Beruflich Dokumente
Kultur Dokumente
Alexandria Division
constitutional prohibition against the imposition of cruel and unusual punishment. The action
arises under the Eighth Amendment of the United States Constitution and 42 U.S.C. §1983 and
Virginia’s statutes governing death by wrongful act, Code of Va. §8.01-50 et seq. The court has
jurisdiction over the Eighth Amendment claims under 28 U.S.C. §1331 and over the wrongful
death claim against under 28 U.S.C. §1367, the latter claim being so related to the Eighth
1
Beginning at ¶20, the complaint duplicates, verbatim or in abbreviated form, factual
allegations set forth in the Statement of Material Facts comprising part of Ms. Walker’s
previously-filed memorandum in opposition to defendants’ pending motion for partial summary
judgment. There are no factual averments here that do not appear, documented and at greater
length, in Ms. Walker’s Statement of Material Facts. This second amended complaint is identical
to the amended complaint of record for the first nineteen paragraphs and in the statement of the
counts with three exceptions: (1) Merry Brinkley, voluntarily dismissed by Ms. Walker on
compassionate grounds by reason of her serious illness, is referred to as “former defendant”
rather than “defendant,” and grammatical and syntactical changes have been made to conform
the text to this state of affairs; (2) Count IV has been restated to reflect the allegations set forth
here, and (3) Count I contains an express rather than implied request for punitive damages.
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Amendment claims over which this court has original jurisdiction that it forms part of the same
case or controversy.
Parties
2. Plaintiff Obah Walker is the sister and the duly appointed administrator of the estate
of
the late Farah Saleh Farah, a mentally ill man 24 years of age, who died on January 23, 2008 of
dehydration after having been in the Alexandria jail for 13 days under defendants’ care.
contracting to provide health care to prisoners in certain American jails and prisons. At all
relevant times it was under contract to provide such services to the inmates of the Alexandria
Adult Detention Center (hereafter referred to as “the jail.”) CCS provided its services here at
issue through the work of its employees and agents, including the named and unnamed
employees and agents referred to in this complaint. In regard to the matters here at issue CCS
acted at all times under color of state and local law, in discharge of governmental obligations to
4. Defendants Nigist Ketema and JoAnn Smith were, at all relevant times, employees of
CCS working full time as nurses at the jail. On information and belief defendant Ketema was a
licensed practical nurse and defendant JoAnn Smith was a registered nurse. Their actions and
omissions here at issue were taken within the scope of their employment with CSS.
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5. Former defendant Merry Brinkley was, at all relevant times, an employee of CCS
working full time as the CCS medical administrator at the jail. On information and belief she
was a registered nurse. She was responsible for ensuring CCS staff performance in accordance
with the standards required by law, by CCS’s policies published to the sheriff and to the City of
Alexandria, and by CCS’s contract to provide medical services to jail inmates. She was on call
24 hours/day, 7 days/week to coordinate any health care issues. Her actions and omissions here
at issue were taken within the scope of her employment with CSS.
6. The defendants herein were all acting under color of state and local law in connection
with their actions here at issue, by reason of their undertaking to fulfill constitutional obligations
of the Alexandria sheriff in relation to ensuring the health and well-being of inmates committed
to the jail. Each defendant is a “person” within the meaning of 42 U.S.C. §1983.
Background Events
7. Plaintiff’s decedent Farah Saleh Farah was born in New York City in 1983. In 1991
he moved with his family to Alexandria, where he attended T.C. Williams High School. Until
approximately his eighteenth year Farah suffered from no significant mental health problems.
Starting in or around 2003, he began to display disturbing symptoms. In 2004 he was diagnosed
as suffering from paranoid schizophrenia. His condition was treated with medication.
8. When Farah stayed on his medication, he was functional, social, competent, and
friendly. When, as a result of his mental illness, he did not take his medication, he would,
among other things, starve himself and refuse water, becoming dehydrated to the point that on
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several occasions when he was brought by family members to the hospital for emergency
9. In approximately the spring of 2007, Farah, on information and belief off his
medication at the time, obtained a handgun. Shortly thereafter he was arrested for carrying a
concealed weapon. He was living at home at the time, with his parents and two sisters.
