The district court held that it does and entered a permanent injunction mandating across-the-board DAA treatment. NEWSOM, Circuit Judge: This case principally presents the question whether the Eighth Amendment requires Florida prison officials to treat all inmates with chronic Hepatitis C- including those who have only mild (or no) liver fibrosis-with expensive, stateof-the-art “direct acting antiviral” (DAA) drugs. _ Appeal from the United States District Court for the Northern District of Florida _ (August 31, 2020) Case: 19-11921 Date Filed: Page: 2 of 58 Before MARTIN, NEWSOM, and BALDOCK,* Circuit Judges. 4:17-cv-00214-MW-CAS CARL HOFFER, Individually and on behalf of a class of persons similarly situated, RONALD MCPHERSON, Individually and on behalf of a class of persons similarly situated, ROLAND MOLINA, Individually and on behalf of a class of persons similarly situated, Plaintiffs - Appellees, versus SECRETARY, FLORIDA DEPARTMENT OF CORRECTIONS, Defendant - Appellant. The state’s plan to monitor all HCV-positive inmates, including those who have not exhibited serious symptoms, and provide DAAs to anyone with an exacerbating condition, showing signs of rapid progression, or developing even moderate fibrosis, satisfies constitutional requirements.Ĭase: 19-11921 Date Filed: Page: 1 of 58 IN THE UNITED STATES COURT OF APPEALS FOR THE ELEVENTH CIRCUIT _ No. Ultimately, the court ordered DAA treatment of all F0s and F1s within two years of their initial staging. Florida adopted Dewsnup's proposal of providing DAAs for all inmates at level F2 and above and monitoring F0- and F1-level inmates and treating them with DAAs under certain circumstances. Dewsnup, who had developed and implemented an HCV-treatment plan for the Oregon prison system. 1983, alleging deliberate indifference to inmates’ serious medical needs. DAAs are very expensive.Ĭhronic-HCV inmates incarcerated in Florida prisons filed a class action under 42 U.S.C. In 2013, a new HCV treatment became available-direct-acting antiviral (DAA) pills, with few side effects and a 95% cure rate. HCV patients were previously prescribed weekly injections of Interferon, which caused unpleasant side effects, and succeeded in eradicating HCV only about 30% of the time. Many people “spontaneously clear” HCV without treatment. HCV primarily attacks the liver, causing scarring, or “fibrosis,” which is measured from F0 (no fibrosis) to F4 (cirrhosis). Only about 1% of the general population suffers from HCV its prevalence among prison inmates is much higher.
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