• The US economy added 256,000 jobs in December, more than the forecast of 164,000.
• Unemployment was expected to hold steady at 4.2% but fell to 4.1%.
• Economists expect 2025 to be a tough labor market for job searchers.

The US labor market ended 2024 on a high note, adding 256,000 jobs in December, above the forecast of 164,000.

Unemployment unexpectedly dropped from 4.2% in November to 4.1% in December. The consensus expectation was that the rate would hold steady.

"We are very proud of our ability to leave with such a strong labor market," Acting Secretary of Labor Julie Su told BI. "People have come into the labor market and are looking for jobs — and they're finding them."

Cory Stahle, an economist at the Indeed Hiring Lab, said there were some concerns in the job market at the start of 2024, but the data indicated signs of equilibrium in the second half.

"In the first half of 2024, we saw unemployment start rising, and it was a pretty good cause for concern," Stahle said. "But then in the back half of the year, we've seen that the unemployment rate has really stabilized."

Labor force participation remained at 62.5% in December. The employment-population ratio increased from 59.8% in November to 60% in December.

Wage growth cooled slightly. Average hourly earnings increased to $35.69 in December, a 3.9% increase from a year earlier. Earnings rose by 4.0% in October and November.

Many sectors saw job growth, especially in healthcare. However, manufacturing, mining and logging, and utilities lost jobs in December.

The new jobs report likely won't derail the Federal Reserve's widely expected pause in its interest-rate easing campaign at its coming meeting after three rate cuts in a row.

CME FedWatch, which shows what traders think will happen to interest rates based on market activity, indicated after the jobs report a 97% chance that rates wouldn't be changed in the first scheduled Federal Open Market Committee meeting of 2025 on January 28 and 29, up from around 93% before the jobs report. There are eight scheduled FOMC meetings in 2025, but the Committee's members signaled in December that the Fed plans only two cuts this year.

In a press conference after the December meeting — where the Fed cut rates by 25 basis points — Fed chair Jerome Powell said that "the labor market is now looser than pre-pandemic" and is gradually still cooling down. He added further cooling isn't needed to reach the Fed's 2% inflation target.

"We're starting to see evidence that the Fed's 100 basis points of cuts are translating into real improvements, improvements in the real economy," Julia Pollak, chief economist at ZipRecruiter, said. "While the labor market often lags behind quite substantially, it seems like perhaps the labor market rebound is starting to take hold."

Economists predict the job market in 2025 will be challenging for job searchers, and employers might be cautious in their hiring plans during the start of the year.

"While business sentiment has picked up somewhat since the election, there is still a lot of uncertainty about future policy changes that will likely make businesses hesitant to ramp up hiring, particularly in the first half of 2025," Dante DeAntonio, a labor economist with Moody's Analytics, said in a written statement in 2024.

The new data could provide a little more optimism. Stahle said even if the labor market is cooler than in recent years, "we're really going into the year with a decent amount of momentum."

• Thousands of LA County homeowners face a volatile home insurance market.
• In recent months, State Farm — California's largest home insurer — dropped thousands of policyholders.
• Some have turned to the state's insurer of last resort.

Thousands of California homeowners at risk due to the Los Angeles County fires find themselves exposed in a volatile home insurance market.

Last year, California's largest home insurer — State Farm — canceled thousands of policyholders' plans across LA County, including the Pacific Palisades and parts of Santa Monica and Calabasas, that are under evacuation orders and warnings as the fires rage. Nearly 70% of State Farm policyholders in the affluent Pacific Palisades neighborhood were dropped by the company beginning in July 2024.

The following table shows the ZIP codes that were under evacuation orders or warnings as of Wednesday afternoon that had the highest rate of nonrenewals from State Farm last year.

Several other major insurers have dramatically restricted their coverage across California in recent years, citing surging costs from more frequent and intense disasters coupled with rising home repair costs and inflation.

Thousands of LA County homeowners who haven't been able to obtain private insurance have joined the ranks of those covered by the state's insurer of last resort — the Fair Access to Insurance Requirements (FAIR) plan. The FAIR plan is regulated by the state government and backed by a slew of private insurance companies. But its premiums tend to be much higher than typical private insurers and its coverage is often more restricted.

This table shows how FAIR insurance coverage has changed in the above ZIP codes between 2023 and 2024.

As private insurers have stepped back in recent years, the number of residential FAIR plan holders across the state jumped 123% between September 2020 and September 2024. The FAIR plan's dollar-value residential exposure surged from $271 billion in September 2023 to $431 billion in September 2024.

It's not clear how many homeowners impacted by the LA County fires are uninsured. Most mortgage lenders require homeowners to purchase insurance, and some require additional insurance for specific disasters, including fires.

Some major home insurers, including Farmer's — the second-largest in California — have recently begun to expand their offerings in California after the state announced new regulations requiring insurers to cover a certain percentage of homes vulnerable to fire in exchange for allowing them to use future risk modeling to calculate premiums.

In 2023, California had the fourth-highest home insurance nonrenewal rate among states, according to a recently released Senate Budget Committee report. Six of the top 10 counties in the country with the highest rates of nonrenewals by large home insurers in 2023 were in California, the report found.

But rising home insurance costs and rates of dropped policies are nationwide problems. The National Bureau of Economic Research recently reported that average home insurance premiums spiked by 13%, adjusted for inflation, between 2020 and 2023. The share of home insurance policies from large insurers that weren't renewed increased last year in 46 states, the Senate report found. And more than 200 US counties saw their non-renewal rates spike threefold between 2018 and 2023.

Areas more vulnerable to disasters, including flooding, wildfires, and hurricanes, have seen the biggest spikes in premiums and dropped policies.

"Our number one priority right now is the safety of our customers, agents and employees impacted by the fires and assisting our customers in the midst of this tragedy," a representative for State Farm told BI.

A representative from the California FAIR Plan Association also told BI in a statement that the insurer is "prepared" to handle the wildfire impact, and "has payment mechanisms in place, including reinsurance, to ensure all covered claims are paid."

Representatives for Farmer's did not respond for comment.

Have you been dropped by your home insurance company or are you facing a steep premium increase? Email this reporter to share your story: [email protected].

• Amazon delayed its full return-to-office plan in some places because of insufficient office space.
• An internal list shows where Amazon employees will work three days a week until space is ready.
• The list has more than 40 locations where the full five-day RTO policy is delayed.

Amazon delayed its five-day return-to-office plan in some locations because of a lack of space, as Business Insider recently reported.

An internal Amazon list viewed by BI shows where employees are being asked to continue following the company's policy requiring only three days a week in the office.

The locations include major tech hubs such as Santa Clara, California; Austin; Beijing; Shenzhen, China; and Bengaluru, India.

Amazon's original guidance required employees to work from the office five days a week beginning January 2. An Amazon spokesperson told BI on Tuesday that buildings were ready for most employees on that day.

The company's real-estate team late last year started notifying employees that they could continue following their current in-office guidance until workspaces were ready, with delays stretching as late as May, according to internal Amazon notifications viewed by BI.

The company has said the return to office will improve collaboration and bring other benefits. CEO Andy Jassy, in a memo announcing the mandate, said Amazon made the decision to "further strengthen" its culture and teams.

Here are more of the Amazon locations where employees are being told to continue working three days a week in the office: Raleigh, Annapolis Junction, Baltimore, Columbia, Austin, Cupertino, Irvine, Nashville, Boulder, Charlotte, Houston, Jersey City, Newark, Atlanta, Dallas, East Palo Alto, Mexico City, Santa Clara, São Paulo, Tampa, Miami, Brooklyn, Columbus, New York, Sacramento, Hamburg, Munich, Tel Aviv, Amman, Milan, Cairo, Madrid, Barcelona, Berlin, Dubai, Istanbul, Beijing, Hyderabad, Shenzhen, Bengaluru, Mumbai, and Shanghai.

Are you a tech-industry employee or someone else with insight to share?

Contact the reporter, Ashley Stewart, via the encrypted messaging app Signal (+1-425-344-8242) or email ([email protected]). Use a nonwork device.

• Economists talked to Business Insider about what they expect to happen in the job market this year.
• Getting a white-collar job could still be hard, and more people may have to return to the office.
• Changes under a new administration could affect hiring and turnover.

Getting a job was tough for many Americans in 2024. If a career shift is your New Year's resolution for 2025, you might still find it challenging.

Job growth has slowed, unemployment has been historically low but rising, and unemployed Americans are staying jobless for longer.

"Heading into 2025, it is going to be a little harder for job seekers across the board," Cory Stahle, an economist at the Indeed Hiring Lab, said in December. "We've seen that just about every category on Indeed has come down year over year in terms of the number of job postings. So that suggests that employer demand has cooled."

Nela Richardson, ADP's chief economist, described the labor market in 2024 as unusually stable and quiet. She pointed to steadily low layoffs and a drop in voluntary turnover amid cooler hiring.

"The stasis is rather abnormal, and I think it's going to make it tough for workers who are looking for new opportunities to find them," Richardson said.

Here's what economists expect when it comes to finding a job, wages and promotions, and other aspects of work life in 2025.

A new administration could bring uncertainty

One reason it's still going to be hard for job searchers to land a job is employers may want to see what policies President-elect Donald Trump pursues early in his second term.

"While business sentiment has picked up somewhat since the election, there is still a lot of uncertainty about future policy changes that will likely make businesses hesitant to ramp up hiring, particularly in the first half of 2025," Dante DeAntonio, a labor economist with Moody's Analytics, said in a written statement.

A potential crackdown on immigration could affect industries with a higher share of immigrant workers, like the construction sector. DeAntonio said those industries "may find themselves scrambling for workers if material changes to immigration policy are enacted." DeAntonio noted the leisure and hospitality industry and agriculture as two others that have historically depended on immigrant labor and could be affected by changes.

The new administration could also affect government workers and job seekers. Trump's Department of Government Efficiency, led by Elon Musk and Vivek Ramaswamy, is figuring out suggestions for cutting federal spending and regulations.

"A drastic reduction in federal regulations provides sound industrial logic for mass head-count reductions across the federal bureaucracy," Musk and Ramaswamy wrote in an op-ed published by The Wall Street Journal.

Employment growth in the federal government has cooled down. Between November 2022 and November 2023, the federal government added 77,000 jobs but just 49,000 the following year.

"Depending on how things go with the new administration, we may see a lot of government workers either losing their jobs or quitting," Brian Rose, senior US economist for UBS's chief investment office, said. "This could be an opportunity for private sector companies to pick up some skilled workers."

Getting a job in a white-collar industry may still be a challenge

Richardson said white-collar job seekers, like those searching for tech roles, should be ready to network and for it to take more time to get a job.

"It's not that these jobs don't exist, and it's not that there's not opportunities out there, but the opportunities that people had gotten used to prior to 2024 have slowed," Richardson said. "This economy coming out of the pandemic really thrived on tech jobs."

DeAntonio said white-collar industries "are likely to remain at the top of the list as difficult for job seekers to enter as those firms have been some of the most cautious in terms of hiring."

Stahle said there are still a lot of jobs available in construction and manufacturing, even if opportunities have slowed from a year or two ago. However, Stahle said software development, marketing, and other knowledge-work jobs "have been hit much harder" by the job market slowdown.

"I think it's going to continue to be kind of a divergence in the labor market where some job seekers will have an easy time next year, albeit a little harder than last year, and then some are going to have a harder time than they've had in a few years," Stahle said in a 2024 interview.

Healthcare, manufacturing, and construction will probably be good places to look for work

Rose said the difficulty of landing work depends on someone's job experience and field of work. While hiring might continue to be rough in finance and tech, construction is one industry that needs workers.

Rose said construction and skilled workers for smaller companies are in high demand. He also thinks lower-paying jobs are in demand.

"If you're in healthcare or the skilled trades, you're in the right place," Julia Pollak, chief economist at ZipRecruiter, said. "If you're anywhere else, you might want to reevaluate your career choices and look into re-skilling and broadening your search."

Healthcare has had large job growth relative to other industries and has largely maintained its growth rate even as broader hiring has slowed.

Richardson sees a hopeful outlook for the interest-rate-sensitive manufacturing sector as the Federal Reserve has cut rates in its last few meetings.

"As we're seeing the Fed continue to try to draw down rates, manufacturing might benefit from that, and new sources of technology and tech advancement, that leads to more hiring in the sector," Richardson said.

More workers might have to head back to the office

AT&T said in December that it wants its office workers fully back to the workplace. Amazon also told employees they need to fully work from the office, but it has delayed the January 2 deadline for some.

"We are likely to see a continuation of the mixed bag of workplace policy changes that occurred this year," DeAntonio said. "Some firms will undoubtedly make a stronger return to office push, especially now as workers seem less inclined to switch jobs as they have in recent years."

Despite those moves, the share of white-collar employees working outside the office has risen. Bureau of Labor Statistics data showed that 46% of management, business, and financial operations occupations worked remotely at least part of the time in November 2024, up from 41% a year prior.

Real wage growth could be strong this year

Stahle said the "outlook for raises and compensation is promising." However, he also said, "we don't want to see wages necessarily pick up to a point where they could fuel inflation."

Stahle said hiring needs to pick up, particularly for roles that haven't had robust growth, to have a soft landing, where inflation slows to the Fed's 2% target while unemployment and layoffs stay steady.

"We want to see people continuing to have decent wage growth, especially wage growth that keeps their purchasing power up and above inflation," Stahle said.

The year-over-year increase in average hourly earnings was 4% in November, down from the growth rate in 2022 and the roughly 4.4% increase at the start of the year, although it's outpaced cooling inflation since mid-2023. Rose thinks wage growth will likely moderate further.

"There's just better balance in the labor market, so less need for companies to raise their wages to attract workers," Rose said about the current slowdown.

However, DeAntonio said if immigration policy changes occur, the labor market may become even tighter, "which will increase leverage for employees in seeking bigger pay increases."

The job market may be unfavorable for new college graduates

Stahle said the job market could be challenging for young people. The unemployment rate for recent college graduates aged 22 to 27 has been ticking up, but it falls short of the rate for those without a degree in this age group.

Rose thinks "recent college grads who went to some private college and spent a lot of money and looking for a high-paying, entry-level job to justify that investment" are having a tough time in the job market.

Are you worried about the job market in 2025, making a career change, or have an interesting career story to tell? Reach out to this reporter at [email protected].

• The US Surgeon General released a report directly linking alcohol to cancer.
• A BI analysis found that spending on most kinds of alcohol has declined — especially among young adults.
• It's reflective of Gen Z's shifting habits when it comes to alcohol consumption.

By the time the US Surgeon General dropped its report linking alcohol to cancer on Friday, Americans had already been curbing their spending on booze over the last several decades — especially young people.

Surgeon General Vivek Murthy said in his latest advisory that alcohol consumption is the third leading preventable cause of cancer in the US, following tobacco usage and obesity. He recommended updating warnings on alcohol packages to raise awareness of the harmful effects of drinking. However, doing so requires an act of Congress.

"For individuals, be aware that cancer risk increases as you drink more alcohol," Murthy wrote in a post on X on Friday. "As you consider whether or how much to drink, keep in mind that less is better when it comes to cancer risk."

Do you plan to change your drinking habits in response to the Surgeon General's recommendation? Tell us why in this survey.

Many Americans have already been cutting back. Business Insider analyzed alcohol spending data from the Bureau of Economic Analysis and the Bureau of Labor Statistics to get a sense of how alcoholic beverage consumption has changed. It showed that spending has decreased over the past few decades, especially among Americans under 25.

With spirits and beer in particular, Bureau of Economic Analysis data shows that personal spending as a share of personal consumption expenditures has dropped since 1959. Spending on wine as a share of personal spending, meanwhile, has seen a small uptick.

Additionally, expenditure data adjusted to 2023 dollars using the consumer price index shows that younger adults under 25 years old spent less on average than this age group years prior. Bureau of Labor Statistics data shows that spending on alcoholic beverages by Americans under 25 is similar to people aged 75 and over.

The decrease in alcohol spending among young people is reflective of Gen Z and millennials' shifting habits and priorities compared to other generations. A Gallup survey from 2023 found that 62% of adults under 35 said they drink, compared to 72% two decades ago, with some of them citing health concerns as a key reason.

Gen Z is also favoring more active settings like fitness groups to socialize instead of drinking, marking a shift in younger Americans' behaviors.

It's unclear how the alcohol industry will respond to Murthy's latest report. However, warning labels on alcoholic drinks have not been updated since the '80s, and Murthy urged Congress to take action by updating labels and revising recommended consumption limits to prevent cancer among the US population.

• Minimum-wage workers in California, Vermont, and 19 other states will earn more at the start of 2025.
• Missouri voters passed a referendum in the November election raising the state's minimum wage.
• An analysis found over 9 million workers will likely be affected by the coming minimum wage increases.

Workers in 21 states are set to start the new year with a raise.

When the clock strikes midnight on New Year's Eve, minimum wages across the nation are set to be hiked. In a few states, the minimum wage will rise to $15 an hour, a longtime target rate for advocates.

Hover over the states in the map below to see how much minimum wages will change.

Of the 21 states that will see an increase, 14 are subject to inflation-based adjustments as part of existing minimum wage laws, per a report from the left-leaning think tank Economic Policy Institute. The EPI report estimated that full-time impacted workers in those states will see their annual earnings increase by $420 on average.

In the November election, Missouri voters approved a referendum to increase the state's minimum wage to $13.75 on January 1, 2025, and then to $15 in 2026. Some small business owners in the state are reportedly already bracing for higher costs, and business groups there have already filed a legal petition to attempt to overturn the new proposition. Recent research has found that independent businesses are, on average, able to shoulder minimum wage increases — although higher minimum wages can lead to smaller restaurants shuttering.

A 2022 ballot initiative in Nebraska has the state on a similar trajectory, with workers set to get an increase to $13.50 in January 2025 and then a hike to $15 in 2026.

Alaska will increase the state's minimum wage to $11.91 on January 1 because of an inflation adjustment. Minimum wage workers will get another raise on July 1 because of a ballot measure in the recent election. The state minimum wage will rise to $13 in the summer, $14 the following July, and $15 in 2027. Its minimum wage would be adjusted for inflation after that.

Delaware and Virginia are the only states in the South that will see minimum wage increases at the start of the year. Five states in the South don't have minimum wage laws, and Georgia's minimum wage is below the federal minimum wage of $7.25, based on data from the Department of Labor. That means those states default to the federal minimum.

An analysis from the Economic Policy Institute found that over 9 million workers are set to directly and indirectly benefit from increased state minimum wages.

Out of those workers, just over 3 million are directly set to see their pay go up. Even more will be affected indirectly. Over 6 million workers are within 15% of the new minimum wage floor — which, per EPI, means their employers are likely to adjust their wages to compete for talent.

In addition to state minimum wage increases happening in almost two dozen states on January 1, the National Employment Law Project said 48 cities and counties will also have minimum wage increases that day.

Nationally, the federal minimum wage has sat untouched at $7.25 since 2009. President-elect Donald Trump has signaled that he could be open to changing that number, telling "Meet the Press" that he would consider raising the federal rate — although he noted that the cost of living across the country varies, making it difficult to enact one flat rate.

Mike Draper, the owner and founder of screen-printing and retail business RAYGUN, whose 10 stores include a location in Missouri, told Business Insider that minimum wage increases — like the one recently approved by that state's voters — could help bolster workers' spending power. Draper already pays his workers a starting wage of $15.50 an hour.

"This is different from a tax increase, or a rent increase, or a cost of goods increase. None of that money is going to go directly back into your community, for the most part," Draper said, adding: "Increases to worker pay is going to be felt immediately."

Are you set to see your wages go up on January 1? Contact these reporters at [email protected] and [email protected].

• Business Insider put over 160 recipes from celebrity chefs to the test to find the tastiest winners.
• We've tried everything from breakfasts and dinners to desserts and specialty bread. 
• Some winning recipes came from Guy Fieri, Ree Drummond, Carla Hall, Ina Garten, and more.

Business Insider put the best recipes from celebrity chefs head-to-head to find the most delicious salads, desserts, bread, beverages, and more. 

Here are some of the winners, from hearty breakfasts to refreshing cocktails.

Editor's note: This story was originally published in September 2021 and most recently updated on December 26, 2024.

Breakfasts

The most important meal of the day deserves a great recipe. Food writers Paige Bennett and Tiffany Leigh tested scrambled eggs, omelets, blueberry pancakes, and breakfast burritos to see if they were worth the hype. 