10. In November, 2007, Farah pleaded guilty to the charge of carrying a concealed
weapon. He was sentenced to serve three months in the Alexandria jail and nine months on
probation, conditioned (among other things) on his remaining on his medication as prescribed.
11. Farah reported to the jail on or about November 28, 2007. He stayed there until
12. During the period of Farah’s November -January incarceration, Farah stopped taking
his medication, Seroquel, an anti-psychotic. His mental condition notably worsened. He also
refused to see his family members, who, pursuant to jail protocol, could not see him without his
permission. He also stopped eating normally and lost weight. All these adverse behaviors
13. In December 2007, plaintiff Obah Walker spoke twice with unidentified personnel at
the jail by phone in an effort to provide and also to receive information about her brother’s
condition. On both occasions she described his periodic self-deprivation of food and water when
not on his medication. She asked for assurances that he was being properly cared for. On both
occasions, the person with whom she spoke declined to provide any information. One of the two
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14. During the period of Farah’s incarceration in November 2007 - January 4, 2008,
defendants were responsible for providing health care to jail inmates, including Farah. On
information and belief, all individual defendants were aware, via personal dealings with Farah or
from medical records that they were charged to maintain, of his illness, his failure to take his
medication, his failure to eat, and his significant mental and physical deterioration.
15. In the period prior to his discharge date of January 4, 2008, Farah began to exhibit
symptoms and behaviors sufficiently problematical that mental health staff at the jail deemed his
hospitalization appropriate. He was not brought to the Northern Virginia Mental Health
Institute, where he had previously been seen, because that facility required preliminary
laboratory studies which CCS would not provide. Arrangements were therefore made for
Farah’s transfer to Mt. Vernon Hospital, and a temporary detention order (“TDO”) mandating
his hospitalization there was secured. On or about January 4, 2008, Farah was discharged from
16. On January 7, 2008, Farah attended a civil commitment hearing for the purpose of
determining whether he would remain involuntarily detained at Mt. Vernon Hospital. While he
had at times refused to eat, he had been compliant with his medication while in the hospital, was
apparently oriented to his surroundings, and denied suicidal and homicidal ideation. The
presiding magistrate found that under the applicable legal standards, Farah could not be detained
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17. Following his release, Farah reported to his probation officer, as required. He told
his probation officer that he refused to take his medications, which he also said he did not need.
These statements were themselves manifestations of his mental illness. The probation officer
reminded him that taking his medications was a condition of his continued probation, and
directed him to return to the probation office on January 10 with his medications in hand.
18. On January 10, 2008, Farah reported back to the probation officer as directed. He
did not, however, have his medication with him, and said that he refused to take it, thereby
manifesting his mental illness. The probation officer thereupon requested issuance of an arrest
19. Later in the day on January 10, 2007, Farah was arrested for violating the terms of
his probation and brought back to the jail. He remained there until the day of his death 13 days
later.
20. At all relevant times, Farah was receiving mental health services from the Alexandria
Community Services Board (“CSB”), whose client he was. He saw CSB psychiatrists and social
21. The CCS staff knew of Farah as a mental health client of the CSB’s from his prior
history and from his identification as such on the jail’s booking unit bulletin board. At least some
of the CCS staff (not, however, including any defendants) also read Farah’s mental health
progress notes.
22. CCS and its employee defendants take the position that Farah, who as a CSB client,
was concededly under the care of a CSB psychiatrist, was not their patient at any relevant time.
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“The defendants deny that Farah Saleh Farah was under their care or the care of any of their
Amended Complaint, ¶2). As stated by CCS’s Chief of Institutional Operations, “[I]f [Farah had
a chronic care plan], it would be a psychiatric (sic) that would not be our responsibility.”
23. CCS denies (sic) that it was the responsibility of HSA Brinkley to be sufficiently
familiar with the jail medical and mental health records of the inmate patients seen at the jail so as
to be able to facilitate continuity of care for any ongoing medical or related conditions.
