Bailey et al v. Livingston et al
Filing
737
MEMORANDUM AND OPINION re: 620 Second MOTION for Preliminary Injunction MOTION for Permanent Injunction (Submission Date 8/3/2017, Miscellaneous Hearing set for 8/8/2017 at 02:00 PM at Courtroom 3A before Judge Keith P Ellison) (Signed by Judge Keith P Ellison) Parties notified. (rosaldana, 4)
United States District Court
Southern District of Texas
ENTERED
UNITED STATES DISTRICT COURT
SOUTHERN DISTRICT OF TEXAS
HOUSTON DIVISION
KEITH COLE, et al,
Plaintiffs,
VS.
BRYAN COLLIER, et al,
Defendants.
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July 19, 2017
David J. Bradley, Clerk
CIVIL ACTION NO. 4:14-CV-1698
MEMORANDUM AND OPINION SETTING OUT
FINDINGS OF FACT AND CONCLUSIONS OF LAW
Introduction ......................................................................................................................................3
I.
Findings of Fact ........................................................................................................................4
A.
Procedural Background ..................................................................................................4
1.
The Plaintiff Classes ...............................................................................................5
2.
The First Preliminary Injunction ..............................................................................6
B.
The Evidence in the Record ............................................................................................7
1.
The Parties ..............................................................................................................7
2.
The Wallace Pack Unit ...........................................................................................8
3.
The Fact Witnesses ................................................................................................10
4.
The Expert Witnesses ...........................................................................................16
5.
Overview of the Factual Issues ..............................................................................20
C.
The Outdoor and Indoor Heat Index at the Pack Unit ..................................................22
D.
The Effects of Heat on the Human Body .....................................................................26
1.
The Effects of Heat on an Individual with Comorbidities ....................................32
2.
The Effects of Heat on an Individual Taking Certain Medications ......................35
3.
The Effects of Heat on an Individual with Multiple Comorbidities
and/or Who Takes Certain Medications ................................................................37
4.
The Heat Index Threshold for Heat Illness ...........................................................39
1
E.
Conditions in TDCJ Facilities, Including the Pack Unit, Prior to 2013........................42
F.
Heat-Related Deaths and Illnesses in TDCJ Facilities ..................................................43
G.
The Current Conditions in the Pack Unit ......................................................................45
1.
Heat Mitigation Measures ......................................................................................45
2.
Heat Wave/Extreme Temperature Policy .............................................................67
3.
Heat-Related Illnesses in the Pack Unit .................................................................70
H.
The Proposed Remedies ................................................................................................72
1.
Air Conditioning ....................................................................................................73
a.
The Effectiveness of Air Conditioning .........................................................73
b.
Pre-Existing Air Conditioned Beds Within TDCJ ........................................74
c.
Medical Providers’ Inability to Recommend Air Conditioned Housing ......75
d.
The Installation and Cost of Air Conditioning at the Pack Unit ...................77
2.
3.
Creation of a Heat Wave Policy for the Pack Unit ................................................81
4.
II.
Window Screens ....................................................................................................79
Other Remedies ......................................................................................................81
Conclusions of Law ................................................................................................................82
A.
The Legal Standard .......................................................................................................82
B.
Likelihood of Success on the Merits ............................................................................83
1.
The Constitutional Requirements .........................................................................83
2.
Conditions of Confinement that Violate the Eighth Amendment ..........................83
a.
Substantial Risk of Serious Injury or Death ..................................................83
b.
Deliberate Indifference .................................................................................86
C.
Irreparable Injury ..........................................................................................................91
D.
Balancing the Harms ....................................................................................................92
E.
The Public Interest ........................................................................................................93
F.
Bond .............................................................................................................................94
III. Remedy ..................................................................................................................................94
IV.
Conclusion ............................................................................................................................99
2
Introduction
Plaintiffs in this class action request relief from conditions in a state prison. In turning to
this subject, the Court is acutely aware of both the limitations of its own competence, and the
importance of ensuring that constitutional treatment is accorded one of society’s most discrete
and disenfranchised minorities.
In a perfect world, the safety and good health of prisoners would be assured by
Solomonic men and women who had simultaneous expertise in the corrections industry,
construction, safety engineering, medicine, and law. In the world we inhabit, however, judges are
asked to make judgments and enforce decisions because courts are, in our government’s
architecture, where individuals and institutions bring constitutional issues. The task is one that
any court must approach with the utmost humility. Still, the fact that a case is difficult does not
lead to the conclusion that a decision should be avoided.
The immediate issue is whether a preliminary injunction should be entered to redress
conditions that are alleged to create an unconstitutional risk of heat-related illnesses at the
Wallace Pack Unit, a prison operated by the Texas Department of Criminal Justice (“TDCJ”).
Although no heat-related deaths have been reported at the Pack Unit, at least 23 men have died
because of heat at TDCJ facilities from 1998 to today. For reasons that will be set forth, the
Court does find that a preliminary injunction should issue to ensure that prisoners at the Pack
Unit are not deprived of their Eighth Amendment right to be free of cruel and unusual
punishment.
3
I. Findings of Fact
A. Procedural Background
Plaintiffs filed this lawsuit on June 19, 2014. Docket Entry No. 1. Initially, Plaintiffs
consisted of four men—David Bailey, Marvin Yates, Keith Cole and Nicholas Diaz—
incarcerated at the Pack Unit. The Pack Unit is a Type-I Geriatric prison, which means it is a
single-level facility with wheelchair accommodations. Id. at 2-3; Docket Entry No. 326 at 12.
The Pack Unit is owned and operated by TDCJ. Docket Entry No. 326 at 12.
Plaintiffs have sued Defendants Bryan Collier, the Executive Director of TDCJ, and
Robert Herrera, the warden of the Pack Unit, under 42 U.S.C. § 1983, alleging that the
conditions of confinement in the Pack Unit violate Plaintiffs’ Eighth Amendment right to be safe
from conditions of confinement that cause a substantial risk of serious injury or death. Docket
Entry No. 629 at 42-43. A smaller subset of the plaintiffs—those who claim to have a
disability—also alleges that TDCJ is violating its right to be reasonably accommodated under the
Americans with Disabilities Act (“ADA”) and Rehabilitation Act (“RA”). Id. at 43-45.
Plaintiffs moved for class certification, and in May 2016, the Court held a four-day
evidentiary hearing. On June 14, 2016, the Court granted Plaintiffs’ motion for class
certification, certifying a general class and two subclasses. Docket Entry No. 473. Around the
same time, Plaintiffs also moved for a preliminary injunction requiring the Pack Unit to provide
safe drinking water, to adopt a formal policy to address the dangers of heat waves, to monitor
regularly the temperatures inside the Pack Unit, and to amend its policy regarding respite areas—
locations that prisoners can go to for relief from the heat. Docket Entry No. 434. The Court
considered evidence on the Motion during the four-day evidentiary hearing. On June 21, 2016,
the Court entered a preliminary injunction ordering the Pack Unit to provide water that
4
conformed to the Environmental Protection Agency (“EPA”) maximum contaminant level
requirements for arsenic. Docket Entry No. 477. Soon thereafter, the Court denied Defendants’
Motion for Summary Judgment. Docket Entry No. 533.
On May 1, 2017, Plaintiffs filed a motion for a second preliminary injunction, and on
May 22, 2017, Defendants responded. Docket Entry Nos. 620 & 641. The Court held a nine-day
hearing in June 2017. Plaintiffs ask this Court to order TDCJ to lower the indoor temperatures at
the Pack Unit to below 88 degrees1 for the summer of 2017. They contend that the extreme heat
they endure at the Pack Unit is dangerous and damaging to their health, and that Defendants’
mitigation measures are wholly inadequate to counter the high temperatures. As a result,
Plaintiffs claim, the heat creates an unconstitutional condition of confinement. Docket Entry No.
620. If the Court fails to order Pack Unit to lower the temperatures, Plaintiffs request various
forms of alternate relief, including mandating three hours of scheduled respite time, installing
portable “cooling units” in the inmate housing areas, monitoring each person’s water
consumption, and requiring medical staff to conduct “wellness checks” for heat-sensitive people.
Id. at 3-13. Defendants argue, primarily, that the mitigation measures they have implemented
since 2015 have eradicated any potential constitutional violation caused by the heat in the Pack
Unit. Docket Entry No. 641 at 13-14.
1. The Plaintiff Classes
In its previous ruling granting Plaintiffs’ motion for class certification, the Court certified
three classes. Docket Entry No. 473. First, the Court certified the General Class, which is defined
as:
All inmates who currently are, or in the future will be, incarcerated at the Pack
Unit, and who are subjected to TDCJ’s policy and practice of failing to regulate
high indoor heat index temperatures in the housing areas.
1
All temperatures noted are in Fahrenheit.
5
Id. at 2-3. The Court also certified two subclasses. The Heat-Sensitive Subclass is
defined as:
All people who are incarcerated at the Pack Unit, or in the future will be, that are
subjected to TDCJ’s policy and practice of failing to regulate high indoor heat
index temperatures in the housing areas, and either: (1) have a physiological
condition that places them at increased risk of heat-related illness, injury, or death
(including, but not limited to, suffering from obesity, diabetes, hypertension,
cardiovascular disease, psychiatric conditions, cirrhosis of the liver, chronic
obstructive pulmonary disease, cystic fibrosis, asthma, sweat gland dysfunction,
and thyroid dysfunction); or, (2) are prescribed an anticonvulsant, anticholinergic,
antipsychotic, antihistamine, antidepressant, beta blocker, or diuretic; or (3) are
over age 65.
Id. at 3. The Disability Subclass consists of:
All people incarcerated at the Pack Unit, or who will be in the future, that are
subjected to TDCJ’s policy and practice of failing to regulate high indoor heat
index temperatures in the housing areas and suffer from a disability that
substantially limits one or more of their major life activities and who are at
increased risk of heat-related illness, injury, or death due to their disability or any
medical treatment necessary to treat their disability.
Id. Defendants appealed the grant of class certification. The Fifth Circuit has yet to issue its
ruling.
2. The First Preliminary Injunction
On June 21, 2016, the Court entered a preliminary injunction finding that the drinking
water at the Pack Unit contained between two and four-and-a-half times the amount of arsenic
permitted by the EPA, and ordering the Pack Unit, for a defined period, to provide water that
conformed with the EPA maximum contaminant level requirements for arsenic. Docket Entry
No. 477. Plaintiffs had also asked the Court to order that each inmate receive three hours of
scheduled respite every day, and to order Pack Unit to measure, daily, the temperature inside
each of the housing areas. Docket Entry No. 434. The Court, at that time, declined to order such
6
relief. Docket Entry No. 477 at 29-30. Defendants appealed the Court’s order, and their appeal
was dismissed as moot. Docket Entry No. 594.
B. The Evidence in the Record
This motion for a second preliminary injunction requires balancing the expediency
demanded by the request for emergency relief with a full and fair consideration of the
voluminous record. The parties submitted hundreds of pages of exhibits. Fifteen witnesses
testified at the nine-day hearing, including four expert witnesses. Additionally, Plaintiffs have
incorporated by reference the testimony and evidence presented at the 2016 four-day hearing.
This consisted of testimony from eight witnesses, including three expert witnesses. Docket Entry
No. 477. Previously, the Court had visited the Pack Unit.
The Court reviews the factual record under the applicable legal framework to resolve the
disagreements between the parties, and to enter the findings of fact and conclusions of law.2
1. The Parties
As described above, the Court certified a General Class and two subclasses in June 2016.
The General Class includes every person currently incarcerated at the Pack Unit, and the two
subclasses include subsets of that population. The named Plaintiffs in the case are Keith Cole,
Jackie Brannum, Richard King, Michael Denton, Fred Wallace, and Marvin Ray Yates.
The defendants in this case are Bryan Collier, the Executive Director of TDCJ, and
Robert Herrera, the Warden of the Pack Unit, both of whom are sued in their official capacities.
TDCJ is also a defendant.
2
Any findings of fact that are also, or only, conclusions of law are so deemed. Any conclusions
of law that are also, or only, findings of fact are so deemed.
7
2. The Wallace Pack Unit
The Wallace Pack Unit is one of 109 custodial facilities operated by TDCJ across the
state of Texas.3 Docket Entry No. 326 at 12. It began housing prisoners in 1983. Id. The facility
has wheelchair accommodations, 60 wheelchair-accommodated cells, and a 12-bed infirmary. Id.
While the facility does house numerous older men, those who are unable to engage
independently in the activities of daily living are assigned to assisted living and/or long-term
inpatient care, in other facilities. Id. These facilities include type-II or type-III Geriatric facilities,
which are required to have air conditioning. Defs.’ Ex. 109 at 1. TDCJ has one type-II Geriatric
facility and one Type-III Geriatric facility. Hearing Tr. 5 at 41.
The Pack Unit houses approximately 1,450 men, and has approximately 334 employees.
Docket Entry No. 326 at 12. The unit has, among other facilities, a cattle farm and an agricultural
farm. Id. There is an air conditioned infirmary, and at least one medical provider is present 24
hours a day, seven days a week. Id. All of the administration offices are air conditioned, as are
the visitation areas, the education department, the barbershop, and a small portion of the craft
shop. Id. at 13-14.
The Pack Unit has three separate housing areas: the main building, the expansion
dormitory, and the trusty camp. Id. at 13. Each of these housing areas is set up in a dormitory
style, with open-air cubicles for each person. Id. Each dormitory has a “dayroom,” with tables,
chairs, and televisions. Pls.’ Ex. 2. None of the dormitories contains conditioned air.4 Docket
Entry No. 326 at 12. Within the main building, four dormitories extend from either side of a
main hallway. Pls.’ Ex. 1 These dormitories are labeled Dormitory A, Dormitory B, Dormitory
3
TDCJ typically incarcerates more than 150,000 people at any given time. Hearing Tr. 6 at 51.
4
The Pack Unit does contain 40 air conditioned beds in a “work unit,” which is an off-site prison
location that houses only trusty inmates. Additionally, twenty segregation cells and twelve
infirmary beds at the Pack Unit are air conditioned. Docket Entry No. 721 at 3.
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C, and Dormitory D. Id. Each dormitory is divided into four sub-dormitories, which are labeled
numerically, from 1 to 16. Hearing Tr. 3 at 17. Two of those dormitories are wheelchair
accessible, and contain 30 cubicles each. Id. at 29; 38-39. The other dormitories house
approximately 54 men each. Hearing Tr. 4 at 227. Each dormitory contains toilets, and all of the
main-building dormitories use a communal shower space with 72 shower heads. Hearing Tr. 3 at
31. The expansion dormitory is housed outside of the main building, but within the perimeter
gates. Id. at 34. This dormitory holds approximately 111 men, and contains showers within the
dormitory. Id. The trusty camp has a 321-person capacity, and is located outside of the main
perimeter fence. It also contains its own showers. Id. at 15, 35.
The parties stipulated that, as of September 18, 2014,5 the Pack Unit contained 728 men
with hypertension (high blood pressure), 212 men with diabetes, 142 men with coronary artery
disease, 111 obese men, 53 men with a psychiatric condition, 66 men prescribed an antipsychotic medication, 22 men with cirrhosis of the liver, 84 men with chronic obstructive
pulmonary disorder (“COPD”), 189 with thyroid dysfunction, and 113 with asthma. Docket
Entry No. 721 at 3-4. There are 188 men in the Pack Unit over the age of 65. Id. Many of these
conditions overlap within one person. However, all of the conditions, individually, cause heat
sensitivity, as will be discussed in greater detail below.6 The Pack Unit also houses a number of
men who are young and healthy. These men work in the fields or the kitchen, help carry drinking
water to the housing areas, and are integral to the functioning of the Pack Unit as a whole.
Hearing Tr. 3 at 21-23.
5
The Court has not been provided with more recent numbers. However, the parties stipulated
that the numbers obtained in 2014 are typical for the Pack Unit. Docket Entry No. 721 at 3-4.
6
All of the individuals listed above are included in the “Heat-Sensitive Subclass” certified by
this Court in 2016. Not all are included on the Heat-Restriction list produced by the University of
Texas Medical Branch, the medical provider for the Pack Unit. Hearing Tr. 4 at 120.
9
3. The Fact Witnesses
The fact witnesses testified about the conditions in the Pack Unit, specifically relating to
extreme heat in the summers, and to the mitigation measures that have been implemented.
The 2017 Preliminary Injunction Hearing
Richard King is a named Plaintiff in this case. He is a 71-year-old man incarcerated at
the Pack Unit. He has been in TDCJ custody for 28 years, and at the Pack Unit for six years. He
currently works in the craft shop in the Pack Unit. Mr. King suffers from high blood pressure,
diabetes, and obesity. He takes Furosemide and Carvedilol, two medications included on the
Correctional Managed Health Care Committee’s policy listing medications that interfere with the
body’s ability to regulate temperature.7 Additionally, in 2010 Mr. King suffered from a viral
infection that attacked his nerves, leading to the loss of 25-30 percent of the use of his legs. He
currently resides in the expansion dormitory of the Pack Unit, also known as E Dormitory. Mr.
King testified that the heat in the E Dormitory during the summer is like “walk[ing] out to your
car in the middle of the summertime.” Hearing Tr. 1 at 16. He stated that, in the summer, he
sweats profusely, his energy level drops, his appetite diminishes, and he finds it difficult to
function normally. Additionally, it is difficult for him to write letters because sweat drips all over
his paper, and when he lies down, sweat pools in his eyes. He finds that it is often cooler to lie on
the concrete floors than in his bunk, because the personal fan that he owns blows hot air and does
not have a cooling effect. He also testified about mitigation measures that the Pack Unit has
implemented, including a cool-down shower in his dormitory, ice water, respite areas, and
7
Pls.’ Ex. 47 at 7. The Correctional Managed Health Care Committee is a statutorily-created
committee “responsible for developing, implementing, and monitoring the correctional managed
health care services for offenders confined in institutions operated by TDCJ.” McCollum v.
Livingston, No. 4:14-CV-3253, 2017 WL 608665, at *2 (S.D. Tex. Feb. 3, 2017).
10
training about heat-related illnesses. He stated that these measures create temporary relief from
the heat. Hearing Tr. 1 at 3-64.
Jackie Brannum is also a named Plaintiff, age 63, and is incarcerated at the Pack Unit.
He has been in TDCJ custody for approximately 22 years, and has been at the Pack Unit for 16
years. Like Mr. King, Mr. Brannum spends much of his time in the craft shop. He suffers from
high blood pressure, diabetes, obesity, and schizoaffective disorder. Mr. Brannum takes
Risperidone, Nortriptyline, Propranolol, and Amlodipine, Lisinopril, Pravastatin, Prozac, and
Carbamazepine, all of which are listed as “drugs associated with heat stress” by the Correctional
Managed Health Care Committee (“CMHCC”). Defs.’ Ex. 4 at 7. He also uses a walker because
of a pinched nerve in his back that makes walking difficult. He currently resides in dormitory
D16, within the main building. Mr. Brannum has not been allowed to work after he passed out
while working in the kitchen several years ago. Although Mr. Brannum was not diagnosed with a
heat-related illness at that time, he notes that it was hot in the kitchen, and that he was placed in a
cool-down area of the infirmary and told to drink cold water. He compares the heat in his
housing area to getting into a hot box in the sun during the summertime. The heat makes him feel
weak, dizzy, and nauseated. His heart feels like it beats faster, he has difficulty breathing, and he
gets headaches. He testified that he often sleeps on the concrete floor during the summer,
because the concrete is cooler than his bunks; however, some officers have told him he cannot
sleep on the floor. Mr. Brannum also complained of insects that get in through the openings in
the wire screens that cover the windows, and which bite him. Finally, Mr. Brannum testified
about his attempts to use the respite areas at the Pack Unit. He stated that, though he has used the
respite areas several times, he has been shuffled between various areas; he has been made to
stand with his nose to the wall in one respite area, despite his mobility impairment; he has been
11
told that he could not go to respite because it was full; and he has been told that in order to stay
in respite in the infirmary, he must submit to a core (rectal) temperature reading. Hearing Tr. 1 at
67-118.
Thomas Pennington is a 52-year-old man incarcerated at the Pack Unit. He has been in
TDCJ for 28 years, and has been in the Pack Unit for the past 11 years. Mr. Pennington has high
blood pressure, diabetes, and deep vein thrombosis (which causes blood clots in his legs), and is
morbidly obese. He must use a cane to walk. He also suffers from sleep apnea, which interferes
with his breathing at night. He uses a Continuous Positive Airway Pressure (“CPAP”) machine
to sleep, but has problems during the summer months because the sweat his body produces
makes it difficult to keep the mask as tight as it needs to be. Mr. Pennington takes Metoprolol
and Furosemide, two medications included on CMHCC’s list of drugs associated with heat
stress. Mr. Pennington currently resides in dormitory B6, which has a Power Breezer that TDCJ
recently installed. Mr. Pennington testified that the Power Breezer does nothing to help with the
temperature in his dormitory. He spoke about his experiences using the respite areas: while he
has never been denied access to respite, he has been discouraged by the constant movement and
standing required of him. He stated that, in the lower administration hallway, he is required to
stand, which is difficult for him. In the barbershop, he may be able to stay for 15-20 minutes
before he is told to go to the infirmary, and is only allowed to stay in the infirmary for a short
period of time as well. About three years ago, he was sent on a stretcher to the infirmary because
he began feeling sick, had difficulty breathing, and felt nauseated as a result of the heat. In June
2017, he felt the same symptoms when he was leaving the inmate cafeteria, and had to go to the
infirmary to cool down. Finally, Mr. Pennington testified about the insects that come into the
housing areas and bite him and the other inmates. Hearing Tr. 1 at 119-159.
