$26.75 Million Verdict for Woman Who Died in Spokane County Jail
After trial: Reduced on appeal: in April 2025 the Ninth Circuit affirmed liability and the $2.75 million compensatory award but vacated the $24 million punitive award as unconstitutionally excessive. No new punitive award was entered; the parties stipulated to dismissal in June 2025 on undisclosed terms.
Won by Budge & Heipt, PLLC.
A federal jury in Spokane awarded $26.75 million to the estate of Cindy Lou Hill, a 55-year-old woman who died of a perforated intestine in the Spokane County Jail after NaphCare staff attributed her symptoms to heroin withdrawal, though the Ninth Circuit vacated the $24 million punitive portion in 2025 and the case was dismissed on remand.
What happened
Cindy Lou Hill was arrested on August 21, 2018, for possession of heroin and booked into the Spokane County Jail. She was 55 years old. Four days later, on August 25, her cellmate found her on the floor of their cell in the fetal position, screaming and unable to move. A nurse employed by NaphCare, the Alabama company Spokane County paid to run medical care inside the jail, came to examine her. Hill's cellmate had to drag her across the floor so the nurse could reach her.
The nurse attributed Hill's symptoms to heroin withdrawal. No physician examined her, no one sent her to a hospital, and no diagnostic testing was done. Hill was instead placed in a medical watch cell, where monitoring fell to jail guards with no medical training. She was found dead there at 5:25 that evening. An autopsy determined that her duodenum had ruptured and that bacteria leaking into her abdomen caused a fatal infection. It was a treatable surgical emergency that was never treated.
Edwin Budge and Erik Heipt of the Seattle civil rights firm Budge & Heipt filed suit for Hill's estate in the United States District Court for the Eastern District of Washington, case 2:20-cv-00410. The estate alleged that NaphCare and Spokane County deprived Hill of her Fourteenth Amendment right to adequate medical care and that NaphCare's staff was negligent in failing to recognize and respond to an obvious emergency.
On July 20, 2022, the jury in Spokane returned its verdict: $2.75 million in compensatory damages, made up of $2 million for Hill's pain and suffering and $750,000 for her loss of enjoyment of life, with fault apportioned 90 percent to NaphCare and 10 percent to the county. The jury added $24 million in punitive damages against NaphCare alone, bringing the total award to $26.75 million. The verdict drew attention well beyond the courtroom. Spokane County approved new funding to increase medical staffing at the jail and later parted ways with NaphCare as its jail medical provider.
The punitive award did not survive appeal. In April 2025, a Ninth Circuit panel affirmed the liability findings and the compensatory award, writing that the jury could reasonably conclude NaphCare routinely sent people with serious, potentially fatal conditions to medical watch for monitoring by medically untrained guards. But the panel held that the $24 million punitive award, nearly nine times the compensatory figure, exceeded constitutional due process limits. It vacated the punitive damages and remanded with instructions that any new award not exceed a four to one ratio to compensatory damages, a ceiling of $11 million.
A new punitive award was never litigated. Back in the district court, the parties reached a resolution whose terms were not disclosed. On June 18, 2025, the court granted their stipulated motion to dismiss, closing the case.
Sources
This account is drawn from contemporaneous public reporting and the court record.
- 1.The Spokesman-Review: Jury awards $27 million to the estate of woman who died in Spokane County Jail·Archived copy
- 2.Prison Legal News: NaphCare's Lack of Care Leads to $26.75 Million Verdict for Washington Jail Death·Archived copy
- 3.Justia: Estate of Cindy Lou Hill v. NaphCare, Inc., No. 23-2741 (9th Cir., April 14, 2025)
- 4.Prison Legal News: Ninth Circuit Hands Partial Victory to NaphCare, Remanding Much of $27 Million Jury Verdict·Archived copy
- 5.Budge & Heipt, PLLC (firm)·Archived copy
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All Budge & Heipt, PLLC proven verdicts →Javier Tapia was 42 when a blood clot went unaddressed for weeks during his 2018 incarceration at the Pierce County Jail in Tacoma, Washington, leading to gangrene and the amputation of his leg below the knee. Tapia sued Pierce County and its jail medical contractor, NaphCare, Inc., alleging deliberate indifference to his medical needs under the Fourteenth Amendment. Pierce County settled separately for $1 million and was dismissed before trial. In April 2025, after a jury trial in Seattle, a federal jury found NaphCare liable and awarded Tapia $5 million in compensatory damages and $20 million in punitive damages, a total of $25 million. The district court denied NaphCare's post-trial motions, and NaphCare has appealed to the Ninth Circuit.
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Larry Price Jr. spent just over a year in the Sebastian County, Arkansas jail awaiting trial on a terroristic threatening charge he could not make $1,000 bail on, and was found dead in his cell on August 29, 2021. He weighed 185 pounds when he was booked, and paramedics who responded to his death estimated his weight at about 90 pounds; the Arkansas State Crime Laboratory listed the cause of death as acute dehydration and malnutrition. His family's federal lawsuit alleged that Sebastian County and its jail medical contractor, Turn Key Health Clinics, LLC, ignored his deteriorating mental and physical condition, including discontinuing his psychiatric medication and failing to intervene as he ate and drank less over months in custody. Represented by Erik Heipt and Edwin Budge of Budge & Heipt, the family settled with both defendants in 2024 for $6 million, split evenly between the county and Turn Key. The county prosecutor filed no criminal charges over the death, and the case settled before trial with no ruling on liability.
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