24. CCS denies (sic) that defendants Ketema and Smith, and HSA Brinkley, were
required to be familiar with Farah’s medical and mental health history at the jail so as to be able
25. The provision of health care in a correctional setting requires substantial specialized
training of otherwise educated health care professionals. CCS’s touted expertise in correctional
26. By its own admission, CCS provided no training on any of the following matters to its
nurses: the taking and recording of vital signs – why, and how often; distributing medication to
medications; identifying signs of dehydration; dealing with patients appearing to suffer from
dehydration; making notes on patient interactions or developments; when and why to call for
assistance from more fully credentialed health care personnel; when and why to recommend
emergency treatment or transfer to an emergency room; and the function of and testing for
electrolytes.
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27. All new employees were supposed to be oriented and trained relative to their duties
and responsibilities in the jail, including the policies and procedures set forth in the CCS nursing
Policies and Procedures Manual, and documentation of that orientation and training was to appear
28. None of the numerous LPNs who dealt with Farah, including defendant Ketema, has
an Operations Site Orientation Checklist or similar document documentation in his or her file.
Nor does defendant Smith, an RN, have any such document in her file.
29. Illemboyo Awosika, an LPN who was tasked to give Farah his medication, recalls
having received a copy of the CCS personnel manual but no other orientation documentation or
training. Another of Farah’s medication nurses, Shelby Crandall, could not recall, at her 2011
deposition, having looked at a CCS policy book since CCS took over the jail contract six years
earlier. She denied that CCS had any policy for addressing dehydration, and was not sure if one
existed for dealing with nausea or vomiting. Ms. Crandall received no training whatsoever from
30. On January 11, 2008, Farah received his initial medical and mental health screen at
the hands of CCS nurses. The physical assessment screening was not done. The mental health
screening and assessment form was not completed, notwithstanding that the nurse noted Farah’s
history of mental health medication and hospitalizations. His schizophrenia was not noted. The
screening nurse could not account for this incompleteness. Screening forms were to be reviewed
and counter-signed by a charge nurse. This too was not done. The screening nurse could not
explain what the review protocol, if any, was. The DON could not explain how this incomplete
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record had been generated, or if it had ever been discussed with anyone.
31. On January 14, 2008, Farah was seen by Albert Yoon, M.D., the CSB psychiatrist
who had been following him before his final incarceration. Dr. Yoon noted: “Came back 5 days
ago after violation of probation. Mental status: no change,” and prescribed continuation of the
Seroquel Farah had been receiving. Dr. Yoon’s note formed part of Farah’s CCS medical chart
and was available for review by CCS nurses and HSA Brinkley.
Health Care (“NCCHC”), requiring that a patient missing three consecutive doses of medication
33. Distribution of medication was done and documented by CCS nurses. Before
administering medication, nurses were to sign their names and place their initials at the bottom of
the MAR, so as to permit their identification. They would give medication to their patients and
place their initials in the square for the proper day and time. When a patient did not receive the
prescribed medication, the nurse was to circle his or her initials in the appropriate square, and on
the following page of the MAR explain the reason for the non-receipt. A refusal form was to be
34. Nurse Awosika was unacquainted with the protocol set forth in ¶33, notwithstanding
that he had worked in the jail since before CCS got the contract. Nurse Shelby Crandall
35. Farah’s MAR shows that he was to receive Seroquel, a psychotropic medication,
every morning and evening starting January 14, for sixty days. He received no medication on the
14th, nor any at 9 p.m. on January 15, there apparently being none “available.” Farah was not
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offered his medication on the morning of January 22 (the day before he died). This is not
explained. Farah never took his morning medication except possibly on the morning of January
18. He never took his afternoon medication except possibly on the afternoon of January 21.
36. Out of the twelve occasions when Farah was recorded on the MAR as not taking his
medication in the period Jan 15-22, explanations were provided, as required, only eight times.
