Another Verdict of Gross Negligence

Jury Awards $950,000 to Aiken County Detention Center Inmate

by Don Moniak

October 22, 2023.

Earlier this month, a twelve-person Aiken County jury heard the case of Rhoads vs Southern Health Partners et al. The Plaintiff in the litigation was Cassiopia Rhoads, an Aiken County resident who was booked (1) into the Aiken County Detention Center on May 3, 2019.

Several days after her prison intake, she began to complain of headaches and nausea, and a large knot had developed on her head. By the end of the month, witnesses described the swelling as having grown to the size of a “softball” or “grapefruit.” Her condition deteriorated to the point that emergency brain surgery was required, during which a large portion of her skull was removed.

On October 13th, the jury returned a verdict that found the Aiken County Sheriff’s Office (ACSO) and the Aiken County Detention Center (ACDC) grossly negligent through “acts or omissions” which “proximately caused injury” to Plaintiff Cassiopia Rhoads.

The jury awarded the Plaintiff $950,000. The Aiken County Sheriff’s Office had been offered a settlement of $250,000 in March of 2022. The Sheriff’s Office declined that offer.

For its part, the detention center’s contract medical provider, Southern Health Partners (SHP), chose to settle for an undisclosed amount prior to the jury trial, and was dismissed from the case. In March of 2021, SHP had declined a $500,000 settlement offer.

The Verdict Form submitted by the jury on October 13, 2023.

The Summons and Complaint

In November 2020, eighteen months after Ms. Rhoads suffered an unknown head injury (2) and subsequent severe complications while incarcerated at the Aiken County Detention Center, the lawsuit alleging negligent, gross negligent , and reckless acts was filed in South Carolina’s Second Judicial Circuit Court (3) by Columbia Attorney Francis Hinson and Florence Attorney Patrick McLaughlin,.

In the detailed Summons and Complaint, it was alleged that ACDC medical provider Southern Health Partners (SHP) and its staff allegedly “failed to properly screen, monitor, and otherwise treat” Ms. Rhoads, failed to properly train corrections officers, and failed to follow its own policies and procedures or comply with contractual obligations. Southern Health Partners’ latest contract to provide medical services at Aiken County Detention Center began on July 1, 2018.

In regard to the Sheriff’s Office and County jail, the Plaintiff alleged they both “failed to ensure that…Correction Officers were properly trained on how to report/monitor inmates for signs of injury, illness, or medical issue which may require medical attention.” The Complaint also listed a long litany of standard operating procedures and training lacking at the jail.

The medical treatment timeline was never in question. Both sides agreed that Ms. Rhoads received medical treatment—at issue was whether the treatment and care by the Defendants was negligent, grossly negligent, and/or reckless. The County did argue that, because Ms. Rhoads had “over twenty medical encounters” in her one-month jail stay, there was no absence of “slight care” and therefore no gross negligence.

Also undisputed was the fact that Rhoads was “barricaded,” in a higher security cell after protesting her lack of care on May 24th and requesting transfer to a hospital. By the time of that lockdown, her head had a grapefruit sized swelling.

And there was no dispute that the end result for Ms. Rhoads included a large hole in her skull after undergoing brain surgery.

Graphic in Plaintiff’s Pretrial Brief

An Expert’s Affidavit

The Summons was accompanied by an affadavit from Dr. Jose Vazquez, the Chief of Infectious Diseases at Augusta University/Medical College of Georgia. The Summons, affidavit, and subsequent filings reported that, at some point Cassiopia Rhoads suffered a head injury that led to medical complications that eventually led to a craniotomy—a brain surgery technique which requires “the surgical removal of part of the bone from the skull to expose the brain” for surgery.

The Vazquez affidavit provides the most succinct timeline and description of what was known at the time, and is summarized here as follows:

Rhoads was incarcerated on May 3, 2019 with no symptoms of injury or illness; and kept in pre-trial detention. Four days after intake she reported headaches, fever, nausea, coordination problems, and fatigue to the medical staff, who also noted a “knot in her head.” Four days after that she was found laying on the floor complaining that, “I have a huge abscess on the side of my head that keeps getting bigger.”

Rhoads requested medical attention on May 16, 20, 21, and 28, every time complaining of symptoms ranging from severe nausea, earaches, dizziness, fever, severe head pressure, vomiting, fluid on the side of her head, a swollen face, and severe pain from a growing abscess and swelling on her head, which had grown to “the approximate size of a softball,” by May 28th.

On June 2, four weeks after reporting symptoms, followed by a visibly deteriorating condition, she was found passed out on the floor. Four hours later she was transported to Aiken Regional Medical Center. According to the affidavit, she was never provided “any medical treatment other than Tylenol, Ibuprofen, and Amoxil;” and her temperature was only taken once. At the hospital, Ms. Rhoads registered a temperature of 102.5 F.