12
Carlos Huerta is a 30-year-old man incarcerated at the Pack Unit. He has been in TDCJ
for three-and-a-half years, and in the Pack Unit for the past two years. He lives in the upstairs
section of the expansion dormitory. Mr. Huerta suffers from high blood pressure and is obese. He
takes Atenolol, which is on CMHCC’s list of medications that interfere with heat regulation. The
heat causes him to feel dizzy, have headaches, and get frustrated. Mr. Huerta testified that he
witnessed a Correctional Officer collapse in the dormitories on a very hot day. He, too, was
diagnosed with heat exhaustion last summer. He testified that he was feeling hot in his
dormitory, so he went outside. Mr. Huerta was walking8 outside, which is something he’s been
told to do to lose weight, and he felt worse. He went back into his dormitory, drank water, took a
cold shower, and got in front of the fan, but still did not feel better. Finally, he asked to go to
medical, where his core body temperature was found to be 102.3 degrees; he was sent to the
hospital, and was diagnosed with heat exhaustion. Finally, Mr. Huerta testified about his one
attempt to use the respite areas; he stated that he did not like it, because some of the officers
would limit how long inmates could stay depending on the officer’s opinion of when they had
sufficiently cooled off. Hearing Tr. 1 at 161-199.
Keith Cole is a named Plaintiff in this case. He is a 63-year-old man incarcerated in the
Pack Unit. He has been in TDCJ for more than 23 years, and has lived in the Pack Unit for the
past six years. He currently resides in dormitory B6. Mr. Cole suffers from chronic
cardiovascular disease, high blood pressure, high cholesterol and diabetes. Mr. Cole takes many
medications, three of which are on CMHCC’s list of medications that cause heat stress:
8
Defendants contend that Mr. Huerta was in fact running outside, which is what the Incident
Report states. The Court does not make credibility determinations at this point, but is merely
summarizing the witness’ testimony.
13
Amlodipine, Metoprolol, and Hydrochlorothiazide.9 He testified that, since the lawsuit was filed,
conditions have improved in the Pack Unit: ice water is more readily available, cool-down
showers have been implemented, and he regularly accesses air conditioned respite areas.
However, he stated that most men living at Pack Unit are not as assertive as he is, and would not
demand access to respite, as he feels he must. Indeed, he estimated that only 15 to 20 men use
respite on a regular basis. Furthermore, Mr. Cole maintained that, even with these measures in
place, he and others are still at risk of harm from the heat in the housing areas. He stated that, on
a daily basis in the summer, he feels dizzy, nauseated, and short of breath. Additionally, he is
bothered by mosquitoes and other insects that get into the dormitory areas through the window
screens. Finally, Mr. Cole testified that the Power Breezer in his dormitory does nothing to cool
the air, and has no cooling effect unless he is standing directly in front of it. Hearing Tr. 1 at 199246.
Robert Herrera has been the Senior Warden of the Pack Unit since 2010. He started his
career as a correctional officer in TDCJ at the age of 18, and has worked his way through the
ranks to become a warden. Defendants offered Warden Herrera’s testimony regarding the
functioning of the Pack Unit on a daily basis, and the various security concerns that he must
consider. He also spoke about the mitigation measures that have been implemented at the Pack
Unit, and their effectiveness in combating heat illness. Hearing Trs. 3 at 3-114, 4 at 2-246, 5 at 321.
Phyllis McWhorter is a registered nurse and the manager for TDCJ’s Mental Health
Services Liaison and Utilization Review. Prior to December 2016, Ms. McWhorter was the
manager of the Health Services Liaison, focusing on heat-related illnesses in all TDCJ facilities.
9
As Mr. Cole did not testify to the names of these medications, they have been gleaned from his
medical documents. Pls.’ Ex. 22.
14
In this role, she collected reports of heat-related illnesses as they were submitted by employees at
the various facilities in TDCJ. She testified as to the number of reports of heat-related illness at
the Pack Unit between the years of 2010 and 2016, and the number of those illnesses occurring
indoors versus outdoors. She also spoke to the ability of medical providers to request that an
inmate be assigned to a Type II or Type III Geriatric Unit, both of which are air conditioned.
Hearing Tr. 5 at 25-98.
Cody Ginsel is currently the Division Director for the Private Facilities Contract
Monitoring Oversight Division. His prior position in TDCJ was as Deputy Director of
Management Operations in the Correctional Institutions Division. Before that, he was a warden
or assistant warden in TDCJ for 13 years. Mr. Ginsel spoke to the financial ability of TDCJ to air
condition the housing areas of the Pack Unit. He also testified about the heat mitigation policies
that have been designed by TDCJ and their implementation in the Pack Unit. Finally, Mr. Ginsel
reviewed the Incident Command System, which is the system that TDCJ alleges to be a heat
wave policy. Hearing Trs. 5 at 99-204, 6 at 2-244.
Kim Farguson is the Director of Maintenance in the Facilities Department of TDCJ.
He testified that he has been working for TDCJ for 20 years, and has a mechanical license to
work in the fields of heating, air conditioning, natural gas piping, and sheet metal, among others.
Mr. Farguson testified as to the electrical capacity in Pack Unit, and its ability to accommodate
the air conditioning units proposed by Plaintiffs. He also prepared a report about the estimated
cost of implementing many of Plaintiffs’ other proposed remedies. Hearing Tr. 8 at 79-120.
LaMorris Marshall is the Captain of correctional officers at the Pack Unit. He has
worked for TDCJ for the past 21 years. Mr. Marshall testified about the mitigation measures that
have been implemented in the Pack Unit, and the inmates’ knowledge of these measures. He also
15
testified as to two incidents that occurred during the first week of the hearing, wherein
approximately 60, and then 150, inmates simultaneously requested respite. These incidents were
significant because, prior to those two days, the largest number of inmates who had requested
respite at the same time was approximately 20. Hearing Tr. 9 at 3-90.
Michael Denton is a named Plaintiff in this case. He is 39, has been living at the Pack
Unit for more than 10 years, and currently resides in the expansion dormitory. He does not have
any medical conditions that impact his body’s ability to regulate its temperature, nor is he taking
any medications that have detrimental effects. He works in the kitchen at the Pack Unit. During
the summers at the Pack Unit, Mr. Denton suffers from headaches, dizziness, and extreme
perspiration. He was one of the approximately 60 men who requested respite simultaneously, and
testified about that experience. Hearing Tr. 9 at 91-126.
The 2016 Class Certification/Preliminary Injunction Hearing10
Cody Ginsel testified at both the 2016 and the 2017 hearings. In 2016, he was still the
Deputy Director of Management Operations in the Correctional Institutions Division of TDCJ.
Mr. Ginsel testified about issues relating to the arsenic levels in the water at the Pack Unit, which
was the subject of the 2016 hearing. However, he also testified about the heat mitigation policies
at the Pack Unit. Thus, for the purposes of this opinion, his testimony in 2017 was substantially
similar to the testimony he gave in 2016. Docket Entry No. 459 at 14-130.
4. The Expert Witnesses
The 2017 Second Preliminary Injunction Hearing
Ron Brown was presented by Plaintiffs to testify under Rule 702 of the Federal Rules of
Evidence on the possibility of air conditioning the Pack Unit, as well as the associated cost. Mr.
10
Witnesses who testified solely about arsenic levels in the water at the Pack Unit are not
included in the summary. They have not been considered in the Court’s analysis of Plaintiffs’
second request for preliminary injunction.
16
Brown testified that he is registered by the State of Texas as a mechanical engineer, and is also
certified in electrical, automatic controls, and energy management. He was licensed as a
professional engineer in 1979, and has been practicing as a mechanical engineer ever since. He
has been registered as an engineer in 26 states, and has spent the majority of his career designing
air conditioning systems for various types of structures. In preparing his opinion in this case, Mr.
Brown toured the Pack Unit, reviewed blueprints and other structural documents, and performed
various calculations using an engineering software. Hearing Tr. 2 at 2-93.
Eldon Vail also testified for Plaintiffs under Rule 702. Mr. Vail spent his career in the
Washington Department of Corrections. He started as a correctional officer before becoming the
superintendent of three different facilities. He worked his way up through the administration,
became the deputy director for seven years, and then in 2007 became the head of the agency until
2011, when he retired. Since that time, he has been consulting on correctional issues for the U.S.
Department of Justice and other entities, as well as serving as an expert in litigation. Mr. Vail
testified about the importance of air conditioning prisons in hot climates, and about his
experience retrofitting two prisons in the state of Washington. He also testified about other states
in the U.S. that require cooled air in their facilities, as well as the mitigation measures in place at
the Pack Unit. Mr. Vail toured the Pack Unit and interviewed several men incarcerated there in
preparing his opinion for this case. Hearing Tr. 2 at 96-280.
Dr. Dean Rieger was presented by Defendants as a Rule 702 witness in corrections. Dr.
Rieger has a medical degree and a master’s degree in public health. Over the course of his career,
Dr. Rieger has been the medical director for a women’s facility in Michigan, the medical director
for the state prison of southern Michigan, the state regional medical director for southeast
Michigan, and the medical director for the Indiana Department of Corrections. From 2006-2016,
17
Dr. Rieger was the Chief Medical Officer and Corporate Medical Director for Correct Care
Solutions, a private managed healthcare company that focuses on correctional healthcare. Dr.
Rieger testified about the effects of heat stress on the human body, the compounding effects
caused by certain conditions or medications, and the mitigation measures in place at the Pack
Unit. Dr. Rieger testified that he has earned approximately $40,000 to $45,000 through his work
for TDCJ in this and other heat-related cases. Hearing Tr. 7 at 2-173.
Frank Traknyak also testified as a Rule 702 witness for Defendants. He is an engineer,
and owns a company called Trak Engineering, which focuses on mechanical, electrical and other
types of engineering. About 60 percent of Mr. Traknyak’s professional focus is on heating and
air conditioning, and he has designed thousands of systems. Mr. Traknyak testified as to the cost
of installing permanent and temporary air conditioning systems in the housing areas of the Pack
Unit. In coming to his conclusions, Mr. Traknyak visited Pack Unit, reviewed drawings, and
performed various calculations using an engineering software. Hearing Trs. 7 at 181-208, 8 at 278.
The 2016 Class Certification/Preliminary Injunction Hearing
Dr. Susi Vassallo testified as a Rule 702 witness for Plaintiffs at the hearing in 2016. Dr.
Vassallo is a practicing physician, board certified in emergency medicine and medical
toxicology. She is licensed in New York and Texas, and is a professor of emergency medicine at
the New York University School of Medicine. She is also on faculty at Dell Medical School, the
new medical school for the University of Texas at Austin. Dr. Vassallo is a specialist in
thermoregulation—the capacity of the body to maintain the temperature of 98.6 degrees. She is
also board certified in correctional health by the National Commission on Correctional Health
Care. Dr. Vassallo testified about the risk of heat-related illnesses for the men incarcerated in the
18
Pack Unit, and the effectiveness of the heat mitigation measures as compared to the effectiveness
of air conditioning. She expounded on the effects of heat on the human body, as well as the
effects of heat on individuals who have comorbidities, or take medications that impede their
ability to thermoregulate. Docket Entry No. 465 at 29-226.
Dr. Michael McGeehin was presented by Plaintiffs as a Rule 702 witness. Dr.
McGeehin spent much of his career as the Division Director for the Division of Environmental
Hazards and Health Effects at the United States Centers for Disease Control and Prevention. He
received his doctorate degree in environmental epidemiology, and has published several peerreviewed epidemiological articles related to heat. Dr. McGeehin testified about various
populations’ risks of heat-related illness. He also spoke to the effectiveness of different heat
mitigation measures. Docket Entry No. 460 at 7-157.
Dr. Dean Rieger testified at both the 2016 and 2017 hearings on behalf of Defendants.
His credentials are detailed above; his testimony in 2016 was substantially similar to the
testimony given in 2017. Docket Entry No. 466 at 4-135.
Dr. Kathryn Means testified on behalf of Defendants as a Rule 702 witness. Dr. Means
is board certified in hospice and palliative medicine. She has practiced as a primary care
physician, but has mostly focused on geriatrics. In 2009, she began working for TDCJ as a
consulting physician in the Health Services Division. After the summer of 2011, Dr. Means was
tasked with reviewing the autopsies of the men who died from heat-related illness. As an expert
in this case, Dr. Means testified about the risk to the named Plaintiffs of heat illness, and spoke
generally about the risk of heat illness faced by all individuals living at the Pack Unit. Dr. Means
reviewed extensive literature relating to heat-related illness, reviewed the medical records of the
named Plaintiffs in the case, and reviewed the medical records of 22 heat related illnesses that
19
had occurred in TDCJ. She was compensated at the rate of $300 per hour, and as of April 1,
2016, had been paid $206,000. At the time that she testified, Dr. Means was a defendant in two
lawsuits stemming from the deaths of two individuals in TDCJ from heat-related illness during
the summer of 2012. Because TDCJ was her employer when the acts alleged in the lawsuits
occurred, TDCJ was covering the cost of Dr. Means’ legal defense, and will pay any judgment
against her. Docket Entry No. 466 at 135-257.
The Court finds that Drs. Vassallo, McGeehin, Rieger, and Means meet the Rule 702
requirements to testify as to the effects of heat on the human body, and on populations as a
whole. The Court also finds that Mr. Brown and Mr. Traknyak are qualified to testify as experts
of mechanical engineering, specifically with regard to air conditioning. Finally the Court finds
that Eldon Vail meets the requirements to testify as an expert in corrections.
5. Overview of the Factual and Legal Issues
There is little dispute that the heat in the housing areas of the Pack Unit during the
summer months could violate Plaintiffs’ constitutional right to conditions of confinement that are
free from a substantial risk of serious harm or injury. The parties’ dispute focuses on the
effectiveness of TDCJ’s mitigation measures in reducing that risk to an acceptable level.
In sum, TDCJ avers that its mitigation measures, which include the constant provision
of ice water, both industrial and personal fans, cool-down showers, access to respite areas,
wellness checks, and the training of both correctional officers and inmates on the recognition of
heat-related illnesses, have successfully reduced the number of heat-related illnesses in the Pack
Unit. Plaintiffs dispute that all of the inmates at the Pack Unit know they have access to respite
areas at any time of day or night, and further contend that the Pack Unit could not accommodate
the numbers of inmates who would want to take advantage of these respite areas. Plaintiffs also
20
assert that correctional officers at the Pack Unit are not, in fact, conducting wellness checks, but
are merely continuing the pre-existing practice of conducting security checks, which do not
assess the inmates’ well-being. Plaintiffs argue that an unconstitutional risk of heat-related
illness remains, and that the only way to reduce this risk is to air condition the housing areas.
This is especially true, according to Plaintiffs, for individuals with heat sensitivities.
For the reasons set out below, the Court finds and concludes that the mitigation measures
put in place by TDCJ are insufficient to combat the substantial risk of serious injury or death
faced by the inmates at the Pack Unit during the summer months. Since the 12 heat-related
deaths in 2011 and 2012, TDCJ has implemented, and attempted to implement, many of the
mitigation measures discussed by the Fifth Circuit in Ball v. LeBlanc, 792 F.3d 584, 599 (5th
Cir. 2015). While these measures have achieved various levels of effectiveness, they do not
reduce the substantial risk of heat-related illness faced by all of the men at the Pack Unit, and
particularly not the men with heat sensitivities. Although Pack Unit officials state that they have
made all of the air conditioned spaces available as respite areas, the testimony of Plaintiffs and of
Pack Unit officials reveals that these respite areas can handle only a fraction of the men living at
Pack Unit, and even then, the men are often forced to stand, not talk, and move quickly from one
respite area to another. Furthermore, the testimony of Plaintiffs and Pack Unit officials belies
TDCJ’s claim that wellness checks are being conducted for those with heat sensitivities. Instead,
it is clear that there is no difference between the security checks that have always been done at
the Pack Unit, and the wellness checks that TDCJ claims are being performed. Thus, two of the
major mitigation measures touted by TDCJ are ineffectively implemented. The other measures
are either entirely ineffective, or are somewhat effective but still insufficient.
21
The Court is particularly troubled by Defendants’ seeming indifference to heat-sensitive
inmates. It finds that this indifference has permeated all aspects of Defendants’ handling of
extreme heat in the summers, from failing to consider the installation of air conditioning after 23
deaths occurred from heat-related illness, to failing to notify prison officials and inmates when
heat advisories have been issued, to placing Power Breezers in a high-humidity environment,
despite Defendants’ own expert opinion that Power Breezers will be ineffective, and even
harmful, in these conditions. In some cases Defendants’ actions have risen beyond indifference
to obstruction, such as when, after this lawsuit was filed, Warden Herrera ordered his staff to
stop measuring the indoor heat index during the summer months.
The Court finds and concludes that, based on the credible, reliable evidence in the present
record, Plaintiffs are likely to succeed on the merits of their Eighth Amendment claim that the
conditions of confinement in the Pack Unit create a substantial risk of serious injury or death.
The Court does not reach Plaintiffs’ ADA and RA claims, as insufficient evidence has been
presented for the Court to determine the likelihood of success as to those claims. Plaintiffs are
entitled to a preliminary injunction, as set out in detail below.
C. The Outdoor and Indoor Heat Index at the Pack Unit
Texas is famously hot, and the Pack Unit is no exception. The Pack Unit is located five
miles south of Navasota, Texas, about 70 miles northwest of Houston, Texas, in the southeastern
part of the state. Pls.’ Exs. 3 & 4. Officials at the Pack Unit monitor the outdoor heat index on a
daily basis. The heat index is the combination of the temperature and relative humidity, and is a
better indication of how the body “feels” heat than air temperature alone. Docket Entry No. 340
22
18 at 7. The heat indices at the Pack Unit during the summer months are represented in the
following chart:11
Outdoor Heat Index at the Pack Unit
Heat Index Highs (2011-2016)
Year
2011
Number of Days:
High Over 100°F
74
Number of Days:
High 90-99°F
16
Number of Days:
High 80-89°F
1
2012
45
43
2
2013
73
16
3
2014
34
47
9
2015
11
71
9
2016
13
55
13
In 2016, the heat index at the Pack Unit reached over 100 degrees on 13 days, and was
between 90 degrees and 99 degrees for 55 days. In 2015, the Pack Unit experienced 11 days on
which the heat index reached over 100 degrees, and 71 days of heat indices between 90 degrees
and 99 degrees. In 2014, there were 34 days of heat indices over 100 degrees, and 47 days of
heat indices between 90 degrees and 99 degrees. In 2013, the number of days over 100 degrees
heat index jumped to 73, with a corresponding decrease to 16 in the number of days between 90
degrees and 99 degrees. In 2012, a summer in which two individuals incarcerated at other TDCJ
facilities died of heat-related illness, the number of days featuring heat indexes over 100 degrees
decreased to 45. In 2011, the year that a heat wave hit Texas that led to the deaths of 10
individuals confined in TDCJ facilities, the Pack Unit experienced 74 days over 100 degrees, just
one more than the number experienced in 2013.
11
The data is taken from Pls.’ Ex. 6.
23
The heat index was regularly measured inside the dormitories until the present lawsuit
was filed. Hearing Tr. 4 at 108. At that point, Warden Herrera ordered his staff to stop measuring
the temperature and humidity. Id. Thus, the Court does not have as much information about the
conditions inside the dormitories as it does about the conditions outdoors. However, the parties
have stipulated that the readings taken for Professor Thomas Sager’s report, commissioned by
Plaintiffs, accurately depict the heat index for the dormitories that were measured from August
27, 2014 through October 8, 2014. Docket Entry No. 693 at 1. These readings are summarized in
the chart below:
Professor Sager used the readings above to determine, within a reasonable degree of
statistical certainty, the heat index inside three Pack Unit dormitories for the period of June 17,
2014 through August 26, 2017, a time period when no measurements were recorded. Id. Prof.
Sager used regression analysis, which is a reliable method of statistical analysis, to come to his
conclusions. These heat indices are represented in the following charts:
24
Prof. Sager’s results reveal that the heat indices inside Dormitory A of the Pack Unit
were over 100 degrees for approximately 13 days from June 17, 2014 through October 6, 2014.
In Dormitory C, that number increased to 41 days. Indeed, Dormitory C experienced eight days
where the heat index reached over 105 degrees. Six of those days occurred in the span of a single
week—in other words, there were three days above 105 degrees, one day below 105 degrees, and
then three more above 105 degrees.12 During these seven days, the heat indices never fell below
12
Although the charts are a helpful visual, they sometimes obfuscate the exact heat index.
However, Prof. Sager provided hourly heat indices as part of his report. (Docket Entry No. 34018 at 132-168.) Thus, on the seven days mentioned above, the heat index in Dormitory C reached
106.5 degrees (8/16/14), 105.05 degrees (8/17/14), 106.6 degrees (8/18/14), 104.1 degrees
(8/19/14), 106.1 degrees (8/20/14), 105.1 degrees (8/21/14), and 106 degrees (8/22/14). (Id. at
162-165.)
25
80 degrees.13 Docket Entry No. 340-18 at 128. Dormitory D experienced 40 days over 100
degrees.
In sum, TDCJ’s recordings of the outdoor heat index in 2014 demonstrate a total of 34
days over 100 degrees. Dormitories C and D experienced 41 and 40 days over 100 degrees,
respectively. Accordingly, the Court finds that the conditions in Dormitories C and D are hotter
than the conditions outdoors. Of the three dormitories that were measured, only Dormitory A is
cooler than conditions outdoors. This conforms with, and bolsters, the testimony of several
Plaintiffs, who testified that the dormitories often feel hotter than outside.14
D. The Effects of Heat on the Human Body
The Court has heard testimony from several experts about the effects of heat on the
human body. There is little disagreement among the experts about the effects; indeed, this is a
well-studied area of health science and medicine. The process by which the human body
maintains its temperature within a safe physiologic range15 is called thermoregulation. Docket
Entry No. 340-18 at 5. Exposure to heat places pressure on the human body. Hearing Tr. 7 at 8.