Out of the fourteen times that Farah had not received his Seroquel during earlier incarcerations (in
2007), explanations were provided by CCS nurses for only six. DON Lewis could not explain
this, notwithstanding that it was part of her job to ensure proper documentation.
37. Nurses Awosika, Crandall, McCarthy and Kim were involved in the attempted
distribution of medication to Farah dating back to a year before his death, as well as being
employed during Farah’s final incarceration. None of their CCS files contains any
MAR properly. Similarly, there is no documentation in Ms. Mason’s or Ms. Lewis’s file
regarding their failures to catch these defaults, even after Farah’s death brought these matters into
sharp relief.
38. Apart from making notes on Farah’s MAR, none of the medication nurses otherwise
reported the fact that this patient was not taking his medication. There is no notation in Farah’s
medical chart of any sort stating or implying that any nurse ever undertook to report the non-
receipt by Farah of his medication to anyone: not to an RN, the DON, the HSA, the CCS
39. CCS’s policy, J-I-95, required that after a patient refused medication three times, this
was to be reported to the prescribing physician. It was a complete dead letter. For her part,
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Sylvia McCarthy, the last nurse to have offered Farah his medication (on the day before he died)
followed a personal protocol of permitting patients to go for one week (sic) before reporting non-
compliance. Discovery has revealed no documentary or testimonial evidence to the effect that
any CCS nurse reported Farah’s failure to take his medication except on the MAR itself.
40. The files of none of the nurses who experienced Farah’s refusal to take his Seroquel
in January 2008 – nurses Awosika, Crandall, McCarthy, and Kim – reveal no memorialization of
counseling, reprimand, or discipline for failure to have informed either the prescribing
psychiatrist or an RN, the Director of Nursing, the HSA, the CCS physician, or anyone from the
CSB that Farah was not taking his medication. Throughout, it was the responsibility of HSA
Brinkley to see that inmates’ medical records were properly maintained. Over two years after
Farah’s death, CCS’s Chief of Institutional Operations professed ignorance of whether she had
discharged that role properly. Id. Angeniece Mason, a CCS registered nurse, was also supposed
to check Farah’s MAR for completeness. She does not recall having done so, however and
presumably did not, since she also testified that faced with evidence that a patient was not taking
41. The CSB personnel providing mental health care to Farah were aware of Dr. Yoon’s
January 14, 2008 prescription of Seroquel. Having received no information to the contrary from
CCS nurses, they reasonably assumed that Farah was taking his medication. The CSB record of
Farah’s final incarceration includes the following references to his medication (all from January
2008): Jan. 11: Farah “does not see why he was ‘being forced’ to take medication”; Jan. 14: Farah
“understood medication benefits versus side effects; Jan. 14: Seroquel prescribed, Farah having
rejected Clorazil; Jan. 15: Farah “taking meds, per note”; Jan. 17: Farah to meet with staff
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psychiatrist “as needed for medication management”; Jan. 22: Farah “saw the psychiatrist last
week and he should be getting his meds”. No one from the CSB was ever informed by CCS that
Farah was not taking his Seroquel. Exactly the opposite was the case, as expressly attested to by
the CSB social workers and therapists who worked with Farah. Guards who rotated on duty at the
booking unit may have had sporadic or anecdotal evidence of Farah’s declining his medication,
but their information was neither systematically obtained or systematically recorded, and on
42. On January 17, 2008, Farah’s case came up at the jail’s weekly Inmate Management
Team (“IMT”) meeting of various units of the Sheriff’s Department, CCS and the CSB. Farah
was on the IMT agenda with the explanation “awaiting space mental health,” and his case was
discussed. HSA Brinkley was present for this IMT meeting. HSA Brinkley and CCS did not
view it as her responsibility, however, to be sufficiently familiar with the jail medical and mental
health records of inmate patients so as to be able to facilitate continuity of care for any medical or
related condition. HSA Brinkley was not aware of Dr. Yoon’s January 14, 2008 Seroquel
prescription or any other medication information available in his chart, since she did not read it.