The winning chef's scrambled eggs had parsley as a secret ingredient 

Emeril Lagasse's flavorful recipe for scrambled eggs was food writer Bennett's favorite.

Though the seasoning alone had 10 ingredients, the rest of the technique only required eggs, cheese, milk, butter, and salt. According to Bennett, the cooking process was easy and took only a couple of minutes.

The eggs were incredibly creamy, runny, and cheesy, paired well with fresh parsley. 

Read more about the winning recipe and full battle here: I made scrambled eggs using 8 recipes from famous chefs to find the best one.

Out of the many omelet recipes, the best one was microwaved

Bennett had a couple of favorite omelet recipes, but one of her favorites included Carla Hall's microwaved eggs.

Filled with mayonnaise, lemon juice, broccoli, and butter, the end result was fluffy and light. It had a nice balance of creamy cheese and crunchy vegetables.

Read more about the winning recipe and full battle here: I made omelets using 6 recipes from famous chefs, and it surprisingly involved strawberries and microwaves.

The key to fluffy blueberry pancakes is whipped eggs

Bobby Deen's winning recipe calls for whipped egg whites.

According to Bennett, the hardest part was whisking the eggs into stiff peaks, but the rest was simple and quick. The final stack was fluffy and delicious, especially with syrup. 

Read more about the winning recipe and full battle here: I tried 3 celebrity chefs' recipes for blueberry pancakes, and the best used whipped egg whites.

Try overnight oats in a canteloupe

Nancy Fuller serves up a hybrid of chia-seed pudding and overnight oats in half of a cantaloupe, then tops the concoction with blueberries and honey.

Bennett put all of the ingredients except the blueberries in a container and placed them in the fridge overnight. The flavor goes so well with the blueberries and honey.

Read more about the winning recipe and full battle here: I made 4 celebrity chefs' recipes for overnight oats, and the best was served in a cantaloupe.

Use simple and fresh ingredients to make delicious blueberry muffins

Ina Garten's simple take on classic blueberry muffins proved to be the best of the bunch.

After using basic ingredients like flour, sugar, baking powder, baking soda, and salt to make the dough, Bennett folded in buttermilk, butter, eggs, lemon zest, and blueberries to make golden and moist muffins. 

Read more about the winning recipe and full battle here: I tried 3 celebrity chefs' blueberry muffin recipes, and the best one was the easiest to make.

Use toasted oats for a hearty loaf of banana bread

To make Alton Brown's banana bread, swap regular flour for homemade toasted-oat flour.

Bennett found the hardest part was making the flour without a food processor. After toasting and pulverizing oats and mixing them in eggs, stick everything in the oven for 10 minutes.

The final product has a distinct nutty flavor without being overpowering. 

Read more about the winning recipe and full battle here: I made 3 banana-bread recipes by Ree Drummond, Alton Brown, and Curtis Stone. One famous chef's use of oats blew me away.

The sweetest cinnamon rolls use strong coffee and maple syrup 

Ree Drummond had the best one-pot recipe for gooey and perfect cinnamon rolls.

After rolling out the dough and filling it with the coffee mixture, Bennett baked them and found that the ingredients made for the fluffiest rolls.

The sugary maple-filled icing is so good, it could be eaten out of the bowl. 

Read more about the winning recipe and full battle here: I made cinnamon rolls using 3 celebrity-chef recipes, and the best one blew me away. 

Use canned pumpkin puree for sweet, flavorful pumpkin bread 

Bobby Flay's recipe calls for a ton of spices, canned pumpkin, and pantry staples like sugar, eggs, and vanilla.

Bennett mixed the wet and dry ingredients together and folded in toasted pecans and walnuts for an added crunch. 

This bread had the richest pumpkin flavor of all the recipes, plus a moist texture and nutty kick. 

Read more about the winning recipe and full battle here: I made pumpkin bread using 3 recipes from celebrity chefs, and the best was the easiest to make.

Three different kinds of alcohol are used to make a sweet and crispy French toast

To make Guy Fieri's French toast, you'll need orange-flavored and creme de banana liqueur, dark rum, milk, cinnamon, and brown sugar. This recipe turned out to be the most expensive of the bunch, thanks to the alcohol. 

Bennett thickened caramel sauce, dipped and fried bread, and carefully sautéd sliced bananas.

The sweet toast was soft but slightly crispy. The bananas gave it a hint of freshness, and the caramel sauce was delicious. You won't even need maple syrup. 

Read more about the winning recipe and full battle here: I made French toast using 3 celebrity chefs' signature recipes, and the best one cost over $40 to make.

Out of all the breakfast burritos, the best one had steak

Fieri's breakfast burrito recipe calls for ingredients like skirt steak, scrambled eggs, onions, and pico de gallo. This recipe made the best-looking burrito and had an umami flavor thanks to the juicy steak.

Leigh arranged the filling, made up of steak, eggs, diced potatoes and onions, cheese, salsa roja, and lettuce, on the tortilla and then griddled the burrito for a couple of minutes. This gave the burrito a nice golden-brown color and grill marks.

The result was an incredibly satisfying breakfast dish loaded with flavors and textures.

Read more about the winning recipe and full battle here: I made breakfast burritos using 3 celebrity chefs' recipes, and Gordon Ramsay's disappointed me most.

Jeff Mauro's recipe for homemade hash browns came together quite easily

Writer Andy Lynes thought Mauro's recipe for hash browns was easy to follow and produced a recognizable version of the breakfast classic.

Notably, this recipe didn't call for eggs or onions. Mauro's recipe required a short list of potatoes, butter, olive oil, paprika, garlic powder, and cayenne powder.

The final hash browns had a great color from the spices, and they crisped up nicely in the pan.

Read more about the winning recipe and full battle here: I tried hash-brown recipes from Ina Garten, Bobby Flay, and Jeff Mauro, and the best was the easiest to make.

Side Dishes 

A meal isn't complete without a generous side. We tested everything from different kinds of bread to salads and spreads to find which ones should be staples at your dinner table. 

For flavorful corn on the cob, try a spicy chile-lime recipe topped with cheese

Bennett followed corn recipes from Fieri, Giada De Laurentiis, Trisha Yearwood, and Aarón Sánchez.

After grilling the corn for 20 minutes, Sánchez seasons it with rocoto-chile paste, fresh cilantro, lime juice, butter, cumin, salt, and pepper.

Bennett topped it with cotija cheese, cilantro, and butter for a spicy and cheesy main dish. 

Read more about the winning recipe and full battle here: I tested 4 corn on the cob recipes by celebrity chefs, and the best was the spiciest. 

The most delicious baked potatoes took all day to make 

Fieri's "Bomb Bakers" potatoes have to soak in brine for two to eight hours before they are rolled in salt and baked.

Bennett let her potatoes marinate in saltwater for six hours, then rolled them in garlic salt, seasoning salt, kosher salt, and black pepper.

She topped them off with a horseradish spread, sour cream, and black pepper for creamy potatoes that packed some heat. 

Read more about the winning recipe and full battle here: I tried baked-potato recipes from Ina Garten, Guy Fieri, Cat Cora, and Nancy Fuller. My favorite took nearly 7 hours.

The best stuffing is the easiest to make

Garten's stuffing was Bennett's favorite because of its complex flavor and easy preparation.

It required only one type of bread, baguettes, which made it easier to prepare. It also had fresh herbs, apples, and almonds combined with savory onions and celery. 

Read more about the winning recipe and full battle here: I made stuffing using 4 recipes from celebrity chefs — the best used a boxed mix and beat Ina Garten's.

To make the best guacamole, you'll need fresh ingredients

Sánchez's guacamole is stuffed with a ton of ingredients, which made it the most time-consuming recipe of them all.

After using a mortar and pestle to grind the ingredients, Bennett noted that the chile, cilantro, sliced radish, and queso fresco added a nice kick to the avocado. 

Read more about the winning recipe and full battle here: I tried 4 famous chefs' guacamole recipes, and I'd make all of them again.

Easy and affordable ingredients can make the tastiest deviled eggs 

Bennett tried deviled-egg recipes from Alex Guarnaschelli, Rachel Ray, and Paula Deen. Guarnaschelli's eggs were not only a breeze to make, but they were also creamy.

Simply toss egg yolks in a bowl with the rest of the ingredients until they become soft. They have a nice kick thanks to the hot sauce, scallions, and paprika. 

Read more about the winning recipe and full battle here: I made deviled eggs using 3 celebrity chefs' recipes, and the best were the cheapest to make. 

This celebrity chef's garlic bread was buttery, spicy, and not at all soggy

The ingredients for Fieri's recipe are a little more complex than others, but the process is quite simple.

Bennett added all the ingredients to a bowl and slathered them on a French baguette. The parmesan, hot sauce, scallions, and parsley balanced each other out. 

Read more about the winning recipe and full battle here: I tried 3 celebrity chefs' garlic bread recipes, and the best one has hot sauce in it.

The best cornbread didn't have any butter but turned out soft and fluffy

Hall follows her grandmother's recipe for golden cornbread. Bennett tested it out and found her technique to be simple and straightforward.

After making a thick batter, heat a cast-iron skillet and pour the mixture in.  The creamed corn and canola oil made for a slice of soft and savory bread. 

Read more about the winning recipe and full battle here: I made cornbread using 5 celebrity chefs' recipes, and there's only one I wouldn't eat again.

For pillowy biscuits, use cake flour and sea salt 

Fieri's buttermilk biscuits had similar ingredients to other recipes. Bennett mixed the ingredients in a food processor, cut the dough into rectangles, and brushed them with butter and salt.

She was initially skeptical of the scone-like appearance but found the cake flour made for a soft and delicious biscuit. 

Read more about the winning recipe and full battle here: I made 4 celebrity chefs' biscuit recipes, and the best were little pillows of deliciousness.

The tastiest rolls were also pull-apart 

Brown's recipe seems complex at first but turned out to be quite simple. Bennett tossed the flour, yeast, sugar, salt, egg yolks, and warmed milk in a stand mixer and let the dough rest.

After letting it rest for an hour, slicing it into strips, and baking them, she found the rolls to be savory and crispy. 

Read more about the winning recipe and full battle here: I made dinner rolls using 4 celebrity chefs' recipes, and the best doesn't even need extra butter.

The creamiest mashed potatoes contain sour cream 

Garten's recipe was a traditional take on mashed potatoes. Bennett put it to the test and used a ricer to break up red potatoes, which was the most time-consuming part.

After mixing it with warm milk, sour cream, and butter, the final result was tangy and savory. 

Read more about the winning recipe and full battle here: I made mashed potatoes using 3 celebrity chefs' recipes, and any of them could work for Thanksgiving with some tweaks.

The best recipe for egg salad was simple and had a dash of fresh herbs 

Garten's egg salad featured dill and mustard, with a stronger egg flavor. Bennett found the process of boiling eggs to be easy and quick.

All she had to do was add eggs to a pot, boil them, drain them, and cover the batch in cold water. Finally, she added some mayonnaise, mustard, salt, and dill. 

Read more about the winning recipe and full battle here: I tried 4 celebrity chefs' recipes for egg salad, and the worst is full of potatoes.

Bennett's favorite pasta salad featured Miracle Whip for a salty and sweet flavor

Sunny Anderson's recipe for pasta salad calls for peas, cheddar, bacon, and Miracle Whip.

Bennett found it to be easy to make. She simply mixed anchovy-free Worcestershire sauce, red onion, apple-cider vinegar, sugar, salt, and pepper with cooked noodles. The sweet replacement for mayonnaise added a tangy kick. 

Read more about the winning recipe and full battle here: I tried 3 celebrity chefs' recipes for pasta salad, and the best doesn't use any mayonnaise.

There was more than one winner for the best potato salad

Fieri and Garten were tied for the best potato salad. Fieri's recipe called for red potatoes, vinegar, mayonnaise, sour cream, green onions, bacon, and chopped green onions.

Garten, on the other hand, used whole-grain mustard, buttermilk, salt, pepper, celery, red onion, and white potatoes. Both were crunchy and tangy thanks to the vegetables and condiments. 

Read more about the winning recipe and full battle here: I tried 4 celebrity chefs' recipes for potato salad, and I'd make them all again.

The best marinara sauce used red wine to create a sweet yet rich flavor profile

Garten came out on top with the best marinara-sauce recipe perfect for any pasta. Garten's marinara recipe required a 1/2-cup of wine, crushed tomatoes, fresh parsley, salt, pepper, onion, garlic, and olive oil.

Bennett sautéd the onions and garlic and then deglazed the pan with red wine, which boiled down pretty quickly. Once she added the other ingredients to the pot and let them simmer, she topped the sauce with some fresh parsley.

Read more about the winning recipe and full battle here: I made marinara sauces using 4 celebrity chefs' recipes, and the best had an unexpected secret ingredient.

Bennett was a fan of Anderson's flavorful coleslaw. The apple-raisin slaw called for mayo, sour cream, golden raisins, celery seeds, apple-cider vinegar, cabbage, shredded carrots, and shredded apples.

The finished dish had a balance of sweetness, savoriness, acidity, and tanginess from the sour cream, apples, and raisins. The flavors worked together to make a light yet refreshing take on the cookout classic.

Read more about the winning recipe and full battle here: I tried 3 coleslaw recipes from Guy Fieri, Ina Garten, and Sunny Anderson, and the best one called for raisins and apples.

Entrées

If you find yourself scratching your head for a meal plan or main course, look no further. We've tested baked potatoes, hamburgers, corn on the cob, roast chicken, and pasta to find the best options for your next dinner. 

The juiciest hamburgers are filled with steak sauce and butter 

Food writer Lucien Formichella made different hamburger recipes from Brown, Fieri, and Garten.

His favorite was by the "Barefoot Contessa," which used the most ingredients — an egg yolk, steak sauce, two kinds of meat, and seasoning.

After hand-mixing everything, Formichella added butter to the meat and cooked it in a pan to make a robust and flavorful patty. 

Read more about the winning recipe and full battle here: I made burgers using recipes from Ina Garten, Bobby Flay, and Alton Brown, and the best used butter.

Delectable roast chicken doesn't need extra seasoning or toppings 

Leigh made roast chicken using recipes from Thomas Keller, Daniel Boulud, and Garten. Leigh found Keller's technique to be a breeze — and it only uses a handful of ingredients.

After defrosting the chicken, patting off the moisture, and sprinkling pepper and salt on the skin, she cooked it in a cast-iron skillet for 50 minutes. The result was crispy, golden brown, and juicy. 

Read more about the winning recipe and full battle here: I made roast chicken using 3 famous chefs' recipes, and the best took the least amount of time and work.

The best macaroni and cheese took 30 minutes to make

Rachael Ray's recipe used affordable pantry staples like extra-virgin olive oil, butter, flour, milk, white cheddar, nutmeg, cayenne, salt, and elbow macaroni.

After shredding the cheese, Bennett made a roux and broiled the mixture for half an hour. It turned out gooey and slightly cheesy. 

Read more about the winning recipe and full battle here: I made mac and cheese using 3 celebrity-chef recipes, and the best one was the easiest and cheapest to make.

For tasty fettuccine Alfredo, incorporate cauliflower and no cream 

Katie Lee Biegel's fettuccine uses less cheese and more vegetables than other recipes. Though Bennett felt this recipe was more complex than the rest, she found it made the perfect sauce.

To make it, boil cauliflower florets, blend them with milk, and add fettuccine to the boiling vegetable mix. After adding Parmesan cheese, she loved the creamy texture and hardly tasted the cauliflower. 

Read more about the winning recipe and full battle here: I made fettuccine Alfredo using 3 celebrity chefs' recipes, and the best doesn't require cream.

For crispy chicken wings, try a flavorful breading and deep-frying 

Anderson's recipe calls for deep-frying and covering the chicken wings with a Buffalo sauce. Food writer Chelsea Davis didn't think that the breading and sauce were anything unique, but she loved that these wings had a nice crunch and tasty deep-fried flavor.

After tossing the wings with a spice blend of flour, cayenne, salt, and pepper, Davis heated oil in a pan and deep-fried the wings for about 25 minutes to create a great taste and texture.

Read more about the winning recipe and full battle here: I made chicken wings using 3 celebrity chefs' recipes, and the best were super crispy.

There wasn't just one winner in the battle for the best chili

Davis made different types of chili from celebrity chefs from Garten, Drummond, and De Laurentiis. She loved Drummond's take on a traditional dish as well as De Laurentiis' recipe for a comforting, vegetable-filled chili.

Davis browned ground meat with onions and added a spice blend — chili powder, cumin, oregano, and cayenne pepper — tomato sauce, beans, and corn grits to make Drummond's chili.

For De Laurentiis' dish, Davis cooked ground chicken with a blend of salt, cumin, fennel, oregano, and chili powder and added corn, white beans, and Swiss chard to the mix.

Davis loved both Drummond's and De Larentiis' chili recipes for their hearty, savory, and complex flavors.

Read more about the winning recipe and full battle here: I made 3 chili recipes from celebrity chefs, and the worst didn't even have beef or beans in it.

Ray's ribs packed flavor and called for a boozy ingredient

Writer Pascale Mondesir thought Ray's dry rub helped make flavorful, delicious ribs.

The recipe called for a dry rub made with brown sugar, espresso powder, mustard powder, paprika, and cayenne. For the sauce, Ray specifically recommended Southern Comfort whiskey, as well as standard ingredients like chicken stock, tomato sauce, brown sugar, vinegar, Worcestershire sauce, hot sauce, garlic, onion, oil, and ground pepper.

Though she wasn't sure if she'd like the mixture of hot sauce and whiskey in the sauce, the finished dish had a good spice level and enjoyable fruity flavor notes from the alcohol.

Read more about the winning recipe and full battle here: I tried ribs recipes from Ina Garten, Guy Fieri, and Rachael Ray, and the best was a little boozy.

Celebrity chef Roy Choi's recipe for grilled cheese kept things simple yet tasty

Writer Meredith Schneider thought Choi's recipe for a grilled-cheese sandwich had an impressive, delicious blend of cheesy flavors. 

The sandwich had the shortest ingredient list out of the recipes she tried, calling for sourdough bread, unsalted butter, yellow cheddar, white cheddar, Gruyère, and Parmesan. 

Schneider even plans to make Choi's sandwich recipe her new go-to grilled cheese.

Read more about the winning recipe and full battle here: I tried grilled-cheese recipes from Ina Garten, Ree Drummond, and Roy Choi. The best one didn't have fancy add-ins.

Desserts

From pastries and cookies to cakes, we've tested delicious recipes that'll satisfy any sweet tooth. 

The tastiest chocolate-chip cookies are the easiest to make 

Bennett found Duff Goldman's recipe to be simple and straightforward.

The recipe needs all-purpose flour, salt, baking soda, butter, sugar, brown sugar, eggs, vanilla extract, and, of course, chocolate chips.

After mixing everything in a bowl, she baked them for 20 minutes for a buttery and picturesque cookie. 

Read more about the winning recipe and full battle here: I made chocolate-chip cookies using 3 celebrity chefs' recipes, and the best is the simplest. 

The perfect pumpkin pie had a bourbon-maple whipped cream 

Though Flay's recipe had a laundry list of steps, Bennett found that making the filling was simple.

After hand-mixing all the ingredients in a bowl and baking a graham-cracker crust, all she had to do was pour the filling in and bake the pie for 90 minutes.

With the whipped cream, the dessert had the perfect balance of vanilla, maple syrup, warm pumpkin, and spices.

Read more about the winning recipe and full battle here: I made pumpkin pie using 3 celebrity-chef recipes, and the worst was from a baking legend.

Dark chocolate-loaded brownies pair well with berries

To make Gordon Ramsay's indulgent brownies, melt dark chocolate and butter in a broiler and add in the rest of the batter ingredients.

After only 20 minutes, toss more chocolate bits into the crust to break it up. Bennett noted they became bubbly and added to the rich flavor and texture of the pastry. 

Read more about the winning recipe and full battle here: I made brownies using 3 different celebrity-chef recipes, and the best one was also the most fun to bake.

The best chocolate pie required the most ingredients, but they were all worth it

Out of the many chocolate-pie recipes, Goldman's technique using a store-bought crust and homemade whipped cream was the tastiest.

Bennett said it took 30 minutes to whisk and thicken the filling, but after that, it simply had to chill in the fridge.

