An Arkansas jail doctor has reached a settlement in federal court with former inmates who alleged they were given ivermectin, the anti-parasitic and deworming drug, as a COVID-19 treatment without their knowledge or consent. The settlement, which contains no admissions of wrongdoing, ends a strange saga that began during the early peaks of the pandemic.
The federal judge handling the case dismissed it on Saturday, and both sides confirmed the settlement to HuffPost Thursday.
The deworming drug is not an effective COVID treatment, but it grew in popularity as major conservative figures pushed it as a folk cure and preventative for the virus in 2021. Some Americans even opted to use the veterinary formulation of the drug when they could not find pills meant for humans. That trend prompted the FDA to warn in a tweet, “You are not a horse. You are not a cow. Seriously, y’all. Stop it.”
A few days after that tweet, in Washington County, Arkansas, news broke that the county jail’s medical provider had prescribed ivermectin to people in the jail — causing one local official to comment that she was “mortified” by the news. Soon, people detained in the jail began coming forward, alleging that not only had they been given large doses of the drug, but that they had been misled about what it was — jail staff, they said, had told them they were receiving some combination of vitamins, antibiotics and steroids.
The defendants in the federal suit that followed — the jail’s medical contractor, Karas Correctional Health, and the company’s owner Dr. Rob Karas — persistently denied wrongdoing, arguing that they did not personally deal with the defendants, and jail staff ought to have informed them of the drugs they were being given.
But lawyers for the four initial plaintiffs — former county jail detainees Edrick Floreal-Wooten, Jeremiah Little, Julio Gonazales, and Dayman Blackburn — alleged they were never told they were being given ivermectin, and that they subsequently experienced bouts of “vision issues, diarrhea, bloody stools, and/or stomach cramps.”
In an amended complaint in July 2022, lawyers said an added plaintiff, Thomas Fritch, who is HIV positive, “continues to experience worsening muscle weakness, tremors, and neuropathy, all which began after being given the drug.”
Earlier this year, in March, U.S. District Judge Timothy L. Brooks declined to dismiss the lawsuit, writing, “Dr. Karas and his staff falsely told the inmates the treatment consisted of mere ‘vitamins,’ ‘antibiotics,’ and/or ‘steroids.’ Critically, the inmates had no idea they were part of Dr. Karas’ experiment.”
The settlement includes a $2,000 payment for each plaintiff. An attorney for the defendants, Mike Mosley, told HuffPost in an email that “our pleadings on file (mainly the motion for summary judgment papers and Plaintiffs’ response and Defedants’ [sic] reply) speak for themselves and in my opinion fully support the denial of wrongdoing and that this was a settlement where all parties agreed there is and was no admission of wrongdoing.”
Holly Dickson, the executive director of the state ACLU, which organized the plaintiffs’ legal representation, told HuffPost Thursday that she was “frustrated” with the obstacles faced by incarcerated people with civil rights complaints. Three of the suit’s defendants are currently in state correctional institutions, records show.
“I’m really proud of our clients in the case for having the tenacity to stand up to their oppressor while they are still subject to being incarcerated,” she added, referring to the settlement as “reasonable.” In her view, the main achievement of the suit had been reached prior to the settlement: changes to the informed consent process in the county jail.
“We are not animals nor are we experimental test subjects for karas medical to test a treatment on unvoluntarily.”
– Grievance from detainee at Washington County Detention Center
Jail records obtained by HuffPost through a public records request show the early complaints of people inside the county jail — whose names were redacted — upon realizing they had been given ivermectin.
“I WAS WRONGFULLY AND DANGEROUSLY AGAINST MY WILL GIVEN THESE MEDS,” one complaint, referred to as a “grievance,” read. “We are not animals nor are we experimental test subjects for karas medical to test a treatment on unvoluntarily,” another stated, noting he or she had learned of alleged ivermectin use in the jail “via the news paper.”
“I am not livestock to be taken medical experiments on, im a human just like you. Cdc and fda said for humans not to take it,” another detainee wrote. “I would not be making a big deal about it if I was given an option.” (The defendants maintained ivermectin used in the jail was formulated for humans, not livestock.) Another grievance read, “I am now having health issues and mental anguish. I’m afraid to seek medical advice because the grievances I’ve entered prior to this have been answered with lies and denial.”
Prior to the lawsuit, Karas posted on Facebook about his use of ivermectin in the county jail, writing in one comment, “I got experience and don’t really need more studies” and bragging of “0% mortality in over 350 documented cases at the jail.”