She was not in any position to inform anyone of Farah’s failure to take his medicine.
43. On January 18, 2008, Yorvska Salazar, a psychologist working for the CSB, was
called to see Farah. She asked him if he was taking his medication. He said he was not. Because
Farah “presented with psychosis,” Dr. Salazar did not accept what he said at face value and went
to the nurse’s station to inquire. The nurses did not, however, provide her with any information.
They did not pull Farah’s MAR to check. They sent her, rather, to speak to HSA Brinkley or
DON Lewis. Such reluctant cooperation with CSB personnel was apparently common among
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CCS staffers. By contrast, CSB mental health data was always available to CCS staff when
requested.
44. Dr. Salazar does not recall what she was told by the CCS administrator to whom she
spoke. The person to whom she spoke retrieved or consulted no records when responding to her
inquiry about Farah, as she recollects. What she does recall, however, is that as a result of what
she was told, she did not fill out a “Mental Health Action Form.” This form was used by CSB to
inform both deputies and CCS personnel of any changes needed in the care or supervision of an
inmate for newly learned mental health reasons. Dr. Salazar herself had filled out just such a
form for Farah after seeing him on January 11, 2008. On January 18, however, she did not. “If
there’s no change, we don’t put in a different Mental Health Action form.” Based on whatever
she was told on January 18 by HSA Brinkley or DON Lewis, she saw no need for any change or
45. This was not be the first time for such an occurrence. The provision of incorrect
information by CCS staff regarding the medication of inmates was a problem for the CSB staff
46. Shortly after 2 a.m. on January 21, 2008, Farah started shouting out that he wanted
ginger ale, a doctor, an “an I.V.” Hearing this, a deputy went to get the nurse on duty. This was
47. Defendant Ketema came to Farah’s cell. Farah told her that he “needed ginger ale
and IV.” He was “vomiting.” Defendant Ketema saw no food, only liquid, in the vomitus. Farah
“could not stand up” or clean his cell. Defendant Ketema told Farah “You can’t do it because you
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don’t have that energy.” His skin was “kind of dry,” with “a kind of dry whiteness.” His eyes
were “you know, his eyes also fitting inside, and his face was, it’s a kind of – I don’t know how to
explain – it was kind of sluggish, and he was weak.” She found Farah “confused.”
48. Defendant Ketema is the last person known to have seen Farah standing. When he
was seen later that morning by defendant Smith, he was lying on the cement floor of his cell. The
49. On January 21 when Farah was seen by defendant Ketema, he would have been
severely ill and obviously in need of immediate medical care. A person encountered in this
condition outside of the jail would most likely be taken to the emergency room. This should have
50. Defendant Ketema identified virtually all the signs of severe dehydration. She also
expressly came to the “nursing judgment” that “I thought it was dehydration.” “I say maybe it’s
dehydration; ... they told me he didn’t eat the ... last two days or three days.” Id. at 13073. While
nurses cannot “diagnose,” they can make nursing judgments, and that is what defendant Ketema
made here.
dryness, eyes, and skin and her contemporaneous nursing judgment of dehydration were accurate.
They are consistent with the results of the autopsy immediately following Farah’s death two days
later, attributing Farah’s death to dehydration and finding “sunken eyes, dry tissue, skin tenting
and electrolyte abnormalities.” Defendant Ketema’s observations are also consistent with the
assessment of Jonathan Arden, M.D., Ms. Walker’s forensic pathologist, made on the basis of the
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52. Defendant Ketema knew that it was necessary to call for a doctor when faced with a
53. DON Lewis and the CCS physician were on call 24 hours/day, 7 days/week, and
defendant Ketema knew how to call for a doctor if needed. Defendant Ketema called no one.
Nor did she attempt to cause Farah to be sent to the local hospital emergency room.
54. Defendants Ketema and Smith deny that they had access to Farah’s medical record
except for the MAR (and in defendant Smith’s case, Dr. Yoon’s January 14, 2008 note noting
Farah’s unchanged mental status and recommencing his Seroquel). Defendant Ketema did not
write a progress note on January 21, 2008 memorializing the symptoms she discerned and her
conclusion of dehydration because, she says, she was unable to find Farah’s chart.
