Case: Floreal-Wooten v. Helder

This is a case about the administering of Ivermectin to incarcerated people without prior informed consent. On January 13, 2022, several detainees at Washington County Detention Center (WCDC), filed this suit in U.S. District Court for the Western District of Arkansas. The plaintiffs sued WCDC and the Sheriff of Washington County (collectively “the County defendants”); several John/Jane Doe correctional officers; and Karas Correctional Health, P.L.L.C. (KCH) and its owner (collectively “Karas”) under 42 U.S.C. § 1983, alleging violations of their Fourteenth Amendment due process and equal protection rights. Represented by private counsel acting on behalf of the Arkansas Civil Liberties Union Foundation, the plaintiffs sought declaratory and injunctive relief. They claimed that the defendants had administered Ivermectin as a supposed treatment of COVID-19 without prior informed consent as to the nature and side effects of the drug. The case was assigned to Judge Timothy Lloyd Brooks.

In their complaint, the plaintiffs alleged that Karas provided the County defendants with healthcare services for detainees at WCDC and that they started to use Ivermectin as a treatment for detainees with COVID-19 as early as November of 2020. According to the complaint, Karas posted publicly about the use of Ivermectin at WCDC and the County defendants were likely aware of the use of the drug at WCDC. After the plaintiffs tested positive for COVID-19 in August 2021, they were relocated to a quarantine block and subsequently given “a cocktail of drugs by Karas defendants to allegedly treat COVID-19.” The plaintiffs alleged that this cocktail included high doses of the drug Ivermectin. Ivermectin is approved by the FDA to treat infections by some parasitic worms, head lice, or skin conditions, like rosacea. The plaintiffs alleged that they were given far over the approved dosage of the drug and that at no point were they told that they were consuming Ivermectin nor were they informed of the potential side effects. Ivermectin was not approved or authorized by the FDA to treat COVID-19 in humans and the FDA had issued a warning against using it to treat COVID-19. The plaintiffs experienced a variety of side effects because of the administration of the drug and filed grievances as a result, thereby exhausting their administrative remedies. 

The plaintiffs alleged that the defendants violated their Fourteenth Amendment due process and equal protection rights. First, the plaintiffs argued that they had a due process right to voluntary and informed consent and that they possessed a significant liberty interest in receiving appropriate medical treatment and avoiding the unwanted administration of drugs. Next, the plaintiffs alleged that they were denied information about the drug that was provided to Karas’s non-incarcerated patients. They alleged that Karas had posted publicly about administering Ivermectin to both the WCDC detainees and his private clinic patients, including information about the drug, dosage, and its potential side effects. The plaintiffs argued that Karas had not treated its private clinic patients and the detainees the same because the detainees did not have access to this information and were not made aware of it. They further argued that “all patients enjoy a fundamental and significant liberty interest in the right to informed consent to medical treatments.” The plaintiffs asserted that “Karas defendants have neither a rational nor a compelling governmental interest in treating COVID-19 patients—incarcerated or not—differently as it relates to obtaining informed consent prior to the administration of medical treatment, including for the drug Ivermectin.”

On April 12, 2022, the defendants filed a motion for judgment on the pleadings arguing that the plaintiffs’ claims were moot. The defendants asserted that all of the plaintiffs were then incarcerated at the Arkansas Department of Corrections, not at WCDC, and that they were not at risk of being incarcerated at WCDC soon or ever again. 

On June 16, 2022, the court consolidated this case with Fritch v. Karas, 5:21-cv-05156, with this case serving as the lead case. 

On July 6, 2022, the plaintiffs filed an amended complaint, substantially altering the initial complaint. The amended complaint added the plaintiffs from the consolidated case, as well as a claim of battery against the Karas defendants. The plaintiffs argued that the administration of Ivermectin was offensive contact because it was inflicted without knowledge or consent. The plaintiffs also dropped their equal protection claim against Karas and dropped all claims against WCDC. The only remaining defendants were the Sheriff and Karas. After filing of the amended complaint, on July 22, 2022, the court denied the defendants’ motion for judgment on the pleadings as moot.

On September 18, 2022, the defendants again moved for judgment on the pleadings, lodging a number of arguments and affirmative defenses. According to the defendants, the plaintiffs’ due process claims should be dismissed because they alleged a substantive due process claim that did not apply in their circumstances. The defendants argued that the Supreme Court had only found that the right to bodily integrity is violated when a person is forced to have a medical procedure. Here, the defendants argued, the plaintiffs were not forced to take Ivermectin. The defendants also asserted that “allegations of lack of informed consent stem from claims of medical malpractice and are negligence-based claims.” The defendants also asserted that the individual defendants (the Sheriff and the owner of Karas) were entitled to qualified immunity because the plaintiffs had failed to allege the violation of a clearly established constitutional right. They further argued that the Sheriff had no personal involvement in the treatment of the plaintiffs and therefore could not be liable for any treatment decisions made. Finally, the defendants argued that the plaintiffs’ battery claim was barred by statutory immunity. Pursuant to Arkansas state law, county agents were immune from tort liability. The defendants also argued that the plaintiffs had not alleged any “touching” that was offensive or harmful. 

On March 16, 2023, the court denied the defendants motion for judgment on the pleadings. The court found that the plaintiffs had sufficiently stated a claim for a substantive due process violation because they had not known they were taking Ivermectin when it was administered to them. The defendants’ argument that the plaintiffs had taken the drug voluntarily was not convincing because the plaintiffs could not refuse the drug if they didn't know what they were taking. The court also found that, if the facts asserted by the plaintiffs were true, the actions of the defendants would “shock the conscience.” In regards to the defendant Sheriff, the court found it plausible that he knew or should have known about Karas’s actions and that he either approved them or turned a blind eye. The court found that the defendants were not entitled to qualified immunity because they had violated a constitutional right and that right was clearly established. Lastly, the court found that the plaintiffs had stated a plausible claim for medical battery “based on affirmative concealment and intentional—rather than negligent—failure to obtain informed consent.” The court also found that statutory immunity only applied to torts of negligence and not intentional torts, which battery clearly was. 

On July 26, 2023, the defendants filed a motion for summary judgment. They argued that there was no constitutional violation based on the facts and that both individual defendants were entitled to qualified immunity. As for KCH, the defendants asserted that the organization did not have an unconstitutional policy or practice that caused an underlying constitutional violation. They argued that summary judgment was also warranted for the battery claim against the Karas defendant because the plaintiffs had failed to allege that Dr. Kara, or anyone else, had administered the Ivermectin to the plaintiffs or had any personal involvement with them. Since the alleged battery was not foreseeable, KCH could also not be found vicariously liable. 

On September 29, 2023, the court dismissed the case with prejudice in light of the parties arriving at a settlement. The Karas defendants agreed to pay $10,000 with each plaintiff receiving $2,000 in exchange for the plaintiffs dismissing all of their claims.

As of September 29, 2023, this case is closed.