In response, the body uses two primary mechanisms to cool itself—evaporative cooling (also
known as perspiration or sweating) and cutaneous vasodilation (dilation of blood vessels close to
the skin). Docket Entry No. 340-18 at 6. These processes are intricately interconnected, and are
managed by the section of the brain called the hypothalamus. Docket Entry Nos. 465 at 52; 34013
This meets the definition of a heat warning, which is issued when the temperature index is
higher than 105 degrees for two consecutive days and does not drop below 75 degrees at night.
Hearing Tr. 5 at 187.
14
Richard King testified that “some days it’s cooler outside because there is a breeze blowing.”
Hearing Tr. 1 at 29. Similarly, Jackie Brannum testified that “outside you get a little breeze. And
inside the building you don’t get any. It’s extremely hot in the summertime.” Id. at 80.
15
The body’s safe physiologic range is typically a set point of 98.6 degrees plus or minus 0.8
degrees. Docket Entry No. 340-18 at 5.
26
18. Both of these processes release heat from the body into the atmosphere, and are critical to
effective thermoregulation. Docket Entry No. 340-18 at 6. As the external environment gets
hotter and more humid, the body must work harder to cool itself by increasing perspiration and
vasodilation. Id. Perspiration requires sweat gland function, which in turn requires
neurotransmission—the proper functioning of the hypothalamus. Id. Vasodilation also requires
neurotransmission, as well as adequate cardiac output. Cardiac output is important because,
when the body needs to emit heat, the heart must pump faster and harder to get sufficient blood
to the skin, in order to release heat from the blood through the blood vessels at the surface of the
skin. Id.
Heat illness occurs when the heat created by the environment overwhelms the body’s
ability to dissipate heat into the environment. Hearing Tr. 3 at 52-53. With regard to
vasodilation, the heart can pump only so hard and fast before the body’s need to maintain blood
pressure results in a limitation in vasodilation. This limitation causes the body to begin to
accumulate heat. Docket Entry No. 340-18 at 6. Body temperature can also rise as a result of
dehydration from excessive perspiration. The act of sweating depletes the body of water and salt,
and without adequate replenishment, a person becomes dehydrated. Id. Dehydration causes
dizziness, a lack of energy, low blood pressure, weakness, and an increased heart rate. Id. A
person who is dehydrated and salt-depleted may be unable to increase cardiac output to the
degree necessary to dissipate heat, because the heart does not have enough fluids to squeeze on
in order to meet the required cardiac output. Id; Docket Entry No. 465 at 67-68. Furthermore, at
a certain level of dehydration, the body will stop sweating in order to maintain its fluid levels.
Hearing Tr. 7 at 16.
27
The environment also has an effect on the body’s ability to dissipate heat. Dr. Rieger,
Defendants’ expert, credibly testified that one of the most important ways that the body manages
heat loss is through perspiration. Id. at 12. However, the amount of perspiration that the air can
absorb from the human body is governed by how much humidity is already in the air. Id. At 100
percent humidity, the air can no longer absorb water, and the body will be unable to cool itself
through perspiration. Id. Thus, Dr. Rieger explained, the higher the humidity, the less efficient
perspiration is, and the less efficient perspiration is, the less heat dissipation can take place. Id.
The Pack Unit is located in a humid geographic region, and the housing areas in the Pack Unit
are likewise extremely humid. Professor Sager’s measurements from August 27, 2014, to
October 6, 2014, show that humidity levels in the housing areas were consistently above 80
percent, and often over 90 percent. Docket Entry No. 340-18 at 123-124. The Court finds that the
high humidity levels in the housing areas of the Pack Unit impede the inmates’ ability to cool
their bodies through evaporative cooling.
Heat stress—conditions that cause the body’s thermoregulatory systems to fully
engage—can cause four major types of heat illnesses. These are heat syncope (fainting), heat
cramps, heat exhaustion, and heat stroke. Docket Entry No. 340-18 at 7. Heat syncope is a brief
loss of consciousness that results from the increased demand on the heart to pump blood to the
skin. Id. The heart becomes so taxed trying to pump enough blood to the skin to cool the body,
generate adequate blood pressure, and provide blood to the brain to maintain consciousness, that
a sudden, brief loss of consciousness may occur. Id. Heat cramps are painful muscle cramps that
result from dehydration and sodium depletion, most often as a result of exercising or working in
a high-heat-index environment. Id.
28
When heat stress begins to overwhelm the body’s ability to cool itself, heat exhaustion
can occur. Id. Although the thermoregulatory systems are fully engaged, the body still cannot
maintain a normal body temperature, and the body’s temperature may begin to elevate. Id. A
person with heat exhaustion may experience chills, a headache, and/or muscle cramps, and may
feel light-headed, thirsty, nauseated, weak, faint, and/or dizzy. Id. at 8. Heat exhaustion may or
may not be accompanied by a rise in core body temperature. Hearing Tr. 7 at 10; Docket Entry
No. 465 at 54. If a person experiencing heat exhaustion does not get out of the heat, heat
exhaustion can lead to heat stroke. Docket Entry No. 340-18 at 8.
Dr. Rieger testified that heat cramps and heat exhaustion are not serious injuries, and Dr.
Rieger does not classify heat syncope as a major heat illness. Hearing Tr. 7 at 8-10. Dr. Vassallo
opines, however, that there is overlap in all of the above-described heat-related illnesses, and that
this overlap should cause concern about all heat-related illnesses. Docket Entry No. 340-18 at 8.
For example, heat exhaustion may include heat cramps and heat syncope. Id. As a result, Dr.
Vassallo concludes that individuals experiencing any of the above heat-related illnesses should
be removed from a hot environment. Id. The Court finds and concludes that heat syncope is a
type of heat-related illness, and that heat syncope and heat cramps, while not fatal, should be
taken seriously in the correctional context because they could, in fact, be symptoms of heat
exhaustion. Heat exhaustion, in turn, can lead to heat stroke, which is a severe and potentially
fatal condition. Id.
Heat stroke is defined as an elevation of body temperature above 105.5 degrees,
accompanied by alteration of mental status. Id. The altered mental status could be subtle, such as
inappropriate behavior or impaired judgment, or it could be more obvious, including confusion,
delirium, stupor, coma, or convulsions. Id. The altered mental status is a symptom of brain
29
functioning beginning to fail because of the rise in core body temperature. Hearing Tr. 7 at 11.
Once brain functioning fails, the body can no longer thermoregulate, because thermoregulation
requires proper brain functioning. Id. The failure to thermoregulate causes the body’s
temperature to rise, causing inflammation, injury to body tissues, and cell death, ultimately
leading to multiple organ system failure and death. Docket Entry No. 340-18 at 8.
There are two types of heat stroke: exertional and classical. Id. Exertional heat stroke
occurs when a person is exercising or engaged in strenuous activity in a hot and humid
environment. Id. Classical heat stroke commonly occurs during heat waves, and victims typically
include persons least able to tolerate or escape from heat. Id. Heat stroke is a medical emergency
that must be treated immediately. Hearing Tr. 7 at 11. If not treated, it may result in permanent
brain damage or death. Id. Studies have shown that heat stroke leads to death in 30 to 80 percent
of cases. Docket Entry No. 340-18 at 9. Those who survive may have a permanent inability to
walk and/or talk. Permanent neurological damage occurs in up to 17 percent of survivors. Id.
Symptoms of less serious heat-related disorders may portend heat stroke. Id. at 8.
However, Dr. Vassallo credibly reports that these symptoms do not always occur: often, the body
develops heat stroke rapidly, and with little warning. Id. at 7. Once heat stress overwhelms the
body’s ability to cool itself, the body’s temperature can rise very rapidly, sometimes leading to
life-threatening manifestations of heat stroke, such as a seizure, within 10 or 20 minutes. Id.
Furthermore, two-thirds of heat stroke victims experience symptoms for less than one day before
becoming hospitalized or being found dead. Id. The rapid onset of heat stroke means that even
frequent observations of persons at high risk of heat stroke are unlikely to give adequate warning
of impending heat stroke. Id. A person who begins to suffer from heat stroke may be unable to
remove himself from heat or call for help because of altered mental status. Id. at 8.
30
Heat stroke is widely recognized to be vastly underreported. Docket Entry Nos. 460 at
91; 340-18 at 41. Heat-related deaths sometimes go unrecognized when medical personnel fail to
consider the conditions in which the individual died, and the possibility that the death was heatrelated. Docket Entry No. 340-18 at 41. Furthermore, a medical examiner or doctor may not
conclude that the cause of death was heat stroke if the body’s temperature is not above 105
degrees, which is the medical threshold for heat stroke. Docket Entry No. 460 at 90-91. But the
deceased are often not found in time to measure accurate core body temperature before the body
begins to cool. Id. Finally, because heat-related illnesses can cause various symptoms and
exacerbate a wide range of existing medical conditions, the etiology of the death can be difficult
to establish. Docket Entry No. 340-18 at 41.
Compelling evidence convinces the Court that heat-related illnesses short of heat stroke
are also underreported. Dr. Vassallo stated that hospitalizations and emergency room visits are
categorized by the primary diagnosis, without reference to underlying factors that contributed to
that diagnosis. Id. at 42. Thus, the role of heat in exacerbating an underlying condition is rarely
acknowledged or reported. Furthermore, heat cramps and heat exhaustion are not reported in the
medical community, so there is no way to determine the rates of heat exhaustion and heat cramps
that occur in the free world. Hearing Tr. 7 at 47. Even if heat cramps and heat exhaustion were
reported, not everyone experiencing those illnesses will go to the doctor or the hospital—many
will treat the condition themselves. Finally, Dr. Vassallo testified that, while the heat-related
illnesses described above may occur from short-term exposure to heat, long-term exposure to
heat is generally bad for one’s health, and increases the risk of mortality from other conditions.16
16
The Court finds that Dr. Vassallo’s expert report and testimony regarding the effects of heat on
the human body were extremely thorough, and that she has extensive knowledge on this subject.
31
Docket Entry No. 465 at 86-87. The intersection of heat and other medical conditions is explored
further below.
1. The Effects of Heat on an Individual with Comorbidities
Individuals with certain conditions are at higher risk for heat-related illnesses, as those
conditions impede thermoregulatory functioning. Conversely, heat stress often exacerbates the
underlying condition, which can lead to permanent injury and/or death. Dr. Vassallo contends
that “many more people die each year from heat-induced exacerbations of underlying medical
vulnerabilities than die from heat stroke.” Docket Entry No. 340-18 at 10. The diseases or
conditions that are widely believed to increase the risk of heat illness are described below, in no
particular order. The majority of these conditions are already recognized in CMHCC’s list of
“Common Comorbidities That May Affect Heat Tolerance.” Defs.’ Ex. 4 at 10. The document
indicates that the list is not all-inclusive, and notably absent from the list is obesity, which both
Plaintiffs’ and Defendants’ experts averred should be included on the list. Docket Entry No. 465
at 62; Hearing Tr. 7 at 73-74.
a. Diabetes
Diabetes causes microcirculatory changes that result in blood vessels that are unable to
dilate adequately (a condition known as arteriosclerosis). Hearing Tr. 7 at 18-19; Docket Entry
No. 340-18 at 14. This impairs the body’s ability to circulate blood to the brain and heart,
disrupting the vasodilatory response to heat. Docket Entry No. 340-18 at 14. Diabetes may also
impair kidney function, and the kidneys’ ability to maintain salt-water balance is an important
part of the body’s response to heat. Id.
32
b. Obesity
Obesity causes an increased risk of heat-related illness because excess fat beneath the
skin can impair the skin’s ability to dissipate heat. Docket Entry No. 465 at 117. The connection
between obesity and heat-related illness has been demonstrated in scientific studies, and
Defendants’ expert does not deny the association. Id.; Hearing Tr. 7 at 74. The Court thus finds
and concludes that obesity is a common comorbidity that affects heat tolerance, despite its
absence from CMHCC’s list.
c. Cardiovascular Disease
Cardiovascular disease, which includes chronic hypertension and arteriosclerosis, causes
a decrease in a person’s “cardiac reserve”—the ability to increase cardiac output. Hearing Tr. 7
at 18; Docket Entry No. 340-18 at 14. This means that the heart of an individual with
cardiovascular disease cannot pump as hard or as fast as necessary to dissipate heat through
vasodilation, impacting the individual’s ability to thermoregulate. Hearing Tr. 7 at 18. The stress
that is placed on the heart from having to pump harder and faster than normal can also cause
damage to the heart, and in some cases can cause the heart to fail. Id.
d. Psychiatric Conditions
Individuals suffering from psychiatric diseases are at an increased risk of heat-related
illnesses because they may have impaired behavioral responses to heat stress. Docket Entry No.
340-18 at 15. They may not have the ability to reason or to help themselves during a period of
heat stress, because their illness may adversely affect their mood, thinking, or behavior. Id More
specifically, individuals suffering from depression or anxiety may be unable to communicate
well with others, or may experience apathy in the face of challenging circumstances, such as heat
stress. Id. In sum, individuals with psychiatric conditions may not be able to take advantage of
33
mitigating measures, recognize the symptoms of heat-related illness when they occur, or ask for
help when needed. Id.
e. Advanced Age
Individuals who are over the age of 65 are at increased risk for heat-related illness for
several reasons. Docket Entry No. 465 at 89. One reason is that, as a person ages, his
cardiovascular reserve decreases, limiting the ability of the heart to pump as hard and fast as
required by heat stress. Id. A person’s ability to sense temperature will also decrease with age.
Id. Furthermore, sweat gland functioning decreases, impeding the body’s ability to cool itself
through perspiration. Id. Thus, both of the major physiological systems responsible for
thermoregulating are negatively impacted by advanced age. Id. at 90.
f. Pulmonary Disease
People with pulmonary disease, such as Chronic Obstructive Pulmonary Disease
(“COPD”), have diseased lungs that cause problems with oxygenation and ventilation. Docket
Entry No. 340-18 at 14. COPD is an umbrella term for various lung diseases, including
emphysema and asthma. People with COPD have a limited ability to oxygenate the body, and
any stressor to the lungs, such as heat and humidity, will worsen their underlying condition. Id.
Furthermore, pollutants are worse in hot weather, and pollutants exacerbate asthma. Id. These
conditions also make people more susceptible to illnesses precipitated by excessive heat. Id.
g. Sweat Gland Dysfunction
Although sweat gland dysfunction was not discussed by Plaintiffs’ expert or Defendants’
expert, it is on CMHCC’s list of common comorbidities that affect heat tolerance. It is clear to
the Court, based on other testimony, that if a person’s sweat glands do not function properly, the
34
body’s ability to cool itself through perspiration will be impeded, leading to an increased risk of
heat-related illness.
h. Cirrhosis of the Liver, Cystic Fibrosis, & Thyroid Dysfunction
Despite their presence on CMHCC’s list of common comorbidities, neither party’s expert
discussed the physiological reasons why cirrhosis of the liver, cystic fibrosis, and thyroid
dysfunction lead to an increased risk of heat-related illness. However, both experts testified that
these conditions create an increased risk, and the Court has no grounds on which to question this
assertion.
2. The Effects of Heat on an Individual Taking Certain Medications
In addition to underlying conditions that exacerbate the effect of heat on the body, certain
medications can impede the body’s ability to thermoregulate, thereby increasing the likelihood of
heat-related illness. This can occur in a variety of ways, usually by impacting the two major heat
regulation systems—perspiration and vasodilation—or by affecting the body’s “thermostat”—the
hypothalamus. There is very little dispute among the parties about the effects of certain
medications on the body’s ability to thermoregulate. Indeed, the categories of drugs described
below come from CMHCC’s own list of “Drugs Associated with Heat Stress.” Defs.’ Ex. 4 at 7.
a. Anticonvulsants
Anticonvulsants increase the likelihood of heat illness by affecting the neurotransmitters
that allow the hypothalamus to function. Docket Entry No. 465 at 63-64. The hypothalamus is
then impeded in its ability to monitor and regulate body temperature through perspiration and
vasodilation. Id.
35
b. Anticholinergics & Antihistimines
Anticholinergics and antihistimines are used to treat a variety of conditions, including
respiratory disorders. They work by blocking acetylcholine, which is the neurotransmitter that
drives sweat glands. Id. at 64-65. Thus, anticholinergics and antihistimines increase the
likelihood of heat illness by interfering with the body’s ability to sweat. Anticholinergics and
antihistimines also impact the hypothalamus, though those effects are less understood. Id. at 66.
c. Antipsychotics
Antipsychotics block acetylcholine, similar to anticholinergics and antihistimines. Thus,
antipsychotics inhibit the body’s ability to sweat. Id. at 65. Antipsychotics also affect dopamine,
which is one of the major neurotransmitters involved with the hypothalamus. Id. Like
anticonvulsants, antipsychotics impede the hypothalamus’s ability to monitor and regulate body
temperature. Id. Finally, antipsychotics can affect the body’s ability to vasodilate properly. Id.
Thus, antipsychotics negatively impact the bodily systems used to regulate temperature, as well
as the part of the brain responsible for those systems. All antipsychotics come with a specific
warning from the manufacturers to avoid heat and dehydration, as noted in CMHCC’s heat
policy. Defs.’ Ex. 4 at 7. Additionally, CMHCC’s policy states that “offenders on antipsychotic
drugs should not be allowed to work or recreate in environments where the apparent air
temperature is 95 degrees or higher.” Id.
d. Antidepressants
The antidepressants listed in CMHCC’s heat policy are all cyclic antidepressants, which
means they are strongly anticholinergic, and therefore impede the body’s ability to perspire.
Docket Entry No. 465 at 66. They also impact the hypothalamus. Id.
36
e. Antimanics
According to Dr. Vassallo, lithium, which is the primary drug prescribed to treat mania,
does affect the body’s ability to thermoregulate, by impacting electrolytes, renal effects, and the
kidney system. Docket Entry No. 465 at 66. CMHCC states, on the other hand, that lithium does
not disrupt the body’s ability to thermoregulate. Defs.’ Ex. 4 at 7. However, lithium is on
CMHCC’s list of drugs associated with heat stress because, “if an offender treated with lithium
becomes dehydrated, they are at an increased risk of lithium toxicity.” Id. Because both parties
recognize that individuals taking lithium are at an increased risk from heat stress, the Court finds
that it does not need to resolve the issue of whether lithium affects the body’s ability to
thermoregulate.
f. Beta Blockers & Calcium Channel Blockers
Beta blockers and calcium channel blockers are used to treat cardiovascular disease.
Docket Entry No. 340-18 at 15. They work by impairing the heart’s ability to squeeze, and
reducing the speed at which the heart beats, thereby lowering cardiac output. Id. However, this
also means that the heart cannot pump as fast or as hard as it would need to in order to dissipate
heat through vasodilation. Docket Entry No. 465 at 67.
g. Diuretics
Diuretics—also known as “water pills”—cause a loss of fluid from the body, and can be
dehydrating. Id.
3. The Effects of Heat on an Individual with Multiple Comorbidities and/or
Who Takes Certain Medications
Dr. McGeehin credibly testified that an individual with any one of the above-described
medical conditions, or taking any of the above medications, will be at an increased risk for heatrelated illness. Docket Entry No. 460 at 62. This risk is further heightened, Dr. McGeehin stated,
37
when an individual has some combination of the conditions and/or medications, particularly
those individuals over the age of 65. Id. Indeed, CMHCC’s own policy states that offenders who
take medications on the “Drugs Associated with Heat Stress” list should not be allowed to work
or recreate in environments where the apparent air temperature is 95 degrees or higher if they are
on more than one such medication, or if they also have an underlying medical condition that
places them at increased risk.17 Defs.’ Ex. 4 at 7.
All but one of the Plaintiffs who testified meet these criteria. Richard King is over the age
of 65 and suffers from high blood pressure, diabetes, and obesity. He is also on two medications
associated with heat stress. Hearing Tr. 1 at 13-14. Jackie Brannum suffers from high blood
pressure, diabetes, obesity, and schizoaffective disorder. Id. at 73-75. He currently takes eight
medications that exacerbate heat stress. Id. Thomas Pennington suffers from high blood pressure,
diabetes, and obesity, and takes two medications associated with heat stress. Id. at 128-129.
Carlos Huerta suffers from high blood pressure, is obese, and takes one medication associated
with heat stress. Id. at 163. Keith Cole suffers from chronic cardiovascular disease, high blood
pressure, high cholesterol and diabetes. Id. at 200. He takes three medications that are associated
with heat stress. Pls.’ Ex. 22.
The Court finds and concludes that heat stress can lead to heat-related illnesses even in
young and healthy individuals. However, this risk is heightened when an individual is over the
age of 65, has a condition that impedes the body’s ability to thermoregulate, or takes a
medication that impedes the body’s ability to thermoregulate. This risk is further heightened
when these conditions and medications are combined in any way.
17
The policy also mandates that individuals on antipsychotics be given a heat restriction. Defs.’
Ex. 4 at 7. The Court notes, and discusses in more detail in Section I.G.1.c, that heat restrictions
in TDCJ apply to work assignments, but have no impact on the placement of an inmate in one of
the 32,000 air conditioned beds that exists in TDCJ. Hearing Tr. 5 at 85.
38
4. The Heat Index Threshold for Heat Illness
As temperatures and humidity rise, the risk of heat-related illnesses rises. Dr. Vassallo
credibly testified that, based on her several decades of clinical experience and a thorough review
of the existing literature, temperatures above a heat index of 88 degrees significantly increase the
risk of heat-related illness. Docket Entry No. 465 at 70, 77. While prolonged exposure to a heat
index above 88 degrees increases the risk of heat-related illness for even young and healthy
individuals, those with heat sensitivities may suffer heat-related illnesses within a few hours. Id.
at 71. As the heat index increases into the 90s and 100s, that risk becomes more pronounced.