55. Defendant Ketema reported on her dealings with Farah to her replacement on the
morning shift, defendant Smith, who came in almost five hours later. It was her “habit and
practice to provide a complete report on inmates whom she saw in a professional capacity.” She
recalls communicating that Farah had not eaten, that he had asked for ginger ale and an I.V., and
that he was nauseous and vomiting. She was told by defendant Smith that the doctor would not
be in that day.
56. In due course, defendant Smith went by Farah’s cell to check on him in light of
defendant Ketema’s report. Farah was lying on the cell floor near the door, facing the back wall.
He wordlessly declined to have defendant Smith take his vital signs. She offered Farah nothing to
drink. Defendant Smith did not otherwise attempt to make, arrangements for Farah to be
57. Defendant Smith denies (sic) that she was neither trained nor permitted to judge the
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relative severity of Farah’s condition without first conducting an examination sufficient to permit
58. During the entire period of his incarceration, January 10-23, 2008, Farah was never
59. Defendant Smith wrote no note appearing in Farah’s chart memorializing her dealings
with him on January 21. She “cannot recall” why she failed to do so. While CCS later informed
the sheriff that defendant Smith had been counseled for this failure of documentation, there is no
documentation to that effect in defendant Smith’s file, and DON Lewis knows of no such
counseling.
60. Excessive electrolyte levels caused by dehydration can cause death. Tests were at all
times available to check the level of electrolytes in inmates requiring such testing. Such testing
would have confirmed the immediate need for emergency hydration. Neither defendant Ketema
nor defendant Smith took any steps to propose or secure electrolyte (or other medical) testing for
Farah.
61. STAT (i.e. immediate) laboratory work was supposed to be available for jail patients
when needed, as part of the contracted-for services CCS committed to deliver. CCS and former
HSA Brinkley contend however, that CCS “did not have the capacity to perform” STAT
laboratory work.
62. Had Farah been properly treated and hydrated on January 21 or 22, 2008, it is
“overwhelmingly likely” that he would not have died of dehydration on January 23. No evidence
63. Both defendants Ketema and Smith, as well as numerous other CCS nurses who
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attended Farah, recognized that the necessary thing to do with a patient who failed to eat for two
days, was experiencing nausea and vomiting with no food in the vomitus, was calling for
something to drink, “an I.V.,” and for a doctor, having dry and discolored skin, being weak to the
point of being unable to stand, and otherwise exhibiting the signs of dehydration, was to call the
doctor.
64. Were a mental health patient not to take his medication, it was the responsibility of
CCS staff to refer the patient to the psychiatrist for appropriate action. Were the patient to
deteriorate physically, CCS staff was required to report this to the medical doctor as well. This
was a matter of “medical obligation.” In Farah’s case at hand, it was a deputy, not a nurse, who
apparently put Farah on call to see a doctor when he came in two days, by which time Farah was
dead.
65. Code of Va. §37.2-1000 et seq. permits the judicially authorized forcible psychotropic
medication of a mentally ill person incapable of making a competent decision to accept treatment.
There is, however, no reason to believe that Farah would have rejected hydration on January 21,
Farah’s Death
66. The day before he died, a CCS nurse offered Farah his medication only once. The
reason it was not offered a second time that day, as prescribed, is nowhere to be found. Nurse
McCarthy, who brought the Seroquel, knew that Farah had failed to take it from her several times
– concededly an unusual situation in this nurse’s experience. Yet she did nothing. She did not
approach him or attempt to speak with Farah, who was on his bunk, non-responsive. She did not
ask or undertake to examine him. The deputy called out “Farah come get your medication,” then
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“The deputy close[s] the door and you go to the next place.” Less than 24 hours later, Farah was
dead.
