Francisco Castaneda, an immigrant from El Salvador, was detained by U.S. Immigration and Customs Enforcement (ICE) from March 2006 through February 2007. He spent most of his detention at the San Diego Correctional Facility (SDCF), operated by Corrections Corporation of America, the nation’s largest private prison operator.
Immediately upon arriving at SDCF, Mr. Castaneda complained to medical staff about a bleeding lesion on his penis. United States Public Health Service medical personnel, senior ICE officers, and administrators within the Division of Immigration Health Services (DIHS) knew that the lesion on Mr. Castaneda’s penis urgently required a biopsy to determine whether he had penile cancer. Not only did Mr. Castaneda repeatedly file urgent requests for medical care, but he resorted to showing guards and medical officials his bloody underwear and bed sheets. They gave him clean replacements, but he never got the medical care he needed.
Eventually, after an evaluation by an outside urologist, Mr. Castaneda learned that the end-result of eleven months of indifference at the detention centers was that he almost certainly had penile cancer. Indeed, near the end of his detainment, he developed a growth near the base of his penis that medical professionals thought could be a tumor, suggesting cancer that had spread. As a result of agitation by the ACLU’s National Prison Project, DIHS finally approved and scheduled a biopsy for Mr. Castaneda. A couple of days before the appointment, however, ICE suddenly released him from custody – thereby releasing the federal government from financial responsibility for the medical care and treatment that Mr. Castaneda would likely – and, as it turns out, did – require.
Frightened by his condition, Mr. Castaneda went to the emergency room at a local hospital in Los Angeles. A biopsy performed on the lump near the base of his penis confirmed that he had invasive squamous cell carcinoma. The doctors advised immediate amputation, noting that, even with surgery, Mr. Castaneda might have no more than a year to live based on their suspicion that the cancer had spread. On Valentine’s Day, February 14, 2007, Mr. Castaneda’s penis was removed.
As Mr. Castaneda underwent chemotherapy in hopes of arresting the cancer and saving his life, Public Justice filed a lawsuit on his behalf in November 2007 against the U.S. government, several federal and California state officials, and a California physician. The suit includes medical neglect claims under the Federal Tort Claims Act and California law, and Bivens claims for violating Mr. Castaneda’s constitutional rights to adequate medical care and equal protection under the laws.
“This case is the quintessential example of what the Eighth Amendment’s prohibition on cruel and unusual punishment was intended to prevent,” said lead counsel Conal Doyle of Willoughby Doyle, LLP in Oakland, California. “Federal officials will never be able to adequately explain their refusal to follow the recommendations and orders of the doctors to whom they sent Mr. Castenada for evaluation.”
Mr. Castaneda died in February 2008, one year after he was released from custody, diagnosed with cancer, and submitted to radical surgery in what turned out to be a futile attempt to arrest the cancer and save his life. Family members were substituted as plaintiffs in an amended complaint.
The federal government argued that the Federal Tort Claims Act (FTCA) makes a lawsuit against the United States the exclusive remedy for illegal actions by government doctors and other officials, but the U.S. Court of Appeals for the Ninth Circuit unanimously ruled on October 2, 2008 that Public Health Service (PHS) officials are not immune from a Bivens action, which allows individuals to sue federal employees for constitutional violations.
In a sharp rebuke of the defendants’ immunity argument, Judge Milan D. Smith, Jr., writing for the three-member panel, described former detainee Francisco Castaneda’s ordeal as a “Kafkaesque nightmare” stemming from not only the government’s “alleged deliberate indifference, but also from Castaneda’s state-imposed helplessness in the face of that indifference.”
In upholding the district court’s decision, the appeals court found in Castaneda v. United States that the PHS defendants “provided no explanation for why Congress would want to provide these persons with the privilege, shared with no other federal employees, to violate the Constitution without consequence.”
“This is a landmark civil rights decision,” said Conal Doyle, Public Justice’s lead counsel in the case. “The Court has ensured that the ‘Kafkaesque nightmare’ endured by Mr. Castaneda will not go unpunished. We intend to relentlessly pursue this case until every government official is held accountable for the atrocities inflicted upon this helpless detainee.”
Castaneda’s case drew national attention when he shared his horror story with a House subcommittee in October 2007, explaining that California state officials and U.S. immigration officials had repeatedly refused him reasonable and humane medical care, including a critical biopsy, even though it had been recommended by state, federal, and private doctors.
The U.S. government has admitted that its negligence caused Mr. Castaneda’s death, but it has not admitted the many other claims still pending.
“The court’s decision will play a critical role in protecting detainees’ constitutional right to adequate medical care,” said Public Justice Managing Attorney Adele Kimmel, co-counsel for Castaneda. “The doctors, nurses, and other public health officials who provide medical care to detainees are now on notice that they can be held accountable for disregarding detainees’ medical needs.”
In addition to Doyle, a partner in Willoughby Doyle of Oakland, Calif., and Kimmel, the Public Justice legal team includes Public Justice Goldberg, Waters & Kraus Fellow Amy Radon and Thomas Dempsey of Los Angeles.