The whipped cream used mascarpone cheese, heavy cream, fresh vanilla seeds, and sugar for a delightfully sweet pie. 

Read more about the winning recipe and full battle here: I made chocolate pies using 3 celebrity-chef recipes, and the worst has tofu in it. 

You can make quick and easy chocolate lava cake using kitchen staples

For an easy-to-make lava cake, try Drummond's recipe. Bennett simply melted butter and chocolate, then mixed it with powdered sugar, eggs, vanilla, and flour.

She cooked them for 13 minutes to make a delicious hybrid of brownies and batter. She recommended serving it with ice cream. 

Read more about the winning recipe and full battle here: I made chocolate lava cakes using recipes from 3 celebrity chefs, and they were surprisingly easy to make.

Citrus-filled gingerbread is perfect for the holidays 

To make Guarnaschelli's chewy and flavorful gingerbread, use orange zest and lemon juice.

Although Bennett found the dough to be sticky and hard to work with, it was easier to roll out after spending 15 minutes in the fridge.

The cookies' combination of orange icing and spice was "love at first bite." 

Read more about the winning recipe and full battle here: I made gingerbread cookies using 3 recipes from celebrity chefs, and the best were nice and chewy. 

Caramel-filled apple pie is perfect for Thanksgiving 

Drummond's recipe for this pie has a long list of ingredients for each component: the crust, the filling, and the topping.

The crust was incredibly buttery and flaky, and the added spices in the crust kept it flavorful. Bennett found the softened apples contrasted perfectly with the crunchy topping. 

Read more about the winning recipe and full battle here: I made apple pie using 3 recipes from celebrity chefs, and the best was the easiest to make. 

The top fruit salads used surprising but refreshing ingredients 

Bennett tried several recipes for the summery salad and found she'd make Fieri's and Flay's recipes again.

The "Diners, Drive-Ins and Dives" host grills his fruit and adds in pound cake, toasted almonds, mint, and lemony whipped cream for a sweet and caramelized dessert.

Flay uses papayas, kiwis, mangos, pineapples, mint, and a ginger-lime simple syrup for a tropical take. 

Read more about the winning recipe and full battle here: I tried 4 potato-salad recipes from Guy Fieri, Sunny Anderson, Ina Garten, and Ree Drummond, and the worst one called for hard-boiled eggs. 

The best pecan pie was made with a homemade crust

Out of all the pecan pies, Bennett found Drummond's recipe to be the tastiest. 

Drummond used pantry staples like brown sugar, salted butter, eggs, and pecans to whip up this deliciously warm pie. Although the dough was pebbly at first, the crust held up well after it baked.

The gooey center and caramelized pecans made this dessert stand out. 

Read more about the winning recipe and full battle here: I made 3 pecan pies using recipes from celebrity chefs, and I'd combine 2 of them for a perfect slice.

The best sweet-potato pie was time-consuming but worth the effort

Bennet thought Hall's sweet-potato pie, which required a homemade crust, was delicious.

Though the pie took about five hours to make altogether, Bennett thought the dessert had a great structure and a perfectly sweet filling.

Next time, she'd add a crispy, sugary topping to the pie.

Read more about the winning recipe and full battle here: I tried sweet-potato pie recipes from Trisha Yearwood, Alton Brown, and Carla Hall. The best had an easy homemade crust.

Drinks

Whether you're looking for a refreshing cocktail or a warm mug of hot chocolate to end your day, we've tested iconic beverage recipes from multiple celebrity chefs. 

To make boozy hot chocolate, you'll need vodka or liqueur

Sandra Lee's boozy and hot chocolate uses simple ingredients like milk chocolate, half-and-half, cinnamon, and either vanilla vodka or hazelnut liqueur.

Bennett found this was the fastest recipe to make. She enjoyed the sweet and nutty flavor, which is perfect for winter. 

Read more about the winning recipe and full battle here: I tried 5 hot-chocolate recipes from celebrity chefs, and my favorite is also a little boozy. 

Steep milk with spices to make a chai-filled milkshake

Anderson's chocolate-chai milkshake was Bennett's favorite of the bunch. She started by steeping milk with cinnamon, pumpkin-pie spice blend, nutmeg, cardamom, fennel seeds, and black peppercorns on the stove for 20 minutes.

The mixture was then strained into a cup and cooled in the fridge. Bennett loved the cinnamon flavor and thick texture of the beverage. 

Read more about the winning recipe and full battle here: I tried 4 celebrity chef's recipes for chocolate milkshakes, and the best was filled with spices. 

To make minty Moscow mules, try this homemade recipe

Bennett's favorite Moscow Mule was from De Laurentiis, and it required some homemade ingredients.

She soaked fresh mint in vodka for a day, added ginger syrup to vodka, and garnished it with a lime slice, a lemon slice, and a sprig of fresh mint.  

It was cold and refreshing, and the ginger and mint flavors came through equally.

Read more about the winning recipe and full battle here: I made Moscow Mules using 4 celebrity chefs' recipes, and the best was hard not to drink like water.

For classic margaritas, try a simple recipe

Geoffrey Zakarian uses lime juice, tequila, orange liqueur, and agave syrup to make a refreshing cocktail.

Bennett found the tartness from the lime juice, the sweetness from the agave, and the saltiness of the rim came together well without any single ingredient overwhelming the drink.

Read more about the winning recipe and full battle here: I made margaritas using 4 celebrity chefs' recipes, and the best was also the quickest to make. 

A balanced negroni has more citrusy flavors than bitter ones

Ray's recipe was incredibly easy to whip up. Bennett mixed all the ingredients in a shaker, including the lemon peel, and served it neat.

She added a lemon peel as a garnish for an extra boost of citrus. She found that the colder the ingredients are, the better they tasted. 

Read more about the winning recipe and full battle here: I made a Negroni using 4 celebrity chefs' recipes, and the best one was easy to make. 

The best recipe for mulled wine was the easiest

Garten's classic recipe had a short ingredient list that included Cabernet Sauvignon and a lot of apple cider.

It also called for honey, cinnamon sticks, orange zest and juice, and a bit of clove and star anise. Bennett had the wine ready in 10 minutes after it simmered in a pot.

It wasn't spicy and had a good balance of sweet honey and cider.

Read more about the winning recipe and full battle here: I tried 3 celebrity chefs' recipes for mulled wine, and the best was the easiest and cheapest to make. 

Add a spicy kick to your Bloody Mary with a jalapeño

Flay's recipe for a spicy citrus beverage calls for plenty of lemon and lime. There's also a jalapeño involved, which Bennett worried would make the drink too spicy.

It took no time at all to muddle most of the ingredients then add in vodka, tomato juice, and Worcestershire sauce. The flavors worked well and balanced one another, and the cocktail had a nice twist from the pepper. 

Read more about the winning recipe and full battle here: I made Bloody Marys using 4 celebrity chefs' recipes, and the best was the easiest to make. 

For fruity mocktails, load up on ginger beer

Although it took a little bit longer to come together than the rest, Zakarian's sparkling mocktail was still easy to make.

Bennett filled a cocktail shaker with ice, then added the fruit juices. She strained the mix into an ice-filled glass, leaving a bit of room at the top to pour in the ginger beer.

The pineapple and mango juices gave it a tropical flavor and sweetness that perfectly paired with the spicy ginger beer, which gave the mix a kick that resembled a real cocktail. 

Read more about the winning recipe and full battle here: I tried 3 fruity mocktail recipes from celebrity chefs, and the best could pass as a real cocktail.

You can't go wrong with a cosmopolitan

Garten's cosmopolitan recipe makes a massive single serving. Bennett mixed vodka, orange liqueur, cranberry-juice cocktail, and some fresh lime juice together.

There was a nice balance of lime and cranberry to take some of the edge off the liquor. Brown's process was simple, aside from finding fresh cranberries. Bennett boiled sugar, cranberries, and water together until most of the cranberries burst open.

After blending everything in a food processor, she added it to a cocktail shaker filled with ice, vodka, and lime juice for a refreshing beverage. 

Read more about the winning recipe and full battle here: I tried 3 cosmopolitan recipes from celebrity chefs, and the best has become my go-to cocktail. 

Every single mimosa recipe was good enough to make again 

Bennett made mimosa recipes from Flay, Pat and Gina Neely, Guarnaschelli, and Ray.

Each recipe highlighted different flavors and garnishes in the simple cocktail. She had no complaints about any of these mimosas because all of them were fruity, sweet, bubbly, and refreshing.

Read more about the winning recipe and full battle here: I made 4 celebrity chefs' mimosa recipes, and I'd make any of them again for my next brunch. 

The fruitiest white sangria only takes 15 minutes to make

Ray's recipe calls for apple liquor and sparkling water, which Bennett respectively swapped for apple brandy and club soda, as well as dry white wine, sugar, and a variety of colorful fruits.

The recipe also calls for fresh, ripe peaches. This cocktail was light, and the varying colors of the fruit this option stand out.

Read more about the winning recipe and full battle here: I tried 3 celebrity chefs' recipes for white sangria, and the best was also the prettiest. 

Over a span of days, Joshua England's pleas for help became more desperate.

"I've been puking all night, and now I'm puking what looks like blood," he wrote to his medical providers on May 22, 2018. "My stomach hurts so, so bad." At the medical clinic that day he clutched his abdomen and described his pain as sharp and intense — an 8 out of 10. But he was seen by a lesser-trained licensed practical nurse, who didn't give him a complete abdominal exam or send him for any lab work. Instead he was given Pepto-Bismol and told to drink water and eat fibrous food.

The Pepto-Bismol didn't help. The next day England wrote that his pain was so bad he could barely breathe. He couldn't eat or sleep. He again went to the clinic, where he said he'd had bloody stool and his pain was now a 10 out of 10. The physician assistant found that his pulse was racing but didn't conduct an abdominal exam. Instead, he chalked up England's symptoms to constipation and prescribed a laxative.

At that point someone with England's symptoms might seek out a new clinic, to get a more thorough workup, or even head straight to an ER. But Joshua England didn't have that option. He was inmate No. 775261 at Joseph Harp Correctional Center, a medium-security facility in central Oklahoma. He'd been sentenced to 343 days in prison after he and some buddies set some hay bales on fire one drunken night. This reconstruction of the events of those days in May 2018 is based on prison and medical records obtained by Business Insider in collaboration with The Frontier, a nonprofit newsroom in Oklahoma.

Four days after he first requested help, England submitted his fourth sick call — a one-page form that prisoners at Joseph Harp used to request medical attention. He again wrote down how it was hard to breathe or even lie down. This time the licensed practical nurse who saw him consulted with the prison's supervising physician, Robert Balogh. Balogh prescribed ibuprofen over the phone. He, and the physician assistant who saw England earlier, each had marks on their records: Balogh had been fined and put on probation for a time by the Oklahoma narcotics bureau, and the license of the PA had once been revoked for prescription fraud.

As medical professionals downplayed England's symptoms, he continued to deteriorate. He couldn't work or eat or shower; instead he remained in his cell, curled up on the floor in tears. Other prisoners reported that he had lost weight, his skin color had changed, and he no longer seemed fully cognizant.

On May 29, 2018, a corrections officer discovered England slumped over on the floor next to his cell. The Choctaw Nation kid who loved fishing and cattle ranching had died, just weeks after turning 21. Autopsy records show that the cause of death was a ruptured appendix.

Appendicitis is easily treated with minimally invasive outpatient surgery. Even treating a ruptured appendix is considered routine as long as the patient is immediately hospitalized. In this case, the PA was notified of his declining condition the morning of his death; he later told investigators he didn't believe England's condition had been life-threatening. A licensed practical nurse who saw England a few days earlier said she suspected he was in withdrawal and seeking painkillers.

Five years after England's death, the Oklahoma legislature approved a $1.05 million settlement with his mother, Christy Smith, to resolve a claim under the Eighth Amendment, which bars "cruel and unusual punishments." During litigation, the Oklahoma attorney general maintained that the prison's course of treatment was legitimate; in settling, the state admitted no wrongdoing.

Balogh, who no longer works for the department, confirmed the probation and said he was cleared to work without monitoring in 2015. He said he worked remotely for Joseph Harp so was reliant on information provided over the phone by the nurse, who he said did not mention that England had been having symptoms over a span of days. "You had a system where, many times, the physician was not there," Balogh said. "There were some ways that information could fall through the cracks."

A spokesperson for the Oklahoma Department of Corrections declined to comment about the case, as did Joan Kane, a clerk for the Western District Court of Oklahoma, on behalf of Judge Charles Goodwin, who presided. "It is atypical for federal judges to speak publicly about specific legal situations or cases," she said. No other judge on a case mentioned in this story agreed to comment.

Few cases win outright

Business Insider analyzed a sample of nearly 1,500 federal Eighth Amendment lawsuits — including every appeals court case with an opinion we could locate filed from 2018 to 2022 and citing the relevant precedent-setting Supreme Court cases and standards — and found that a settlement like Smith's was exceedingly rare.

The cases in BI's sample overwhelmingly detailed serious claims of harm, including sexual assault, retaliatory beatings, prolonged solitary confinement, and untreated cancers. Prisoners lost a vast majority of them — 85%.

Roughly three-quarters of civil suits filed in the United States settle, and nearly half of nonprisoner civil-rights suits do. In BI's sample of Eighth Amendment cases, just 14% settled. Many of the settlements were sealed. Of the rest, none involved an admission of wrongdoing by prison officials. BI was able to identify just six cases that settled for $50,000 or more; half of those, including the England case, involved prisoner deaths.

Many of the cases settled for modest amounts: An Oregon prisoner received $251 over a claim that she was sexually assaulted by another prisoner and then pepper-sprayed by a guard. A Nevada prisoner got $400 on a claim that guards beat and pepper-sprayed him while he was in restraints. A New York prisoner won $2,000 for claims that he suffered debilitating pain while prison officials delayed treating his degenerative osteoarthritis.

In 11 cases — less than 1% of the sample — the plaintiffs won relief in court.

Seven of these plaintiffs won damages, the result of six jury trials and one default judgment; plaintiffs in the other four cases, including two class actions, were granted motions for injunctive relief, such as being freed from a prolonged stint in solitary. In one of these cases, a plaintiff in Wisconsin was granted access to gender-affirming surgery to treat her gender dysphoria after a seven-year delay. Along the way, the 7th Circuit granted the officials qualified immunity, which protects the conduct of public officials in the line of duty, so the plaintiff was denied damages. Beth Hardtke, the director of communications for the Wisconsin Department of Corrections, said the department updated its transgender-care policy in response to the ruling.

Litigants without lawyers

Another pattern jumped out: In every case in BI's sample in which a prisoner prevailed, the plaintiff was represented by legal counsel. They were outliers.

In the vast majority of cases, 78%, prisoners litigated pro se — without counsel — in large part because a Clinton-era law, the Prison Litigation Reform Act, tightly capped attorney fees, making it prohibitive for lawyers to take prisoner cases. BI interviewed 10 attorneys who represented prisoners or their families in cases that prevailed; they all said the cases would have struggled to succeed without counsel.

"Pro se litigants do not win cases in federal court," said Victor Glasberg, one of a team of attorneys who successfully proved in 2018 that conditions on Virginia's death row violated prisoners' Eighth Amendment rights. "When faced with abysmal anti-plaintiff litigation and jurisprudence, the chance of a pro se litigant getting to first base is about as good as my flying to the moon."

Even lawyers struggle to master the convoluted standards that now guide Eighth Amendment claims, said Chris Smith, a Mississippi attorney who won a constitutional claim over inadequate medical care in 2021.

Smith told BI that his team's ability to access documents was critical for winning the case; he and his colleague spent days combing through 5-inch binders containing years of medical records to prove the corrections department was responsible for treatment delays.

But prisoners face a litany of hurdles, he said, starting with the difficulty they face obtaining records.

They don't have experience in the rules of civil procedure, he said. They don't know how to plan a litigation strategy, or draft jury instructions, or take depositions.

In England's case, because he had died, his mother was the plaintiff in a 2019 lawsuit alleging that corrections and medical staff had failed to treat his appendicitis. Since she was not incarcerated, she was able to secure legal counsel free from the PLRA's fee caps.

The settlement, reached after a four-year legal battle, did not require the defendants to admit to any wrongdoing. State taxpayers, rather than the named defendants, footed the bill.

"The people that actually were responsible for it," England's stepfather, Darren Smith, said, "have no accountability whatsoever."

Prisoners succeed more before juries

One federal judge, Lawrence Piersol of the South Dakota District Court, said that in his experience, jurors are not generally sympathetic to imprisoned plaintiffs. BI's data indicates that plaintiffs actually fare somewhat better before juries than before judges. Of the 1,488 cases in BI's sample, prisoners prevailed more often before juries. Just 2% of the cases BI reviewed were decided by a jury. Yet more than half of the 11 prisoners who won their suits had jury trials.

Glasberg, the Virginia attorney, said he suspected that if more cases were decided by jurors, it would "significantly improve the plight of people in prisons and jails." Many prisoners, he said, see their cases dismissed preemptively by a judge, before a jury has the chance to hear evidence.

One Louisiana prisoner, Tony Johnson, was awarded $750,000 in 2020 after a jury found that a guard at Angola had sexually assaulted him. The guard denied the allegations.

Johnson's lawyer, Joseph Long, told BI that the verdict was the result of years of litigation, including obtaining dozens of depositions and spending nearly $40,000 on the case. The underlying Eighth Amendment claim, he said, entailed abuse with the potential to infuriate even jurors sympathetic to law enforcement.

"Prison isn't supposed to be good, but when they get raped by a guard even the most hard-bitten conservative has to admit that's wrong," Long said. The guard resigned from the prison in 2014 and was never criminally charged; four years after the verdict, Long said, his client has yet to receive his money from the state. The Louisiana Department of Public Safety & Corrections declined to comment on the record.

Chris Smith's client, a Mississippi prisoner named Thad Delaughter, had complained for years about severe hip pain caused by rheumatoid arthritis. Eventually, in 2011, he was allowed to see an outside specialist who found that he needed surgery to reconstruct his hip. The operation was scheduled, only to be abruptly canceled; one of Smith's arguments in court was that prison officials didn't want to foot the substantial bill.

The treatment kept getting delayed as his condition deteriorated. At trial, jurors found that Gloria Perry, the department's chief medical officer, had violated Delaughter's constitutional rights by delaying the procedure; he was awarded $382,000 in damages and, in 2022, had the operation.

Perry denied any wrongdoing, saying in court filings that her actions didn't rise to the level of a constitutional violation; her motion for a new trial was denied. A representative of the Mississippi Department of Corrections said Perry no longer worked for the department and declined to comment on litigation matters; her attorney did not respond to queries.

'I want him to live'

Among the jury wins for prisoners in BI's sample were two cases filed against doctors who worked for Wexford Health, the private correctional healthcare company. In one case, an Illinois prisoner named William Kent Dean convinced a jury that his kidney cancer had metastasized after healthcare providers failed to diagnose and adequately treat his symptoms over a span of seven months. At one point, email records showed, Wexford employees discussed admitting him into hospice in lieu of paying to treat his illness. "He's the love of my life," Dean's wife, Cynthia Dean, said during the trial, "and I want him to live."

In 2019, Dean won $11 million in damages at trial against Wexford and two of its medical providers. Appeals court judges of the 7th Circuit then sent the case back, after finding that Dean hadn't proved the defendants were "deliberately indifferent" to his suffering, as the Supreme Court requires.

One 7th Circuit judge, Diane Wood, dissented, writing, "Wexford directly learned of the lack of significant medical intervention and the arc of Dean's cancer's progression, yet still did not act efficiently or effectively."

Dean died of kidney cancer in 2022 at the age of 61.

Wexford and the Illinois Department of Corrections did not respond to requests for comment.

In August, a new jury again found in favor of Cynthia Dean, who had taken over as plaintiff. This time the award was $155,100. Wexford, in a court filing, denied all of the allegations.

BI's database is packed with cases that also allege significant harm — but the plaintiffs lost.

One was another Illinois prisoner under the care of Wexford, who sued his doctor for waiting over a year to test for an abdominal hernia — prolonging his pain and delaying corrective surgery. Another involved an Oklahoma man who filed suit saying that a prison doctor had improperly discontinued his medication to treat chronic nerve pain from tongue cancer. Both cases were dismissed when judges found the prisoners could not prove their doctors were deliberately indifferent.