This is illustrated by the National Weather Service’s Heat Index Chart:
Pls.’ Ex. 11. The National Weather Service (“NWS”) is a division of the National Oceanic and
Atmospheric Administration, and the above chart is widely accepted within the field of
climatology. Docket Entry No. 465 at 73. Indeed, TDCJ uses the chart in Administrative
Directive 10.64, and CMHCC uses a version of this chart in its heat policy. Defs.’ Exs. 1 at 14; 4
39
at 5. The chart demonstrates that, while a heat index of 88 degrees falls at the high end of the
“caution” section, as temperatures and humidity increase, the level of danger also rises.
Dr. Vassallo testified that her clinical experience and the chart above informed her choice
of 88 degrees as the heat index threshold, and that her review of the scientific literature
subsequently confirmed this number. Docket Entry No. 465 at 75-76. For example, one study she
reviewed found that mortality increased in cities in North America, Europe, and South America
when temperature and humidity climbed above the 88 degree heat index. Id. at 77. Another study
showed an increase not only in mortality, but also in emergency department visits and
hospitalizations, above a heat index of 89 degrees. Id. at 81-83. Dr. Vassallo did not testify, and
the Court does not hold, that any risk of heat-related illness disappears below the 88-degree
threshold, or that the risk of heat-related illness skyrockets at the 89-degree mark. The NWS
chart is designed to demonstrate a gradually increasing level of risk, which is appropriate for the
scientific understanding of how heat stress affects the human body. But for purposes of litigation,
the Court has no basis upon which to question Dr. Vassallo’s choice of 88 degrees as a threshold
above which the risk of heat-related illness increases, and the Court finds that this choice is
sound. Specifically with regard to Plaintiffs in this case, Dr. Vassallo concluded that all of the
inmates at the Pack Unit, “including young and healthy men with no known medical problems,
are at substantial risk for serious heat-related disorders during periods of persistent exposure to a
heat index above 88 degrees.” Docket Entry No. 340-18 at 11. The Court agrees.18
18
Defendants do not appear to dispute this finding. They presented no evidence at the 2017
hearing alleging that inmates are not placed at a risk of harm by the temperatures and humidity at
the Pack Unit. Although Dr. Kathryn Means, who testified at the 2016 hearing, took issue with
Dr. Vassallo’s application of epidemiological studies to the population at the Pack Unit, the
Court found her testimony to be biased and not credible. Docket Entry No. 473 at 10. Instead,
Defendants contend that any risk has been effectively mitigated by the measures currently in
place at the Pack Unit. Docket Entry 641 at 9 (“The protective measures currently in place at the
Pack Unit are effective and ameliorate the risk that inmates might otherwise face in the summer
40
The Court further finds that the heat indices in the housing units of the Pack Unit, as
measured and aggregated by Dr. Sager in 2014, climbed above this 88-degree threshold—often
well above—for 100 of the 106 days measured between June 27, 2014 and October 6, 2014.
Although the Court’s analysis would be assisted by the provision of more recent heat indices in
the Pack Unit housing areas, Warden Herrera ordered his employees to stop taking those
measurements when the present lawsuit was filed. Defendants have provided no evidence that
the heat indices recorded in 2014 were anomalous, and the Court has no reason to believe that
they are not representative of the majority of summers at the Pack Unit.
Indeed, during the hearing on Plaintiffs’ motion for preliminary injunction, a heat
advisory was issued for Grimes County, where the Pack Unit is located, indicating that the heat
index was expected to rise “near or above 108” degrees that day. Hearing Tr. 6 at 136-137;
Defs.’ Ex. 138. These temperatures fall into the “Danger” category of the NWS heat index chart.
Hearing Tr. 6 at 137. TDCJ’s “Training Circular” on extreme heat, which is given to inmates and
staff, instructs that, when a heat advisory is issued, inmates and staff should, “Take Action! A
Heat Advisory is issued within 12 hours of the onset of extremely dangerous heat conditions . . .
Take precautions to avoid heat illness. If you do not take precautions, you could become
seriously ill or even die.” Pls.’ Ex. 53 at 2; Docket. Entry No. 326 at 25.
There was some question at the hearing as to why Warden Herrera had not received a
notice of this heat advisory from the state operations center for TDCJ, the department in charge
of monitoring NWS advisories and disseminating them to the appropriate officials. Hearing Tr. 5
at 182. Cody Ginsel, the Rule 30(b)(6) representative for TDCJ, testified that Warden Herrera
did not receive the heat advisory because “[the state operations center] receive[s] these pretty
much every day during the summer.” Id. at 182-183. Thus, TDCJ’s own representative concedes
temperatures without the measures.”).
41
that heat indices up to or over 108 degrees are such regular occurrences during Texas summers
that TDCJ does not disseminate the advisories to the affected regions. Furthermore, while urging
inmates to “take action” and “take precautions” in the face of a heat advisory, TDCJ does not
alert the affected prison officials, much less the inmates, when these heat advisories are issued.
That heat advisories are issued so often in Texas does not mean that the risk is any less, nor does
it excuse TDCJ from the obligation to alert affected populations and take the necessary steps to
protect inmates. If anything, the routineness of these heat advisories reveals the extremity of the
heat in Texas in the summer months, and TDCJ’s knowledge of the risk posed by this heat.
Accordingly, the Court finds and concludes that, during the summer months, the men
incarcerated in the Pack Unit face, on a daily basis, temperatures that substantially increase their
risk of heat-related illness, aggravate any underlying medical conditions, or both. While this risk
is pronounced even for young and healthy individuals, the risk increases significantly for
individuals with certain medical conditions, who are on certain medications, and/or who are
above the age of 65. The Court must next address the mitigating measures that TDCJ has
implemented in the Pack Unit and other facilities, and determine whether those measures reduce
this risk of harm to a constitutional level.
E. Conditions in TDCJ Facilities, Including the Pack Unit, Prior to 2013
TDCJ has made some changes to the conditions in the Pack Unit and other facilities over
the last few years—after a series of heat-related deaths in 2011 and 2012, and after this and other
related lawsuits were filed against TDCJ and its officials. TDCJ’s heat mitigation measures are
described in two documents: Administrative Directive 10.64, entitled “Temperature Extremes in
the TDCJ Workplace,” and an annual “Heat Precaution” message that is sent via email. Pls.’ Exs.
42, 57. In 2011, the heat precaution message instructed wardens to: provide additional water in
42
the housing areas, and provide ice water if ice was available; train employees and inmates to
make them aware of the signs of and treatment for heat-related illnesses; situate fans, when used,
in such a way to draw air through the structure and exhaust it outside; use air blowers to increase
ventilation, when appropriate; allow additional showers for inmates when feasible; allow inmates
to wear shorts in dayrooms and recreational areas; clean window screens to ensure maximum air
flow; allow all inmates to purchase fans; and ensure that inmates who have been indigent for the
past six months and cannot afford to buy a fan are issued a fan, on a first-come-first-served basis.
Pls.’ Ex. 57.
As explained in this Court’s opinion in McCollum v. Livingston, these measures were
inadequate, in large part because they allowed significant discretion on the part of each warden:
with regard to how much water to provide; whether to provide ice, and if so, how much; and
whether to allow additional showers. McCollum v. Livingston, No. 4:14-CV-3253, 2017 WL
608665, at *15 (S.D. Tex. Feb. 3, 2017). Additionally, no respite program existed before 2015.
Hearing Tr. 4 at 27.
F. Heat-Related Deaths and Illnesses in TDCJ Facilities
From 1998 to present, at least 23 men incarcerated in TDCJ facilities have died as a result
of heat-related illnesses.19 Pls.’ Ex. 18. Although TDCJ makes much of the nationwide heat wave
in 2011 which caused the death of 10 men in TDCJ facilities (Hearing Tr. 6 at 148), the other 13
deaths were spread over the course of eight summers: three men died in 1998, two men in 1999,
one man in 2000, another in 2001, one in 2003, one in 2004, two in 2007, and two in 2012. Pls.’
Exs. 18, 19. Defendants have presented no evidence that Texas experienced abnormally high
temperatures during those summers, as it did the summer of 2011. Although no deaths have
19
Given Drs. McGeehin and Vassallo’s testimony about the underreporting of heat-related death,
this number may in fact be larger. See Section I.D supra.
43
occurred since 2012, this does not necessarily mean that the risk of death has been eliminated.
Indeed, three summers passed between 2007 and 2011 without any heat-related deaths, but the
10 deaths in 2011, and the two in 2012, reveal that the risk was still very real.
Since 2011, TDCJ has made an effort to track heat-related illnesses in its facilities. With
the caveat that heat-related illnesses are likely vastly underreported, reports collected by TDCJ
show that in 2011, 163 incidents of heat-related illness20 were reported in facilities across the
state. Pls.’ Exs. 16; 21. One hundred and nine of these incidents occurred indoors. Id. In 2012,
the total number of heat-related illnesses fell to 118, with 56 of those incidents occurring
indoors. Id. In 2013, 118 total incidents were reported, with 45 occurring indoors; in 2014, 97
total incidents were reported, with 42 occurring indoors; and in 2015, 94 total incidents were
reported, with 55 occurring indoors. For the summer of 2016, 108 heat-related illnesses were
reported, with 62 occurring indoors.
It is also clear is that correctional officers employed by TDCJ are suffering heat-related
illnesses while on duty at the facilities. During this litigation, TDCJ produced records evidencing
heat-related illnesses suffered by hundreds of correctional officers. Pls.’ Ex. 16 at 160-266.
Despite the significant number of deaths, and the large number of heat-related illnesses
suffered by inmates and correctional officers alike, the Court finds that TDCJ has never seriously
considered air conditioning the housing areas of its facilities. Hearing Trs. 6 at 160-161, 214215; 7 at 135.
20
TDCJ defines a heat-related illness as heat cramps, heat exhaustion, or heat stroke. Especially
with inmates who have other morbidities, there would appear to be enormous discretion in
determining whether illnesses are called “heat related” or something else—e.g., diabetic,
psychiatric, or cardiovascular.
44
G. The Current Conditions in the Pack Unit
Defendants have presented extensive evidence regarding the mitigation measures
currently in place, and they assert that these measures are effective at reducing the risk of heatrelated illness faced by inmates during the summer months. Docket Entry No. 641 at 9.
1. Heat Mitigation Measures
While there is little debate about the existence of some of TDCJ’s mitigation measures,
others are keenly contested. What follows is a summary of each of the mitigation measures that
TDCJ claims it has implemented, as well as this Court’s factual findings regarding its
implementation and effectiveness.
Ice Water
There is no dispute that TDCJ now provides ice water in all of the housing areas, 24
hours a day, 7 days a week. Hearing Tr. 1 at 227. Cups are issued to indigent individuals upon
arrival at the facility; otherwise, cups are purchased at the commissary. Hearing Trs. 5 at 148; 6
at 129.
The ingestion of cold water is a beneficial method of controlling or reducing body
temperature; furthermore, the ingestion of water is essential in a hot environment in order to
avoid dehydration, because of the amount of perspiration that occurs. Hearing Tr. 7 at 24; Docket
Entry No. 340-18 at 6. Dr. Rieger explained that cold water helps cool down the body through
conduction—the transfer of heat between two objects. Hearing Tr. 7 at 21-22. Essentially,
conduction occurs when cold water has direct conduct with the warm stomach; heat energy
transfers until both the stomach and the water are the same temperature. Id. at 24. The Court
finds that Dr. Rieger’s testimony regarding the cooling effects of drinking cold water is valid,
and that providing ice water in the housing areas 24 hours a day is a helpful mitigation measure.
45
However, Dr. Vassallo pointed out that there are potential adverse side-effects to drinking
excessive water, such as a condition called hyponatremic, where the body’s level of sodium
becomes abnormally low. Docket Entry No. 465 at 168. Given the helpful but limited cooling
effect of ice water, the levels of heat faced by the men incarcerated at the Pack Unit, and the
potential hazards incurred by drinking too much water, the Court finds that ice water alone could
never suffice to mitigate the risk of injury.
Cool-Down Showers
Defendants have also instituted “cool-down showers” at the Pack Unit. Hearing Tr. 1 at
204-205. For the dormitories in the main building, the communal shower area, with 72 shower
heads, has 12 shower heads set to cold water at all times. Twice a day, all 72 showers are
switched to cold water, and all of the men living in the dormitories are allowed to take showers.
Hearing Tr. 3 at 31-32; 110-111. Furthermore, Warden Herrera testified that, if any person in the
main-building dormitories wants a cool-down shower, “all he needs to do is ask a staff member,
and he is going to be directed to the shower area.” Id. at 31-32; 111. In order to test his staff’s
compliance with this policy, Warden Herrera has, on an unknown number of occasions, asked an
inmate to request a shower, and then followed up to see if permission was granted. On one
occasion, the inmate was not allowed to access the showers, and Warden Herrera instructed the
correctional officer at that time that inmates must be allowed to go to showers upon request. Id.
at 111-112. However, there are no documents, flyers, or training programs informing inmates in
the main-building dormitories that they can access cold showers at any time. Hearing Tr. 1 at 6061; 205. Some of the Plaintiffs testified that they were unaware that they could access cool-down
showers at any time. Id. at 141; 204; 229. Other than Warden Herrera’s informal conversations
with inmates at the Pack Unit, there has been no effort made to inform inmates about the
46
beneficial health effects of taking cool showers during the summer months. Hearing Tr. 4 at 198199.
The wheelchair-accessible dormitories, Dormitories A2 and A4, have one handicappedaccessible shower inside each dormitory. Hearing Tr. 3 at 31-32. These showers have an
adjustable handle that allows the inmate to choose between cold or hot water. Id. at 32. In the
expansion dormitory, one shower is set up to run cold water. Id. at 34. Because the shower is in
the dormitory, inmates do not need to request permission to access it. Id. at 34. However, 56 men
live in the expansion dormitory, and must share the single cold-water shower. Hearing Tr. 1 at
30. Mr. Huerta testified that there is sometimes a line to use this shower. Id. at 198. In the trusty
dormitory, Warden Herrera believes that all of the showers have an adjustable handle, allowing
them to run hot or cold. Hearing Tr. 3 at 37.
Dr. Rieger credibly testified that cold showers help to cool the body by transferring heat
from the body into the water molecules, also through conduction. Hearing Tr. 7 at 26. Water is
an efficient means of removing heat from the body. In fact, immersion in an ice bath is the most
generally accepted treatment for heat stroke. Id. at 26. However, Dr. Rieger also testified about
the possibility of developing hypothermia—a dangerous decrease in the body’s temperature—by
taking a cold shower when one is not overheated. Id. at 27, 29-30. The Court finds that cooldown showers are an effective means of cooling the body when the body is overheated.
However, the Court finds that cool-down showers are a less effective mitigating measure for
preventing individuals from becoming overheated in the first place. Indeed, Dr. McGeehin
credibly testified that showers reduce the body’s temperature for the short term, but that the
beneficial effect is limited by putting the body back into a hot and humid environment. Docket
Entry No. 460 at 45-45. This testimony supports and bolsters the testimony of the plaintiffs, who
47
credibly and consistently testified that the cool-down showers help while they are in the shower
and for a brief time afterward, but that within 15-20 minutes they are again sweating profusely
and feeling hot. Hearing Tr. 1 at 43; 87; 118; 141.
Fans
Each housing area contains two large ceiling fans and one large floor fan. Defs.’ Ex. 27;
Hearing Tr. 3 at 36-37. Additionally, each inmate is allowed to buy a personal fan for use in his
cubicle. Hearing Trs. 4 at 244; 5 at 121. Each cubicle has a power outlet. Hearing Tr. 8 at 72. If
an individual is indigent, he is provided a fan through a loan program. Hearing Trs. 4 at 199; 5 at
121. Just before the hearing on Plaintiffs’ motion for injunctive relief, TDCJ installed eight
Power Breezer units in some of the Pack Unit housing areas. Hearing Tr. 5 at 170. A Power
Breezer is a large oscillating fan that produces a light mist. Id. Defendants readily admit that
these fans are not designed to cool down the entire housing area; instead, they are supposed to
create a slight cooling effect for inmates standing directly in front of them. Id.
The Court finds that Defendants have made a genuine effort to ensure that there are
adequate fans in the housing areas at the Pack Unit. But there are significant problems with their
heavy reliance on fans as a mitigation measure. First, the Center for Disease Control (“CDC”)
does not recommend the use of fans above a 95 degree heat index, as fans actually increase heat
stress by blowing air that is warmer than the body’s temperature over the skin’s surface. Docket
Entry No. 460 at 37-38. Another study found that “the use of fans indoors in rooms without air
conditioning should be strongly discouraged . . . when the heat index exceeds . . . 99 degrees
Fahrenheit.” Id. at 38. Indeed, TDCJ’s own “Training Circular” about heat, which is distributed
to all inmates, instructs, “Do not direct the flow of portable electric fans toward yourself when
room temperature is hotter than 90 degrees. The dry blowing air will dehydrate you faster,
48
endangering your health.” Pls.’ Ex. 53 at 1. The Court also notes that the CDC advises
individuals to “not rely on a fan as your primary cooling device” during periods of extreme heat.
Defs.’ Ex. 88 at 2. Accordingly, the Court finds that the use of fans is unhelpful, and potentially
harmful, when the heat index exceeds 95 degrees, as is regularly the case in the housing areas of
the Pack Unit.
As to the Power Breezers, Defendants’ own expert, Mr. Traknyak, testified that, given the
high humidity of the climate at the Pack Unit, Power Breezers are not a good idea, as they simply
increase the moisture in the air. Hearing Tr. 8 at 70-71. Indeed, Mr. Traknyak had previously
opined that evaporative coolers are effective in dry climates, and therefore would not be effective
in the Hutchins Unit, which is located outside of Dallas, Texas. Id. at 115-116. Dallas has a less
humid climate than the Pack Unit, which is significantly closer to the Gulf of Mexico. Id. at 116.
Thus, in Mr. Traknyak’s opinion, Power Breezers would be even less effective at the Pack Unit
than at the Hutchins Unit. Id. at 116. Because Power Breezers do not cool the housing areas, but
instead increase the humidity in an already-humid environment, the Court finds that these units
are not only ineffective, but potentially harmful. Furthermore, because TDCJ placed these units
in the Pack Unit one week before the preliminary injunction hearing, without asking their own
expert if they would be effective, the Court finds that this was not a serious attempt to mitigate
the heat.
Relaxed Dress Code
Men living at the Pack Unit are allowed to wear shorts and t-shirts in the housing areas
during the summer months. Hearing Tr. 5 at 167. They are not allowed to go without a shirt. Id.
When they go to other areas of the unit, they are required to wear long pants. Id. Dr. McGeehin
testified that the less clothing one wears in warm climates, the more comfortable one will be,
49
because perspiration is aided by the exposure of skin to moving air. Docket Entry No. 460 at 41.
Thus, a person in a hot, humid climate will be more comfortable in shorts and a t-shirt than a
suit. Id. However, Dr. McGeehin emphasized that this is true only up to a certain temperature,
and that there have been no peer-reviewed studies conducted to test the efficacy of wearing
shorts as a heat-mitigation measure. Id. at 41-42. The Court finds that, while wearing shorts and
a t-shirt in extreme heat is certainly more comfortable than having to wear long pants and a long
sleeve shirt, and might have a minimal cooling effect, it does not substantially help to cool the
body.
Open Windows
All of the housing areas except for the expansion dormitory have windows that can be,
and are, opened during the summer months. Hearing Tr. 5 at 151. This allows for a breeze, if
there is one, to enter the housing units, and for ventilation to occur. The expansion dormitory has
windows that do not open; in order to provide ventilation, the Pack Unit has a ventilation system
and a large fan to circulate the air. Id. Open windows can have a cooling effect only when there
is cool air or a breeze to blow through them. Thus, during the hottest part of the day, windows
will have no cooling effect. Plaintiffs testified that the open windows do little to help with the
heat in the housing areas, because “when it’s hot it’s hot air [] coming in the window.” Hearing
Tr. 1 at 141. Given the extremely hot and humid outdoor temperatures at the Pack Unit that
occur on a daily basis during the summer, the Court finds that having windows open during the
daytime provides a minimal cooling effect, if any. The Court additionally finds that having the
windows open at night would provide a cooling effect if the heat index drops. However, this
effect could occur only to the degree that the heat index drops. The Court also notes that this
cooling effect would not be felt by those incarcerated in the expansion dormitory, who do not
50
have access to open windows. Thus, although temperatures have not been taken in the expansion
dormitory since the start of this litigation, the Court doubts that the temperature of the expansion
dormitory would decrease significantly at night, the way it does in other housing areas. See
Section I.C supra.
Furthermore, although open windows provide some cooling effect at night, Plaintiffs
have credibly complained of insects, such as mosquitos and beetles, that consistently enter the
housing units through the wire security screen and bite them. Hearing Tr. 1 at 88; 141-142; 222.
Respite Areas
One of the most recent, and most debated, mitigation measures implemented at the Pack
Unit is its respite program. Hearing Tr. 4 at 27-28. Both parties agree that respite—the ability to
spend time in an air conditioned environment—can be a beneficial mitigation measure. The
parties dispute the extent to which respite, in general, can reduce the risk of harm posed by heat,
as well as the adequacy of the Pack Unit’s respite program, specifically.
The 2017 “Heat Directive” email sent to all TDCJ officials dictates that, “[d]uring
extreme temperatures, offenders must be allowed access to respite areas,” but gives no other
guidance or direction. Defs.’ Ex. 7 at 1. Although the Pack Unit does not have air conditioning in
the housing areas, like other TDCJ facilities, it contains many air conditioned locations. These
locations include the infirmary, the education department, a barbershop located inside the main
building, hallways, the officer dining room, and all administrative offices. Pls.’ Ex. 129.
Defendants maintain that inmates can access all of these locations at any time, on request,
and that they may stay in the areas for as long as they want. Docket Entry No. 641 at 11 (“Staff
have identified 20 different air conditioned areas that may be accessed as respite wherein
offenders may remain for an unlimited time in order to cool down. Offenders are granted access
51
to one of these areas on request, without exception.”). Defendants further claim that “there are
few or no restrictions on what an offender may bring to a respite area,” and that inmates are
allowed to talk to each other in the respite areas. Id.
