$10 Million Settlement After Woman, 26, Died of Dehydration in Untreated Heroin Withdrawal in County Jail

Madaline Pitkin was 26 years old when she was booked into the Washington County Jail in Hillsboro, Oregon in April 2014, arrested for possession of heroin. She was going through withdrawal, and withdrawal from opioids, while rarely fatal on its own in a healthy adult with access to basic supportive care, produces severe vomiting, diarrhea, and fluid loss that can become dangerous without treatment.

Over the roughly one week she spent in custody, Pitkin submitted at least four medical request forms describing how sick she felt. Her language in those forms became central to the case her parents later built: she wrote that she needed help, and she described feeling close to death. The jail's healthcare, at the time provided under contract by Corizon Health, a private company that supplies medical staff to jails and prisons around the country, did not respond to those forms with the level of care her condition required. A nurse evaluated her and got her condition wrong. The jail's medical unit gave her Gatorade and Loperamide, an over-the-counter antidiarrheal, rather than the intravenous fluids that dehydration of that severity calls for. No doctor was on duty the day she died; the jail's one physician had been terminated the day before.

Pitkin was found dead in her cell on April 24, 2014. An autopsy found no drugs or medication in her system at the time of death. Her cause of death was dehydration, not any acute effect of heroin or withdrawal medication, a finding her family's attorneys used to argue that basic, inexpensive medical care, an IV, would have kept her alive.

Her parents, Mary and Russell Pitkin, sued Washington County and Corizon Health in the U.S. District Court for the District of Oregon in 2016, alleging that jail staff and Corizon's medical personnel had been deliberately indifferent to an obvious and worsening medical emergency. The case is against Washington County's own jail health contract, predating Corizon's later contract to provide medical care across the Oregon Department of Corrections; this was a county jail case in Hillsboro, not a state prison case.

John Coletti and Timothy J. Jones of Paulson Coletti Trial Attorneys represented the Pitkin family. The case settled before trial, and a federal judge approved the $10 million settlement on December 7, 2018, split between Washington County and Corizon Health. At the time, it was reported as the largest payment Corizon had ever made to resolve a single inmate death claim. Both defendants' agreement to pay was treated in reporting on the case as a rare, practical acknowledgment of fault in a jail medical-neglect death, without either defendant admitting liability in the settlement's language.