A woman in California sued after doctors persistently misdiagnosed a growing lump that, years later, was diagnosed as Stage 4 breast cancer. Even then, she said, doctors denied and delayed chemotherapy as the cancer spread.

The US District Court for the Eastern District of California dismissed her case when she died. There was nobody to take over for her as plaintiff.

Terri Hardy, a spokesperson for the California Department of Corrections and Rehabilitation, declined to comment on the breast cancer case and said the department works to ensure that its complaint process is fair, thorough, and timely. A spokesperson for the Oklahoma Department of Corrections declined to comment on the tongue cancer case.

Large settlements for prisoner deaths

One way for a plaintiff to win a large settlement, BI found, is to end up dead.

Of the six lawsuits BI identified that settled for $50,000 or more, half of those were filed by family members such as Josh England's mother, Christy Smith, whose sons or brothers died behind bars. Unlike prisoner plaintiffs, these surviving relatives didn't have to overcome the PLRA's hurdles.

"Somebody has lost their life, so there should be a lot of money," said Paola Armeni, a Las Vegas attorney. "They're not getting their loved one back."

Armeni's case is one of a handful in our sample in which a lawsuit forced substantive change. She represented the family of Carlos Perez Jr., a Nevada prisoner who was killed in 2014 at Nevada's High Desert State Prison by a trainee officer named Raynaldo-John Ruiz Ramos. Ramos shot Perez multiple times with birdshot, a kind of ammunition used to hunt small game. "They lit him up," Armeni told BI. "The birdshot was from his waist up. It was a murder."

Six months later, a prisoner named Stacey Richards was permanently blinded when a corrections officer shot him with birdshot at another Nevada prison, Ely State.

After an eight-year legal battle, the state settled last year with Perez's family for $1.6 million. That same year, a case filed by Richards settled for $2.25 million. In exchange, Richards' attorney agreed that his client wouldn't talk to the press about the case. Ramos maintained in court that firing his weapon was a reasonable use of force to break up a fight between prisoners.

As a result of Perez's death, the state corrections commissioner was forced out and the department commissioned an external review of its use-of-force policies, ultimately agreeing, in 2015, to phase out the use of birdshot, which prison guards had deployed for decades.

In reaching a settlement with the Perez family, the state did not accept liability for Perez's death, even though the Clark County coroner's office had ruled it a homicide.

The Nevada Department of Corrections declined to comment; Ramos' attorneys did not respond to requests for comment.

Ramos was charged with involuntary manslaughter. In 2019, he entered a plea deal. In exchange for community service and a mental-health evaluation, he avoided prison.

On the morning of March 16, 2015, the night-shift nurses of Martin Correctional Institution clustered in the medical exam room to brief Robert Silvis, the prison's nursing director. Silvis had just started his shift at the facility in Indiantown, Florida, and the nurses looked stunned. They explained, as well as they could, what had occurred the night before.

A man was dead.

Silvis called a prison captain and pulled the surveillance tape.

The video showed someone Silvis recognized as Carolyn Conrad, a licensed practical nurse, entering the D block dormitory at 7:24 p.m. to begin the nightly ritual of distributing medication to the men. When a corrections officer arrived outside cell D2210, he discovered Christopher Cox sprawled on his stomach on the concrete floor. Cox was unresponsive, his arms slack against his sides, his face bloodied and pressed against a pillow, a white T-shirt twisted into a noose around his neck.

Corrections officers handcuffed Cox's cellmate, Hurley Brown, then cuffed Cox's arms and legs before turning his limp body to the side and removing the noose. At 7:28 p.m., Conrad entered the cell. She left seven minutes later. Records show that Conrad, who had been working at the prison for only a month, did not call 911 or start CPR.

Silvis was taken aback. He knew someone with a practical-nurse license, which requires a high-school diploma and a year of vocational school, is not credentialed to diagnose or decide a course of treatment. Anyone with that license certainly lacks the training or authority to declare a person dead. When she saw that Cox was unresponsive, Conrad was required to alert emergency services and start CPR until a more senior medical professional could relieve her. Instead, witnesses later told a state investigator, she left Cox while his skin was still warm.

Silvis called Conrad to demand an explanation. He recalls her telling him she hadn't started CPR on Cox because she believed he was already dead.

As with many men and women incarcerated in the United States, Cox's life was left in the hands of overstretched and minimally qualified medical providers operating in institutions that rarely face accountability for shoddy care. At Martin that night, there was no doctor on duty, only one registered nurse and a group of four LPNs, including Conrad, to care for up to 1,500 men.

Outside the prison walls, someone witnessing a murder can call for an ambulance. But incarcerated people cannot visit a medical clinic on their own, or choose their own doctor. They cannot seek a second opinion, make an appointment with a specialist, pursue additional testing, or control the type or quality of care they receive. They cannot dial 911.

Injury and illness are commonplace in prisons. In a 2009 study of nearly 7,000 men incarcerated in 12 state prisons, 19% reported being physically assaulted by a fellow prisoner over a six-month period; 21% reported being assaulted by prison staff. Meanwhile, waves of men and women, locked up during the height of the war on drugs and mandatory minimum sentences, are now growing old behind bars, often with chronic health conditions such as HIV. Over a third of those incarcerated in US prisons have been given diagnoses of mental illness — a higher rate than on the outside.

Prison healthcare budgets have struggled to keep pace with these growing needs, and much prisoner healthcare has been outsourced to for-profit providers. With fixed per-patient revenue, these privately owned companies have an incentive to avoid expensive procedures and otherwise cut costs. Prisons and private contractors alike have depended on less-trained health providers, such as licensed practical nurses, to keep staffing costs low. A legal settlement in California established that one leading private prison health provider, Corizon, had saved 35% for every low-level nurse who did the work of an RN. Prisons may have a single doctor on staff, and recruitment and retention have become such an acute problem that medical contractors have often retained doctors who have racked up a long history of complaints.

As these problems mounted in the 1980s and 1990s, Congress and the Supreme Court limited prisoners' ability to get relief. To win a lawsuit over constitutionally inadequate medical care, a prisoner must now survive the many restrictions imposed by the Prison Litigation Reform Act, which in 1996 mandated preliminary screenings and other measures meant to weed out frivolous prisoner lawsuits. A prisoner also has to overcome a Supreme Court standard known as "deliberate indifference." As defined in the 1994 case Farmer v. Brennan, the standard says that "cruel and unusual punishments" hinges on the defendant's mindset. Under this standard, the potentially lethal effects of Conrad's decision not to treat Cox would not be enough. A successful Eighth Amendment suit would have to show that Conrad was aware of the risk of harm her inaction presented.

While prisoners can file malpractice claims in state court, there they typically face caps on damages and are unable to recoup attorney fees. And any prisoners seeking injunctive relief — such as a transfer to a hospital — must file a federal constitutional claim. So the barriers to relief in the federal courts introduced by Congress and the Supreme Court have proved nearly insurmountable, preventing claims of even the most egregious forms of medical neglect from prevailing in court.

Business Insider analyzed a sample of nearly 1,500 federal cases alleging cruel and unusual punishment in violation of the Eighth Amendment, including every appeals court case with an opinion we could locate filed from 2018 to 2022 and citing the relevant precedent-setting Supreme Court cases and standards. Nearly two-thirds of those cases involved allegations of constitutionally inadequate medical care. Among them were claims of grievous harm: untreated infections so severe they resulted in amputations; deaths from treatable conditions like gallstones or appendicitis; and agonizing months and years spent waiting for diagnosis and treatment as cancerous tumors swelled, metastasized, and grew lethal.

Hundreds of prisoners complained of inadequate treatment for potentially fatal illnesses such as hepatitis C and HIV or said their mental-health crises were met with violence or solitary confinement rather than care. Dozens said they experienced excruciating pain — stemming from conditions such as collapsed vertebrae or severe infections — that went untreated for months or years. Still more said they were denied basic medical accommodations such as dentures and walkers.

Together, the claims describe a US prison medical culture defined by a gross disregard for human life.

For generations, federal courts have understood the constitutional protection against cruel and unusual punishment to guarantee prisoners the right to adequate healthcare. Occasionally, over the past 30 years, the ACLU or other powerful litigators have managed to win Eighth Amendment cases in which courts have mandated oversight measures and reforms in a prison's, or a prison system's, medical care. But such sweeping accountability measures are rare.

In BI's sample, nearly nine out of 10 cases alleging substandard care were unsuccessful. Most of the remainder settled; many for a few hundred dollars, and all without an admission of wrongdoing, whether by the prison, the department of corrections, or the private medical contractor.

Plaintiffs in only five of these cases won their Eighth Amendment claims.

"Medical treatment only violates the Eighth Amendment when it is 'so grossly incompetent, inadequate, or excessive as to shock the conscience or to be intolerable to fundamental fairness,'" the judges of the 11th Circuit Court wrote in 2022, citing case precedent in denying a claim of inadequate care by a prisoner named Maximo Gomez, who was at risk of suicide.

Such readings of the Constitution have largely insulated prison healthcare providers from legal accountability.

In 2017, Gomez told officers at Hamilton Correctional Institution in Florida that he was experiencing intense distress, extreme depression, and suicidal ideation, according to his civil complaint. A licensed practical nurse employed with Centurion Health, then contracted to provide care in some Florida prisons, spent six minutes conducting what appeared to be a cursory mental-health assessment and determined that he did not need to be placed in an observation cell. Corrections officers, Gomez said, joked that they'd treat him with "hot sauce," slang for pepper spray.

A surveillance camera recorded Gomez flinging himself to the ground, screaming that he needed help and might kill himself. It showed corrections officers wrestling him into arm and leg restraints; his complaint said they then locked him in a shower cell, punched and kicked him in the face, and blasted him with pepper spray as he begged for psychiatric care.

In court filings, the officers said they used force on Gomez "to force compliance" after he refused to submit to restraints but denied punching or kicking him, and the Centurion nurse said she gave Gomez a mental-health assessment according to correctional staff instructions.

Gomez's lawsuit was dismissed. "The Eighth Amendment," the judges wrote, quoting precedent, "does not require medical care to be perfect, the best obtainable, or even very good."

The Florida Department of Corrections declined to comment on individual cases but said each prisoner is "continuously monitored and evaluated for medical, dental, and mental health needs throughout incarceration" in accordance with Florida law.

A 'difference of medical opinion'

The night Cox died, he was three years into a 25-year sentence for murder. At about 7 p.m., a prisoner named Derek Cedri heard the sounds of a struggle in the cell next to his and then a cry for help, he later told a Florida Department of Corrections investigator. On the other side of the cell block, a second prisoner peered through his narrow cell window and caught a glimpse of Brown with his arm wrapped tightly around Cox's throat.

Cedri did the only thing he could: He shouted to a nearby corrections officer that a man was being killed. The officer did not respond; he later told investigators he didn't hear Cedri cry out. Meanwhile, Brown continued to attack Cox; medical records would later show he bludgeoned Cox's face and stomped on his head and neck.

"Man down!" other prisoners yelled. Soon men across the unit were battering their steel cell doors into a steady thunder. Nearly 30 minutes passed before prison medical staff and corrections officers appeared. Four minutes after that, Conrad, the licensed practical nurse, arrived and left without performing CPR.

Conrad did not respond to inquiries by phone, email, or mail.

Her decision not to provide care may not have been an anomaly. In dozens of cases in BI's sample, incarcerated people said they were denied emergency medical treatment by corrections officers or medical staff despite obvious medical distress.

While incarcerated at Camille Griffin Graham Correctional Institution in South Carolina in April 2019, Julie Mason later told a court, she woke nauseated and in severe abdominal pain.

Because she was incarcerated, Mason had only one way to seek medical care: placing a sick call. These written requests don't always prompt immediate attention; in some cases, court records show, they go unanswered for weeks. Even when a diagnostic test for cancer is delayed or an appointment to address excruciating pain is repeatedly rescheduled, prisoners have no internal recourse except to submit another sick call — or submit a complaint to prison administrators. Prisoners' requests for care, court records show, are sometimes met with suspicion if not outright contempt: the prisoner with acute appendicitis denied emergency care by a nurse who thought he was just seeking pain meds; the suicidal prisoner who said he begged for psychiatric care and was told by a guard to "go for it."

In her civil complaint, Mason said she had sent repeated sick calls requesting emergency medical treatment over two days, all unanswered. When Mason continued to complain of severe pain, she said, a corrections officer offered her Tylenol but failed to report her condition to medical staff. The next day, another officer discovered Mason in her cell, collapsed in her own vomit. Mason was sent to medical twice, where nurses checked her vitals; one sent her back to her cell with anti-nausea medication. Hours later, she suffered a grand mal seizure. Only then did a nurse seek sign-off from a prison doctor to send her to a local emergency room, where she was given a diagnosis of necrotizing pancreatitis, a condition that puts a patient at risk for a fatal septic infection. Mason spent nine days in the hospital.

The US District Court for the District of South Carolina agreed with defense arguments that the nurse had sent her for emergency care, and that the corrections officer had "checked on her" and provided "something for her pain at least one time." Under the deliberate-indifference standard, the judges decided, those actions were enough to show that Mason had received adequate care. She lost the case.

The South Carolina Department of Corrections did not respond to requests for comment.

"Where a prisoner has received some medical attention and the dispute is over the adequacy of the treatment, federal courts are generally reluctant to second guess medical judgments," Judge Anthony Celebrezze of the 6th Circuit wrote in a 1976 court opinion. Over successive decades, such judicial caution has become pervasive. In hundreds of cases BI analyzed, if healthcare professionals offered any medical attention at all, judges deferred to their judgment.

Many chalked up the gap between the medical care a prisoner said they required and what was provided to a "difference of medical opinion."

The judges of the South Carolina District Court, and all but one of the other judges mentioned in this story, declined to comment or did not respond to queries.

For months in the summer of 2016, James Kirk complained to the healthcare staff at Jackson Correctional Institution in Wisconsin of classic symptoms of heart failure — acute chest pain and labored breathing. Kirk had a history of heart attacks and had been told he had coronary artery disease and congestive heart failure. But according to his complaint and internal grievance files, the prison medical staff denied Kirk's request to be seen at a hospital. Instead, they issued him an inhaler, attributing his chest pain to his age, history of smoking, or inclement weather. A month later, Kirk collapsed and was transferred to a local hospital. There, doctors discovered a total obstruction of one of his coronary arteries.

Kirk received treatment and survived. When he sued the medical staff involved in his care, the defense argued that Kirk "appeared stable and they were trying different treatments and medications to address his symptoms." The judges of the 7th Circuit found that under the deliberate-indifference standard, the "disagreement" between the hospital doctors and the prison's health providers over Kirk's medical needs was insufficient for an Eighth Amendment claim. He lost the case.

Beth Hardtke, a spokesperson for the Wisconsin Department of Corrections, declined to comment on the Kirk case but said the department "strives to provide the same quality of healthcare as is available in our communities."

In at least a dozen cases BI examined, outside medical authorities, such as hospital doctors, testified that the medical treatment prisoners received was substandard. Yet such testimony rarely persuaded judges that claims had met the deliberate-indifference bar.

One particular case stood out. In late 2010, Dr. Jerry Walden, a physician who'd once served as chief medical officer at a federal prison, was asked by the family of a Michigan prisoner, who had advanced hepatitis C and end-stage liver failure, to advocate on his behalf. After reviewing the medical records, Walden wrote to the Michigan Department of Corrections that the prisoner, Kenneth Rhinehart, who had been serving time for murder since 1973, needed specialized acute care and that if prison administrators were unable to provide it, they "should seriously consider pursuing a medical commutation for this very ill man."

Rhinehart was never offered medical release, and medical staffers at the G. Robert Cotton Correctional Facility continued to delay his treatment. His medical appointments were rescheduled and canceled. His repeated petitions for care were dismissed or ignored. In March 2011, Rhinehart sued, asking the court to compel doctors with Prison Health Services — the private company that then provided medical care to Michigan prisons and later merged with Corizon — to offer care that would prolong his life.

Months later, in June, Rhinehart was rushed to the emergency room after he complained of severe abdominal pain. Arteries in his esophagus had burst — a complication of advanced liver failure, hospital doctors later said. Rhinehart underwent emergency surgery to repair the tears in his throat.

An MRI scan during his hospitalization showed that a mass on his liver had grown to 11 centimeters. Walden wrote again to prison administrators. The mass might be cancerous, Walden wrote, and prison doctors had left it untreated for over a year. Rhinehart needed to be seen by an oncologist immediately.

The prison's medical contractors never scheduled the appointment.

Not long after, the arteries burst again. He woke in his cell doubled over in pain. Blood poured from his mouth and nose, nearly filling a small trash can in his cell. He had a second emergency surgery. To decrease his chances of another bleed, Dr. Lynn Schachinger, who performed this surgery, recommended Rhinehart be transferred to an acute-care facility for the installation of a stent. Rhinehart's condition was serious, Schachinger wrote to Rhinehart's prison doctors, and without further treatment he might "bleed to death."

Corizon doctors refused to authorize the stent procedure, and Rhinehart was sent back to prison instead. When a colleague of Schachinger's insisted on documenting the prison's decision to withhold care, Jeffrey Stieve, then the prison's chief medical officer, balked. "I believe he was threatening me and the department with his refusal to accept our primary management of the patient," Stieve wrote in Rhinehart's medical file.

Stieve and the Michigan Department of Corrections did not respond to requests for comment. A spokesperson for YesCare (formerly Corizon) declined to comment on individual cases but said the correctional healthcare industry "is filled with mission driven professionals who are committed to serving incarcerated individuals, many of whom have never received healthcare in their life, within a challenging prison environment."

By February 2013, Rhinehart's disease was consuming him. He died after a Corizon provider gave him a high dose of morphine. An autopsy commissioned by Rhinehart's family listed the cause of death as an overdose.

Rhinehart's brothers continued his federal case, accusing Corizon, the company's health providers, and other defendants of inflicting pain, depriving their brother of potentially life-prolonging treatment, and then giving him a lethal morphine dose. In court filings and depositions, Walden, Schachinger, and three other outside doctors all testified to the profound inadequacy of Rhinehart's care, saying his treatment "constituted cruel and unusual punishment."

Corizon doctors argued in court filings that Rhinehart's prognosis was poor and his suffering would have been acute with or without the treatment delays. They argued that the stent procedure would not have prolonged his life and their treatment plan of beta blockers, pain medication, and 24-hour surveillance was sufficient.

Judges of the District Court for the Eastern District of Michigan and the 6th Circuit appeals court nevertheless found that the Corizon doctors had provided constitutionally adequate care. Their decision not to install a stent boiled down to a "mere difference of doctors' opinions," so they had not been indifferent to his suffering.

Hesitation by the courts

The Supreme Court's deliberate-indifference standard hinges on something that, the data shows, is nearly impossible to prove: mindset. Judges are asked not only to assess the cruelty of what a prisoner experienced but to decide whether that harm was the result of someone's reckless disregard. In doing so, judges have accepted the slightest bit of care as evidence that prison healthcare providers were doing an adequate job.

Mark Mann's experience in the Florida prison system echoed Kenneth Rhinehart's. Mann first complained of stomach cramping and blood in his stool in May 2014. Prison doctors ordered an abdominal X-ray and stool screenings, which returned normal results. As Mann's abdominal pain continued over the next two years, according to medical records, prison medical staff ordered X-rays and lab work but did not conduct a thorough oncological screening. The prison doctor gave diagnoses first of hemorrhoids, then of acid reflux. He prescribed Imodium and Maalox. It wasn't until June 2016, after Mann repeatedly complained of "extreme pain," that the prison's doctor ordered a CT scan.

Mann had Stage 4 colon cancer.

In 2019, Mann sued Corizon and Centurion Health, the private companies then contracted to provide care in Florida prisons, and his prison doctors. He called an expert witness, a colon and rectal surgeon, who described Mann's doctor as "grossly negligent" for failing to order further tests over a period of two years as Mann's cancer progressed.

A spokesperson for Centurion declined to comment on Mann's case but told BI that "Centurion seeks to improve the lives of all those entrusted to our care."

Corizon called an expert witness, too, a family and internal medicine doctor, who said Mann was appropriately treated and a colonoscopy was not warranted given that Mann was young — he was in his 30s at the time — and had no risk factors for colon cancer. Centurion said its medical providers gave Mann continuous care, diagnosed his disease, and "were not indifferent to Mann's cancer" but rather "helped cure it." (Mann has since died.)