Despite the seemingly inviting and open nature of the respite program described above,
the evidence revealed that very few men have been requesting or using respite: when the hearing
started, only 15-20 inmates had ever used respite at the same time. Hearing Tr. 4 at 31. The
parties disagreed about why respite areas were being utilized in such low numbers, considering
the seriousness of the heat in the housing areas. Mr. Ginsel testified that the reason is because
“they choose not to go.” Hearing Tr. 5 at 147. This statement is belied by the overwhelming
weight of the evidence.
To start, Warden Herrera testified that inmates at the Pack Unit are not allowed to choose
which area they go to for respite, but are instead directed to an area by a correctional officer.
Hearing Tr. 4 at 31. Once that area is full, correctional officers will direct inmates to the next
location. When the hearing started, only five of the 20 identified locations had been used as
respite areas. Id. These were: the barbershop, the lower administration hallway, the education
department hallway, the infirmary, and the craft shop. Id. at 32. The Court will discuss the
evidence regarding each of these areas in turn.
The Barbershop: The barbershop is the first place that Warden Herrera uses as a respite
area. Hearing Tr. 3 at 92. The barbershop contains two barber chairs and two small benches
placed against two walls. Defs.’ Ex. 129. The inmates are not allowed to sit in the barber chairs,
and the benches can hold approximately four to five people each. Hearing Trs. 1 at 216; 9 at 18.
Warden Herrera estimates that the barbershop can hold about ten people before it is full. Hearing
52
Tr. 3 at 70. When the barbers are working, there are individuals waiting to get haircuts, meaning
fewer people can be accommodated for respite. Hearing Tr. 1 at 26.
Plaintiffs also presented evidence that offenders are often told that they cannot talk in the
barbershop. Hearing Tr. 9 at 45-46. The barbershop has a door with a mesh-covered opening that
leads into an area used for legal visits, staff trainings, and other meetings. Id. at 46; Defs.’ Ex. 36
at 1. Captain Marshall testified that, while that area is in use, he or other officials will order the
inmates in the barbershop to stop talking. Hearing Tr. 9 at 44-45; 47-48. Additionally, Captain
Marshall conceded that, at some point in the summer of 2016, a sign was placed in the
barbershop that said “No talking in the barbershop.” Id. at 48. Although Captain Marshall
testified that this sign was on paper and was immediately taken down, Mr. Denton, one of the
named plaintiffs, testified that the sign was in fact painted onto the wall. Id. 70; 107.
Lower Administration Hallway: Warden Herrera testified that, after the barbershop is
full, he sends people to the lower administration hallway. Hearing Tr. 3 at 70. This hallway is
close to a central desk that is staffed with correctional officers, so Warden Herrera does not have
to use any extra correctional officers in order to monitor the inmates in respite. Id. at 76. The end
of this hallway leads to the administrative segregation area, which is where men are held in
protective custody. Id. at 100. When an inmate has to enter or leave the administrative
segregation unit, the lower administrative hallway must be cleared, which means individuals who
are there for respite must leave and go somewhere else until the transfer has been completed. Id.
at 101. Warden Herrera estimates that approximately ten individuals can use the hallway as
respite. Id. at 75. At the time the hearing began, there were no chairs in the lower administration
hallway, so inmates were forced to stand if they wanted respite. Id. at 76. Over the course of the
hearing, ten chairs were placed in the hallway. Hearing Tr. 9 at 19.
53
Mr. King testified that during one of the times he sought respite, he was sent to the
barbershop, but it was too crowded. Hearing Tr. 1 at 27. He was then moved to the lower
administration hallway, where he was told to stand, facing the wall.21 Id. After about ten minutes,
he was told to leave while prison officials moved an inmate from administrative segregation. Id.
Because Mr. King suffered a viral infection that has limited the use of his legs, and suffers from
obesity, he has difficulty standing for long periods. Id. at 6-7. After about 30 minutes in respite,
Mr. King chose to return to his housing area rather than remain standing and moving from one
location to another. Id. at 27. Mr. Brannum was also told to face the wall and stand while in the
lower administration hallway for respite. Id. at 86. Mr. Brannum uses a walker, and he was able
to stand for only about 20 minutes. Id. at 87. Similarly, Mr. Pennington, who uses a cane to walk,
has been discouraged by the need to stand in the barbershop and lower administration hallway, as
well as the frequent need to move from one respite area to another; he testified that, eventually,
he gives up and returns to his housing area. Id. at 132-133.
Education Hallway: The third place used for respite is the education hallway—a
hallway directly outside of the library, the law library, and five classrooms. Hearing Tr. 9 at 19.
The hallway has benches and chairs that can fit about 25 to 30 people, some sitting and some
standing. Hearing Tr. 7 at 77; Defs.’ Ex. 126.
Library: Next, Warden Herrera would turn to the library, which he testified could hold
40 people. Hearing Tr. 3 at 78. Depending on the time of day, Warden Herrera may not need to
reposition any correctional officers in order to use the library as a respite area, because he
21
When asked if there is a policy of making inmates face the wall in the lower administrative
hallway, Warden Herrera stated that any time someone is being taken to administrative
segregation, inmates are required to face the wall. Hearing Tr. 3 at 102. The Court notes the
inconsistency of this statement with Warden Herrera’s earlier statement that anytime someone is
being taken in or out of administrative segregation, the entire hallway is cleared. Id. at 101.
54
already has two officers stationed in the library during the day. Id. at 78-79. However, Warden
Herrera may need to cancel or reschedule library hours in order to do this. Id. at 80; 84.
Infirmary: If the library becomes full, Warden Herrera testified that he would use the
infirmary as the next respite area. Id. at 81. There are two benches in the infirmary that could
hold approximately 15 to 20 men. Id. at 81. During the day, there are already two officers
stationed in the infirmary, so there would be no need to reposition correctional officers. Id. at 81.
Mr. Denton and Mr. Brannum testified that, when they have gone to the infirmary for respite,
they have been told that they were required to submit to a measurement of their core body
temperature, which is done by taking a rectal temperature. Hearing Trs. 1 at 87; 9 at 125. Mr.
Denton testified that this requirement deterred him from using respite. Hearing Tr. 9 at 125.
All Other Locations: Once the above five areas are full—after approximately 105
inmates have requested respite simultaneously—Warden Herrera would have to start rearranging
his correctional officers, and disrupting the normal functioning of the prison, in order to
accommodate more people in respite. Pls.’ Ex. 129; Hearing Tr. 3 at 82-83. The next areas that
Warden Herrera would use, in order, are: the caged area of the visitation room located in the
main building, which is typically used for non-contact visits, where he could fit approximately
25 people, Defs.’ Ex. 130; the visitation room, which could accommodate approximately 40
individuals, Id.; the officers’ dining hall, which could fit around 40 people, Defs.’ Ex. 128; the
five classrooms in the education wing, which could hold around 150 people total; the law library,
which could fit about 40; the sewing room and administration offices in the boiler room and
kitchen, which could hold about 30 people total; a small air conditioned room within the craft
shop, which could hold approximately 10 people; and the property office, chaplain’s office, and
food service manager’s office, which could hold about 5 each. Hearing Tr. 3 at 82-95.
55
Trusty Camp: In the trusty camp, which houses 314 inmates, there is an air conditioned
administration building that could hold approximately 80 individuals, and an education area that
could hold between 50 and 60 men. Id. at 99. These areas are located outside of the perimeter
fence, and as a result would likely never be used for non-trusty inmates. Hearing Tr. 2 at 153.
Evidence was also presented regarding the information that the Pack Unit has conveyed
to inmates about the respite program. The primary source of information is a poster that is
designed, in Warden Herrera’s words, “to make sure that every offender on the unit understands
that they can request and go to respite at any given time.” Hearing Tr. 3 at 103. This poster is
placed on a bulletin board used for posting notices to inmates and correctional officers. Id. This
poster reads as follows:
NOTICE TO OFFENDERS
Areas are being made available for offenders who are experiencing difficulty due
to heat. These areas are located at Education Department, Lower Administration,
Officers Dining Hall, Infirmary, Laundry Captain Office, Food Service Captain
Office, Lieutenants office, Regular Visitation Room, Barber Shop (officer and
offender), Trusty Camp office (Sgt. And Lt.), Trusty Camp visitation, Trusty
Camp Food Service office, Agriculture office, Farm Shop office, Kennel office,
Unit Maintenance office, Warehouse office, BOQ dayroom. If you are
experiencing difficulty due to the heat, please notify a staff member immediately.
Pls.’ Ex. 52. The notice appears also in Spanish. Id. Although Warden Herrera testified that there
is not, in fact, a requirement that inmates feel ill before requesting respite (Hearing Tr. 3 at 105106), Mr. Vail stated that inmates could interpret the language “offenders who are experiencing
difficulty due to heat” as requiring that they feel ill before seeking respite. Hearing Tr. 2 at 148.
Warden Herrera agreed that there are much clearer ways to communicate the intended message
to inmates. Hearing Tr. 4 at 27. Defendants’ own expert, Dr. Rieger, stated that the poster should
be rewritten, as it is unclear and difficult to understand. Hearing Tr. 7 at 74. This is especially
56
important in a correctional facility, he said, where the average reading level of inmates is
generally accepted to be around the third grade. Id.
Another poster has been placed on the same bulletin board, labeled as a notice to
correctional officers. This poster says, “Respite areas are being made available for offenders to
prevent the development of heat-related illnesses.” Hearing Tr. 2 at 263-264.
In addition to the posters, TDCJ’s Risk Management Department has created several
handouts that are given to inmates. One, a handout that discusses suicide prevention and the
Prison Rape Elimination Act, as well as temperature-related illnesses, says nothing about the
respite program, or the importance of seeking out air conditioning during the heat. Pls.’ Ex. 54.
A four-page “Training Circular” gives information about heat-related illnesses and their
prevention. This handout says that inmates should “use air conditioners or spend time in air
conditioned locations such as identified respite areas.” Pls.’ Ex. 53 at 1. On the second page, the
handout tells inmates to “stay indoors and, if at all possible, stay in an air conditioned place. If
your home does not have air conditioning, go to the shopping mall or public library.” Id. at 2. On
the fourth page, there is a section marked “Respite Areas,” which writes, “During the extreme
temperature months, offenders will be allowed access to respite areas. Ensure employees and
offenders are trained, and are compliant with heat precaution procedures to include knowledge of
respite area locations and offender access.” Id. at 4. Although this second handout does more
than the poster and the first handout to identify the importance of spending time in respite areas,
the information is still vague, and is not specific to the Pack Unit. In addition, the inclusion of
information about going to a shopping mall or public library confuses and dilutes the message.
The Court finds, based on the unclear and incomplete communication and training
described above, that both inmates and correctional officers are unaware of, or confused about,
57
the limitations and rules regarding respite. This is confirmed by Plaintiffs’ testimony. Mr.
Brannum testified that he has been refused access to a respite area by correctional officers.
Hearing Tr. 1 at 86. Mr. King does not think he can access respite areas 24 hours a day. Id. at 16;
26. He believes that respite closes around 10:00 p.m., and does not know of anyone who went to
respite after that time. Id. at 16. Mr. Pennington has been told that he cannot take a book to
respite. Id. at 134. Mr. Huerta testified that he does not think he can stay in respite as long as he
wants, because some officers will tell him to leave once they think he has been there long
enough. Id. at 174. These issues could be easily resolved with effective training of, and
communication with, the correctional officers and inmates at the Pack Unit.
Before the hearing began, only 15-20 men in the Pack Unit had ever requested respite at
the same time. However, during the first week of the hearing, on the night of Thursday, June 22,
2017, and during the day on Friday, June 23, 2017, a large group of men at Pack Unit requested
respite. Hearing Tr. 9 at 27. Captain Marshall testified that on Thursday night, approximately 65
to 70 men requested respite, and Pack Unit staff placed them in the barbershop, the lower
administrative hallway, and the officers’ dining hall. Id. at 27-28; 32. Later, the men were
escorted from the officer’s dining hall into the education hallway and library. Id. at 28. In the
library, Captain Marshall stated that most men had chairs, and the rest were “placed
strategically” so they could rest their backs against walls and shelves. Id. at 28. On Friday,
approximately 150 men requested respite, and they were placed in the barbershop, lower
administrative hallway, and two classrooms in the education department, because the library was
being used for a class at that time. Id. at 29; 32. Approximately 80 men were placed into the
library and had access to one bathroom; there was a line of men waiting to use this bathroom. Id.
at 35. Captain Marshall testified that there were “no problems at all” accommodating the influxes
58
of men. Id. at 29. But the Court finds Captain Marshall’s testimony less than credible.22
Plaintiff Michael Denton was one of the men who requested respite on Thursday, June
22, 2017, and he testified about this experience. When he requested respite at around 5:30 p.m.,
he was sent to the officers’ dining hall, where about 45 other men were located. Id. at 97. Upon
arrival, he and the other men were told by a correctional officer, “If you all want to play, then we
can play, too. If you are in here and your house isn’t in compliance, 23 we’re going to write you a
22
The Court finds that Captain Marshall was impeached during the hearing in a way that
damaged his credibility. Captain Marshall testified that inmates are allowed to talk in respite
areas, and that he had never ordered inmates to stop talking in a respite area. Hearing Tr. 9 at 42.
Plaintiffs then produced a grievance filed against a correctional officer who ordered inmates in
the barbershop to stop talking. Hearing Tr. 9 at 42-43. The correctional officer responded, on the
grievance form, that Captain Marshall “gave a direct order not to talk to each and every one of
them that was sitting in there.” Hearing Tr. 9 at 44. When presented with this grievance, Captain
Marshall explained that any time legal visits or staff trainings are happening in the room adjacent
to the barbershop, inmates are ordered to stop talking. Hearing Tr. 9 at 46. His reason for not
testifying about this when directly questioned was that all inmates in the barbershop, whether
there for haircuts or respite, were ordered to stop talking, so he was not simply ordering those in
respite to stop talking. Hearing Tr. 9 at 46-47. The Court finds this explanation dubious, and
finds that Captain Marshall was attempting to cover up or downplay evidence that was
unfavorable for Defendants. The Court also finds that Captain Marshall’s memory proved
unreliable. On direct examination, he testified that 140 to 150 inmates had used respite on
Thursday and Friday, June 22 and 23. Hearing Tr. 9 at 27. On cross examination, he said that in
fact the number of inmates using respite on Thursday was around 60, and on Friday the number
increased to 150. Hearing Tr. 9 at 32. However, he then said that there were 82 men in the library
alone on Thursday, which would be impossible if only approximately 60 men requested respite
that night. Hearing Tr. 9 at 35. Accordingly, the Court significantly discounts Captain Marshall’s
testimony.
23
This refers to a rule that any time an inmate is outside of his designated living area, his cubicle
is required to be clean, with personal effects properly stored. Hearing Tr. 9 at 97. Although this
rule is always in place, and is regularly enforced, the Court finds that the specific targeting of
inmates who request respite could intimidate inmates who are less apt to assert their rights. This
is consistent with the testimony of Mr. Cole that “certain offenders [are] more assertive than
others and they are not afraid to get up against the system. They will get out like I do. But the
vast majority of offenders on my unit, they are afraid.” Hearing Tr. 1 at 210. Mr. Vail also
testified that Mr. Cole’s assertion of his rights is “not the characteristic of a lot of inmates. A lot
of inmates will be afraid to access these areas for the fear of running into conflicts with the
staff.” Hearing Tr. 2 at 225.
59
case.”24 Id. at 97. After being in the officers’ dining room for approximately 20 minutes, the men
were moved to the library. Id. When they got there, all of the chairs were taken, so Mr. Denton
had to either stand or sit on the floor. Id. at 98. Mr. Denton counted approximately 55 men in
chairs in the library, and approximately 15 men sitting on the floor. Id. He stated that the library
was crowded, and that when the air conditioning vent stopped blowing cold air, it became very
warm. Id. at 100. He said that the process of getting everyone into respite on Thursday evening
was disorganized, and that the correctional officers seemed frustrated, and vented this frustration
at the inmates. Id. at 101. The Court finds Mr. Denton’s description of the events of Thursday
evening to be more persuasive than Captain Marshall’s. Defendants’ cross-examination of Mr.
Denton failed to raise any significant issues with his testimony.25 His memory was clear, he was
not evasive, and his testimony appeared unbiased. Even when it hurt Plaintiffs’ case, Mr. Denton
was honest—for example, when Defendants’ and Plaintiffs’ counsel followed-up about the
correctional officer’s statement that “houses better be in order,” Mr. Denton readily admitted that
this rule is always in place and is enforced on a daily basis. Id. at 108; 123.
Based on the evidence described above, the Court finds that the events during the first
week of the hearing reveal how unprepared the Pack Unit is to deal with any significant number
of inmates requesting respite. The number of men who requested respite on Friday is just over
ten percent of the number of inmates housed at the Pack Unit, yet Defendants struggled to find
places in which to put them. On Thursday, that number was even smaller, but inmates were
shuffled from one location to another, and they were crammed into the library, some with no
24
“Writing a case” means taking disciplinary action against an inmate.
25
Defendants attempt to impeach Mr. Denton’s credibility with his criminal conviction under
Rule 609 of the Federal Rules of Evidence. Hearing Tr. 9 at 111. The impeachment seems to
have been based in large part on the fact that Mr. Denton still claims to be innocent. But the
Court finds that Mr. Denton’s conviction does not reduce his credibility with regard to the events
of Thursday evening.
60
place to sit. Officers were frustrated, and were vocal about their frustration. This does not
evidence a well-functioning program where, in the words of Warden Herrera, “every offender on
the unit understands that they can request and go to respite at any given time.” Hearing Tr. 3 at
103. Plaintiffs may be aware that they can request respite, but they are likely also aware that their
request may provoke the ire of correctional officers; that they may have to walk from one respite
area to another; that they may have to stand, despite any discomfort or pain; and that they may
not be able to talk or read, much less watch television or play games.
Mr. Vail, Plaintiffs’ expert on corrections, credibly testified that, based on his review of
the evidence, Defendants’ respite program has not been designed to incentivize its use. Hearing
Tr. 2 at 162. He identified several problems with the respite program at the Pack Unit. In general,
Mr. Vail is of the opinion that inmates at the Pack Unit are not being encouraged to use the
respite areas, and that in fact there are several disincentives in place. Id. at 153. First, he testified
that there are no dedicated staff members assigned to some of the respite areas that might be able
to handle a larger volume of inmates. Id. at 146. Instead, inmates are sent to areas like the
barbershop and the lower administration hallway, which cannot accommodate many people and
are not designed to allow for other activities, such as writing, playing games, or watching
television. He identified the inability to sit and talk, and the occasional requirements to stand
with one’s nose against the wall or to submit to a rectal temperature, as significant disincentives
to using the respite areas. Id. at 146-147. He stated that having respite areas in administrator
offices is problematic because there is potentially confidential or secure information located in
those offices; furthermore, most inmates will not feel comfortable spending time in an
administrator’s office, for fear of being labeled an informant. Id. at 152-153.
61
In order for the Pack Unit to have a fully-functioning respite program, Mr. Vail
recommends creating a comfortable environment where inmates can sit, talk, relax, and engage
in activities, such as reading, watching television, or playing games. Id. at 160; 236. He
recommends publicizing the program, and clearly communicating where respite is, what hours it
is open, and what the rules are once there. Id. at 160; 148. He thinks that the poster regarding
respite should be more clear, more inviting, and explain why respite is important for one’s
health. Id. at 149. Ideally, there would be a dedicated space for respite; for example, air
conditioning a location such as the gym could provide an area large enough to accommodate a
higher volume of inmates in respite. Id. at 163; 278. Mr. Rieger agrees that, in order to
successfully implement a respite program, inmates should be able to sit down, read, talk, and
generally be comfortable. Hearing Tr. 7 at 140-141.
Based on the above-described evidence, the Court finds that Plaintiffs are failing to use
the respite areas at the Pack Unit, not because they simply choose not to, as Mr. Ginsel proposed,
but because the respite program is poorly designed, administered, and communicated. Accessing
respite means being forced to stand, or sit in hallways with nothing to do, or sit in a barbershop
in silence; officials have not communicated the extent and limits of the respite program to the
inmates or correctional officers; and the prison has not educated the inmates about the
importance of seeking respite on a daily basis during the summer months. This is not the robust
respite plan described by Defendants in their briefing, nor is it the type of program that would
constitute an effective mitigating measure.
However, even if a successful respite program were implemented at the Pack Unit—one
that incorporated all of the suggestions made by Mr. Vail and Dr. Rieger—the Court finds that
62
significant evidence supports Plaintiffs’ claim that they still would not be free from a substantial
risk of serious injury or death.
Dr. Rieger testified that respite is an effective mitigation measure because it removes a
person from a hot environment for that period of time, and provides that person with an
opportunity to cool down, decreasing their body temperature if it has begun to rise. Hearing Tr. 7
at 56. Dr. Vassallo testified, however, that for the time Plaintiffs are not in respite areas, which
would be the majority of the hours of the day, they would be subjected to temperatures that could
cause sickness and death. Docket Entry No. 465 at 135. Given the rapidity with which a person
can develop heat stroke, several hours in the temperatures at the Pack Unit could result in serious
injury. Docket Entry Nos. 465 at 135; 340-18 at 7. This is especially true for individuals with
underlying conditions, or on medications, that hasten the onset of heatstroke. Docket Entry No.
465 at 135.
