PHOENIX — A federal appeals court gave the go-ahead Thursday for a class-action lawsuit alleging inadequate health care provided to more than 34,000 inmates in state prisons that amounted to unconstitutional cruel and unusual punishment.

Judge Stephen Reinhardt, writing for the 9th U.S. Circuit Court of Appeals, rejected efforts by the Department of Corrections to limit the case to just the specific claims of 13 inmates who filed suit two years ago. The lead plaintiff, Victor Parsons, was sentenced to prison from Pima County.

The judge said the attorneys for the inmates provided detailed allegations of everything from “outright denials of health care” to improper isolation policies. They also had information on how spending on certain services dropped by more than a third over a two-year period, even as the inmate population did not.

Perhaps the most significant point in Thursday’s ruling is that the court concluded the claims, if proved true, were not unique to the individual inmates but instead “systemic failures” in the prison’s health-care system “that expose all inmates to a substantial risk of serious harm.” And if that is the case, Reinhardt said that would require a wholesale revamp of the agency’s policies — and not simply correcting the problems of the 13 inmates.

Attorney Dan Barr, part of the legal team representing the inmates, said a class-action lawsuit is appropriate.

“It’s a case not about any one particular prisoner or group of prisoners but the entire prison health-care system which puts all inmates in the state of Arizona in danger of receiving unconstitutionally low levels of health care,” he said.

A trial is set for Oct. 20 in federal court in Phoenix. Barr said the ruling, unless overturned, means if Judge Neil Wake finds constitutional violations, he can order the Department of Corrections to change its policies for current and future inmates.

Agency spokesman Doug Nick said his agency disputes the inmates’ allegations that their rights are being violated and “looks forward to vigorously challenging them and presenting our case at trial.”

The lawsuit focuses on the more than 34,000 inmates housed in state-run facilities, inmates whose health care is supposed to be provided by private firms under contract with the state. Another nearly 6,900 are in private prisons and not affected by the ruling.

Among the allegations are “lengthy and dangerous delays” and “outright denials of health care,” failure to provide necessary medication, a practice of “employing insufficient health-care staff,” substandard dental care and denial of basic mental-health care to suicidal and self-harming prisoners.

The lawsuit also said that inmates in isolation units were denied adequate recreation and nutrition, constant cell illumination and inadequate mental-health-care staffing and treatment.

To prove their case, the inmates presented evidence of the agency’s policies, internal communications and reports from four experts in prison medical care and conditions of confinement. They provided specific incidents:

  • One involves an inmate who collapsed in his cell from a heart attack but where the lawsuit says officers told prisoners who asked for help to “wait and see what happens.” While the inmate was taken, eventually, to the medical unit, he was told he had a medical appointment in a few days. But the inmate, according to the lawsuit, had another heart attack the next day and died.
  • The legal papers also cite a prisoner four months pregnant who experienced painful contractions and spotting blood. But a staffer at the medical unit told her it was nothing serious and “all in her head,” refusing to allow her to see someone for evaluation. She eventually miscarried.

Reinhardt said the response to the lawsuit was a summary of agency policies, “several of which had been modified mere days before the defendants filed their brief in district court. Reinhardt also noted there was no rebuttal of the expert witness reports.

“Further, the defendants did not address the individual policies and practices complained of by the plaintiffs nor present evidence meant to deny their existence,” he wrote.

Reinhardt said the lawsuit is not based on any one specific claim that a particular inmate received inadequate care but rather that the agency’s policies and how they are administered “expose all inmates in ADC custody to a substantial risk of serious harm.” And the judge said that is precisely the kind of claim anticipated by the Eighth Amendment protection against cruel and unusual punishment.

Reinhardt said it would be improper to deny legal relief to inmates if they can prove unsafe and life-threatening conditions “on the ground that nothing yet had happened to them.” And Reinhardt said the fact that not every inmate has been injured is irrelevant.

“After all, every inmate in ADC custody is necessarily subject to the same medical, mental health and dental care policies and practices,” he said. “And any one of them could easily fall ill, be injured, need to fill a prescription, require emergency care or specialist care, crack a tooth or require mental health treatment.”

Reinhardt said “it would indeed be surprising if any given inmate did not experience such a health-care need while serving his sentence.”