Eleventh Circuit judges found that this scope of care, including the X-rays and lab work, was enough. The treatment Mann received may have violated the "applicable standard of care," the judges said, but Mann's symptoms had been addressed with both testing and medication. "When a prison inmate has received medical care," the judges said, citing an earlier decision, "courts hesitate to find an Eighth Amendment violation."

Beverly Martin, a former federal appeals court judge, reviewed Cox's case in 2019, the same year Mann filed suit. "The law was exceedingly tough on prisoners back in 2019," she told BI. "And I think it has gotten tougher since then."

The judicial hesitation to second-guess medical providers was visible in another case the following year, when a group of prisoners at Federal Correctional Institution Elkton, a low-security prison in eastern Ohio, sued the federal prison system at the start of the pandemic. They asked the court to order the release of medically vulnerable prisoners and mandate additional COVID-19 safety precautions. By the time they filed suit in April 2020, three men at the facility were already dead. Hundreds of other prisoners were believed to be infected. The prisoners won a preliminary injunction requiring the prison to evaluate medically vulnerable prisoners for temporary release. But the Bureau of Prisons got the injunction reversed on appeal.

The 6th Circuit Court agreed with defense arguments that since the prison had implemented an "action plan" of sorts — including issuing each prisoner two paper masks and a 4-ounce bottle of soap each week — the bureau had not been indifferent to the spread of the deadly virus among the 2,300 men trapped in Elkton's crowded housing units. The case eventually settled, with the bureau agreeing in May 2021 to track COVID-19 infections at the facility.

Ben O'Cone, a spokesperson for the bureau, declined to comment on specific cases but said the bureau is committed to upholding prisoners' constitutional rights and makes "every effort to provide essential medical, dental, and mental health (psychiatric) services."

BI identified nearly 200 cases in the sample in which courts found that prisoners had suffered serious harm — including heart failure and untreated cancer — but struck down their cases on mindset alone. In more than 250 other cases, federal judges never made a finding on the objective severity of the harm, deciding solely on the basis of mindset that no constitutional violation had occurred.

In 2023, most malpractice suits in the United States settled, and the average medical malpractice payout was about $400,000, according to a federal database. A 2019 study of insurance claims calculated that the average payout for grievous malpractice — such as a cancer misdiagnosis — was above $700,000.

In the handful of settlements in BI's sample in which the damages were disclosed, the settlements were far smaller. Leaving aside two cases in which prisoners died, no settlement over inadequate care was larger than $45,000, and many were for far less.

One of these cases was filed by a woman incarcerated at Coffee Creek Correctional Facility in Oregon. Her 2017 civil filing said that after a fellow prisoner sexually assaulted and beat her in the shower, corrections officers responded to her screams for help by pepper spraying her and putting her in solitary confinement. The pepper spray, she said, left her with excruciating blisters on her underarms, under her breasts, along her cesarean-section scar, and on her genitals. For over a week, while locked in solitary, she begged for medical treatment without response.

In 2023, she reached a settlement for $251 in damages.

The Coffee Creek defendants denied in court filings that they'd withheld medical care, saying the prisoner was "seen numerous times by medical following the incident." In settling, they admitted no wrongdoing; the Oregon Department of Corrections did not respond to requests for comment.

Medical attention without medical treatment

The most frequent repeat defendants in BI's sample were not individual doctors and nurses, but for-profit companies such as Wexford, Centurion, CoreCivic, and the private-equity-backed Wellpath and Corizon (now YesCare) that receive multimillion- or billion-dollar contracts to provide medical care in state prisons.

As defendants in prisoner suits, the companies have an advantage over individuals: To win an Eighth Amendment claim against a contractor, a prisoner must prove their suffering was due to a company policy or custom. In BI's sample, private medical contractors almost never lost.

In a strongly worded 2022 decision in a class action suit in Arizona, a district judge found that the state, in partnership with Wexford, Corizon, and Centurion, had provided "plainly grossly inadequate" healthcare. She mandated the creation of new policies to force both "quantitative and qualitative" improvements in care and appointed a court monitor.

Such court outcomes are extremely rare.

Of the 210 cases in BI's sample that named private medical contractors or their employees, the defendants prevailed 84% of the time. Almost all of the remaining cases settled.

A 2020 New York University Law Review article argued that the PLRA and the Supreme Court's deliberate-indifference standard had effectively shielded private medical contractors from large liability damages, court monitoring, or other significant forms of federal judicial oversight — and that this had shifted companies' cost-benefit analysis. "The absence of any true threat of legal action exacerbates this environment of unaccountability," Micaela Gelman, then an executive editor of the law review, wrote, and "leads to dangerous, ineffective healthcare that is shielded from constitutional challenge."

Gelman further argued that the low chance of facing penalties, combined with pressure from state agencies to cut costs and pressure from investors to maximize profits, had incentivized private companies to cut corners.

A spokesperson for Centurion, a defendant in 16 cases in BI's sample, said it was "spot on" that funding levels for prison healthcare lagged behind marketplace costs but added: "Any assertions that denying care or using staff with insufficient licensure or credentials to increase profit are patently false. Not providing the very services a company is hired to provide is not a sound, long-term business model for any company in any industry, particularly healthcare."

Ryan Gustin, a spokesperson for CoreCivic, a defendant in seven cases in the sample, said, "We take seriously our role and responsibility to provide high-quality comprehensive medical, dental, and mental-health care to every individual," noting that medical personnel were onsite 24/7 and worked closely with outside hospitals and specialists.

In a 2009 review of cases filed on behalf of Massachusetts prisoners alleging inadequate medical care, Joel H. Thompson, the managing attorney at the Harvard Prison Legal Assistance Project, found evidence that in fact private contractors had exploited the deliberate-indifference standard to avoid accountability. He found that private contractors delayed medical testing when it might have led to diagnoses that would obligate them to pay for more advanced care; that they avoided referring patients to expensive specialists or outside facilities; and that they conducted routine examinations documenting patient complaints but rarely prescribed further medical intervention.

They provided medical attention without providing medical treatment, he concluded. And the courts signed off.

Prisoner court filings describe all of these patterns at Wexford, one of the nation's largest prison health providers. The privately held company was a defendant in 94 suits across eight states in BI's sample — nearly half of the cases with private-sector defendants.

Several of the suits, according to one federal judge, accuse Wexford of running a business designed "to skimp on medical care in order to enrich themselves" by means of chronic understaffing, routine delays in critical cancer screenings and necessary surgeries, and declining to provide even basic medical treatment. As with the other private companies, Wexford typically prevailed. The company settled one in five cases in BI's sample, mostly for undisclosed amounts and all with no admission of wrongdoing, and lost two cases outright. In one case, Wexford paid $155,000 in damages to the widow of an Illinois prisoner, William Kent Dean, who died of kidney cancer after Wexford doctors delayed lifesaving care.

Wexford did not respond to requests for comment.

A 2018 decision by the 7th Circuit appeals court in a case filed by Kelvin Norwood, then incarcerated at another Illinois prison, Stateville Correctional Center, was typical. Norwood's knee was badly injured, and he had sued Wexford, several Wexford employees, and other defendants for providing him with inadequate medical care for a tear in his meniscus, severely damaged cartilage, and a partially ruptured Baker's cyst. His claim had failed against all of the defendants at the district court.

In his appeal, Norwood argued that two Wexford healthcare providers, Dr. Parthasarathi Ghosh and a physician assistant, had prescribed insufficient pain medication and delayed or withheld critical treatment, including medically necessary surgeries and assistive devices such as a brace and a cane. They had done so for eight years, Norwood said, years marked by intense pain.

"Norwood has been the victim of serious institutional neglect," the judges found. "These delays look like features of the Wexford system of healthcare, rather than anything Dr. Ghosh controlled." Still, they decided in the defendants' favor, finding that Ghosh and the PA had not been indifferent because they had provided ongoing care.

Neither Ghosh nor his attorneys responded to requests for comment.

Ghosh was a defendant in multiple cases in BI's sample, though he always prevailed. And he was not alone. Dozens of prison healthcare workers were repeat defendants. The two doctors with the most complaints were, like Ghosh, employed by Wexford.

One, a doctor named Saleh Obaisi, was sued by Illinois prisoners nine times over five years over claims that he'd provided inadequate medical care, delayed essential surgeries, or failed to treat crippling pain. In each case Obaisi denied he'd been indifferent to his patient's medical needs, and he prevailed in all but three.

Vipin Shah, another Illinois doctor employed by Wexford, appeared as a defendant in eight cases. Shah was accused of providing inadequate care for severe infections and, like Obaisi, delaying necessary surgeries. Shah also denied each time that he'd been indifferent; he prevailed every time.

Despite these red flags, Obaisi remained employed with Wexford until his death in 2017, and Shah, according to court filings, remained on Wexford's payroll until July 2021, a year after the last of the eight complaints against him was filed.

Shah, Obaisi's estate, and their attorneys did not respond to requests for comment.

Wexford was the company in charge of Cox's care at Martin Correctional Institution that spring of 2015.

Wexford misses 'red flag' symptoms

The morning after Cox died, Silvis, the nursing director, began to ready charges against Conrad with the Florida nursing board. He thought her failure to provide CPR constituted a violation of her medical license.

That day, March 16, 2015, he called Wexford, his employer, to report what had happened and inform them of his decision. Silvis' manager told him not to report Conrad, who was at the time employed by a Wexford subcontractor. Instead, Silvis recalled, the manager asked him to quietly bar Conrad from ever returning to work at Martin.

Wexford wanted it buried, Silvis thought. How could you protect a nurse who went against practice and cost someone their life?

Less than three months later, Wexford did fire someone — and it was Silvis.

On June 10, he wrote to a Florida state investigator to report the Cox incident and charge that "upper mgt at Wexford is not concerned with inmate care or safety." The state investigator closed Silvis' complaint against Wexford, saying the allegations had previously been addressed in two related cases. Conrad was barred from working at any Florida state prison, according to the investigative report, and she was later fired from her job at the nursing temp agency. In a deposition, Conrad said she retired.

In addition to Silvis, BI spoke with three other former Wexford healthcare providers. All four described the company's cost cutting as extremely dangerous. They said the company drove revenue by chronically understaffing facilities and retaliating against staff who reported lapses in care.

One of those providers was a 16-year prison nursing veteran named Tracie Egan, who found a job as a health-services administrator with the company at Southern New Mexico Correctional Facility in Las Cruces, New Mexico, in April 2022. She said she knew almost immediately that she'd made a mistake.

On her first day, she expected training. Instead, she told BI, she got a pile of outdated policy manuals and a chilly welcome. Within a few days, multiple nurses quit. By her first weekend, Egan was left with a skeletal medical staff to serve nearly 1,000 men, many of whom were on complex combinations of medication or had significant medical needs.

In a suit Egan later filed claiming retaliation, she said she was soon working 19-hour shifts, scrambling to sort pills and handle prisoner sick calls. Sixteen nurses short of a full staff, she was drowning. Routine care was falling through the cracks, she said in court filings. Without dedicated nurses to administer the prison's pharmacy, medications were haphazardly stored, sorted, and distributed, increasing the risk of mix-ups or accidental overdoses. Men sometimes went weeks without their pills and longer without nurse's visits.

She asked Ronald Martinez, then the prison warden, for more staff, training, and resources. In October 2022, she said in court filings, she reported the facility to the state pharmacy board for what she said was a lack of safety precautions in the handling of medications. Then she appealed to Wexford's regional managers. Her daily requests turned into desperate pleas. She told Martinez and her regional managers that she considered the situation extremely dangerous, both for herself and for the people in her care.

She said that Martinez responded by criticizing her job performance and that her Wexford regional managers refused to take remedial action.

Martinez did not respond to requests for comment. Brittany Roembach, a spokesperson for the New Mexico Corrections Department, noted that Martinez and the department were recently dismissed from Egan's lawsuit and said that the agency "remains committed to the health and safety of our inmates and to maintaining high standards of care within our facilities."

Egan said she returned home after one shift, about six months into her job, feeling demolished, only to find two $50 gift cards and a signed note from a Wexford official, Jim Reinhart, thanking her for sticking with the job. "Wexford appreciates everything you are doing to try and fix Southern," Reinhart, who is now Wexford's director of business affairs and transitions, wrote. "Most people would have walked away by now but somehow you have stuck it out."

Reinhart did not respond to requests for comment.

She felt proud and even hopeful. She decided to email Reinhart directly, according to her complaint, alerting him to her working conditions and asking for assistance.

Egan was fired shortly after. In court filings, Wexford denied that Egan was insufficiently trained, that her workplace was unsafe, and that the company had failed to respond to her requests for support. Wexford said any harm that Egan suffered was caused by Egan's conduct alone. Egan's retaliation suit against Wexford remains ongoing.

A December 2023 monitoring report, the result of a consent decree requiring Illinois to improve care in the state's prisons, where Wexford runs medical operations, documented the company's routine failure to meet its medical care obligations. The report describes a litany of preventable deaths and critical lapses in treatment.

The Illinois Department of Corrections did not respond to requests for comment.

The monitor reviewed records of 107 prisoner deaths in the state from 2021 to 2023 and identified nearly 900 treatment deficiencies. Over and over, Wexford doctors and nurses did not recognize or treat "red flag" symptoms; chronically delayed or denied treatments, tests, and referrals to specialty care; and failed to provide basic emergency medical care such as taking vital signs or calling 911.

In dozens of cases, the report found, men and women under Wexford's care were subjected to prolonged treatment delays. A critical lack of staff, the report said, may explain the "widespread and therefore systemic" deficiencies. As of June 2023, the report said, Wexford had failed to fill even half of its contractually obligated medical positions.

In December 2023, Illinois state officials awarded Wexford another five-year contract worth more than $4 billion.

'There was nothing more I could do'

In the months and years after Cox's death, the state's investigative report and subsequent court filings laid out the events of his final hours in granular detail.

At 7:28 p.m. on March 15, 2015, Carolyn Conrad, the Wexford subcontractor, entered Cox's cell at Martin Correctional Institution. She noted his stilled chest and blood trickling from his nose and mouth. Two corrections officers told a Florida state investigator they saw Conrad search for a pulse at Cox's wrist. In a later deposition, Conrad said she also checked Cox's pupils, looked for breath or other signs of life, rubbed her knuckles against his sternum to check for reflexive movement, and administered a few chest compressions, though the officers who were present recall none of this.

"He's dead," she told them, and exited the cell.

Cox's mother, Monica Stone, commissioned an independent review of the autopsy report by a forensic pathologist. He noted that Cox's brain had swollen against his skull, an indication, he said, that Cox's heart was still beating for an indeterminate period of time after he was attacked. Whatever chance Cox had of survival was lost when no one gave him CPR. That failure, the pathologist wrote, was "grossly negligent and should be considered as contributory to his death."

Five minutes after Conrad left, two other licensed practical nurses arrived sprinting into his cell. They started chest compressions and ordered officers to call 911. Paramedics arrived at 8:16 p.m. and, nearly an hour after Conrad and the corrections officers first saw that Cox was unresponsive, they declared him deceased.

Cox's mother, Monica Stone, sued Conrad, the prison warden, the corrections officers who first arrived at his cell, and the secretary of the Florida Department of Corrections in 2017. She argued that they'd violated her son's constitutional rights by withholding critical medical care.

Conrad had told Florida investigators that she had not received any training from the prison or from her employer, the nursing temp agency contracted by Wexford. In her subsequent court deposition, Conrad said she did not knowingly withhold care because she genuinely thought Cox was dead.

"I believed there was nothing more I could do," she said.

Shaniek Mills Maynard, a magistrate judge, did not find a constitutional violation. Conrad may have been negligent, she reasoned, but if the licensed practical nurse genuinely believed him dead, she had not been deliberately indifferent to his suffering.

A district judge, Robin L. Rosenberg, concurred. In the eyes of the courts, Conrad's failure to give CPR was not constitutionally inadequate care. The District Court for the Southern District of Florida granted summary judgment to every defendant.

On appeal, the judges of the 11th Circuit found Conrad's decision to withhold care "regrettable and potentially tragic."

"But there is nothing in the record," they said, "indicating that it was made in bad faith."

It rained heavily the night before the retaking of New York's Attica Correctional Facility. A guard, William Quinn, had been killed. Negotiations had ended. The men on the D yard waited for the inevitable.

Four days earlier, on September 9, 1971, 1,281 prisoners had wrested control of Attica, taking 42 prison staffers hostage and delivering a manifesto demanding humane treatment including adequate healthcare, independent oversight, and an end to racial discrimination.

"We are men," said L.D. Barkley, one of the leaders of the revolt. "We are not beasts, and we do not intend to be beaten or driven as such."

In the early-morning light on September 13, men in D yard heard the thrum of a helicopter as it flew over Attica's 30-foot stone walls and flooded the yard below with tear gas. Steady gunfire from ground forces tore through the gas clouds, chipping the concrete and shredding the bodies of hostages and prisoners alike. Terrified, the men desperately searched for cover. They found none. One prisoner was shot 12 times at close range by two separate guns. Another lay dying of a gunshot wound when a New York state trooper stepped up to finish him off, firing buckshot directly into his neck. A paramedic later testified he saw a trooper execute a prisoner begging for help at point-blank range. State troopers and corrections officers fired nearly 400 shots, killing 39 people — 29 prisoners and 10 prison staff — and wounding 89 more.

The surviving prisoners were corralled and moved to A yard, stripped, and ordered to lie face down in the mud. If they moved, troopers beat them and threatened to shoot them where they lay. Hours later, still naked, they were ordered to stand and run, hands above their heads, through what judges would later refer to as the "gauntlet" — a tunnel leading inside that was lined with troopers and corrections officers. They struck prisoners with clubs and hurled racist epithets. Many prisoners stumbled to the ground and ended up crawling on pavement littered with shattered glass. Once inside, officers threatened some prisoners with castration. Others they forced to play Russian roulette with live ammunition or lined up against the wall in mock executions.

It took nearly three decades for the surviving D yard prisoners to reach a final resolution on their claims that those nightmarish days and nights constituted "cruel and unusual punishments," in violation of the Eighth Amendment. In the intervening period, a series of new laws and legal standards changed the landscape for incarcerated plaintiffs. The Supreme Court introduced one standard in 1976, further codified in 1994, that prison officials violate the Constitution only when they are "deliberately indifferent" to a prisoner's suffering. And in 1986, the court granted broad protections to law enforcement, as long as their actions were not "malicious and sadistic." Guards, the justices found, often had to make decisions "in haste, under pressure, and frequently without the luxury of a second chance."

One set of claims, over the failure of New York's corrections commissioner, Russell Oswald; Attica's warden, Vincent Mancusi; and other senior officials then in charge to provide adequate medical care and prevent retaliatory violence by officers after the uprising was quelled, was decided on the new deliberate-indifference standard. Those claims settled in 2000 without state officials admitting any wrongdoing; damages were capped at $10,000 for anyone not subject to torture, serial beatings, or gunshot wounds.

Another set of claims, covering the planning and execution of the retaking itself, was decided in 1991 on the malicious-and-sadistic standard. The plaintiffs' lawyers argued that the standard had been met, as defendants were responsible for the "wanton infliction of pain and suffering for the purposes of 'maliciously and sadistically' punishing rebellious prisoners."

The judges of the 2nd Circuit disagreed. Aspects of the plan, such as declining to give prisoners an ultimatum before opening fire or allowing correctional officers to participate in the retaking "despite the extreme hostility the officers bore toward the prisoners as a result of the takeover," might constitute negligence or even indifference, Judge Jon O. Newman wrote. But that was not enough, without evidence that those elements were designed to wantonly inflict pain. "Tactical decisions needed to be made," he wrote, and courts cannot substitute their own judgment for that of law enforcement officials on the ground.

One of the most infamous campaigns of state violence against incarcerated people in US history did not, in the eyes of the court, constitute cruel and unusual punishment.

A lone prisoner victory

Senior corrections officials agree that physical force is sometimes necessary to maintain order and safety for both staff members and the prisoners in their care. If prisoners are harming themselves or another person, for example, quick intervention can be critical.

Training documents Business Insider obtained from 37 state departments of correction show that officers in most states are guided to use the minimum amount of force necessary to maintain order. Many departments train officers on de-escalation techniques meant to defuse violence before force is necessary and instruct them to use force "only as a last resort."