On June 5, Ms. Rhoads “underwent a craniotomy, a surgical opening into the skull, and was diagnosed with epidural abscess and osteomyelitis” due to an antibiotic (methicillin) resistant strain of staphylococcus aureus.

Dr. Vazquez concluded in his affidavit that, had her “condition been properly identified and treated, she likely would have only required a course of antibiotics for treatment and would not have had to undergo surgery.”

Excerpt from the April 29, 2020 affidavit of Dr. Jose Vazquez. Aiken County’s denial in an interrogatory of the diagnoses of “epidural abscess and osteomyelitis” necessitated the hiring of a second expert witness to testify at the trial.

Witness Affadavits and the Motion for Spoliation.

The Plaintiff’s health condition in May of 2019 was later described in layman’s terms by several witnesses— whose testimonies were cited in a Motion for a Determination of Spoliation. In that motion, the Defense alleged that, “ACDC did not preserve any of the copious amounts of video footage taken of Plaintiff during detainment in May and early June of 2019,” and asked for an “adverse inference” against the defense for what the videos would have contained.

Testimony of deposed witnesses cited in the spoliation motion included these statements:

  • “The abscess grew enormous and was both visible and obvious.” 
  • “I could not look at Cassi without immediately noticing this giant deformity, which had caused her head and face to become misshapen and was rather gross to look at…you did not have to be a nurse or a doctor to know that something was wrong with Cassi.” 
  • “Despite the growing abscess contorting the side of her head, Plaintiff was not taken to (ARMC) until June 2, 2019, at which time the infectious process had been allowed to continue for so long that a sizable portion of the Plaintiff’s skull had been destroyed. Plaintiff required brain surgery and now has a large hole in her skull about the size of a fist….she had been complaining about the abscess since her 9th day of the 31-day detainment.” 

    (The court’s ruling on the motion is not contained in the public case files)

    The Plaintiff’s Pretrial Brief.

    By the time of the trial, further documentation of the extent of the injury was presented. Whereas a craniotomy involves replacement of the skull “flap” removed during surgery, in this case a portion of the skull had to be removed, resulting in a craniectomy. In the pre-trial brief, the abscess and associated complications were described as follows:

    Plaintiff had developed a large boggy lesion over [her right] temple.’..the abscess on the right side of Plaintiff’s head had grown to approximately 9.7 x 2.2cm in size, had destroyed a large portion of her skull, and was so extensively invading her brain that it was causing a ‘right-to- left-midline shift’ (meaning that Plaintiff’s brain had been forcefully pushed to one side by the invasion of the infectious mass into her skull).”

    Plaintiff was ultimately diagnosed with a subgaleal abscess, an epidural abscess, osteomyelitis (a bone infection), and sepsis. Plaintiff required neurosurgery to remove the infectious mass, and, because the abscess had become so large and invasive due to the failure of the Plaintiff to receive adequate medical treatment in a timely manner, a substantial portion of the Plaintiff’s skull had to be removed.”

    In total, Ms. Rhoads spent thirty-five days in Aiken Regional Medical Center.

    Minimum Standard of Care

    Aiken County parties were represented by Attorney Andrew Lindemann, whose specialties include defending government agencies from various legal complaints. Lindemann has successfully represented Aiken County and the City of Aiken in numerous lawsuits. Southern Health Partners was represented by James Long and Amy Geddes from the Nexsen Pruet law firm of Columbia.

    The case for all parties centered in large part on the extent to which Minimum Standards for Local Detention Facilities in South Carolina (MSSC) applied to the defending parties. Southern Health Partners argued twice in its first answer that the minimum standards “are not binding on SHP or its employees, or its physician/provider contractors.”

    The County’s legal position was that the minimum standards “have never been adopted as regulations and do not have the ‘force of law,’” and therefore are not legally applicable to the detention center. This dispute was summed up in Sheriff Hunt’s Trial Brief simply as “the parties do not appear to agree on the duty of care owed under South Carolina law.”

    In addition to the standard lengthy arguments pertaining to the levels of immunity from damage claims enjoyed by government agencies and employees, Lindemann pursued several other arguments on behalf of the Aiken County government agencies, which were best articulated in Sheriff Hunt’s Trial Brief :

  • Due to the “division of labor” in prisons, Corrections Officers are not obligated to attempt to override the opinions of medical professionals; and Southern Health Partners was responsible for medical treatment at all times. 

    The “division of labor” argument did not survive the scrutiny of one corrections officer. In her deposition she described having made more than twenty complaints about medical treatment shortcomings to her supervisors. When asked if she disagreed that licensed medical professionals “should make medical decisions instead of unlicensed corrections officers,” she replied:

    Under certain circumstances, absolutely, because it falls under deliberate indifference when the medical department won’t send someone out and you can clearly see they are in need of medical attention they are not providing adequately.”