Indeed, the Plaintiffs who testified that they were regularly accessing respite areas stated
that they still experienced symptoms of heat-related illness. Mr. Brannum works in the craft
shop, and he testified that he accesses the air conditioned portion of the craft shop on a daily
basis and is able to cool off in that room. Hearing Tr. 1 at 110. However, Mr. Brannum—who is
63 years old, suffers from high blood pressure, diabetes, obesity, and schizoaffective disorder,
and takes eight medications that affect his ability to regulate temperatures—still experiences
weakness, headaches, a rapid heartbeat, difficulty breathing, and nausea during the summer
months. Id. at 78. Mr. King, who is 71 years old, suffers from high blood pressure, diabetes, and
obesity, and takes two medications that interfere with thermoregulation, also works in the craft
shop, and uses the air conditioned room for respite on a daily basis. Id. at 54. But he also
continues to feel symptoms of heat-related illness when he is in his housing area, including
63
difficulty functioning, sluggishness, and a diminished appetite. Id. at 17. Mr. Cole, who is 63
years old, suffers from chronic cardiovascular disease, high blood pressure, high cholesterol, and
diabetes, and takes three medications that interfere with heat regulation, uses respite on a daily
basis. Id. at 228. Yet he testified that he also feels the symptoms of heat-related illness every day
when he is in the housing units. Id. at 219. He feels dizzy, nauseated, and has difficulty
breathing; additionally, his underlying conditions, such as his heart problems, are more
aggravated in the summer than during the winter months. Id. at 219.
The Court finds that respite areas are a useful mitigation measure while an individual is
in them, as well as to the degree that they allow that individual’s body temperature to normalize
before going back into housing areas. However, the respite program at the Pack Unit suffers
many deficiencies, described above, that make its use difficult and unpleasant, and that
discourage inmates from seeking respite. Even if respite were actively encouraged and made to
be more comfortable, it is clear that Warden Herrera could not accommodate large numbers of
inmates in respite at any given time without drastically changing the operations of the Pack Unit.
Assuming that the Pack Unit could create a respite program that functions as intended, inmates at
the Pack Unit are still left vulnerable to heat-related illness from the extreme heat faced while in
their housing areas. This risk is especially heightened for individuals with conditions, or on
medications, that affect their ability to thermoregulate.
Wellness Checks
Defendants claim that wellness checks of inmates on the heat-restriction list are
performed every 30 minutes at the Pack Unit, and that this is an effective mitigation measure. It
is somewhat unclear what is meant by “wellness check.” TDCJ’s 2017 Heat Directive states that,
“During normal security checks, officers must conduct wellness checks and seek care for
64
offenders requesting medical assistance or exhibiting signs of illness.” Defs.’ Ex. 7 at 1. Neither
TDCJ nor the Pack Unit has written directions about how to conduct a wellness check. Hearing
Tr. 4 at 6. Defendants’ expert, Dr. Rieger, testified that a wellness check simply means human
contact. Hearing Tr. 7 at 95. Specifically, it gives “each person in that contact an opportunity to
see the other, to look at their state, to ask questions if they want to, not ask questions if they
don’t want to.” Id. at 95. He emphasized the importance of looking at each inmate and making
eye contact with each inmate. Id. at 96. Plaintiffs insist that a wellness check should be
conducted by medical personnel, and should include specific questions that each inmate is asked.
Docket Entry No. 620 at 5; Hearing Tr. 9 at 94.
What is in fact occurring at the Pack Unit appears to be less involved than any of the
descriptions above. Warden Herrera testified that wellness checks are essentially security checks,
which have been performed in TDCJ facilities since 1980, but stated that “we pay a little bit
closer attention to the ones on the [heat-restriction] list.” Hearing Tr. 4 at 6. Thus, in the summer,
during the security check that is performed every 30 minutes, officers are expected to pay closer
attention to the inmates that are on the heat-restriction list, which each officer receives. Warden
Herrera testified that security/wellness checks for an entire dormitory, housing 56 men, take
around four or five minutes to complete. Id. at 12.
The named Plaintiffs who are on the heat-restriction list all testified that there is nothing
different about the security checks that occur in the summer as opposed to those that occur in the
winter. Hearing Tr. 1 at 30; 89; 143; 216. Mr. King stated that, if an inmate is awake,
correctional officers “just walk on past” without stopping. Id. at 30. If an inmate is asleep, the
officer will wake him up and ask, “Are you alive?”26 Id. at 30; 142; 156; 216-217. The Court
26
Both Defendants’ and Plaintiffs’ experts found this practice troubling. Dr. Rieger testified that
he did not see what is added by waking inmates up in the middle of the night, as opposed to
65
finds that the consistency of Plaintiffs’ testimony lends credibility to their assertions;
furthermore,
their
statements
are
supported
by
Warden
Herrera’s
testimony
that
security/wellness checks for 56 inmates take four or five minutes to complete. There are no
written materials instructing officers on how to conduct wellness checks, nor are there
documents that are filled out during wellness checks to ensure that they were properly done and
that each inmate was observed. Hearing Tr. 4 at 26. Mr. Vail credibly testified that wellness
checks, as currently performed, do little to prevent heat-related illness. Hearing Tr. 2 at 274.
Although Dr. Rieger stated that wellness checks were effective in reducing heat-related illness,
the checks that he described are not occurring at the Pack Unit. Hearing Tr. 7 at 95. However,
even if wellness checks were conducted in a more thorough manner, Dr. Vassallo opined that the
rapid onset of heat stroke means that even frequent observations of persons at high risk of heat
stroke are unlikely to give adequate warning of impending heat stroke. Docket Entry No. 340-18
at 8. Thus, the Court finds that the wellness checks implemented at the Pack Unit are an
ineffective mitigating measure for heat-sensitive inmates.
Employee and Inmate Training
In the 2017 Heat Directive email, TDCJ states that employees and offenders should be
trained to be aware of “the signs and treatment for heat-related illnesses.” Defs.’ Ex. 7 at 1.
TDCJ also states, in the email, that employees and offenders should be trained and compliant
with heat precaution procedures, “including knowledge of respite area locations and offender
access.” Id. Finally, all employees are to be given Employee Information Cards, which contain
information about symptoms and treatment of heat-related illnesses. Id. TDCJ has produced a
training video that is shown to employees and inmates on a regular basis. Hearing Tr. 3 at 107.
simply checking to make sure the inmate is breathing. Hearing Tr. 7 at 97. Mr. Vail similarly
expressed his opinion that this practice is problematic. Hearing Tr. 2 at 135.
66
This video shows the symptoms of heat-related illnesses, but says nothing about the availability
and importance of respite. Hearing Tr. 4 at 59.
As discussed in detail in the section of this opinion dealing with respite, there appears to
be very little communication to inmates about the importance of seeking respite during extreme
temperatures. Such information could be useful to inmates, although it would be limited by the
capacity and comfort problems with the Pack Unit’s respite program, as previously identified.
2. Heat Wave/Extreme Temperature Policy
Defendants’ expert, Dr. Rieger, testified that, eventually, Texas will experience another
heat wave—the question is not “if,” but “when.” Hearing Tr. 7 at 80. The Court and the parties
have no way of knowing when a heat wave will occur, but it is clear that one will come.27 Given
the many deaths and heat-related illnesses in TDCJ that resulted from the 2011 heat wave, the
import of having detailed and thorough responses in place cannot be overestimated. This is
especially true given Dr. Rieger’s testimony that, in the event of a heat wave, the current
mitigation measures would not suffice to protect the inmates in the Pack Unit. Id. at 79-80.
Defendants argue that they already have a heat wave policy, in the form of their “Incident
Command System” (“ICS”). Docket Entry No. 641 at 31. ICS is a system used nationwide to
respond to emergencies and to communicate within and between agencies. Hearing Tr. 4 at 179.
Within TDCJ, ICS is initiated any time there is some type of emergency in a facility, such as a
sick inmate, a fight, or an alleged sexual assault, all the way up to a complete evacuation of a
unit. Id. at 179; Hearing Tr. 5 at 173. For large-scale events, such as a hurricane, the official
27
The Court takes judicial notice that “climate scientists forecast with a high degree of
confidence that average temperatures in the U.S. will rise throughout this century and that heat
waves will become more frequent, more severe, and more prolonged.” Daniel W. E. Holt, Heat
in U.S. Prisons and Jails: Corrections and the Challenge of Climate Change, Columbia Law
School
Sabin
Center
for
Climate
Change
Law,
i
(August
2015),
https://web.law.columbia.edu/sites/default/files/microsites/climate-change/holt_-_heat_in_us
_prisons_and_jails.pdf.
67
command center is located in Huntsville, Texas, and includes various TDCJ administrators.
Hearing Tr. 5 at 173. Mr. Ginsel insists that ICS is a heat wave policy, and testified that, if TDCJ
believes there may be a heat wave, the ICS command center will come together “to make the
determination are we going to shut down activities on the unit or are we going to evacuate
offenders from that unit.” Id. at 178. Although the Incident Command System was in place in
2011, Mr. Ginsel testified that it was not initiated with regard to the heat wave that killed ten
men in TDCJ facilities. Id. at 178. This casts doubt on Mr. Ginsel’s confidence that ICS will be
activated, and will provide the necessary procedures, in the event of another heat wave.
Other than Mr. Ginsel, none of the witnesses thought that ICS was a heat wave policy.
Warden Herrera testified that there is no heat wave policy for TDCJ or for the Pack Unit.
Hearing Tr. 4 at 169. Despite acknowledging that the Pack Unit will experience another heat
wave at some point in the future, and that a formal heat wave policy would be helpful in the
event of a heat wave, Warden Herrera stated that he will not develop a heat wave policy unless
ordered to do so by his supervisors or this Court. Id. Dr. Rieger testified that he does not think
that ICS is a heat wave policy, and that he would want a written policy dictating how to respond
to a heat wave. Hearing Tr. 7 at 74. Mr. Vail testified that TDCJ does not have a heat wave
policy, and that, while ICS is a structure with which to respond to different types of emergencies,
it contains no protocols specific to a heat wave. Hearing Tr. 2 at 141-142. Mr. Vail used the
example of an escape to demonstrate his point: if an inmate escaped, TDCJ would certainly use
ICS. However, it would also use its written policy dictating what specific steps to take in
response to the escape, such as alerting local law enforcement, setting up roadblocks, and calling
in scent-tracking dogs. Id. at142; Hearing Tr. 5 at 202. Mr. Ginsel responded that there is a
separate written policy for escapes because “an escape is an escape whether you escape from one
68
prison or another.” Hearing Tr. 5 at 202. He averred that this cannot be said for a heat
emergency. Id. at 203.
The Court finds that Mr. Ginsel’s testimony on this matter is not credible. It is clear to the
Court and to every other witness, including a Defendant in this case, that ICS is not a heat wave
policy. It is also apparent that a heat wave policy would be beneficial when the next heat wave
occurs. Finally, the Court finds Mr. Ginsel’s reasoning that TDCJ cannot develop a specific
written protocol for heat waves because the response to a heat wave will not be the same in every
facility exceedingly unpersuasive, for the following reasons.
First, Mr. Vail and Dr. Rieger listed several protocols that could be implemented at most,
or all, facilities, in the event of a heat wave. Mr. Vail testified that, in the event of a heat wave,
air conditioners could be rented, more ice water could be provided, or more medical staff could
be brought in. Hearing Tr. 2 at 142. Dr. Rieger stated that kitchens could be shut down to reduce
heat, cold meals could be served to reduce heat gain from hot meals, recreation could be
eliminated, and heat-sensitive inmates could be moved to a facility with air conditioning.
Hearing Tr. 7 at 81. Both experts emphasized that these are just suggestions that could be
rejected, and that TDCJ is in the best position to brainstorm as to what procedures would be most
effective considering its resources and facilities. Hearing Trs. 2 at 142; 7 at 80.
Second, the “Heat Directive” email, which Defendants call a policy, lists steps that
should be taken in all TDCJ facilities during the summer. Defs.’ Ex. 7. These steps include
things like, “All offenders may purchase a fan if they do not already have one,” and, “Make sure
window screens [in housing areas] are clean so air flow is not restricted.” Id. at 3. But the Court
is aware that certain facilities in TDCJ do not have electrical outlets for personal fans. McCollum
v. Livingston, 2017 WL 608665, at *3 (S.D. Tex. Feb. 3, 2017). Others have windows that are
69
sealed shut, such as the expansion dormitory at the Pack Unit. Thus, TDCJ’s Heat Directive lists
protocol that cannot always be followed, due to the uniqueness of each facility. This did not
prevent TDCJ from creating protocols that should be followed to the best of each warden’s
ability; nor should differences in facilities prevent the development of a heat wave policy.
Finally, if in considering the creation of a heat wave policy, TDCJ honestly concludes
that it is impossible to list protocols to be followed at every facility, there is no reason why TDCJ
could not order each facility to develop its own heat wave policy. Alternatively, TDCJ could
develop a list of suggested protocols, and require that individual facilities create their own
policies based on those suggestions. For these reasons, the Court is not persuaded that the
difficulties of constructing a heat wave policy justify Defendants’ failure to do so. The Court
does not doubt that ICS will, and should, be used during the next heat wave. But the risk that
heat waves present requires preparation well beyond this system.
3. Heat-Related Illnesses at the Pack Unit
Defendants make much of the fact that only five reported heat-related illnesses occurred
in the Pack Unit in 2016, and that as of June 19, 2017, none had been reported in 2017. Hearing
Tr. 5 at 38. The Court regards these statistics with skepticism. The Court has found that heatrelated illnesses are vastly underreported. See Section I.E.2 supra. Indeed, Mr. Pennington
testified that, earlier this summer, he began to feel dizzy, had difficulty breathing, and felt
“funny,” like he was going to faint. Hearing Tr. 1 at 138-139. He went to the infirmary to cool
down but was not diagnosed with a heat-related illness, although the nurse told him his
symptoms were a result of the heat. Id. All of the Plaintiffs described experiencing symptoms
similar to those of Mr. Pennington on a regular basis, but these symptoms are very rarely
reported or diagnosed as a heat-related illness.
70
Furthermore, the Court finds that Ms. McWhorter, who collects the incidents of heatreported illness across TDCJ, may have underrepresented the number of reported illnesses. For
example, Ms. McWhorter’s documents indicate that six heat-related illnesses occurred at the
Pack Unit in 2012. Hearing Tr. 5 at 82. Yet documents produced by TDCJ reveal 12 incidents of
heat-related illness at the Pack Unit. Id. Ms. McWhorter was unable to provide an explanation
for this discrepancy.
Even if the number of heat-related illnesses is as low as Ms. McWhorter testified, it does
not support Defendants’ argument that the mitigation measures implemented in 2015—respite
areas, cool-down showers, and wellness checks—have caused a decrease in the risk of heatrelated illness. According to Ms. McWhorter, the number of reported heat-related illnesses in the
Pack Unit was five in 2012; two in 2013; three in 2014; three in 2015; and five in 2016. Defs.’
Ex. 50. Defendants’ own statistics reflect no decrease in reported heat-related illnesses since the
implementation of the measures touted by Defendants. Furthermore, the Court finds that these
numbers more likely reflect systemic under-reporting of heat-related illnesses in TDCJ, rather
than the success of the new mitigating measures. The Court finds that this under-reporting has
various causes, such as the medical reasons discussed in section I.E.2, as well as inmates’ lack of
knowledge regarding the symptoms and seriousness of heat-related illness; inmates’ sense of
learned helplessness from years of complaints about the heat going unheeded; requirements, such
as the measuring of core body temperature with a rectal thermometer, that discourage the
reporting of heat-related illness; and the instinct to treat the symptoms of heat-related illness
without going to the infirmary.
Finally, the Court finds that high numbers of heat-related illnesses are not a prerequisite
for a finding that a substantial risk of serious harm exists. “That the Eighth Amendment protects
71
against future harm to inmates is not a novel proposition.” Helling v. McKinney, 509 U.S. 25, 33
(1993); see also Ball, 792 F.3d at 593 (“To prove unconstitutional prison conditions, inmates
need not show that death or serious injury has already occurred.”) “It would be odd to deny an
injunction to inmates who plainly proved an unsafe, life-threatening condition in their prison on
the ground that nothing yet had happened to them.” Helling, 509 U.S. at 33. The Court applauds
the efforts that TDCJ has made to implement mitigating measures at the Pack Unit and other
facilities. But Plaintiffs have shown that heat-related illnesses still occur at the Pack Unit, in spite
of these mitigation measures. The record is replete with evidence of unreported heat-related
illnesses experienced by Plaintiffs on a regular basis. Expert witnesses have convincingly
testified that Plaintiffs face a substantial risk of harm from the current conditions at the Pack
Unit. Credible evidence reveals that Defendants have no substantive plan in place in the event of
a heat wave, and there is no dispute among the experts that the current mitigating measures
would not suffice during a heat wave. Plaintiffs do not need to show high numbers of heatrelated illnesses at the Pack Unit to establish that they are still at risk of current and future harm.
Accordingly, the Court finds that Plaintiffs face a risk of current and future harm from the
conditions at the Pack Unit.
H. Proposed Remedies
Plaintiffs have proposed numerous remedies, should the Court find an ongoing
constitutional violation. The primary remedy they seek is for the Court to order the Pack Unit to
reduce the temperatures in the housing areas. Should the Court agree, and order Defendants to
reduce the temperatures, no other remedies are sought. However, if the Court does not order such
relief, Plaintiffs request numerous forms of alternate relief, discussed below.
72
1. Air Conditioning
Despite a variety of fans and ventilators in the housing units at the Pack Unit, TDCJ has
not reduced the heat index in those areas. Thus, the primary relief sought by Plaintiffs is the
reduction of the indoor apparent temperatures in the housing areas to below 88 degrees.
Although it is possible to cool spaces without the installation of air conditioning units, see Ball v.
LeBlanc, 223 F.Supp. 3d 529, 537-541 (M.D. La Dec. 22, 2016), rev’d on other grounds, the
simplest way to do so is to install some sort of air conditioning system.
a. The Effectiveness of Air Conditioning
Dr. McGeehin credibly testified that “heat is one of the few things that we can point to
something and say that eliminates the risk.” Docket Entry No. 460 at 155. In the case of heat,
that “something” is air conditioning. Id. Dr. McGeehin specifically testified that the deaths that
occurred in TDCJ facilities as a result of heat-related illness could have been prevented by air
conditioning, and that air conditioning would eliminate the risk of injury or death that currently
exists in the Pack Unit. Id. at 155, 157. In 1995, 90 percent of all homes in southern states were
air conditioned, and that number has likely increased in the past 22 years. Id. at 156. (This
statistic is the most recent one to appear in the record.) The American Society of Heating,
Refrigerating and Air-Conditioning Engineers (“ASHRAE”) produces standards by which
engineers design structures and air conditioning systems. The ASHRAE 55 comfort standard has
been in place since 1981, and dictates that structures should be air conditioned to about 75
degrees. Hearing Tr. 8 at 16. Dr. Vassallo testified that death rates in free society were much
higher before air conditioning existed or became standard. Docket Entry No. 465 at 100. Because
deaths from heat stroke were not reported, it is impossible to know how many of those deaths
were caused by extreme heat. Id. But the Court finds convincing Dr. Vassallo’s hypothesis that
73
significantly more people died of heat stroke before air conditioning existed than do now.
Regardless, it is clear that air conditioning effectively reduces the risk of heat-related illness,
even in climates with extreme heat, such as Texas.
b. Pre-Existing Air Conditioned Beds Within TDCJ
TDCJ currently has over 150,000 beds in its 109 facilities across the state. Of those beds,
32,434 are air conditioned. Hearing Tr. 6 at 24; Defs.’ Ex. 109 at 3. Twenty-eight facilities have
air conditioning in all of the housing areas, 53 facilities have air conditioning in some of the
housing areas, and 23 facilities have no air conditioning at all in the housing areas. Defs.’ Ex.
109 at 3. Defendants contend that none of the beds in air conditioned housing would be
appropriate for the inmates at the Pack Unit, for a variety of reasons. Of the air conditioned beds
throughout TDCJ facilities, 3,745 are segregation cells, and 11,616 are treatment28 beds, leaving
17,073 air conditioned general population beds. Id. Mr. Ginsel testified that approximately 3,386
of these general population beds are located in female units. Hearing Tr. 6 at 24-25. State jails,
which are designed to house people sentenced to two years or less for a non-aggravated crime,
contain 4,274 of the air conditioned beds. Id. at 23, 25. Transfer facilities have 2,068 air
conditioned beds, and are generally less secure than long-term facilities such as the Pack Unit.
Id. at 25-27. This means they would be unable to accommodate many of the inmates at the Pack
Unit who have long sentences. Id. An estimated 234 beds are located in pre-release facilities,
which are designed for inmates within three years of release. Id. at 27; Defs.’ Ex. 109. About
3,229 beds are used for “safekeeping,” high-security inmates, or “transient” inmates. Hearing Tr.
6 at 33. “Safekeeping” beds are used to house vulnerable populations, such as transgender or
gender-nonconforming inmates, or inmates who are small in stature. Id. at 28-29; Defs.’ Ex. 109.
28
“Treatment” beds include beds used for offender programs, medical, and mental health.
Placement in these beds is generally done at the recommendation of the Board of Pardons and
Parole (for programs) and medical staff (for medical and mental health). Defs.’ Ex. 109 at 3.
74
High-security beds are used for inmates with a “G5” security level, which means they are one
step from going to administrative segregation—they are inmates with a history of aggression or
possession of weapons in prison. Hearing Tr. 6 at 31. “Transient” inmates are those who are in
between locations, for a variety of reasons—pending a move to another facility, or while an
investigation into an alleged threat is ongoing. Id. at 31-32. In sum, Mr. Ginsel stated that any
court order to move inmates from the Pack Unit into pre-existing air conditioned beds would
force vulnerable and/or high-security inmates into bunks that are not designed and are not
appropriate for them. Id. at 38.
