ACLU of Arizona Sues County Officials Over Inhumane Confinement of TB Patient

Affiliate: ACLU of Arizona
May 31, 2007 12:00 am

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PHOENIX, AZ – The American Civil Liberties Union of Arizona today filed a lawsuit on behalf of Robert Daniels, a tuberculosis patient who has been held in the jail ward at the Maricopa Medical Center for the past nine months, charging that treating a severely ill patient like a criminal is inhumane and unconstitutional.

“Individuals quarantined because of public health risks are held under civil rather than criminal laws,” said Daniel J. Pochoda, ACLU of Arizona Legal Director. “Robert Daniels is a sick patient who has been detained for non-punitive purposes and public health officials are legally and morally obligated to treat him in a humane manner.”

Daniels was placed in quarantine at the jail ward of the county hospital in August 2006. He was diagnosed with an extremely drug-resistant strain of tuberculosis (TB) that he will probably live with for his entire life, even if he becomes non-contagious. At a hearing in July 2006, Daniels was involuntarily committed after Maricopa County Public Health Department officials claimed he was a serious public health risk for not wearing a mask while visiting a local convenience store. One month later he was thrown in jail.

“I’m slowly dying in this room,” said Daniels, who has a wife and daughter in his native Russia. “I didn’t realize how serious this was, and I regret that, but nothing justifies the kind of treatment I’ve received in here. The solitary confinement starts to mess with your head and it has taken a serious toll on my body.”

In its complaint, the ACLU argues that the county has failed to implement procedures on how to humanely quarantine sick patients for lengthy periods of time, and in an effort to cut costs deliberately failed to explore alternative locations in which to quarantine Daniels. Maricopa County Sheriff Joe Arpaio publicly stated that in the interest of security he would treat any person housed in the jail ward in the same manner as all other jail inmates.

Like jailed inmates accused of crimes, Daniels is subjected to intrusive strip searches and he is unable to receive any visits from family and friends. He isn’t permitted to exercise or walk outside, and has no access to social or recreational activities like the Internet. He has been outside only once in the past nine months, and was shackled hand and foot. The lights in his cell are required to be kept on at night, and video cameras record his every move. He can’t see through the frosted windows in his room and wasn’t able to shower or call anyone until a few weeks ago.

“It’s psychologically damaging to exist in a vacuum without meaningful activities or opportunities to interact with others,” said ACLU of Arizona cooperating attorney Linda Cosme. “By placing Robert Daniels in these deplorable conditions, the county clearly has no intention of helping him get better. For years, they’ve been aware of the need to create an adequate quarantine area for extremely ill patients, yet they’ve chose to ignore the needs of some of the most vulnerable people in Maricopa County in favor of harsh, jail-like conditions for people who are sick and accused of no crimes.”

Further, Cosme said, there is little evidence that Maricopa County has followed state law, which requires the county to provide Daniels with the least restrictive environment for the quarantine.

“The power to forcibly detain and confine a person is an extraordinary power and, like all government powers in a civilized democracy, can never go unchecked,” said Barry Steinhardt, Director of the ACLU’s Technology and Liberty Project. “Quarantine and isolation must be last resorts that are employed only after less restrictive alternatives have been employed and failed, or are impossible to use under the circumstances.”

While the ACLU is not challenging or questioning the county’s decision to place Daniels in quarantine, the organization’s lawsuit charges that the conditions of his confinement are not conducive to the successful treatment of his illness and that the county failed to follow professional standards for confining patients with drug-resistant TB patients.

“Voluntary quarantine at home is usually the most extreme scenario that we typically encounter, so this is a very rare case,” said George J. Annas, Chairman of Health Law Department at the Boston University School of Public Health. “There are no real protocols for treating extensively drug-resistant TB, but that doesn’t justify treating him like anything but a sick patient in a hospital.”

The ACLU argues in its lawsuit that the county is violating Daniels’ Fifth and Fourteenth Amendment rights to due process and equal treatment and has substantially deprived him of his fundamental rights to liberty, travel and privacy. The ACLU also asserts that county health officials have violated Daniels’ rights under the Americans with Disabilities Act of 1990 (ADA). Because Daniels has a contagious and drug-resistant form of TB, he has a serious, long-term physical impairment and is considered a disabled person under the ADA guidelines.

The ACLU is asking the court to issue a preliminary injunction forcing the county to provide Daniels with “reasonable accommodations” in a hospital ward that are helpful for his mental and psychological well being, including giving him additional privacy, allowing him to walk outdoors and interact with family members and friends, and providing him with access to a computer.

The ACLU also is asking the court to require the county to adopt policies with specific guidelines for implementing the least restrictive environment for contagious people and to require the state to provide adequate funding to appropriately quarantine people with long-term, contagious illness.

The ACLU’s lawsuit, Daniels v. Robert England et al., was filed late this evening in federal district court in Phoenix. (Case No: 2:07-cv-1080). The complaint is attached in .pdf format.

To read a statement on the ACLU’s views on a recent quarantine case in Atlanta, go to:

To read the ACLU’s comments on the CDC’s proposed rules on the quarantine of travelers, visit:

A Q&A on the Model State Emergency Health Powers Act is online

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