A Seattle federal jury has determined NaphCare owes $25 million to a man who claimed his leg had to be partially amputated because the correctional healthcare provider failed to address signs of his declining health after he suffered blood clots while behind bars at a Washington county jail.

Following a 10-day trial and more than eight hours of deliberations, the jury found on Friday that NaphCare Inc. violated Javier Tapia’s right to adequate medical care under the 14th Amendment while he was being held at the Pierce County Jail in 2018. The verdict form shows jurors also concluded NaphCare employees “acted pursuant to a widespread or longstanding custom” of the company, ultimately resulting in Tapia’s injury, and they awarded the plaintiff $5 million in compensatory damages and $20 million in punitive damages.

Tapia presented evidence at trial that NaphCare put profit over care by allowing licensed practical nurses to act beyond the scope of their licensure, relying on jail guards to conduct medical monitoring instead of trained healthcare professionals, and failing to adequately communicate with the jail’s mental health professionals about inmate’s need, according to plaintiff’s attorney Ryan David Dreveskracht of Galanda Broadman PLLC.

“For Javier, this is one step toward his goal of making sure that this never happens again to anyone incarcerated in our community jails,” Dreveskracht told Law360 on Monday. “The jury did the right thing to send a message to NaphCare: That if you are going to operate in Washington state and in our jails, providing care to the most vulnerable population in our communities, you need to do it right.”

A NaphCare spokesperson said Monday that the company is “disappointed that the life-saving care provided by our healthcare staff was not acknowledged.

“Despite the outcome of this case, we believe in the diligence and professionalism of our team,” the spokesperson said. “We fundamentally disagree with the outcome and will move forward with appeal.”

Tapia first sued the correctional healthcare provider in state court in 2021, claiming he developed an initial blood clot at the jail in mid-September 2018 and continued to suffer for two weeks without proper medical attention, as his leg and foot blistered and festered with infection. According to the lawsuit, Tapia was booked into the jail in June 2018 on suspicion of driving a stolen vehicle, as well as outstanding warrants from the Washington State Department of Corrections. About three months into his stay at the jail, a corrections deputy noted he was having trouble following basic rules, the suit said.

Over the two-week span in September 2018, while Tapia was in solitary confinement, the jail’s mental health professionals documented concerning symptoms as his mental health deteriorated, Tapia’s attorney said. But he was not medically evaluated by NaphCare until Oct. 1, 2018, when he was sent to Tacoma General Hospital with a swollen black foot a nurse described as “suspected gangrene.”

“By the time that he finally got to Tacoma General Hospital, his foot was basically dead and rotting from the toes,” Dreveskracht told Law360.

Doctors later determined more clotting had built up when the first blood clot went unaddressed, hardening the veins in Tapia’s left leg to the point that the limb had to be surgically removed below the knee, according to the plaintiff’s counsel.

In court filings, NaphCare denied that it had any practices or customs that went against inmates’ constitutional right to medical care, while also arguing that Tapia couldn’t prove the company’s workers were to blame for his injuries.

In a March 10 trial brief, NaphCare said Tapia suffered from “phlegmasia cerulea dolens,” described as a rapid-onset vascular condition that’s often lethal but does not affect a person’s mental state. Tapia did not raise concerns about his foot until Oct. 1, 2018, when NaphCare employees noticed the discoloration and immediately sent him to the hospital, the correctional healthcare provider said.

“By responding immediately to Tapia’s emergent and deadly condition, NaphCare and its nurses saved Tapia’s life,” the company said in the brief. “They did not recklessly disregard any obvious risk to his health.”

Dreveskracht, however, told Law360 it was a corrections officer who flagged Tapia’s black foot on Oct. 1, 2018. Tapia himself had been nonverbal for weeks, as documented by jail guards and the county’s mental health professionals.

“These are all the signs of someone who was mentally decompensating because of the blood clots in his leg,” the plaintiff’s attorney said. “He could not alert people because he was very, very sick.”

Tapia also asserted negligence claims against Pierce County, court records show. However, he agreed to drop those claims after reaching a settlement with the county, according to a March 7 stipulation.

Tapia is represented by Ryan Dreveskracht and Corinne Sebren of Galanda Broadman PLLC and Ed Budge of Budge & Heipt.

NaphCare is represented by David A. Perez, Juliana Bennington, Shae McPhee and Jacob Dean of Perkins Coie LLP.

The case is Tapia v. NaphCare Inc et al., case number 2:22-cv-01141, in the U.S. District Court for the Western District of Washington.

–Editing by Linda Voorhis.