But in the 50 years since the Attica uprising, many corrections departments have failed to check staff violence when it tips into excess. Government oversight reports and journalistic investigations over the years have documented systemic abuse in multiple state prison systems: guards brutalizing incarcerated people in New York state, a pattern of sexual assault committed by prison staff in California, and a culture in Alabama prisons in which "unlawful uses of force" were common, including two beating deaths by staff in 2019 alone.

In the face of these institutional failures, federal courts have declined to step into the breach. BI analyzed a sample of nearly 1,500 Eighth Amendment lawsuits, including every appeals court case with an opinion we could locate filed from 2018 to 2022 citing the relevant precedent-setting Supreme Court cases and standards. Of these, 208 cases involved claims of excessive force.

In analyzing these cases, BI found that courts have often sanctioned extreme acts of violence by guards against prisoners. Dozens of plaintiffs in BI's sample said they were beaten while immobilized in restraints. Another dozen said they were subjected to racist abuse or threatened with retaliatory violence. Others said they were placed in life-threatening chokeholds or hit with plastic or rubber bullets shot at such high velocity they cracked femurs and skulls. Multiple people said they were sexually abused by prison staff, including two while in restraints. All of these plaintiffs lost their cases.

Judges dismissed many excessive-force claims under strict administrative requirements imposed by the Prison Litigation Reform Act, a 1996 federal law designed to curb "frivolous" prisoner lawsuits. Judges dismissed others for failing to meet the malicious-and-sadistic standard, or due to doctrines that protect law enforcement officials like prison guards. Judges rarely questioned the authority of prison staff to determine when a use of force was justified.

Sixty-one of the excessive-force cases, almost a third, settled. Only one of the excessive-force plaintiffs, Jordan Branstetter, won his case in court.

In that case, Branstetter said a corrections officer at a state prison in Hawaii had viciously assaulted him for nearly 20 minutes, punching him in the back of the head as he curled into a fetal position on the floor, then kneeing him in the back, breaking two ribs, and choking him.

The Hawaii Department of Corrections and Rehabilitation did not respond to requests for comment.

Less than a third of the cases reached settlements — far less than is typical for civil suits filed in the outside world. Of the excessive-force settlements made public, two were for more than $1 million, but the typical award was about $9,000. None of those cases involved an admission of wrongdoing. Whether for technical reasons or because they viewed the use of force as necessary, federal courts across the country offered impunity to officers accused of excessive force the vast majority of the time.

In September 2022, Judge James Jones of the District Court for the Western District of Virginia ruled that officers at Virginia's Red Onion State Prison were justified in deploying a dog to attack Cornelius Lightfoot. Two officers, thinking Lightfoot had a weapon, tried to frisk him and, when he resisted, tackled him to the ground; a handler then allowed his dog to tear open the flesh of Lightfoot's thigh. An incident report showed that Lightfoot was unarmed by the time the dog attacked; he said in his complaint that the officers had acted in retaliation, taunting him just before the attack that the dog would get his "grievance-filing ass."

The officers said they thought Lightfoot had posed "a serious threat to staff safety." Jones reviewed surveillance footage and determined that Lightfoot was resisting the officers as they tried to subdue him and dismissed the case, ruling that "no reasonable jury could find that any of the defendants used physical force or the canine 'maliciously and sadistically to cause harm.'"

The UCLA law professor Sharon Dolovich discussed the malicious-and-sadistic standard in a 2022 Harvard Law Review article. "That this standard is intrinsically defendant friendly," she wrote, "is undeniable."

Jones, and every other judge mentioned in this story, declined to comment on the record for this story or did not respond to queries. Kyle Gibson, a spokesperson for the Virginia Department of Corrections, declined to comment on the Lightfoot case but said that the agency had "zero tolerance for excessive force or abuse" and that violators "are disciplined according to agency operating procedures."

At about the same time as Jones' ruling, judges with the 5th Circuit appeals court ruled that five officers at a Texas prison known as Coffield Unit were justified when they pepper-sprayed a prisoner who had refused to leave his cell, then put him in a chokehold and wrestled him to the ground. The prisoner, Robert Byrd, was serving a life sentence for capital murder; as he was splayed under the weight of four officers, a fifth officer smashed his outstretched arm with a riot baton, breaking a bone.

While officers later photographed a wooden shank they said was recovered from Byrd's cell, an internal prison investigation determined that Byrd was restrained and unarmed when he was struck and that at least one officer, the one wielding the baton, had deployed excessive force. Still, the appeals court decided that even if Byrd was unarmed, he was violently resisting, so force was "obviously necessary." All the officers had deployed force, Judge Stuart Kyle Duncan wrote in the majority opinion, "in a good-faith effort to maintain or restore discipline."

Amanda Hernandez, a spokesperson for the Texas Department of Criminal Justice, said the video footage of the incident was key to the state's case because it showed a "'hostile, combative, utterly noncompliant' prisoner who was committed to violent resistance."

"We are to accord prison officials 'wide-ranging deference,'" Duncan, one of the 5th Circuit judges who heard Byrd's case, wrote, quoting case precedent. "The Supreme Court has told judges not to micro-manage the force necessary to quell such volatile situations."

Judges dismissed other cases on technicalities.

In August 2022, D'Andre White, a prisoner at Ionia Correctional Facility in Michigan, filed suit claiming that, earlier that year, he'd been shackled by his hands and feet in a bathroom stall during a court appearance when he asked a guard to uncuff one hand so he could more easily use the toilet. The guard refused, White said, then grew irate at how much time White was taking. White said the guard then grabbed him by the throat, slammed him to the ground, kicked him repeatedly, and dragged him to the court's holding cell.

Robert Jonker, a judge in the District Court for the Western District of Michigan, ruled against White, finding that he had not fulfilled his prison's internal grievance process before filing suit, as required by the PLRA.

The Michigan Department of Corrections did not respond to requests for comment.

Two years later, in 2024, Judge Christine O'Hearn of the District Court for the District of New Jersey dismissed the case of Tyrone Jacobs, a federal prisoner who said that four officers had retaliated against him for filing complaints against the prison. He said the officers handcuffed him, pulled him from his cell, and, out of view of surveillance cameras, slammed his head against the wall and dragged his face along the concrete. Jacobs said one officer screamed, "I will fucking kill you."

Because Jacobs had missed a deadline to appeal his internal prison grievance, O'Hearn decided in favor of the defendants.

A 'good-faith effort' to restore discipline

In BI's sample of excessive-force lawsuits, one facility stood out: California State Prison, Sacramento, popularly known as New Folsom. The vast complex surrounded by steel fences and guard towers was built in the 1980s, just across from the Gothic granite tower of Old Folsom, the site of Johnny Cash's legendary 1968 live album. The new facility has a reputation for violence. California Department of Corrections and Rehabilitation data shows corrections officers there deployed force at a far higher rate than any other California prison over the past decade. In 2023, the most recent year for which data is available, New Folsom officers used force — fists, baton strikes, pepper spray, or high-velocity less-lethal ammunition — in nearly 700 documented incidents. That's nearly twice a day. By comparison, officers at the California City Correctional Facility, a high-security facility in Southern California that was recently decommissioned, used force 192 times — less than four times a week.

Violence by guards at New Folsom sparked three complaints of excessive force in BI's sample; all of the plaintiffs lost.

The allegations contained in the legal complaints, together with evidence from state oversight reports and criminal cases against former officers there, hint at a corrections culture in which casual violence prevails and retaliatory cruelty often goes unchecked.

Terri Hardy, a spokesperson for the California Department of Corrections and Rehabilitation, emphasized that in each California case mentioned in this story, the department prevailed, and said the department "takes every allegation of employee misconduct seriously."

One complaint describes an incident that took place in February 2015, in New Folsom's C yard, where a man named Tshombe Kelley, who was serving 52 years for murder, approached a group of officers to ask a question. When he and another prisoner didn't immediately comply with an order to back away and drop to the ground, incident reports show, officers swiftly reacted. One officer, who said he saw Kelley clench a fist, blasted him in the face with pepper spray. Kelley said he reeled back and stumbled to the ground; officers said he again failed to comply with an order to lie flat. Two other officers then deployed physical force, an incident report shows; Kelley said they punched him, kicked him, and dragged him in the dirt. Transcribed surveillance video describes the officers wrestling Kelley into handcuffs and pinning him down with their knees on his shoulder and back, as he pushed against their combined weight.

An officer heard him plead, "I can't breathe."

Instead of easing up, officers deployed a spit mask, a cotton bag that covers the face and head. Blinded and panicked, his throat burning from the pepper spray, Kelley later said, he lost consciousness.

Kelley sued and lost. Officers said in court filings that they feared Kelley and another prisoner might attack them; they said Kelley had refused a direct order to hit the ground and resisted their attempts to restrain him, and only one recalled hearing Kelley say he couldn't breathe. Surveillance video showed that as Kelley was pinned down — and struggling to breathe — he arched his back and thrashed his legs. Carolyn Delaney, a magistrate judge with the District Court for the Eastern District of California, found that the officers' use of force was necessary to combat Kelley's "ongoing resistance."

Judges also sided with guards who injured prisoners they didn't perceive to be resisting.

In October 2020, less than a year after Kelley's case was dismissed, a prisoner named Nathanael Carter Jr. noticed a fight erupt in the New Folsom B yard, according to his civil suit. Guards ordered all prisoners to the ground. Carter immediately complied, dropping to his stomach, arms spread-eagled. From the guard tower, an officer fired two less-lethal rounds from his state-issued 40 mm launcher into the crowded yard, according to multiple incident reports. Both shots missed the men fighting. But one round smashed into Carter's skull, leaving a hematoma the size of an egg and triggering migraines, blackouts, and memory loss.

Like Kelley, Carter lost his case. He'd argued in court filings that he was an innocent bystander who was shot despite "getting on the ground following instructions." The guard said he'd hit Carter by accident, and Dennis Cota, an Eastern District magistrate judge, ruled that the use of force related to "the prison's legitimate penological interest in maintaining security and order."

In more than a dozen cases in BI's sample, judges found that the question of whether a use of force was malicious and sadistic was immaterial, as long as officers were doing their job.

Federal courts grant broad protections to law-enforcement officers for actions taken "under the color of law" — in the line of duty.

That's how one California prisoner's case failed before the District Court for the Eastern District of California. In his complaint, the prisoner said that six corrections officers at a federal prison in Atwater in April 2021 threw him to the ground, handcuffed him, and slammed his head against the wall before dragging him to a holding cell where they physically and sexually assaulted him while calling him racist slurs.

Magistrate Judge Stanley Boone recommended dismissal of the case, finding that any remedy the court might impose "risks interference with prison administration." District Judge Jennifer Thurston agreed and dismissed the case.

Ben O'Cone, a spokesperson for the Federal Bureau of Prisons, did not address the Atwater case but said the agency "does not tolerate excessive use of force" and thoroughly investigates all allegations of employee misconduct.

Cases against corrections officers run into another set of challenges under the doctrine of "qualified immunity." Unless a court has previously found that a particular use of force constituted a constitutional violation, a defendant is given the benefit of the doubt under the doctrine. The Supreme Court standard, established in 1967 and refined in 1982, shields public officials from civil liability when they're legitimately acting in the line of duty. The standard has drawn national attention as an obstacle to police accountability. In prisons, BI has found, qualified immunity has also protected corrections officers who have been accused of excessive force.

That's how things played out in court in the wake of a December 2016 incident at the Darrington Unit, now called Memorial Unit, in East Texas. That day, a prisoner named Marquieth Jackson threw water at a corrections officer passing by his solitary-confinement cell. Incensed, the officer brandished his pepper spray and threatened Jackson. He then spun and blasted a prisoner in a nearby cell in the face at point-blank range.

Why he did so is contested: The officer, Tajudeen Alamu, said that after he was doused with water, he ran for cover by the cell of the other prisoner, Prince McCoy Sr. Alamu said that McCoy threw something that hit him in the face — court documents later identified it as a wad of toilet paper — and that his mind then "went blank" and he reacted instinctively. McCoy denied throwing anything and said Alamu attacked him in anger "for no reason at all."

Alamu did not respond to requests for comment by phone and mail.

After losing at the district court level, McCoy appealed and got a rare finding from the judges of the 5th Circuit. They decided that Alamu had been "malicious and sadistic" in his use of force, in violation of the Eighth Amendment. But after finding that no previous case in the 5th Circuit had established that pepper spraying a man confined in his cell constituted excessive force, they granted Alamu qualified immunity.

"How could any guard not know that an unprovoked use of pepper spray is unlawful?" Gregg Costa, one of the appeals court judges, wrote in a furious dissent. "Yet the majority concludes it would have been reasonable for a guard to think the law allowed him to gratuitously blind an inmate."

The other judges' reading of the qualified-immunity standard, Costa wrote, "ensures vindication of the most egregious constitutional violations."

McCoy appealed, and the case made it to a jury, which again found for the defendant. But the jury disagreed with the 5th Circuit on one critical point: The pepper-spray deployment, they found, had not been malicious and sadistic.

A culture of silence

This pattern of rejection by the courts is especially devastating to prisoners, given how hard it is for them to file suit in the first place.

For nearly 30 years, thanks to the PLRA, any prisoner who wants to file an excessive-force claim has to first file an internal grievance — a petition to prison administrators to address violations committed by their staff. But it can be dangerous for prisoners to report an incident involving the very officers who control every aspect of their daily lives. The cases BI reviewed contain multiple claims of retaliation against prisoners who decide to complain.

One complaint, filed by a New Folsom prisoner named Christopher Elliott, offers a window into the ordeal prisoners often face when they seek redress.

In January 2021, Elliott tried to raise an excessive-force complaint, filing a grievance that said a corrections officer had shoved him onto the concrete floor of his cell and jumped on him while his legs were shackled and his arms were cuffed behind his back. Medical records show a laceration on his left hand, which he said got pinned behind him in metal cuffs, spattering blood across the floor.

After Elliott filed the grievance, he said in a court filing, the corrections officer returned to his cell to issue a threat: If Elliott didn't stop pursuing the grievance, the officer would force Elliott to perform oral sex on him — and order Elliott killed.

When asked about allegations of violent retaliation by prison staff, Hardy, the California corrections spokesperson, said the department had "fundamentally reformed" its approach to investigating allegations of staff misconduct and had deployed body cameras and audio surveillance to "create an environment in which incarcerated and supervised persons are comfortable raising concerns without fear of retaliation."

Akiva Israel, a transgender woman who was incarcerated at another California men's prison, Mule Creek, filed an internal grievance in April 2021 accusing an officer named J. Padilla of threatening to sexually assault her. She said other gay and transgender prisoners immediately warned her to be careful: Reporting the officer might invite even worse consequences.

Israel later filed a civil complaint saying that a week after she submitted the internal grievance, officers handcuffed her and brought her to a prison administrator's office where they hurled transphobic and homophobic slurs and again threatened her with sexual violence. "You fuck with Padilla," she quoted one officer saying, "You fuck with me."

She said the officers then marched her to solitary, stripped her naked, threw her to the floor, and kicked her in the head. They then yanked her off the ground, she said, suspending her by the metal cuffs, causing "excruciating agony," and slammed her to the concrete floor.

Kimberly Mueller, a judge with the District Court for the Eastern District of California, dismissed Israel's case without prejudice on a technicality. Handling her case without an attorney, she had missed a deadline to file an amended complaint while being treated for breast cancer.

In Elliott's case, Kendall Newman, a magistrate judge in the same court, also recommended dismissal on technicalities: Elliott might have a case, Newman said, but he had not signed his complaint filing and his claims of retaliation were unsupported by evidence.

It has become so rare for the courts to find constitutional violations that the wins send shock waves through prison communities. On October 17, 2022, William Shubb, a senior judge in the Eastern District, sentenced a former New Folsom guard, Arturo Pacheco, to 12 years in prison for knocking the legs out from under a handcuffed 65-year-old prisoner who landed face-first on a concrete walkway, breaking his jaw. The prisoner, Ronnie Price, suffered a pulmonary embolism and died two days later.

In the lead-up to Pacheco's sentencing, a New Folsom prisoner named Mario Gonzalez fired off an urgent letter to Shubb, saying Pacheco and another indicted officer "know more than what they've shared." He said many more staff there should be prosecuted, including corrections officers who he said "cuff us and beat us" and lieutenants who he said had lied in incident reports to cover up excessive force.

In an earlier civil suit, Gonzalez said he'd reported to his prison psychologist that a group of officers was committing "illegal beatings of fellow inmates" and that he feared for his safety. Soon after, he wrote, four officers cornered him in his cell: One put Gonzalez, who then used a walker, into a headlock, wrenching his spine backward until he feared it would snap. Three others kicked him in the ribs, torso, back, and groin, then scooped urine and feces into his mouth.

"My back was broken. My ribs were broken," Gonzalez wrote to Shubb, injuries that he had documented in his civil suit and in prison grievances. "I have night terrors at least 4-5 times a week. I also cannot get that piss and shit taste out of my mouth." He said he reported the incident but believed no internal investigation had taken place. His case was dismissed repeatedly over six years while he was in prison, most of the time without a lawyer. He wrote to Cota, the Eastern District magistrate judge, alleging that officers were retaliating against him for being outspoken by locking him in solitary confinement and inciting fellow prisoners to attack him.

"I pray you please take action cause my life is endangered," he wrote in one letter.

Still, his complaint languished. Only after Gonzalez got a new lawyer and was released from prison in the fall of 2023 did Cota allow his case to continue. (The case remains ongoing.)

The California state prison system has been under official scrutiny for decades, springing from a 1995 decision by a federal judge finding a pattern of egregious violence perpetrated by guards at Pelican Bay State Prison, some 380 miles northwest of New Folsom, in violation of the Eighth Amendment. California prison officials, the judges found, "permitted and condoned a pattern of using excessive force, all in conscious disregard of the serious harm that these practices inflict."

It remains the only case decided under the malicious-and-sadistic standard to spark significant prison reforms in the state.

The court mandated a suite of new oversight mechanisms, including the appointment of a special master and a new use-of-force action plan.

Nearly a decade later, the special master issued a scathing evaluation: California prison officials had deliberately misled the court by filing false or misleading reports. The report found that administrators had endorsed a "code of silence" — an informal but aggressively policed policy under which corrections officers refuse to report misconduct to avoid being labeled "a rat."

The special master found California's entire system for investigating and disciplining officers accused of excessive force was "broken to the core." The court ordered a new plan, which included direct oversight and annual reports from the state's inspector general.

The special master's mandate has long since expired. Yet the inspector general's annual reports continue to identify severe deficiencies in how California prisons deploy and investigate the use of force.

In 2023, the most recent year examined, the inspector general reviewed 730 use-of-force incidents and identified 225 that appeared to involve staff misconduct, including 82 incidents where staff may have deployed excessive force. Prison officials initially failed to refer nearly half of those 225 incidents to internal affairs for investigation, including incidents involving the potential use of excessive force and those involving the potential withholding of medical treatment or failure to follow protocol.

The inspector general found that officers repeatedly failed to turn on their body cameras, sometimes wrote misleading or blatantly untrue use-of-force incident reports, or failed to report deployments of force at all. In the vast majority of cases, supervisors rubber-stamped the use of force as acceptable, often without interviewing the prisoner in question or reviewing all of the available video evidence. Even after the inspector general's investigators identified cases that appeared to involve excessive force, they found that prison officials sometimes declined to open internal affairs investigations into the officers involved.

These patterns had been long documented. In each of the five years preceding 2023, the inspector general found that California prison staff appeared to have violated use-of-force policies in at least 40% of the hundreds of incidents the office reviewed. Each year, the office also found significant deficiencies in how managers investigated use-of-force incidents — and found that supervisors regularly declined to take action against officers who deployed "unreasonable force."

If the courts were expected to provide a backstop, they failed.

Over the same five years in BI's sample, no federal judge found for the plaintiff in a single excessive-force claim filed by a California prisoner.

Over the past decade, Minnesota's prisons have experienced officer assaults, lockdowns, and chronic staffing shortages. They have faced allegations of substandard medical care, inhumane living conditions, sexual abuse by guards, and retaliation against prison employees who have sounded the alarm. "It's a very sick system," one former lieutenant told Business Insider. Officers "have each other's back," she said, "even if that means lying."

