted detainees under the 14^th amendment which protects due process for criminal conviction. In this case, the Supreme Court ruled that failure to provide medical care was a form of punishment imposed on an individual who had not been convicted of a crime. So, although unconvicted jail detainees and prison inmates have medical rights based on two different constitutional amendments, their medical care rights are essentially the same and legal claims of injustice are brought to court through Section 1983 of the Civil Rights Act.

So, a Section 1983 case is a civil rights case rather than a medical malpractice case and comes with a few peculiarities. Instead of looking to determine if the standard for nursing care was provided, a Section 1983 case is looking at the primary determinants of deliberate indifference to a serious medical need.  See my prior posts for more details on deliberate indifference and serious medical need. Although a Section 1983 case can be tried in either a state or federal court, plaintiff lawyers with background in these cases tend to lean toward federal courts as federal judges are receptive to claims of constitutional rights violations. Section 1983 claims also have a longer shelf-life as medical malpractice claims are governed by state law and can have a shorter timeframe for filing. In addition, plaintiff attorneys like Section 1983 cases because their fees, if they prevail, must be covered by the defendant (if reasonable). This element of the law allows for the pursuit of ‘smaller’ claims that might not otherwise be considered.

Have you heard the term ‘Section 1983’ or ‘1983 Case’ in your practice of correctional nursing? Share your experiences in the comments section of this post.

Photo Credit: © Matthew Benoit – Fotolia.com