Finally, Mr. Ginsel testified that, once all of the above-listed beds were subtracted from
the approximately 17,000 non-treatment and non-segregation air conditioned beds, there would
be zero beds available for anyone from the Pack Unit. Id. at 34-35. The Court notes that, until
2013, TDCJ did not know how many air conditioned beds existed system-wide. Id. at 50. The
survey on which the above numbers are based was conducted, in part, because of a media
inquiry. Id. at 50. The Court finds that Mr. Ginsel persuasively testified that all of the air
conditioned beds in TDCJ are accounted for and in use by inmates who could not be readily or
safely transferred to non-air conditioned beds.
c. Medical Providers’ Inability to Recommend Air Conditioned
Housing
Medical providers have the ability to recommend that an inmate be placed in a Type-II or
Type-III Geriatric facility, which are required to have air conditioning. Hearing Tr. 5 at 41.
However, there are only two such facilities in all of TDCJ, and there are strict criteria for who
can be housed in each. Id. at 41; Hearing Tr. 6 at 36. The Duncan Unit is the only Type-II
Geriatric facility in TDCJ. Hearing Trs. 5 at 41; 6 at 35. It has 566 air conditioned beds. Hearing
Tr. 6 at 35. According to TDCJ, a Type-II Geriatric facility is designed for elderly male
75
offenders and has some capacity for wheelchair-bound offenders. Defs.’ Ex. 116 at 3. But, Mr.
Ginsel explained that there are also strict security considerations for assignment to the Duncan
Unit. Hearing Tr. 6 at 36. The facility was originally a transfer facility, and as such has only one
perimeter fence. Most facilities, including the Pack Unit, have two perimeter fences. Id. at 25-26,
36. As a result, Mr. Ginsel testified, inmates with long sentences could not be housed at the
Duncan Unit. Id. at 36. Furthermore, the Duncan Unit does not have psychiatric services, so
inmates with mental illness could not be housed there. Id. For these reasons, the Duncan Unit is
not a viable facility in which to house inmates at the Pack Unit. The only Type-III Geriatric
facility in TDCJ is located in the Estelle Unit. Id. at 38. It has 264 air conditioned beds, and is
designed for individuals who are capable of some self-care but who need constant medical
attention. Id; Defs.’ Ex. 109 at 1.
Ms. McWhorter, the former manager of TDCJ’s Health Services Liaison, testified that, in
order for an inmate to be assigned to a geriatric unit, a medical provider would send a request to
Health Services Liaison. Hearing Tr. 5 at 41. TDCJ would then determine whether that inmate
meets the security criteria for those units, and whether there is space. Hearing Tr. 6 at 36.
Other than the Duncan and Estelle units, medical providers do not have the ability to
recommend that an inmate be placed in air conditioned housing area because of his medical
condition or medication regimen. Pls.’ Ex. 116. Indeed, TDCJ’s “Health Services Liaison
Facility Types List” states explicitly that Health Services Liaison “cannot request reassignment
of an offender to an air conditioned or climate-controlled facility.” Id. (emphasis in original).
This is why the “heat-restriction” placed on many of the inmates at the Pack Unit includes a
prohibition on working and recreating in environments above 95 degrees, but does not
recommend housing in a climate-controlled environment.
76
d. The Installation and Cost of Air Conditioning the Pack Unit
The parties have divergent views about the difficulty and cost associated with installing
air conditioning units at the Pack Unit. The Court heard extensive testimony from both parties’
expert witnesses regarding this issue and has reviewed both expert reports. The experts testified
about the cost associated with renting and purchasing air conditioning equipment. Since this is a
preliminary injunction, however,29 the Court focuses on the evidence regarding the temporary
installation and rental of air conditioning units.
Plaintiffs’ expert, Ron Brown, testified that the cost of renting, shipping, installing, and
running air conditioning units for all of the dormitories of the Pack Unit for three months would
be approximately $108,000.30 Hearing Tr. 2 at 36. Defendants’ expert, Frank Traknyak, on the
other hand, testified that the cost of air conditioning the dormitories for three months would cost
over $1.2 million. Hearing Tr. 7 at 204. The Court finds that both experts were discredited on
cross-examination, and that neither of their estimates accurately describes the cost associated
with air conditioning all housing areas of the Pack Unit for three months. However, the Court
finds that Mr. Brown’s estimate is closer to the actual cost, as explained below.
Mr. Traknyak based his estimate on the rental of a chill water system, which is a more
expensive class of equipment than the package units recommended by Mr. Brown. Hearing Tr. 8
at 45. Mr. Traknyak also testified that generators would have to be rented in order to run the
units, and that the fuel alone for these generators would cost $316,000 per month. Hearing Tr. 7
at 204. However, the Pack Unit already owns a standby generator, and has excess capacity in its
existing electrical supply, both of which could be used to power the air conditioning units.
29
Under the Prison Litigation Reform Act, a preliminary injunction automatically expires after
90 days. 18 U.S.C.A. § 3626(a)(2).
30
Mr. Brown also found that it would cost approximately $20,000 to air condition the gym in the
Pack Unit for three months. Hearing Tr. 2 at 44-46.
77
Hearing Tr. 8 at 65-69. Although the Court is not considering the costs involved with installing
permanent air conditioning at the Pack Unit at this time, the Court notes that Mr. Traknyak
testified that it would cost over $22 million to install permanent air conditioning at the Pack
Unit.31 Id. at 42. A large portion of this cost derives from the assumption that there would need
to be significant changes to the building structure to ensure compliance with all current
construction codes, such as the building code and energy code. Id. at 42. Mr. Traknyak’s
testimony was significantly undermined when he testified on cross examination that he knew that
TDCJ does not have to comply with building codes, but still chose to incorporate those costs into
his estimate. Id. at 29-30. The Court finds that Mr. Traknyak’s estimate for the cost of
temporarily air conditioning the Pack Unit is needlessly high and does not accurately reflect the
true cost that would be incurred by TDCJ.
The Court also finds that Mr. Brown underestimates the cost of temporarily air
conditioning the Pack Unit. Several problems with Mr. Brown’s calculations were revealed on
cross-examination. Mr. Brown used industry-standard software for calculating the amount of
cooling necessary to bring the Pack Unit to his design point of 85 degrees. Hearing Tr. 2 at 1415. The software accounts for a variety of factors, including the type of walls that surround the
structure in question. The Pack Unit’s walls are made of insulated sheet metal. Id. at 69.
However, Mr. Brown based his calculations on insulated concrete. Id. Mr. Brown testified that
these two materials are similar, and that using insulated sheet metal would not have made a
significant difference in the outcome of the calculations. Id. at 69-70. The software used by Mr.
Brown also accounts for location, but only has certain locations to choose from, so the user must
select the closest one. Mr. Brown input “Austin” as the location, which is 100 miles away from
31
Mr. Traknyak also testified that it would cost $79 million to install air conditioning at the
Hutchins Unit; $135 million at the Michael Unit; $109 million at the Hodge Unit; and $79
million at the Gurney Unit. Hearing Tr. 8 at 3-4.
78
the Pack Unit. Meanwhile, Mr. Traknyak input Easterwood Airport, which is 30 miles away
from the Pack Unit. Id. at 71. Mr. Brown was using an older version of the software, which does
not have Easterwood Airport as an option, so Austin was the closest location. Id. at 72. Although
neither of these inaccuracies likely had a large effect on the resulting estimates, they do detract
from Mr. Brown’s overall credibility.
Mr. Brown also designed his air conditioning system to cool to 85 degrees, not including
humidity, compared to Mr. Traknyak’s cooling point of 80 degrees. Hearing Tr. 8 at 43-44. Mr.
Traknyak’s lower cooling point increases the amount of power required, and the resulting cost,
of his system. Id. But the Court finds that Mr. Brown’s cooling point of 85 degrees is not
adequately protective, considering the high levels of humidity at the Pack Unit. Finally, Mr.
Brown did not make any room for “redundancy”—the idea that if one unit breaks, there is
another on hand that can supply sufficient air conditioning. Hearing Tr 2. at 68. Mr. Traknyak,
on the other hand, included 15-20% redundancy in his estimate. Hearing Tr. 8 at 60. Because of
the above-described problems problems with Mr. Brown’s calculations, the Court finds that Mr.
Brown’s estimate is probably slightly lower than the actual cost. However, the Court finds that
Mr. Brown’s estimate is closer to the actual cost than Mr. Traknyak’s estimate.
2. Window Screens
Plaintiffs request that Defendants be required to install window screens with insectresistant mesh to prevent insect infiltration, while permitting airflow from open windows.
Warden Herrera testified that, when he first became warden of the Pack Unit, the windows had
mesh screens that kept out all insects. Hearing Tr. 4 at 76. There was a problem with inmates
cutting the screens or pushing them out in order to smuggle contraband, so the prison replaced
the screens with stainless steel screens. Id. at 76-78. These screens cannot be cut through, and are
79
bolted into place. Id. at 78. However, the holes between the wires are larger, allowing insects to
get through. Id. at 78-79; Hearing Tr. 8 at 93 . Mr. Vail, Plaintffs’ expert on corrections, testified
that while he understands the need for the security screens, he has seen other prisons where
screens that can keep out insects are placed on the outside of the security screen. Hearing Tr. 2 at
174. This way, security is not undermined, and insects are unable to enter the housing areas.
Mr. Ginsel testified that he believes placing an additional screen over the existing screen
would hinder airflow into the housing areas. Hearing Tr. 5 at 154. While Mr. Ginsel has worked
in corrections for many years, he is not an expert on climate or cooling, and as such his
testimony on this issue must be discounted. It is certainly possible that an additional screen could
hinder airflow, but the Court has been presented with no evidence upon which to make that
determination.
As to cost, Mr. Farguson, TDCJ’s Director of Maintenance, estimated that installing
mesh screens at the Pack Unit would cost approximately $72,000. Hearing Tr. 8 at 94; Defs.’ Ex.
120 at 4. Although Mr. Farguson forgot to input the estimated cost of the screens themselves, the
Court finds that Mr. Farguson’s estimate is unrealistically high. Hearing Tr. 8 at 93-94. Mr.
Farguson estimated that it would take 622 hours to install the screens—77 eight-hour days.
Defs.’ Ex. 120 at 4. Mr. Farguson does not explain, in his report or his testimony, how he
reached this number, or why it is so high. Mr. Farguson also estimates spending over $6,000 on
paint and primer, presumably to paint the window frames, but does not explain why this is
necessary for installation. Id. Accordingly, the Court discounts entirely Mr. Farguson’s
testimony regarding the cost of installing window screens. The Court further finds that TDCJ’s
estimate about the cost of installing window screens exemplifies Defendants’ consistent over-
80
estimation of the cost of implementing Plaintiffs’ proposed remedies throughout the preliminary
injunction hearing.
The Court finds that the men living in the housing areas with windows that open should
not have to choose between the potential cooling effect from the windows, and insect infestations
in their dormitories. The Court further finds that there is simple solution to this dilemma: placing
mesh screens outside the security screens.
3. Creation of a Heat Wave Policy for the Pack Unit
Plaintiffs request that the Court order Defendants to develop a heat wave policy for the
Pack Unit. The Court has already discussed the importance of a heat wave policy, and has found
unpersuasive TDCJ’s argument that the Incident Command System is a heat wave policy.
Additionally, the Court (and both parties’ experts) disagree with Defendants that it would be too
difficult to devise a substantive policy that would apply to all units. Even if it were, Plaintiffs
request that a heat wave policy be created for the Pack Unit only. Defendants have presented no
convincing reasons why this should not be ordered, should the Court find an ongoing
constitutional violation.
4. Other Remedies
Plaintiffs request many other remedies, such as opening all sealed windows, monitoring
Plaintiffs’ water intake, granting access to on-demand showers, announcing temperatures in the
dormitories, scheduling respite, conducting wellness checks with medical staff, monthly inmate
training, the use of Power Breezers and IcyBreeze units, distributing individual water coolers,
and more. For the reasons explained in Section III, the Court does not find it necessary to discuss
these remedies at this time.
81
II. Conclusions of Law
A. The Legal Standard
To obtain a preliminary injunction, the plaintiffs must establish “(1) a substantial
likelihood of success on the merits, (2) a substantial threat of irreparable injury if the injunction
is not issued, (3) that the threatened injury if the injunction is denied outweighs any harm that
will result if the injunction is granted, and (4) that the grant of an injunction will not disserve the
public interest.” Janvey v. Alguire, 647 F.3d 585, 595 (5th Cir. 2011); Nichols v. Alcatel USA,
Inc., 532 F.3d 364, 372 (5th Cir. 2008).32
None of the four requirements has a fixed quantitative value. Texas v. Seatrain Int’l, S.A.,
518 F.2d 175, 180 (5th Cir.1975). Therefore, in applying the four-part test, “a sliding scale is
utilized, which takes into account the intensity of each in a given calculus.” Id. This requires “a
delicate balancing of the probabilities of ultimate success at final hearing with the consequences
of immediate irreparable injury that possibly could flow from the denial of preliminary relief.”
Klitzman, Klitzman & Gallagher v. Krut, 744 F.2d 955, 958 (3d Cir.1984).
The decision to grant or deny a preliminary injunction is discretionary with the district
court. Miss. Power & Light Co. v. United Gas Pipe Line Co., 760 F.2d 618, 621 (5th Cir.1985).
However, because a preliminary injunction is an extraordinary remedy, it “should not be granted
unless the party seeking it has clearly carried the burden of persuasion on all four requirements.”
Planned Parenthood Ass’n of Hidalgo Cty. Tex., Inc. v. Suehs, 692 F.3d 343, 348 (5th Cir.2012).
32
“[A]t the preliminary injunction stage, the procedures in the district court are less formal, and
the district court may rely on otherwise inadmissible evidence, including hearsay evidence.”
Sierra Club, Lone Star Chapter v. F.D.I.C., 992 F.2d 545, 551 (5th Cir. 1993).
82
B. Likelihood of Success on the Merits
1. The Constitutional Requirements
The Eighth Amendment expressly prohibits “punishment” that is “cruel and unusual.”
U.S. Const. amend. VIII. “The Constitution does not mandate comfortable prisons, but neither
does it permit inhumane ones.” Farmer v. Brennan, 511 U.S. 825, 832 (1994) (internal quotation
marks and citation omitted). The Eighth Amendment imposes a duty on prison officials to
provide “humane conditions of confinement” by ensuring that inmates receive adequate food,
clothing, shelter, and medical care, and that “reasonable measures” are taken for inmate safety.
Id.
A plaintiff must meet two requirements to establish an Eighth Amendment violation.
First, “the deprivation alleged must be, objectively, sufficiently serious.” Id. at 834 (internal
quotation marks and citations omitted). Conditions of confinement that deprive an inmate of “the
minimal civilized measure of life's necessities . . . are sufficiently grave to form the basis of an
Eighth Amendment violation.” Wilson v. Seiter, 501 U.S. 294, 298 (1991) (internal quotation
marks and citation omitted). Second, the plaintiff must show that the prison official acted with
deliberate indifference to that known risk. Farmer, 511 U.S. at 834.
2. Conditions of Confinement that Violate the Eighth Amendment
a. Substantial Risk of Serious Injury or Death
Plaintiffs have shown a substantial risk of serious injury or death as a result of the
conditions at the Pack Unit. The Fifth Circuit has found extreme heat in prisons to violate the
Eighth Amendment when insufficient mitigation measures are used. Ball, 792 F.3d 584
(affirming necessity of injunctive relief to protect inmates from high indoor temperatures);
Gates, 376 F.3d at 339 (same). Outdoor conditions at the Pack Unit routinely exceed 100 degrees
83
during the summer months. During the hearing, a heat advisory was issued for the county in
which the Pack Unit is located, warning that the heat index would reach “near or above 108”
degrees that day. Evidence reveals that the conditions inside some of the housing areas are even
hotter than those outside. Despite these conditions, which are known to cause a high risk of heatrelated illness, Defendants have not found a way to cool the housing areas to a safe temperature,
or to sufficiently counteract the risk without cooling the housing areas.
The evidence further shows that heat-related illness can lead to serious injury or death
quickly, with little warning, and in ways that make it difficult for those experiencing the
symptoms to get the proper help. Indeed, at least 23 men have already died from heat-related
illnesses in other TDCJ facilities. Although TDCJ has implemented more mitigating measures in
all facilities since those deaths, the Court has found that these mitigating measures are often
ineffective, and that the risk of serious injury or death remains. This risk is especially heightened
for inmates who suffer from conditions or take medications that impede the body’s ability to
regulate its temperature.
Defendants emphasize that they have implemented mitigating measures above and
beyond those mandated by the Fifth Circuit in Ball, 792 F.3d at 599 (listing measures such as
diverting cool air from the guards’ pod into the prison tiers; allowing inmates to access air
conditioned areas during their tier time; allowing access to cool showers at least once a day;
providing an ample supply of cold drinking water and ice at all times; and supplying personal ice
containers and individual fans). But in listing those measures, the Fifth Circuit did not hold that
those were the only measures necessary to meet the requirements of the Eighth Amendment.
Rather, the Fifth Circuit found that the district court’s order to air condition Louisiana’s death
row violated the Prison Litigation Reform Act, which requires district courts to order remedies
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that eliminate the constitutional injury without more. Id. at 599. Because measures short of air
conditioning existed but had not been implemented, the Fifth Circuit found that those measures
could eliminate the injury in a less intrusive manner than air conditioning. Id. Implicit in the
Fifth Circuit’s holding is that, if those measures were subsequently found to be insufficient to
rectify the constitutional violation, other remedies, such as air conditioning, would be
appropriate. Indeed, the Fifth Circuit has affirmed determinations that prison officials violated
the Eighth Amendment despite evidence that the officials implemented some remedial measures,
when those remedial measures proved inadequate to protect inmates from extreme heat. Webb v.
Livingston, 618 Fed. Appx. 201, 209 n. 7 (5th Cir. 2015) (“the mere presence of remedial
measures would not end the inquiry, as such measures must be adequate.”).
Although Defendants have implemented the mitigating measures contemplated by the
Fifth Circuit in Ball, Plaintiffs have shown that those measures are insufficient to protect against
a substantial risk of harm. Plaintiffs testified that the conditions in the housing areas are
unbearable, and cause them to experience the symptoms of heat-related illnesses on a daily basis.
The mitigating measures put in place by Defendants are by and large ineffective at reducing the
heat stress placed on Plaintiffs’ bodies. In some cases, they even increase the heat index, as
exemplified by the Power Breezers that add humidity and the fans that blow hot air on Plaintiffs’
bodies. In other cases, they create new problems, such as the open windows that allow insects
into the housing areas. They do not stop Plaintiffs from experiencing the symptoms of heatrelated illnesses and do not reduce the risk of serious injury or death to a socially-acceptable
level. In sum, the Court concludes, based on the findings detailed in the previous sections, that
Plaintiffs have shown a substantial risk of serious illness or death from the current conditions at
the Pack Unit.
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b. Deliberate Indifference
Deliberate indifference is defined as a failure to act where prison officials have
knowledge of a substantial risk of serious harm to inmate health or safety. Farmer, 511 U.S. at
837. The deliberate indifference standard is an “extremely high” standard to meet. Domino v.
Texas Dep’t of Criminal Justice, 239 F.3d 752, 756 (5th Cir. 2001). A prison official is not liable
for deliberate indifference unless the official knows of and disregards an excessive risk to an
inmate’s health or safety. Id. The official must be aware of facts from which the inference could
be drawn that a substantial risk of serious harm exists, and he must also actually draw the
inference. Id. “Whether a prison official had the requisite knowledge of a substantial risk is a
question of fact subject to demonstration in the usual ways, including inference from
circumstantial evidence.” Ball, 792 F.3d at 594 (quoting Farmer, 511 U.S. at 826). However, a
prison official’s knowledge of a substantial risk of harm may be inferred if the risk was obvious.
Farmer, 511 U.S. at 829.
The evidence in the record reveals that Defendants know that a risk of serious harm exists
as a result of the extreme temperatures at the Pack Unit. Defendants are aware that nearly two
dozen men have died of heat-related illness at TDCJ facilities, and that inmates and correctional
officers regularly experience heat-related illnesses. Furthermore, their own policies reflect the
known danger of the heat in Texas. For example, as stated in TDCJ’s “Training Circular” on
extreme heat, “A Heat Advisory is issued within 12 hours of the onset of extremely dangerous
heat conditions . . . Take precautions to avoid heat illness. If you do not take precautions, you
could become seriously ill or even die.” Pls.’ Ex. 53 at 2. Similarly, as written in TDCJ’s “Heat
Directive” email, “It is the time of year again, when employees and offenders may be affected by
extreme heat conditions. Due to the potential for extreme heat conditions in the coming months,
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it is imperative that everyone take precautions to help prevent or reduce heat-related illnesses.”
Defs.’ Ex. 7 at 1. As to heat waves, Warden Herrera testified that he knows another heat wave
will hit the Pack Unit at some point in the future, but stated that he has no intention of creating a
heat wave policy unless ordered to do so by this Court or his superiors. Defendants’ expert
testified that he believes there should be a heat wave policy, and that the current mitigation
measures will not suffice in the event of a heat wave. Considering this evidence, the Court
concludes that Defendants are aware of a substantial risk of serious harm to Plaintiffs.
Alternatively, the Court concludes that the risk of harm from the extreme temperatures at the
Pack Unit is obvious.
Specifically with regard to the heat-sensitive subclass, the evidence shows that
Defendants are aware of the increased risk of harm faced by heat-sensitive inmates. TDCJ’s
Administrative Directive 10.64 discusses offenders who have been identified “as having a
condition or being on a medication that makes the offender more susceptible to temperaturerelated issues.” Defs.’ Ex. 1 at 1. As stated in TDCJ’s “Training Circular”:
TDCJ and medical staff shall work together to identify offenders susceptible to
temperature-related illness due to medical conditions. Medical staff shall provide
correctional staff a list of offenders susceptible to temperature-related illness due
to medical conditions, including offenders on prescribed diuretics or other
medications known to inhibit the dissipation of heat.
Pls.’ Ex. 53 at 3. Similarly, TDCJ’s “Heat Directive” instructs officials to provide the heatrestriction list, “a list of offenders identified as heat sensitive,” to all officers assigned to housing
areas. Defs.’ Ex. 7 at 1. Accordingly, the Court finds that Defendants are aware of an increased
risk of serious injury or death faced by inmates with heat sensitivities.