67. In the early morning of January 23, 2008, a guard, concerned with Farah’s breathing,
called for a nurse. Defendant Ketema responded to Farah’s cell. She came without any medical
equipment. She did not provide any guidance or direction to the deputies trying to save Farah’s
life by means of cardio-pulmonary resuscitation. She was, by her own admission, in shock and
“traumatized.”
68. Farah was brought to the Alexandria Hospital by emergency medical technicians
responding to a 911 call made by deputies over defendant Ketema’s advice that it was
69. Pursuant to company protocol, CCS personnel conducted a formal mortality review of
Farah’s death on February 20, 2008. As a “description of medical state just prior to death,” the
resulting CCS form submitted by HSA Brinkley to CCS reads, “Patient had no reported or
70. Within days of Farah’s death, CCS employees conducted a review of the CCS
program at the jail, giving rise to a “comprehensive” report. The report was a paean of praise by
CCS about CCS. Notwithstanding the failure to staff as contracted (e.g., posting an RN at night),
there was no problem found with staffing. Notwithstanding the absence of orientation checklists
from the files of multiple LPNs, there was no problem found with the orientation checklists. The
report identified no problems with health assessment and medical record keeping,
notwithstanding that discovery into a single patient’s chart has revealed a host of problems. It is
conceded that this patient was not singled out for non-compliant charting, nor is there any such
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claim. As for Farah’s death literally days before the review took place, the report remarks: “The
clients are somewhat concerned (sic) with the recent death of an inmate, but are waiting for the
autopsy report.”
71. The CCS director in charge of investigating inmate deaths for CCS was Jon Bosch, a
company vice president who was also Chief of Institutional Operations at CCS. He was “on the
team for implementing the program” in Alexandria. He generated no report on Farah’s death, and
knows of none. He was ignorant of: defendant Ketema’s actions on January 23; whether the
jail’s videotapes of Farah and his nurses had been reviewed; why defendant Ketema had been
fired and CCS documentation regarding same; who an unidentified “problem nurse” was;
defendant Smith’s dealings with Farah and any problems associated therewith; when “basic
training” had allegedly been given to the nurses; how the CSB maintained its records; whether
RNs were consistently absent at night; whether there was documented training on the automatic
defibrillator, and whether there were times when Farah’s chart was improperly maintained. One
thing Mr. Bosch did know, however: “[HSA] Merry [Brinkley] did not trust her staff to do stuff.”
72. During the period of his incarceration in January, 2008, Farah was not of “sound
mind” or was “insane” within the meaning of Fines v. Kendrick, 219 Va. 1084 (1979) and Hill v.
73. All inmates’ medical care in the jail was the financial obligation of defendant CCS.
Defendant CCS, a profit-making entity, constantly recalled to its staff the need to stay within
budget. CCS’s policy in this regard, which occasionally inhibited proper treatment, was noted by
non-CCS personnel at the jail. The implementation of this policy by CCS fostered a corporate
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culture that facilitated defendants’ deliberate indifference to the palpable and serious medical
defendants Ketema and Smith set forth above arose from defendant CCS’s deliberate indifference
to the foreseeable consequences, in the form of injury to inmate patients, of failing properly to
75. As a result and as an exemplification of the deliberate indifference set forth above,
Farah, manifestly ill as he visibly was, was permitted to waste away and die, while being seen
twice daily by CCS nurses. Severe dehydration is painful and debilitating, and Farah suffered
greatly before he finally lapsed into unconsciousness. This result could and would have been
avoided had defendants acted consistently with their constitutional, contractual and professional
duties.
