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9TH CIRCUIT LETS PRISONER ADA SUIT GO FORWARD

Ignore, Deny, Dissemble.  The Federal Bureau of Prisons’ (and state prison systems’ as well) approach to inmate medicine seems to follow this formula.  First, ignore the inmate’s medical problem for as long as possible. Then, when it’s no longer possible to pretend the problem isn’t there, deny treatment without a stated basis, let alone justification. Finally, when the inmate is out of options and must sue, dissemble: tell the court that the inmate never complained about the problem, that the problem is no longer there, and that anyway, you are treating the problem so the case is moot.

Last week, beleaguered inmates seeking basic medical care were heartened by a procedural victory in the 9th Circuit, where a state prisoner won the right to a trial under a seldom-used tool in the prisoner’s medical-care toolbox, the Americans with Disabilities Act. The ADA, found at 42 USC § 12101,  prohibits discrimination based on disability. It affords much the same protections against discrimination to Americans with disabilities as the Civil Rights Act of 1964 does based on race, religion, sex, national origin, and other characteristics. In addition, unlike the Civil Rights Act, the ADA also requires covered employers to provide reasonable accommodations to employees with disabilities, and imposes accessibility requirements on public institutions (including prisons) to make reasonable accommodations for people with disabilities.

The 9th Circuit’s decision reminds us of both how miserable living with a disability in prison can be and how the ADA can be used for relief.

Bilal Adom is a California state prisoner who has a spinal condition that causes him chronic, severe pain and severely limits his mobility. He underwent spinal surgery in 2008 and has an active recommendation pending for a second surgery. He is also a stroke survivor. Adom uses a wheelchair to get around and wears a prison-issued vest that signals he is mobility impaired.

Because of his condition, Adom suffers from incontinence. For nearly a year after Adom’s incontinence symptoms emerged, prison staff provided him with adult diapers through the prison system’s Durable Medical Equipment program. After Adom was transferred to a different housing unit, prison staff cut off his access to the supplies without explanation. As the Court drily put it, “Without these supplies, Adom would soil himself and his surrounding environment, including his bed and wheelchair.”

Adom asked the prison to restore his access.  His requests were ignored. Following a medical appointment in which a doctor’s “forceful” examination led to Adom’s involuntary urination in his wheelchair seat, he asked the physician to help him get his diapers.  She did nothing. Adom subsequently made multiple written requests for incontinence supplies.

On September 13, 2022, he filed a healthcare services request notifying the prison that he had run out of diapers and that his supplies were not refilled on the normal schedule. In one request, he explained that “he was unable to control his evacuations, that he was using makeshift diapers made of torn towels, trash bags, tissues, and plastic, and that he was ‘humiliated and dehumanized.” On September 18, 2022, Adom submitted a Reasonable Accommodation Request, notifying the prison that he suffered from both urinary and fecal incontinence, that his incontinence supplies were not issued the prior week, that he was soiling his linens, and that he was unable to get new linens or diapers. Between written requests, he informally asked “several building officers” to retrieve, or allow him to retrieve, his incontinence supplies.

A month after his blizzard of requests, the prison formally denied Adom’s request for diapers, telling him instead that staff would “provide [him] a shower as soon as safety and security permits,” and ensure that his soiled clothing was properly washed. The prison denial falsely ruled that “there was no indication found for incontinence supplies.”

Finally, after five months of the worst sort of misery, Adom’s incontinence supplies were restored. Nevertheless, he sued, raising a variety of claims, including an 8^th Amendment deliberate indifference count and an ADA count. He sought money damages and an injunction requiring the prison to provide adult diapers. 

The district court was unimpressed and granted summary judgment to the prison system. It held that Adom’s request for injunctive relief was moot because in January 2022, the prison had reinstated his incontinence supplies. The district court further held that Adom was not entitled to money damages under the ADA because he failed to establish that the prison discriminated against him because of his incontinence. Instead, the court said that because the prison provided testing and some alternative accommodations, the district court held that Adom’s evidence “most reasonably indicated a disagreement about medical treatment, rather than disability discrimination.”

Last week, the 9^th Circuit reversed the summary judgment decision and sent the case back for trial.

The 9th held that Adom satisfied the three primary elements of his ADA claim and therefore was entitled to declaratory relief where a reasonable jury could conclude that (1) he is disabled within the meaning of the ADA by virtue of his spinal condition, incontinence, or both; (2) he was denied meaningful access to the prison’s toileting and hygiene services because he needed the accommodation of adult diapers to relieve himself hygienically and with dignity; and (3) the denial was by reason of Adom’s disabilities, because it is his disabilities that make it harder for him use the prison’s toileting and hygiene services.

The panel also held that Adom provided enough evidence to earn the right to a trial on whether the prison acted with deliberate indifference when it denied him the benefits of its services (which he must show to get money damages). Rejecting the prison’s contention that a jury could not find deliberate indifference because its staff determined that incontinence supplies were not medically necessary, the panel held that “a public entity is not excused from its obligation to provide a reasonable accommodation solely because it determined the accommodation is not medically necessary or indicated.”

The Circuit remanded the case to the district court.

Adom v. California Dept of Corrections & Rehab, Case No. 24-4756, 2026 U.S. App. LEXIS 27530 (9th Cir. Sept. 8, 2026)

~ Thomas L. Root