The evidence shows that, despite knowing of the substantial risk of harm faced by all
inmates at the Pack Unit, and the increased risk of harm faced by the heat-sensitive inmates,
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Defendants have disregarded this risk. Defendants argue that they have implemented several
mitigating measures since the deaths in 2011 and 2012, and that this shows that they are not
deliberately indifferent. But the effectiveness of the measures implemented by TDCJ is relevant
to the Court’s analysis. Webb, 618 Fed. Appx. at 209 n. 7 (“the mere presence of remedial
measures would not end the inquiry, as such measures must be adequate.”).
The Court has already found that the large fans and personal fans used in the Pack Unit
dormitories are ineffective, and are in fact potentially harmful, above temperatures of 95 degrees.
Defendants are aware of this fact—indeed, it is written into their “Training Circular.”33 Yet they
still use fans as one of the major mitigating measures in the housing areas, despite knowing that
the heat index regularly reaches 95 degrees. One week before the hearing on Plaintiffs’ motion
for preliminary injunction, Defendants placed eight “Power Breezers” in several of the housing
areas at the Pack Unit. These fans release a light mist, slightly cooling the area immediately in
front of the fan. However, Defendants’ own expert opined that Power Breezers would not be
effective in the high-humidity environment at the Pack Unit, and would only increase the
humidity, thus potentially raising the heat index.34 The Court found that Power Breezers are an
ineffective mitigating measure. Additionally, the open windows in some of the housing units
provide little or no cooling effect during the day, but may have some cooling effect at night.
However, the gauge on the window screens is too large, allowing insects to infest the dormitories
at night. If Plaintiffs were to close the windows in the housing units, though, they would lose any
potential cooling effect from open windows, as well as the additional ventilation that windows
provide. This exact scenario was considered by the Fifth Circuit in Gates v. Cook, 376 F.3d 323
(5th Cir. 2004). The Fifth Circuit held that insufficient gauge on window screens could cause an
33
34
See Section I.F.1, supra.
See id.
88
Eighth Amendment violation by exacerbating heat problems if it deterred inmates from keeping
their windows open. Id. at 340.
Defendants have also emphasized the extent of their training, for inmates and correctional
officers, about the risks and symptoms of heat-related illness. These training documents highlight
the need to “take action” during heat advisories that often occur during the summertime. Yet
TDCJ does not disseminate the advisories that it receives to the affected regions. As a result,
prison officials and inmates remain unaware of the substantial risk that they face. This ignorance
is exacerbated by Warden Herrera’s decision to stop measuring the indoor heat index at the Pack
Unit when this lawsuit was filed.
Finally, the Pack Unit has implemented a respite program, which it touts as an extremely
effective mitigation measure. The Court has found, however, that this program often requires the
men at the Pack Unit—a large proportion of whom are older or have mobility impairments—to
stand for long periods of time, sometimes with their noses against a wall; sit in silence; or walk
from one area of the prison to another as the small respite areas become full. Furthermore,
because the Pack Unit only air conditions spaces intended for use by administrators and staff, the
program can accommodate only a fraction of the inmates at the Pack Unit before the normal
operations of the prison would have to start shutting down, as Warden Herrera testified. And
when a larger group of men attempted to access respite during the hearing, they were threatened
with retaliation by at least one of the correctional officers. The Court has found that this program
does not function in a way that is an effective mitigating measure when considering the extreme
temperatures faced by inmates in their housing areas.
What TDCJ did not do in the face of the substantial risk of harm is also relevant to the
Court’s analysis. The Court has found that TDCJ has never considered installing air conditioning
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in any of its facilities that were not built with air conditioning, even after inmates started dying
from heat-related illness. Although the Court understands that the task of retrofitting facilities is
considerable, even Defendants’ expert thought that it should have been considered. Hearing Tr. 7
at 135. TDCJ has also never examined options, short of retrofitting facilities, that could place
heat-sensitive inmates in air conditioned housing. Before 2013, at which point TDCJ received a
media inquiry, TDCJ did not know how many air conditioned beds existed in its facilities. TDCJ
has never conducted an official analysis to look into the possibility of housing heat-sensitive men
and women in the pre-existing air conditioned beds. This could have been done using data that
TDCJ already has, would have been a minimal burden to TDCJ, and could have resulted in
protecting men and women that TDCJ knows are vulnerable to heat-related illness. Finally, the
Court has found that Defendants have failed to develop a heat wave policy, despite the ten deaths
that occurred in TDCJ during the 2011 heat wave. Both parties’ experts agreed that Defendants
should have a heat wave policy in place, and Defendants’ expert testified that the current
mitigating measures would not keep inmates safe in the event of another heat wave. 35
Defendants’ reasons for failing to develop a heat wave policy are exceedingly unpersuasive.
In sum, the Court finds that, despite a significant risk of harm faced by the men at the
Pack Unit, Defendants have done the bare minimum. They have implemented mitigating
measures that they know, or should know, are ineffective given the extreme heat at the Pack
Unit, and they have failed to consider seriously the many more effective options available to
them. In doing so, they have ignored the risk of harm faced by the population they serve.
Accordingly, Plaintiffs have shown that Defendants are deliberately indifferent, and as such,
Plaintiffs have shown a likelihood of success on the merits of their Eighth Amendment claim.
35
See Section I.F.3 supra.
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In sum, the Court finds and concludes that:
The outdoor heat index at the Wallace Pack Unit (“Pack Unit”) regularly exceeds 100
degrees in the summer, and the conditions within some of the housing units are even
hotter.
The extreme heat inside and outside the Pack Unit places stress on the human body,
causing a risk of illness. This risk, while present for all, is heightened for some—men
who are heat-sensitive, with conditions or medication regimes that decrease the body’s
ability to regulate temperature.
The mitigation measures put in place by TDCJ and Pack Unit officials to combat the
extreme heat are insufficient to decrease the risk of harm to an acceptable level.
The conditions of confinement at the Pack Unit violate the Eighth Amendment right to be
free from cruel and unusual punishment.
C. Irreparable Injury
“When an alleged deprivation of a constitutional right is involved, . . . most courts hold
that no further showing of irreparable injury is necessary.” 11A WRIGHT & MILLER, FEDERAL
PRACTICE & PROCEDURE, § 2948.1 (3d ed. 1998), see also ODonnell v. Harris Cty., Texas, ––
F.Supp.3d ––, 2017 WL 1735456, at *81 (S.D. Tex. Apr. 28, 2017). Plaintiffs have shown that
the conditions of confinement at the Pack Unit create a substantial risk of serious injury or death.
The heat-sensitive Plaintiffs have testified that they feel, on a daily basis, symptoms of heatillness, even with access to all of the mitigating measures in place at the Pack Unit. 36 Plaintiffs
have presented evidence that even young and healthy offenders are at serious risk in the
temperatures at the Pack Unit, and that they do not have adequate access to respite in air
36
See Section I.F.1 supra.
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conditioning.37 The Warden of the Pack Unit has credibly and consistently testified that, without
an injunction from this Court, the conditions of the Pack Unit will not change.38 Hearing Tr. 4 at
79; 85; 106; 109; 118-119. As a result, Plaintiffs will continue to be denied their EighthAmendment right to conditions of confinement that do not subject them to an unacceptable risk
of harm.
The record evidence shows that Plaintiffs’ injury is irreparable. Twenty-three individuals
have already died from heat-related illnesses at other facilities in TDCJ. Those who experience
heat stroke but do not die are at risk of being permanently disabled. Furthermore, the symptoms
of heat exhaustion and heat stroke cause severe pain and suffering. Several of the plaintiffs who
testified have already experienced heat exhaustion, and all of them described experiencing
symptoms of heat-related illness. The heat-sensitive inmates face a particularly high risk of
suffering from heat-related illness, as their thermoregulatory functions are compromised. This
factor weighs strongly in favor of granting Plaintiffs’ request for injunctive relief. See also Ball,
988 F.Supp.2d at 688 (irreparable harm from heat in Louisiana death row that created a high
probability of developing a heat-related illness).
D. Balancing the Harms
Courts “must balance the competing claims of injury and must consider the effect on each
party of the granting or withholding of the requested relief.” Amoco Prod. Co. v. Village of
Gambell, Alaska, 480 U.S. 531, 542 (1987). “In exercising their sound discretion, courts of
equity should pay particular regard for the public consequences in employing the extraordinary
37
See id; Section I.D. supra.
38
At times, the Warden seemed to be inviting a judicial decree to prompt reforms or
improvements that otherwise would never materialize.
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remedy of injunction.” Weinberger v. Romero–Barcelo, 456 U.S. 305, 312 (1982) (citation
omitted).
Defendants produced plentiful evidence about the cost of implementing each requested
remedy. Although the Court has found that Defendants’ estimates were often overstated, the
Court acknowledges, and takes seriously that Defendants will incur no small cost in
implementing the remedies required by this injunction. However, the evidence in the record
shows that TDCJ has an annual budget of over $3 billion, and an annual maintenance budget of
over $40 million. Hearing Tr. 5 at 105; Docket Entry No. 720-8 at 10. Thus, the Court finds that
the remedies ordered will not negatively impact the public, because TDCJ has sufficient
budgetary resources with which to implement the remedies. Even if the remedies ordered would
be “fiscally catastrophic” for TDCJ, as Defendants maintain they are, the Fifth Circuit has held
that “inadequate resources can never be an adequate justification for depriving any person of his
constitutional rights.” Udey v. Kastner, 805 F.2d 1218, 1220 (5th Cir. 1986).
The Court further finds that the security of the prison will not be undermined by the
remedies ordered by this Court. The Court grants substantial discretion to the prison to
implement the remedies in a way that takes into consideration all of the security concerns
inherent in a prison. Accordingly, public safety will not be compromised. Conversely, if the
Court were to fail to order remedies in this lawsuit, Plaintiffs’ safety would be severely
undermined, leading to a substantial risk of irreparable injury. Accordingly, the Court finds that
this factor weighs heavily in favor of granting a preliminary injunction.
E. The Public Interest
“It is always in the public interest to prevent the violation of a party’s constitutional
rights.” ODonnell, –– F.Supp.3d ––, 2017 WL 1735456, at *83 (citing Simms v. District of
93
Columbia, 872 F.Supp.2d 90, 105 (D.D.C. 2012) (collecting cases)). The Court has found that
Plaintiffs’ Eighth Amendment rights are being continuously violated by the conditions of
confinement at the Pack Unit. Accordingly, this factor weighs heavily in favor of granting a
preliminary injunction.
F. Bond
A federal court may waive the bond requirement. Fed. R. Civ. Pro. 65(c); City of Atlanta
v. Metro. Atlanta Rapid Transit Auth., 636 F.2d 1084, 1094 (5th Cir. 1981); Corrigan Dispatch
Co. v. Casa Guzman, S.A., 569 F.2d 300, 303 (5th Cir. 1978). The Court finds that waiving the
bond is appropriate in this case; Plaintiffs are indigent, see Wayne Chem., Inc. v. Columbus
Agency Serv. Corp., 567 F.2d 692, 701 (7th Cir. 1977), and Plaintiffs have brought this suit to
enforce constitutional rights, see City of Atlanta, 636 F.2d at 1094. No bond is imposed.
III. Remedy
Under the Prison Litigation Reform Act (“PLRA”), “[i]n any civil action with respect to
prison conditions, to the extent otherwise authorized by law, the court may enter a temporary
restraining order or an order for preliminary injunctive relief. Preliminary injunctive relief must
be narrowly drawn, extend no further than necessary to correct the harm the court finds requires
preliminary relief, and be the least intrusive means necessary to correct that harm. The court
shall give substantial weight to any adverse impact on public safety or the operation of a criminal
justice system caused by the preliminary relief and shall respect the principles of comity set out
in paragraph (1)(B) in tailoring any preliminary relief. Preliminary injunctive relief shall
automatically expire on the date that is 90 days after its entry, unless the court makes the findings
required under subsection (a)(1) for the entry of prospective relief and makes the order final
before the expiration of the 90-day period.” 18 U.S.C.A. § 3626(a)(2).
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Paragraph (1)(B) of the PLRA states, “The court shall not order any prospective relief
that requires or permits a government official to exceed his or her authority under State or local
law or otherwise violates State or local law, unless—
(i) Federal law requires such relief to be ordered in violation of State or local law;
(ii) the relief is necessary to correct the violation of a Federal right; and
(iii) no other relief will correct the violation of the Federal right.” 18 U.S.C.A. §
3626(a)(1)(B).
“The PLRA greatly limits a court’s ability to fashion injunctive relief.” Ball, 792 F.3d at
598. “Under the PLRA, plaintiffs are not entitled to the most effective available remedy; they are
entitled to a remedy that eliminates the constitutional injury.” Id. at 599, citing Westefer v. Neal,
682 F.3d 679, 683–84 (7th Cir. 2012). “In Eighth Amendment cases, plaintiffs can only obtain a
remedy that reduces the risk of harm to a socially acceptable level.” Id.
The Court has concluded that Plaintiffs have demonstrated a likelihood of success on the
merits of their Eighth Amendment claim. They have shown that conditions in the housing areas
of the Pack Unit, even with all of the mitigating measures in place, subject them to a substantial
risk of serious injury or death. This risk is significantly higher for plaintiffs in the heat-sensitive
subclass.
The Court does not minimize in any degree the limitations of the PLRA in ordering the
relief necessary to cure this violation. With regard to the young and healthy inmates, given the
mandate that any relief ordered be narrowly drawn, extend no further than necessary to correct
the harm, and be the least intrusive means necessary to correct that harm, the Court concludes
that it cannot order the Pack Unit to lower the temperatures in the housing areas at this time.
Instead, it orders the Pack Unit to implement a fully functioning respite program—one that
95
corrects the many problems identified by the Court, and one that has the capacity to
accommodate, realistically and comfortably, a significant portion of the prison. The Court is
concerned that, even with a fully functioning respite program in place, young and healthy
inmates may still be subjected to unconstitutional conditions. This is especially so given the
possibility of another heat wave in the near future. However, given the potential effectiveness of
a respite program for young and healthy inmates, the Court concludes that this, along with the
other mitigation measures currently in place, may correct the harm, and the Court is bound by the
PLRA not to order more extensive corrective measures in the housing areas for the young and
healthy inmates at this time.
As to the heat-sensitive subclass, however, the Court concludes that even a fully
functioning respite program will not correct the harm. The Court heard compelling expert
testimony that the measures implemented by the Pack Unit, even if functioning as intended, do
not reduce the risk of substantial harm to inmates in this subclass. The conditions and
medications encompassed in the heat-sensitive subclass make those Plaintiffs significantly more
likely to experience heat-related illness, even with access to respite. The Court has found that
heat-sensitive Plaintiffs who are already accessing respite on a daily basis are still experiencing
the symptoms of heat-related illnesses. These illnesses can occur rapidly and with little warning,
and can lead to serious pain or death. The only way to reduce this risk to an acceptable level is to
house heat-sensitive inmates in areas with apparent temperatures lower than 88 degrees. Because
TDCJ has made clear that it cannot house the heat-sensitive Plaintiffs in any of TDCJ’s preexisting air conditioned beds, Defendants must lower the apparent temperatures in the housing
areas where the heat-sensitive plaintiffs reside to a heat index of no more than 88 degrees. This
requirement does not extend further than necessary to correct the harm, because the Court does
96
not order Defendants to reduce temperatures to a level that may be comfortable, but simply to a
level that reduces the significant risk of harm to an acceptable one.
The Court further orders Defendants to place window screens with a gauge that is small
enough to guard against insects on the outside of the security screens of the dormitories. Finally,
the Court orders Defendants to develop a heat wave policy for the Pack Unit that dictates the
criteria for determining when action should be taken, and what those actions should be, in the
event of a heat wave.
The Court concludes that the relief ordered does not require Defendants to exceed their
authority under Texas law. As previously discussed, TDCJ has an annual budget of $3 billion,
and an annual maintenance budget of $40 million. Although the cost of implementing the
remedies is still unknown, the Court concludes that the cost will come nowhere near the annual
maintenance budget for TDCJ. In fact, Defendants’ expert concluded that air conditioning all of
the Pack Unit for the summer would cost $1.2 million. The Court found that this estimate was
too high, and that the estimate by Plaintiffs’ expert of $110,000 was closer to the actual amount.
Regardless, the Court certainly does not order Defendants to air condition all of the housing
areas in the Pack Unit. And the Court does not even require any air conditioning of the areas now
used to house the heat-sensitive subclass. Defendants may re-configure areas that are currently
air conditioned to accommodate the heat sensitive, or move them to other facilities in Texas.
Defendants have access to expertise in many different fields and can no doubt draw on that
expertise in considering different options to afford the heat sensitive a safer living environment.
It is within TDCJ’s authority to use its pre-existing budget to comply with this order. However, if
it is determined that TDCJ does not have authority to comply with this order, the Court
concludes that federal law requires the relief to be ordered, the relief is necessary to correct the
97
violation of Plaintiffs’ Eighth Amendment rights, and no other relief will correct the violation of
their Eighth Amendment rights.
Although normally a court is required by Rule 65 of the Federal Rules of Civil Procedure
to describe, in reasonable detail, the acts required by its injunction, the Supreme Court has held
that in cases against state prisons, a district court must give “adequate consideration to the views
of state prison authorities.” Lewis v. Casey, 518 U.S. 343, 362 (1996). This Court recognizes the
difficulties of running a prison such as the Pack Unit, and the various considerations that
administrators must weigh when making any changes. Thus, instead of “dictat[ing] precisely
what course the State should follow,” Lewis, 518 U.S. at 362, quoting with approval Bounds v.
Smith, 430 U.S. 817, 818 (1977), in designing a more robust respite program and in determining
how to lower the temperatures in the housing areas of the heat-sensitive plaintiffs, the Court
orders that Defendants submit proposed remedies that comport with the Court’s order. However,
because the hottest days of summer are ongoing, these remedies should be submitted within 15
days of this order. A hearing is hereby set for August 8, 2017, at 2:00 p.m., at which time
Plaintiffs can respond to Defendants’ proposals. The remedies ordered by this Court must be
implemented within a time frame to be determined at the hearing.
In sum, the Court orders that:
Defendants correct the numerous problems with the existing respite program identified
by the Court in this opinion;
Defendants lower the temperature in the housing areas of heat-sensitive inmates;
Defendants install window screens, with gauges that block insects, in the windows of the
housing areas;
Defendants develop a heat wave policy for the Pack Unit;
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Defendants propose remedies that conform to the Court’s order within 15 days.
IV. Conclusion
The Court can anticipate that there will be many among the public who will recount
stories of having survived abodes in hot climates without the benefit of modern technology. The
Court also has personal experience to that effect. Further, the Court is well aware that, in the
history of correctional institutions, technical melioration of summer heat is a late arrival.
The Court is unpersuaded that the experience of those in the free world can be fairly
compared with those who are imprisoned. Choice abounds among those on the outside, whereas
the availability of choices to the imprisoned is strictly controlled by third parties. In the free
world, those who are hot can visit air conditioned spaces in shopping malls, museums, houses of
worship, community centers, public transportation, automobiles, and in the homes of friends and
family. Swimming pools may be available. And those in the free world do not have to confront
the fact that the space they inhabit today will likely be the space that they will inhabit for years,
and even decades, to come. Nor do they commonly suffer from the co-morbidities discussed
herein.
Similarly, to deny modern technology to inmates today for the simple reason that it was
not available to inmates in past generations is an argument that proves too much. No one
suggests that inmates should be denied up-to-date medical and psychiatric care, or that they
should be denied access to radio or television, or that construction of prison facilities should not
use modern building materials. The treatment of prisoners must necessarily evolve as society
evolves.
99
As Dostoyevsky said more than 150 years ago, “The degree of civilization in a society
can be judged by entering its prisons.”39 Prisoners are human beings with spouses and children
who worry about them and miss them. Some of them will likely someday be shown to have been
innocent of the crimes of which they are accused.40 But, even those admittedly guilty of the most
heinous crimes must not be denied their constitutional rights. We diminish the Constitution for
all of us to the extent we deny it to anyone.
The Court has considered an extensive record consisting of hundreds of exhibits and 13
days of testimony, heard over the course of two summers. The Court has also visited the Pack
Unit. The record evidence, the arguments of counsel, and the case law on prison heat all show
that Plaintiffs are entitled to preliminary injunctive relief. Each summer, including this one,
Plaintiffs face a substantial risk of serious harm from the sweltering Texas heat, and Defendants
have been deliberately indifferent in responding to this risk.
The Court does not come to its decision lightly. “Institutions charged with safeguarding
the public have an extraordinary trust and a difficult task. The difficulty and importance of the
task cannot defeat an equally important public trust . . . —to enforce the Constitution.” Odonnell,
–– F.Supp.3d ––, 2017 WL 1735456, at *89. The punishment of men and women who have been
convicted of crimes in our society is limited by the bounds of the Eighth Amendment. The Court
concludes that the conditions in the Pack Unit have slipped beyond those bounds, requiring
intervention by this Court and injunctive relief for Plaintiffs.
Plaintiffs’ clear likelihood of success on the merits of their claims at trial, the irreparable
injuries they will suffer without an order of relief from this Court, the public interest, and the
39
Fyodor Dostoyevsky, The House of the Dead 76 (C. Garnett trans., 1957).
40
52 men and women have been exonerated by DNA in Texas. The Cases, The Innocence
Project, https://www.innocenceproject.org /all-cases/#texas,exonerated-by-dna.
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relative weight of the harms should the Court refuse relief all weigh strongly in Plaintiffs’ favor.
Accordingly, the above-described relief is ordered.
SIGNED in Houston, Texas, on this the 19th day of July, 2017.
KEITH P. ELLISON
UNITED STATES DISTRICT JUDGE
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