  • Even if there was no training of the kind authorized in the SHP contract, the Sheriff’s Office is not legally required to train corrections officers in medical monitoring and care. 
  • A damage claim was unwarranted because the Sheriff’s office had no legal obligation to enforce the terms of the County’s contract with Southern Health Partners, citing state law precedent that “a mere breach of contract is not actionable as a tort in South Carolina.”

    Aiken County’s overall defense appears to have relied more on disagreements in interpretation of the law between the two parties, and not as much on the facts of the case. The jury heard both, rendered its verdict that the Sheriff’s Office and its Detention Center were grossly negligent in the care of inmate Cassiopia Rhoads, and chose to award the Plaintiff damages nearly four times an earlier settlement offer.

    This was the second jury verdict of gross negligence against the Sheriff’s Office and its Detention Center in the past year. One year ago an Aiken County jury returned a verdict of gross negligence in the case of Owens vs Sheriff Michael Hunt et al and awarded former inmate Otis Owens $175,000.

    Like the Rhoads case where the jury award was nearly four times greater than the settlement offer, the jury award in the Owens case was more than twice the settlement offer.

    Both cases also involved formal allegations of malfeasance in the Sheriff’s Office and/or county jail. In the Owens case, the accusation was that ACSO “nefariously colluded, deceived opposing counsel, and wasted the Court’s time for the purpose of attempting to force the trial without Owens present.” In the Rhoads case, there was the Motion of Spoliation asserting missing video tape evidence.

    If the Owens jury verdict was considered an anomaly at the time, County officials might ask if the Rhoads case indicates a costly trend for county taxpayers.


(1) The first general provision of Title 24 of South Carolina law—Corrections, Jails, Probations, Paroles, and Pardons—pertains to a Sheriff’s responsibility for managing county jails: 

The sheriff shall have custody of the jail in his county and, if he appoints a jailer to keep it, the sheriff shall be liable for such jailer and the sheriff or jailer shall receive and safely keep in prison any person delivered or committed to either of them, according to law.”

Given this basic fact that all prisoners must be kept safely, the cause for arrests or convictions is irrelevant in the case of gross medical negligence or other inmate mistreatment; and therefore is only footnoted here.

The lawsuit does not at any time document the cause of the arrest and incarceration. Case records at show Ms. Rhoads was arraigned on a fraudulent check charge on May 4, 2019, and burglary on the same day.

Prior to May 2019 she had an eight-year history of arrests for offenses such as forgery, receiving stolen property, shoplifting, petty larceny, and bad check writing. Following her hospitalization, she was charged with a number of offenses including grand larceny, unlawful carrying of a firearm, burglary, and heroin possession.

(2) While no cause for the initial injury or other harm to the head was identified by the Plaintiff, the Defendants offered differing causes.

In a Memorandum in Opposition to Plaintiff’s Motion to Compel, Southern Health Partners speculated that drug use was the cause, without naming the drug in question:

This case is not complicated. Plaintiff was incarcerated at the Aiken County Detention Center, but was a heavy drug user and contracted an infection likely from injecting herself with illegal drugs. The infection manifested itself in a very rare and unusual location – her cranium.

In Defendant Hunt’s Pre-Trial Brief, the Defense merely stated Ms. Rhoads fell, but that no head injury was detected.

The defendant, who was a severe heroin and meth drug addict, had fallen prior to her arrest and incarceration on May 3, 2019. The medical screening done at intake at ACDC does not reflect any head injuries.”

(3) A second, federal court lawsuit was filed in May of 2022 naming Southern Health Partners, three of its employees, and four ACDC corrections officers as defendants. The federal Complaint alleges violations of Eighth Amendment and Fourteenth Amendment constitutional rights.

The Summons for that suit provides additional insights into the case, including the lack of a “post-incident review:”

No post-incident review was conducted to identify how an inmate who had repeatedly complained of a visibly deteriorating condition, and who had correctional officers advocating on her behalf, was allowed to suffer and deteriorate.”

The federal Complaint also details the gray area in the “division of labor” argument. For example, Paragraph 38 describes instances where corrections officers discussed Ms. Rhoads’ medical condition and how to respond to it both amongst themselves and with medical staff. In one instance, a Deputy disputed a nurse’s opinion that Ms. Rhoads was “self-inflicting,” an unlicensed opinion that was proven to be true.

2 thoughts on “Another Verdict of Gross Negligence”

  1. Thank you Don for the good work documenting and describing a problematic aspect of Aiken County criminal justice. There is rarely just 1 roach in the proverbial kitchen. . . I might suggest spending a day listening to the proceedings at magistrate court. Tells one everything they need to know about local .gov’s view on justice.

  2. As a retired Trauma-ICU RN (MCG 1984-1986), I find it particularly disturbing that the ARMC Emergency Department admitting MD didn’t order a head CT, which would have been diagnostic of an intracranial abcess, especially in light of her symptoms of nausea and vomiting. I wouldn’t send my worst enemy to ARMC.

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