“I pray the blinders fall from your eyes and you use the brain God gave you to do something besides vent management,” Karas wrote to one concerned Facebook commenter.
In court documents responding to the lawsuit, the defendants argued that they were shielded by qualified immunity — a legal concept that protects government officials from certain civil liability in the course of performing their duties — and that they were not personally responsible for any violation of the defendants’ rights.
“Notably absent is any allegation that Dr. Karas personally treated the Plaintiffs, personally failed to advise the Plaintiffs the med protocol for COVID included Ivermectin or had any interaction (personal involvement) with Plaintiffs,” one of the defense’s argument for summary judgment read in July this year. The filing added later: “If a non-party med-passer, despite the employee’s undisputed training, failed to advise Plaintiffs what medicines they were receiving, the undisputed evidence is that was a clear deviation from the practices of KCH and Dr. Karas.”
Karas also argued that the defense had produced “thousands of documents in discovery, including studies and links to studies, showing the efficacy of Ivermectin in treating COVID symptoms and preventing death.”
He claimed among other sources that he relied upon information from the Front Line COVID-19 Critical Care Alliance to develop his COVID protocol. The extremely controversial group “championed ivermectin as a covid panacea,” The Washington Post summarized earlier this year. In August, two physicians affiliated with the group had their board certifications revoked by the American Board of Internal Medicine (ABIM) for spreading “false or inaccurate medical information.”
Plaintiffs in turn argued that the so-called “Karas Covid Protocol,” which included ivermectin, was Karas’ own formulation, and that the defense offered “no testimony or evidence that any agent of Karas Defendants told Plaintiffs they were being prescribed or given ivermectin.” They also pointed out that, following the public revelations regarding the ivermectin use in the jail, Karas Correction Health began using specific, detailed consent forms before administering the COVID protocol — as opposed to the general “consent for treatment” form that all inmates typically signed when they entered the jail, and which the plaintiffs acknowledged signing.
On Aug. 26, 2021 — just a couple days after the jail’s use of ivermectin became public knowledge — a Karas Correctional Health nurse practitioner instructed staff in an email, “Please do not start the covid + or high risk covid + protocol or any detainee without the medication consent signed. The medications must be [sic] clearly show yes or no circled.”
After explaining that medical providers should review “each medication” with inmates, the nurse practitioner concluded her email, “ALL detainees sign NO QUESTIONS !!!!”
In a separate email to a supervisory deputy U.S. marshal that day, the same nurse practitioner wrote, “starting today all detainees who have tested positive for Covid 19 will be offered a detailed consent with each individual drug listed. The detainee may elect to refuse or accept each individual drug/vitamin.”
“If the Karas Defendants believed that a more detailed consent was necessary — and in fact, made the execution of such a consent form a condition precedent to prescribing the Karas Covid Protocol — a reasonable jury could certainly come to the same conclusion,” plaintiffs argued in an Aug. 30 filing, opposing defendants’ motion for summary judgment.
The plaintiffs — and Dickson, speaking to HuffPost — argued that Karas had performed an “experiment” on inmates, prescribing them higher doses of ivermectin than he did clients at his public-facing pharmacy. Karas repeatedly denied that allegation despite the judge’s use of the term — and despite Karas posting online about “[t]he slight difference between jail protocol and the clinic regimen being that we kept the .2-.4 mg/kg Ivermectin dosing on our jail patients.”
HuffPost was unable to reach plaintiffs in the case for comment on the settlement. But Dickson, the Arkansas ACLU executive director, said the lawsuit and ultimate settlement terms underscored “why court cannot be the only place where folks can go to get relief for civil rights violations.”
The county’s government, she said, had failed to protect the rights of detainees in the county.
When Karas appeared before the state’s medical board in April 2022, the board’s then-vice chair, Brian Hyatt, noted that a sample of jail records showed that no detainees receiving COVID treatment had signed a consent form. Karas said that he was “surprised” that the consent form was “getting missed on that many people,” and noted the update he’d implemented to the consent process. Then thanked the board for not suspending his license on an emergency basis.
When he reappeared before the body two months later, the board voted to take no action against him.
By the end of the year, it was unclear whether Washington County would continue contracting its jail medical duties to Karas. His medical malpractice insurance had gone up from $125,000 to $650,000, and Sheriff-elect Jay Cantrell told a county committee that he’d initiated a search for a new contractor. Ultimately, Karas’ bid was $132,000 lower than the next lowest offer, and he was awarded the contract again — for $2.2 million, nearly double what he’d charged the year prior.