Within this troubled system, officers and prisoners said one facility has stood out: Minnesota Correctional Facility–Rush City.

A former Rush City therapist described it as one of the state's most dangerous prisons, and a former corrections officer there recalled near-daily fights. "The staff up there are a bunch of cowboys," a former Rush City lieutenant said. Officers there "go hands-on much quicker than they would at any other facility," he added. "It was a culture that was just ingrained from the day it opened."

The first lieutenant, who spent a year at Rush City, described the place as a "time bomb."

The routine brutality earned Rush City a moniker: Gladiator School.

Despite the frequent violence, Dario Bonga, a longtime Rush City prisoner, said one assault, in particular, had stuck with him. It was the day a prisoner bashed in James Vandevender's head.

Bonga was one of six prisoners and officers who said the attack was so brutal they still remembered it over a decade later.

A methodical attack

On June 8, 2012, Vandevender, then 25, had only a few months left on his yearlong sentence over assaulting someone during a fight. He and Bonga were working that day in the prison's industry area, folding balloons, when Bonga was startled from his work by a loud thud. A prisoner had swung at Vandevender's head with a four-by-four wooden post. Bonga watched in shock as the man, later identified as Mark Latimer, continued his methodical attack.

Surveillance footage obtained by BI corroborates Bonga's account. It shows Latimer pick up an unsecured wooden board from a shelf in the woodworking area, drop it, and walk away. A few seconds later he's back, and this time he quickly pulls out a wooden post. No officers are visible in the video; the unguarded woodshop wasn't operating that day.

In the surveillance footage, Latimer saunters several hundred feet across the workshop with the four-by-four. No one tries to stop him — no corrections officer; no one from Minncor Industries, the corrections division that oversees prison labor — as he approaches Vandevender's worktable, hoists the post over his shoulder, and begins to swing.

Only after the sixth blow — after Vandevender has collapsed onto the table, bleeding from his nose and mouth, and after Latimer has slipped into the crowd of panicked men — do officers come running.

Later, at the hospital, a doctor told Vandevender's mother, Peggy Vandevender, that her son had a 20 to 30% chance of survival. He spent 45 days in a coma and woke up 40 pounds lighter. His face was numb, and he couldn't speak or read. He thought he had a prison softball game that weekend, not processing that he had been in the hospital for a month and half.

Years later, the effects of Vandevender's traumatic brain injury persist. Tests indicated a decline in cognitive function. Seizures have forced him to take epilepsy medication. Deep depression sent him in search of meth, which landed him at Rush City again.

When Vandevender arrived back, about four years later, Bonga thought he was seeing a ghost. No one thought he could have survived that beating.

'Unacceptable' risks

In 2018, Vandevender filed a lawsuit alleging that prison officials, by failing to protect him from the attack that day, had violated his Eighth Amendment rights to be free from "cruel and unusual punishments." His attorneys argued that officials had been aware of the risks: For several months before the assault, officials had specifically instructed prisoners to pile and store the boards in an unsecured area that was accessible to prisoners, against prison policy. Vandevender's complaint said that in the weeks before the attack, a prisoner had warned a guard that "the open pile of wood was a threat to the health and safety of all of the inmate population and could be used as a weapon against him and other inmates." The prisoner said the guard told him it was none of his business and "not to worry about it."

There was reason for concern: Vandevender's complaint cited an incident in which, he said, one Rush City prisoner had assaulted another with the wooden handle of a pitchfork, "causing serious head injuries." When, six years after Vandevender's assault, a corrections officer named Joseph Gomm was killed by a prisoner wielding a sledgehammer taken from a work area at another Minnesota prison, Gomm's family sued, alleging a "long-standing culture" in which Minncor's revenue was prioritized over safety.

"Had there been more staff, had there been more cameras out there, absolutely Officer Gomm would not have been killed," a former Rush City corrections officer told BI. "Same thing with Vandevender."

Aaron Swanum, an information officer for the Minnesota Department of Corrections, said that among Minncor staff, only production supervisors are required to receive security training. At Rush City, he said, there is just one.

After reviewing the circumstances surrounding Vandevender's attack for his case, Tim Gravette, a corrections consultant, concluded that Rush City staffers were negligent for failing to properly follow state correction policies, and that if they had, Latimer couldn't have attacked Vandevender in the way he did. "I find the lack of work material accountability to be unacceptable practice," he wrote.

Paul Schnell, Minnesota's corrections commissioner, said that while he couldn't comment on Vandevender's case because it predated his tenure, "obviously we want to be in a place where we're trying to take the steps to keep people safe."

He said that since he became commissioner in 2019, he'd established an Office of Professional Accountability to address employee complaints, revived an independent ombudsman office to address internal grievances, started a body-camera pilot program, and, in the wake of Gomm's murder, increased the number of staff and cameras in the industry area of the prison where he died. The department confirmed that there have been no such changes at Rush City.

Whether a prisoner wins or loses a lawsuit, Schnell said, "we're certainly looking at our practices no matter what."

He said that "everything's incremental" when it comes to corrections reform.

"The challenge is that we were struggling to get our staffing complement up in general, so while we may have put more bodies in Minncor, we were shorter elsewhere," he said. "It's always give-and-take."

A guardrail against cruelty

From its beginnings, the Eighth Amendment was understood as a guardrail against unabashed cruelty; by the mid-20th century it was also being used to push back against inhumane prison conditions, violence, and medical neglect. Then, in the 1980s and 1990s, as mass incarceration was on the rise, the Supreme Court issued a series of opinions that shifted the focus away from these underlying abuses to the question of prison officials' intent.

In practice, these decisions made it difficult for prisoners to assert their constitutional rights.

One of those pivotal cases was 1994's Farmer v. Brennan. The court unanimously ruled that prison officials were liable for Eighth Amendment violations only if they acted with "deliberate indifference" to a prisoner's suffering. To meet this standard, Justice David Souter wrote, prisoners must show that officers were aware of and disregarded a serious risk of harm, saying this approach "comports best with the text of the Amendment." Officials were now on the hook only if they had the knowledge that a particular harm would occur if they didn't act.

While Souter said a court could infer awareness if the risk was obvious, the standard still required incarcerated plaintiffs to marshal proof of something ineffable — a prison official's inner thoughts.

Business Insider's analysis of a sample of nearly 1,500 Eighth Amendment cases — including every appeals court case with an opinion we could locate filed from 2018 to 2022 citing the relevant precedent-setting Supreme Court cases and standards — shows that mindset has become an extremely difficult standard to meet. For the vast majority of prisoners in BI's database who filed their suits without counsel, proving mindset can be almost impossible — 85% of their cases decided under the deliberate indifference standard lost.

All of the remaining pro se cases settled, often for modest amounts.

"However obvious the circumstances, people may at times remain oblivious," Sharon Dolovich, a law professor at UCLA, wrote in an anthology on the Eighth Amendment. "And when this is true of prison officials, no constitutional liability may lie, however 'soul-chilling' the conditions."

Deference to officials, coupled with "the long and troubling history of unspeakable maltreatment against incarcerated people by the very actors charged with their protection," she wrote, has created a landscape where "the power that prison officials have over incarcerated persons is sure to be abused."

In BI's sample, a few attorneys successfully proved mindset, sometimes by obtaining explicit circumstantial evidence, such as email exchanges introduced in the case of one Illinois prisoner that show prison healthcare providers floated the possibility of sending him to hospice care after his oncologist recommended treatment that would cost $15,000 a month. But such cases were rare.

Few sitting judges would comment to BI about the deliberate-indifference standard; some did not respond to interview requests, while others declined to comment. One who did, Lawrence Piersol, a federal judge in South Dakota, decided a case under the standard filed in 2020 by a prisoner named Jason Dunkelberger. While incarcerated at the South Dakota State Penitentiary, Dunkelberger said, the tips of his fingers were severed by a metal shear in the prison machine shop that he'd never been trained to use; in a deposition, he said he was told he'd be sent to solitary if he refused the assignment, given to him by a fellow prisoner put in charge by the machine shop's supervisor. He said he waited 90 minutes before being sent to the hospital, where the fingers were amputated.

The South Dakota Department of Corrections did not respond to requests for comment.

In his lawsuit, Dunkelberger argued that prison staff had violated his constitutional rights by failing to keep him safe. Because the directive to use the machine had come from a prisoner, and not an officer, Piersol ruled that officials couldn't be considered deliberately indifferent. Piersol said his decision spoke for itself, but he agreed to comment on Eighth Amendment cases generally.

"It's difficult for a prisoner to succeed," Piersol said. "But sometimes there are some decent settlements."

Dunkelberger's claim couldn't meet that high bar. Vandevender's didn't either.

Donovan Frank, a federal judge with the District of Minnesota, granted the prison officials qualified immunity in the Vandevender case, finding that he had failed to prove they "were subjectively aware of a substantial risk posed by the wooden boards." Even if they should have known that leaving them unsecured violated Rush City's tool policy, Frank wrote, that "does not satisfy the subjective-culpability requirement."

He dismissed the case before Vandevender could take discovery.

After Vandevender appealed, the 8th Circuit agreed with Frank, deciding that Vandevender was the victim of a surprise attack and that corrections officers therefore could not have violated his rights by failing to protect him. The court determined that the prior assault with a wooden pitchfork handle hadn't signaled a "pervasive risk."

When BI spoke with Mark Bradford, Vandevender's attorney, two years after he lost the case, he seemed defeated.

"I'm not sure what more you could possibly do to show deliberate indifference," he said. "It really is a troubling standard that the 8th Circuit has employed here."

Appended to the appeals court's judgment is a separate opinion, authored by Judge Jane Kelly, who wrote that she concurred only because she was bound by 8th Circuit precedent. "Our caselaw may set the bar too high for the typical inmate to sufficiently plead prison officials were deliberately indifferent to a substantial risk of serious harm in a case like this one."

'The easiest lie to tell'

The Eighth Amendment cases BI reviewed include claims of untreated cancers and heart disease, retaliatory beatings, sexual assaults, limb amputations, and prisoners wasting away in squalid cells littered with feces and dead flies. There was a New York teenager who said he was put in a vermin-infested cell in late 2021 where he was attacked by a bat and bitten by a poisonous spider, an Arizona prisoner who said in 2020 he was given only Tylenol to treat a broken jaw, and a Michigan man who filed a complaint in 2019 saying his eyesight deteriorated because prison doctors refused to conduct cataract surgery. Again and again, courts dismissed these cases, finding that prisoners had failed to meet the deliberate-indifference standard. The standard introduced three decades ago by the Supreme Court — and its interpretation by federal courts in the years since — has created formidable obstacles to accountability in this country's prisons.

The Arizona Department of Corrections, Rehabilitation & Reentry did not comment on the broken-jaw claim but said that Gov. Katie Hobbs had appointed a new corrections director, Ryan Thornell, in January 2023 "to make needed changes to the correctional system" and that he was ensuring "high-quality, patient-centered care and wellness are becoming standard practice." The New York and Michigan corrections departments did not respond to requests for comment.

Of the cases in BI's sample, 1,361 were argued under the deliberate-indifference standard. Only 10 plaintiffs prevailed in court; another 164 cases settled without the prison admitting liability. All 10 of the successful plaintiffs were among the minority in the sample who were represented by counsel.

David Fathi, the director of the National Prison Project at the ACLU, told BI the standard has been "an enormous barrier to justice for incarcerated people." If prisoners encounter conditions that are "inhumane, unhealthy, dangerous, or even lethal," he argued, "that should be enough to violate the Eighth Amendment — you shouldn't have to go looking for someone who was thinking bad thoughts."

David Shapiro, the executive director of the Chicago Lawyers' Committee for Civil Rights, has litigated dozens of Eighth Amendment cases on behalf of prisoners.

"I didn't know this person was going to get attacked by another incarcerated person," he said of defenses under the deliberate-indifference standard. "I didn't know that this person was having chest pains because they were experiencing a heart attack."

As long as prison officials assert that they didn't know about the risk, he said, a federal court will rarely find an Eighth Amendment violation.

"What is the easiest lie to tell?" he said. "I didn't know."

'A dark and evil world'

For generations, the federal courts took a mostly hands-off approach to conditions in America's prisons. That changed in the wake of the Civil Rights Movement, as judges began to issue Eighth Amendment rulings that secured key rights for prisoners.

In 1970, for instance, a federal judge put every Arkansas prison under court order, calling the state system "a dark and evil world completely alien to the free world." Six years later, another federal judge found prisons in Alabama "wholly unfit for human habitation" in violation of the Constitution.

About this time, a Texas prisoner named J.W. Gamble sued his facility over inadequate medical care, arguing that officers had failed to treat his intense pain after a 600-pound cotton bale fell on him during a work assignment. While the Supreme Court found that Gamble's constitutional rights hadn't been violated, the 1976 decision, written by Thurgood Marshall, established that prisoners have a right to medical care under the Eighth Amendment.

"Deliberate indifference to serious medical needs of prisoners constitutes the 'unnecessary and wanton infliction of pain,'" Marshall wrote. "An inmate must rely on prison authorities to treat his medical needs; if the authorities fail to do so, those needs will not be met."

It was a consequential decision. It was also, fatefully, the court's introduction of the phrase "deliberate indifference."

"There it sat," John Boston, the former director of the Prisoners' Rights Project of the New York City Legal Aid Society, said, "extremely vulnerable to a more conservative court coming along and trying to define it downward in ways disadvantageous to prisoners."

That shift occurred quickly. As President Ronald Reagan ramped up the war on drugs, legislators from both parties, committed to a tough-on-crime agenda, began to pass a raft of criminal-justice measures. The impact of these policies is now well known. In less than 30 years the country's penal population grew sixfold to a peak of more than 2 million, leaving the US incarcerating more people than any other country.

The critical Farmer v. Brennan case came when Dee Farmer, a transgender woman, filed a claim saying federal prison officials had failed to protect her from sexual assault. In an interview, she described how, after being raped by another prisoner at knifepoint, she was sent to segregation for over a year.

When Farmer won her case before the Supreme Court, it was hailed as a major victory for transgender rights. The decision also cemented the current deliberate-indifference standard.

Farmer's lead attorney, the ACLU's foremost prison expert, Elizabeth Alexander, argued that the standard should hinge on what officials had the professional responsibility to know. The solicitor general, Drew Days III, disagreed, contending that officials should be held liable only for risks they were aware of. "Petitioner's 'should have known' approach ignores the 'deliberateness' requirement of the 'deliberate indifference' standard," he wrote in his brief.

The Supreme Court agreed with Days, finding that officials were liable only if they personally knew of and disregarded the risk, regardless of the gravity of the harm to the prisoner.

Some issued warnings at the time. Michelle Alexander, the noted civil-rights lawyer and author, who was then a clerk for Justice Harry Blackmun, suggested that the majority opinion "would allow a prison official to argue to the jury that although a particular risk of harm was plainly obvious, and a reasonable prison official would have been aware of it, he wasn't."

In his own concurring opinion, Blackmun described the new standard as fundamentally misguided. "A punishment is simply no less cruel or unusual because its harm is unintended," he wrote.

Alexander, in a recent email, described the decision as one of many during that period that created what she called "unconscionable obstacles to meaningful relief for people ensnared by our criminal injustice system."

Vandevender is one of hundreds of prisoners in BI's sample for whom those obstacles were insurmountable. Prisons are inherently dangerous places, the 8th Circuit concluded in his case, and "inmates bent on assaulting other inmates will use even the most harmless objects as weapons."

Judge James Loken, who authored the majority opinion, wrote that, for Vandevender, "the outcome was tragic, and an assault with this weapon was, in hindsight, no doubt avoidable."

Still, he concluded by quoting the Farmer decision, writing, "an official's failure to alleviate a significant risk that he should have perceived but did not, while no cause for commendation, cannot under our cases be condemned as the infliction of Eighth Amendment punishment."

A fiancée's warning

Six years after Latimer's assault on Vandevender, Rush City experienced another violent attack. This time, officials were repeatedly warned of the risk.

Trina Murray was at home in bed one night when she got the call. She was confused; her daughter never phoned that late. She listened with a rising panic as she learned that her only son, David Hodges, had been assaulted at Rush City.

Hodges is a large man, tall and broad-shouldered, with the word "family" inked onto his right forearm. But Murray still worried about his exposure to violence when, in 2011, he was sent to prison for sexual assault. She knew what Minnesota's prisons could be like, having worked in two of them.

She tells one story from when she was an officer at Minnesota Correctional Facility–Lino Lakes, a medium-security prison outside Minneapolis, in the 1990s. There, in her telling, she witnessed a group of officers placing bets on how many prisoners they could send to solitary confinement. When she reported the behavior, she became the target of a campaign of retaliation. The officers, all men, followed her to her car. They called her the N-word, she said, and told her to go back to Africa. Later someone threw a rock through the window of her home. Eventually, she quit.

After the call that evening in September 2018, she scrambled to learn what had happened to her son. In incident and investigative reports, Hodges claimed that another prisoner, Courtney Osgood, had entered his cell with a shank, angry that Hodges had refused to pay off a debt owed by Hodges' cellmate. Osgood grabbed Hodges' locs, ripping some out, and attempted to stab him. Hodges, who had been making coffee on a small hotplate, threw the boiling water at Osgood, who raced out of the cell.

Prison officials weren't aware of the altercation, according to an incident report, until Hodges' then-fiancée called the prison, concerned about his safety. Once alerted, Hodges' subsequent civil complaint said, they sentenced Osgood to 20 days in segregation — and gave twice that to Hodges. Gene Olson, a prison lieutenant who investigated the incident, said in a deposition that he couldn't prove Hodges' account of the attempted stabbing because officials couldn't track down the shank. Osgood also denied Hodges' account in a message to BI, calling it a "fabricated narrative."

In segregation for about six weeks, locked in a tiny cell, the lights on 18 hours a day, Hodges said, he obsessed about one thing: what was waiting for him when he got out.

"It's prison politics 101, if I assault you and I hurt you real bad, you're looking to get your lick back," he said. "Needless to say, I'm a big guy, and I know this time he was coming with help."

Hodges begged officers to move him to a different unit, verbally and in writing. Murray, his mother, along with his fiancée, his sister, and his grandmother, called and wrote over a period of six weeks to the prison and to state corrections headquarters, imploring officials to take action because they feared for his life. "What exactly must he do to get a transfer to another facility for his safety?" his fiancée asked in a late-October email to the warden at the time, Jeffrey Titus. "Why must something really bad happen before he is taken seriously."

Every prison in Minnesota has an incompatibility-review committee composed of prison staff that meets to decide whether particular prisoners pose a risk to each other and need to be separated. Their deliberations, a former corrections staffer at Rush City told BI, are usually documented in great detail. Rush City's panel, which included Olson, had met in late September 2018 and decided that Hodges and Osgood didn't need to be separated. Ashlee Berts, a corrections program director who oversaw the committee, said in a deposition two years later that no notes were kept to explain their rationale. She said she didn't remember who was on the committee, whether it had convened in person or over email, and what was discussed. Olson said under oath that, despite the pleas from Hodges and his family, he didn't believe Hodges faced any threats.

Schnell, the corrections commissioner, said he expected his staffers to fully document incompatibility reviews. "It's news to me that there wasn't that information," he said of Berts' claim that no records were kept. "We want to be in a position where we can say that we have documentation that we did that and the basis for it."

In early November, just hours after Hodges was released from segregation, Osgood and a fellow prisoner assaulted him in the living unit, throwing a mixture of hot water and capsaicin, a chili-pepper extract, in his face. Surveillance video shows Hodges trying to escape as the two men come toward him. They land a series of punches as Hodges waves his arms in a futile attempt to make contact with his assailants. His eyes were blinded and burning, he told BI, saying it felt like an eternity before officers arrived. Medical records show he suffered a nasal fracture, second-degree burns, and an eye injury.

Ten days after the assault, the committee made a new determination: Hodges and Osgood were incompatible, and Hodges' transfer request was granted.

Almost five years later, Hodges discussed the incident while sitting in an empty visitors' room at Minnesota Correctional Facility–Moose Lake, a state hospital turned prison an hour north of Rush City. The window blinds concealed a barbed-wire fence just outside. He wears wire-framed glasses now, to help with the blurred vision he's lived with since the attack. "I had a lot of sleepless nights," he said. "Every time I think about the situation, I'll have flashbacks." In a July 2019 incident report, an officer described finding him crying in the midst of an anxiety attack.