Timeliness
76. This action is timely, having previously been brought in Alexandria Circuit Court on
Causes of Action
77. By reason of their actions and inactions set forth above, defendants Ketema
and Smith are liable for the wrongful death of Farah Salem Farah. Plaintiff, the court-appointed
administrator of his estate, is entitled to an award of damages under Code of Va. §8.01-52 against
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them payable to Farah’s beneficiaries designated by Code of Va. 8.01-53(A)(ii), Farah having left
no spouse or child. These beneficiaries are Farah’s parents, Fatoum Assowe and Saleh Farah, and
his siblings Ali Farah, Ayan Farah, Marian Farah, Obah Farah Walker and Saada Farah. Each has
suffered sorrow and mental anguish and loss of society, companionship, comfort, guidance and
kindly offices from Farah, among other losses cognizable under law. Under the theories of
respondeat superior, agency and non-delegable duty, defendant Correct Care Solutions, L.L.C. is
liable for these damages, and any others proximately caused by the negligence, gross negligence
or deliberate indifference to Farah displayed by any other CCS employee or agent who had
78. Wherefore, plaintiff Obah Farah Walker, administrator of the estate of the late Farah
Farah, seeks an order of this court awarding actual damages and punitive damages against all
defendants, jointly and severally, in amounts appropriate to the proof at trial, to the benefit of
Farah’s statutory beneficiaries, his parents and siblings, plus her costs and such other relief as is
just.
79. By her actions and inactions set forth above, defendant Ketema, while
acting under color of state and local law in the discharge of the government’s obligation to
provide necessary health care to incarcerated persons, was deliberately indifferent to the dire,
palpable and undeniably serious medical needs of Farah, and his attendant pain and suffering,
thereby violating Farah’s rights under the Eighth Amendment of the United States Constitution, to
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80. Wherefore, plaintiff Obah Walker, administrator of the estate of the late Farah Saleh
Farah, seeks an order of this court awarding the estate damages against defendant Ketema for
Farah’s pain and suffering in the Alexandria Adult Detention Center prior to his death, in an
amount appropriate to the proof at trial; punitive damages in an amount appropriate to the proof at
trial; her costs, including reasonable attorney’s fees; and such other relief as is just, including
declaratory relief.
81. By her actions and inactions set forth above, defendant Smith, while
acting under color of state and local law in the discharge of the government’s obligation to
provide necessary health care to incarcerated persons, was deliberately indifferent to the dire,
palpable and undeniably serious medical needs of Farah, and to his attendant pain and suffering,
thereby violating Farah’s rights under the Eighth Amendment of the United States Constitution, to
82. Wherefore, plaintiff Obah Walker, administrator of the estate of the late Farah Saleh
Farah, seeks an order of this court awarding the estate damages against defendant Smith for
Farah’s pain and suffering in the Alexandria Adult Detention Center prior to his death, in an
amount appropriate to the proof at trial, punitive damages appropriate to the proof at trial, as well
as her costs, including reasonable attorney’s fees, and such other relief as is just, including
declaratory relief.
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83. By disclaiming responsibility for Farah as a CSB patient, not a CCS patient, and acting
accordingly as set forth above, through its various employees and agents whose actions it has
defended and ratified, defendant CCS denied Farah the medical care that he needed to contend
with his serious medical condition clearly apparent by the morning of January 21, 2008, when
defendant Ketema saw him as set forth above. This policy of non-responsibility for CSB patients
caused Farah his life within 48 hours. CCS’s policy was in stark derogation of its obligation –
constitutional as well as contractual and professional – to provide necessary medical care to all
jail inmates facing serious medical problems, as Farah did. CCS thereby exhibited deliberate
indifference to the medical needs of CSB clients, including specifically Farah, whose needs were
serious and apparent, in violation of the Eighth Amendment of the United States Constitution.
84. By reason of the failures to train and supervise its nursing staff set forth above, where
the need for such training was obvious, where its absence was calculated to lead to injury and
constitutional deprivation to inmate patients, and where such resulting injury and deprivation in
fact occurred to Farah, all as set forth above, defendant CCS violated Farah’s rights under the
85. Wherefore, plaintiff Obah Walker, as administrator of the Estate of Farah Saleh
Farah, seeks an order of this court awarding the estate damages for Farah’s pain and suffering in
the Alexandria Adult Detention Center prior to his death against defendant CCS in an amount
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appropriate to the proof at trial, punitive damages appropriate to the proof at trial, as well
as her costs, including reasonable attorney’s fees, and such other relief as is just, including
declaratory relief.
Respectfully submitted,
By counsel
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