Like Vandevender before him, Hodges filed a lawsuit alleging that prison officials at Rush City failed to keep him safe.

With Vandevender, the court's ruling hinged on the fact that he'd experienced a surprise attack. But the attack on Hodges came after a campaign of urgent warnings that he feared for his life.

The defendants argued that launching the incompatibility review was itself proof they hadn't been deliberately indifferent to Hodges' welfare. A federal judge, Wilhelmina Wright, accepted the officers' claim that they had determined in good faith that Osgood no longer posed a threat.

"The fact that this conclusion proved to be incorrect does not demonstrate that Defendants recklessly or intentionally ignored an obvious risk," Wright wrote in deciding in the officers' favor. The 8th Circuit — the same appeals court that decided Vandevender's case — agreed with Wright on appeal, finding that the officials had simply "predicted incorrectly." Hodges' claim failed.

A modern-day 'Lord of the Flies'

The sample BI analyzed is full of cases in which officers failed to act on warnings that prisoners were at risk.

Marc Bakambia, another Rush City prisoner, said that after a group of prisoners beat him up and threw him over a railing, he was placed in their same unit and assaulted again, leaving him with bone fractures and a traumatic brain injury. Craig Shipp claimed he had sought orthotic shoes for his diabetes and degenerative joint disorder but Arkansas prison and medical staff denied his repeated requests; he said he eventually developed an infection severe enough to result in the amputation of his right foot. Mitchell Marbury claimed he requested a transfer after a friend warned him that a fellow prisoner was out to get him; he said an Alabama corrections officer laughed and told him to get a shank. Less than a week later, he said, he was stabbed in the facility's day room.

The Arkansas and Alabama corrections departments did not respond to requests for comment; the Minnesota corrections department did not comment on the Bakambia case.

"Marbury's argument is essentially that every prisoner who tells prison officials about an unspecified threat from an unspecified inmate without more is entitled to protective custody or a transfer," 11th Circuit judges wrote in the majority opinion. "Our caselaw establishes a higher standard for deliberate indifference."

"The Eighth Amendment does not allow prisons to be modern-day settings for Lord of the Flies," Judge Robin Rosenbaum wrote in a scathing dissent. By not holding officials responsible, she said, "the Majority Opinion condones this behavior and ensures it will occur again."

In reviewing Hodges' appeal, Kelly, the 8th Circuit judge, wrote her own opinion, as she had in the Vandevender case. She disagreed with how her colleagues assessed the question of mindset, writing that a committee finding alone should not release prison officials from liability. She also noted that "the absence of documentation regarding prison decisions or prison officials' inability to remember events central to their decision-making process may be relevant," raising the question of whether those gaps could have been deliberate.

Many corrections officers are made aware of the mindset standard. BI requested officer training materials from every state prison system and obtained them from 37 — most of which explicitly trained on deliberate indifference. Taken together, the documents indicate that the standard, as interpreted by federal courts, could encourage prison staff to remain incurious about what goes on in their facilities.

As Oregon's training materials say, "basically, deliberate indifference is a cognitive choice to do what you did."

Fathi, of the ACLU, reviewed a sample of the training materials BI obtained and said the guidance might lead officers "to act in ways that violate people's rights and that harm people very severely."

Many of the materials, he said, appear to train officers to treat prisoner complaints with suspicion. In a 2021 Mississippi slide deck, for instance, corrections officials were told prisoners try to compromise their integrity "as entertainment and for their amusement" or "to facilitate an escape, assault, rape or murder." A slide in a 2018 Utah training PowerPoint displayed the header "inmates do crazy things… then sue YOU for it."

"It's good to train them on the law," Fathi said. "But they should also make clear that we expect more than the absolute minimum that's required to avoid violating the Constitution."

Memory issues

On a muggy June morning in 2023, as the sun was just beginning to peak out in Euless, Texas, James Vandevender was already up in his father's modest one-story house in the Dallas suburb, pouring himself a cup of coffee. He had moved there from Minnesota, after his last prison stint, looking for a fresh start.

He was dressed in khakis for his job installing high-end appliances. A tattoo of his son's name showed below his shirt sleeve, and a scar cut across his cropped brown hair.

He moved through the same routine as every morning: packing his lunchbox, scarfing down breakfast, and swallowing an array of anti-seizure pills and antidepressants.

Still, that day, he forgot to put the ice pack in his lunchbox and had to redo it. When he headed outside to toss out the trash, he couldn't remember where he stowed the garbage bins. By the time he and his coworkers gassed up and headed off to the first house, Vandevender had misplaced his phone.

As they wrapped up their first job and headed back to their truck, Vandevender realized he'd left his tool bag inside.

At the next house, the men were tasked with installing a mounted range hood they'd never encountered before. It was a tricky job, Vandevender said. By late afternoon, visibly frustrated, he called the installation a "fucking joke."

His coworker Mike, in a black baseball cap to protect from the sweltering sun, took a breather in the driveway, away from the tension inside. "He's been having memory issues all day long. It's an everyday thing," he said of Vandevender. "That's when he gets frustrated."

Ashley Christen, the mother of Vandevender's 20-year-old son, said that when the two of them were growing up in rural Minnesota, Vandevender was smart and quick-witted, known for delivering the best one-liners. As a kid, he loved to hunt and spend time on his grandfather's dairy farm; his mother, Peggy, said he was fun and lovable, always offering to help out around the house.

But since the assault, they both said, he's struggled to communicate. He's forgetful, irritable, and prone to snap. Peggy said he relied on scribbled notes to get through the day.

"It shouldn't have happened," she said. "It was because of their lack of watching the people," she added. "It was due to their negligence."

On a recent fall afternoon, 12 years after Latimer bludgeoned him with the wooden post, Vandevender sat down with a friend to watch surveillance footage of the attack for the first time. He doesn't remember anything from that day; his first recollection is waking up weeks later, confused and shackled, in a hospital bed flanked by corrections officers.

"I just want to make sure you're mentally prepared to see it," the friend told him, before pressing play. "I want to," Vandevender said.

When the video finished, there was a long silence.

Eventually, he started talking. He said the footage took him back to his time in prison — the smell, the barbed wire, the disrespect. He said that he noticed Latimer picked up the post from an unauthorized part of the industry area, where prisoners weren't allowed, and that any unused lumber should have been disposed of. He said he felt the weight of what it must have been like for his mother, when she got the call every parent of an incarcerated child dreads.

When asked about the life he could have had, the one where he got out of prison at age 25 without the burdens of a traumatic brain injury, he struggled to respond.

"I don't want to talk about it," he said.

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Nearly three years into Bill Clinton's first term as president, US senators took to the floor to tackle an urgent concern. Prisoners across the country were filing too many lawsuits.

"The vast majority of these suits are completely without merit," Sen. Orrin Hatch, the Republican chair of the Judiciary Committee, said in September 1995. "It is time to lock the revolving prison door and to put the keys safely out of reach of overzealous federal courts."

Sen. Harry Reid, who would go on to become the Senate Democratic majority leader, ticked off a litany of ridiculous cases he said were clogging up the nation's courts. There was the Missouri prisoner who sued because his facility didn't have salad bars on the weekends. And the Nevada prisoner who said his constitutional rights had been violated when he received chunky peanut butter — not smooth — from the prison canteen.

"And to think, we, the taxpayers, are paying for all of this," Reid said.

Reid and Hatch were speaking in support of the Prison Litigation Reform Act, introduced by the most powerful man in the Senate at the time, the Republican Bob Dole. Dole, then the majority leader, had pitched it as a common-sense reform that would sharply curb such "frivolous lawsuits." Hatch insisted it wouldn't affect prisoners who raised legitimate claims.

The National Association of Attorneys General helped craft the legislation and circulated top-10 lists of "frivolous" prisoner lawsuits, including the complaints about salad bars and peanut butter, to garner support. A few attorneys general — from red and blue states alike — took their case to The New York Times. "We feel strongly that convicted criminals should not be granted unlimited free access to our courts to conduct their costly and most often frivolous lawsuits," they wrote.

"It was about resources," a former attorney general who backed the legislation said. "You are just struggling to run what was then the state's largest law office. So to me it was a question of degrees. Let's find some balance and look at cases that need to be looked at and get rid of steak and wine and peanut butter cases."

Some elected officials issued warnings. Sen. Ted Kennedy of Massachusetts called the bill "patently unconstitutional," and Joe Biden, then a Delaware senator, said it placed "too many roadblocks to meritorious prison lawsuits." But it passed easily, buried in an omnibus appropriations bill, with little legislative debate about its potential repercussions.

In April 1996, Clinton signed the PLRA into law.

A separate system of justice

While it had never been easy to file a lawsuit from prison, the rules of play had been roughly the same as for any other indigent person seeking redress in court. The PLRA changed that, effectively carving out a separate and unequal system for prisoners.

Prisoners could now win monetary damages only if the harm they endured was physical, rather than mental or emotional. Strict caps on attorney fees discouraged lawyers from representing prisoners, leaving the vast majority of plaintiffs, many without a high-school diploma, to file on their own.

Many prisoners would no longer get their day in court: A judge or staff attorney would screen cases before any evidence could be presented or any motions could be made. If the screener deemed a case frivolous or decided it had failed to clearly state a constitutional claim, the judge could simply dismiss the case. A prisoner who had three suits dismissed in this way — the "three strikes" rule — would be barred from filing another without paying prohibitive court fees.

Crucially, any claims that made it to court would be dismissed if a prisoner could not show they had exhausted their prison's internal grievance process — procedures that a number of state corrections departments have turned into arcane, highly technical affairs.

"In a busy court, there's a template to get rid of the cases," Nancy Gertner, a former federal district judge in Massachusetts, said of the PLRA, "and invariably they're gotten rid of."

The senators were right that there had been an uptick in prisoner lawsuits. But that increase closely tracked the rise of the prison population as the war on drugs and punitive sentencing laws more than doubled incarceration rates from 1986 to 1996, the year the PLRA became law.

Reid had compared prisoners to "an alcoholic locked inside a liquor store," abusing the nation's legal system with easy access to the courts. But legal scholars have found that the rate of prisoner legal filings had actually stayed relatively consistent.

In fact, Margo Schlanger, a law professor at the University of Michigan, found that in the year before the PLRA was signed into law, prisoners filed a similar number of lawsuits per capita as people on the outside.

Within five years of its passage, prisoner suits dropped by 43%, even as the prison population continued to grow, according to Schlanger's research. Schlanger examined prisoner filings again in 2022 and found that the filing rate never rebounded.

Cases that prisoners have filed since the law's passage, she found, have struggled to succeed. To understand why, Business Insider analyzed a sample of nearly 1,500 federal cases alleging "cruel and unusual punishments" in violation of the Eighth Amendment, including every appeals court case we could locate with an opinion filed from 2018 to 2022 citing the relevant Supreme Court cases and standards.

Some were filed by former prisoners after their release, or by their families, who were not bound by the PLRA. But in an examination of the roughly 1,400 cases filed by people while they were imprisoned, the impact of the PLRA jumped out — 27% of those cases failed because of the law's requirements.

In BI's district court sample, the PLRA's effects were more dramatic — 35% failed because of the law.

A few dozen of the claims BI examined appeared to center on minor matters: For instance, an Indiana prisoner claimed he developed a rash after he wasn't allowed to shave, an Alabama prisoner said he was served undercooked food, and a Michigan prisoner sued saying he'd been denied shoes while being held in a dirty shower. But the vast majority clearly involved claims of substantive harm. Among them were dozens of claims that prisons had allowed retaliatory beatings, stabbings, sexual assaults, and egregious forms of medical neglect.

These include the case of Kenneth Coleman, a Florida prisoner. He said prison officials put him in the same cell as an "enemy" who later assaulted him, leaving his left eye with a sag. He lost his case for failing to complete the prison's grievance process before filing suit. They include a case out of Colorado, in which the plaintiff said she began self-mutilating after medical providers failed to dispense the hormone blockers that had been prescribed to treat her diagnosed gender dysphoria; her case was dismissed because the court ruled that self-harm didn't count as a physical injury. And they include the case of Benjamin Gottke in Louisiana, whose left leg was amputated below the knee after, he said, corrections officials failed to protect him from being assaulted. His case was dismissed at screening for failure to properly state his legal claim.

The Louisiana and Colorado corrections departments declined to comment on the record. A spokesperson for the Florida Department of Corrections did not comment on the Coleman case but said, "We ensure the safety and healthcare of our inmate population in accordance with Florida law."

When prisoners' cases are knocked out by the PLRA, they rarely succeed on appeal. Such appeals, BI found, failed nine out of 10 times.

Victor Glasberg, a civil-rights attorney in Virginia, has represented prisoners for decades and successfully litigated an Eighth Amendment case about conditions on the commonwealth's death row. "The Prison Litigation Reform Act is the worst piece of federal legislation to have been enacted in my lifetime, and I was born in 1945," he said. "It is malicious, vindictive, and grossly unfair."

An undiagnosed tumor

Kevin Harrison Jr. was 24 years old and not long into a life sentence for murder when he first noticed lumps on the left side of his chest. In July 2011, he saw Michael Hakala, a doctor at Southeast Correctional Center in Missouri who worked for a prison healthcare company called Corizon Health, now YesCare, which was then contracted to provide healthcare to the state's prisoners. In a civil complaint he would later file, Harrison said Hakala assured him that the lump was benign without ordering a biopsy.

Two years later, the lumps had grown considerably, Harrison's complaint said. During shirtless basketball games, he said, other prisoners told him he looked as if he'd been shot.

Harrison said Hakala again assured him that nothing was wrong.

More than seven years after his first appointment, in November 2018, Harrison said he was granted a visit with another doctor; that doctor also worked for Corizon. Concerned by what had become a gnarled mass, the doctor ordered a biopsy. At 31 years old, Harrison was told he had a rare form of skin cancer.

He underwent what he described as a grueling, invasive surgery that required doctors to cut deep into his pectoral muscle to remove the tumor. He wore a bandage for months as his chest slowly healed, and he lived with debilitating pain. Several years later, the muscle pain and spasms have barely abated, he said, and with his follow-up appointments often delayed he worries the cancer will return.

In March 2022 he filed suit against Hakala and other medical staff alleging that they had violated his constitutional rights by failing for years to biopsy his tumor.

His case was dismissed during screening.

Patricia Cohen, a magistrate judge for the Eastern District of Missouri, found that his handwritten complaint, filed without counsel, had failed to make a clear Eighth Amendment claim: He hadn't shown he could prove the defendants had intentionally delayed his treatment.

As in many claims dismissed at screening, the judge gave Harrison 30 days to file an amended complaint. In this case, a court clerk, Nathan Graves, said Cohen had provided Harrison with "clear instructions" for how to do so. Harrison, whose request for an attorney was denied by the judge, told BI he missed the deadline because he was locked in solitary confinement for assaulting two corrections officers. He refiled the case last year, which is still pending; the defendants have yet to respond to the underlying claims.

Tad Eckenrode, Hakala's attorney, declined to comment on the pending litigation but noted that Harrison's claims remained unproven allegations; the Missouri Department of Corrections declined to comment. A YesCare spokesperson declined to speak about Harrison's case but said by email, "Our industry is filled with mission driven professionals who are committed to serving incarcerated individuals, many of whom have never received healthcare in their life, within a challenging prison environment," adding that "ignoring the many successes and positive advancements in our industry only serve to make it more difficult to retain and recruit medical professionals to serve incarcerated populations."

Of the 376 cases in BI's sample disqualified by the PLRA, 75% were dismissed at screening, denying the plaintiffs the chance to argue their case in court — or seek discovery. Over half of those cases involved allegations of inadequate medical care, including several for potentially fatal illnesses, such as Harrison's cancer.

"As a result of the PLRA, people who have suffered horrific harm, people who have extremely meritorious and compelling cases, get thrown out of court for reasons that have nothing to do with the merits of their case," said David Fathi, the director of the National Prison Project at the ACLU. "It just tilts the playing field against prisoners across the board."

Several cases in BI's sample dismissed at screening involved claims that negligence had left prisoners with permanent disabilities. A Kansas plaintiff said one of his feet was amputated after an infection was allowed to fester; a prisoner in California said he was left with persistent migraines and dizziness after a guard, while trying to quell a fight between two other prisoners, shot him in the head. Eight prisoners who alleged that they'd been sexually assaulted had their cases dismissed at screening.

The Kansas Department of Corrections declined to comment; a spokesperson for the California Department of Corrections and Rehabilitation did not address the shooting claim but said the department had "fundamentally reformed its approach to addressing allegations of staff misconduct to enhance staff accountability and improve transparency."

A ticking clock

Prisons are hierarchical systems, largely insulated from the outside world, where corrections officers control every aspect of a prisoner's life. The PLRA effectively requires prisoners experiencing abuse or neglect to confront those officers directly, mandating that they pursue grievances internally before they have the right to seek redress in court. Prisoners in multiple cases said that requirement came with consequences.

In the spring of 2016, a Texas prisoner named Juanita Ornelas began a prolonged battle with the prison bureaucracy. Ornelas, a transgender woman who said she presents as masculine in prison for safety reasons, said she was being repeatedly sexually and physically abused by another prisoner at the William R. Boyd Unit in East Texas.

Ornelas, who was serving time on weapons charges, was required by Texas corrections policy to try to resolve the issue informally and then to submit a formal grievance, on a specified form, all within 15 days of the incident. The unit's grievance coordinator would then have at least 40 days to respond, at which point, if Ornelas wasn't satisfied, she would have another 15 days to file an appeal.

In a complaint that she would later file in the Western District of Texas, Ornelas said she had been terrified her attacker would kill her if she filed a grievance. She said that she had witnessed attacks on other people who had filed grievances and that it was common knowledge that officers at Boyd often ratted out prisoners who disclosed sexual abuse. When Ornelas finally asked an officer for a grievance form, she said in a memorandum she introduced in court, the officer refused and instead told her to stop snitching.

Desperate for help, she said, she instead submitted several I-60s — a form Texas prisoners use for routine transfer requests — to Alexander Hamilton, an investigator in the criminal justice department's office of the inspector general who had once visited the unit. Ornelas thought if she reported the assaults directly to Hamilton, she would have a better chance at getting moved out of danger.

But her I-60s to Hamilton went unanswered and the abuse continued, she said.

Amanda Hernandez, a spokesperson for the Texas Department of Criminal Justice, said that Ornelas' claims were investigated and could not be substantiated and that "the agency takes all allegations of abuse seriously," promptly forwarding them to the appropriate authorities. The office of the Texas attorney general, which represented Hamilton, did not respond to queries.

In early June 2016, officials moved Ornelas to a different prison. It had nothing to do with the rape allegations, she told BI; she'd been accused of housing a weapon in her cell, though she said it wasn't hers. There, 200 miles away, she submitted a series of grievances to document the abuse she said she experienced at Boyd. Even then, Ornelas said in her memorandum, officials repeatedly refused to process the forms or said they hadn't received them. In January 2017, she said — nine months after she had sent her first I-60 to Hamilton and four months after she went on a hunger strike — a grievance form was finally processed.

"I couldn't believe it was so hard to report something like that," Ornelas said. "They just completely ignored and disregarded the sexual-abuse report."

A year later, Ornelas filed a pro se lawsuit alleging that Hamilton had violated her Eighth Amendment rights by failing to protect her from repeated sexual assaults. Though Ornelas said the rapes were so violent they left her bloodied, the attorney general never weighed in on the underlying claims in court, focusing on Ornelas' failure to meet the deadline for submitting a prison grievance before filing suit; a district judge, Alan Albright, agreed with that assessment and dismissed her case. On appeal, the 5th Circuit ruled that even if Ornelas had followed prison protocols, she'd still lose the case: She had offered no proof that Hamilton ever saw or received the letters.

The offices of Albright and the other federal judges who presided over cases decided in this story declined to comment, didn't respond to interview requests, or, in the case of Cohen, the judge in Missouri, said the decisions spoke for themselves.

'Byzantine grievance processes'

The requirement to exhaust a prison's internal grievance system before filing suit is one of the PLRA's most significant obstacles. Of the prisoner cases knocked out by the law in BI's sample, nearly one in four failed because judges decided the plaintiff had not fully complied with the grievance process.

"The exhaustion-of-remedies requirement definitely incentivizes prison systems to create Byzantine grievance processes," Corene Kendrick, the deputy director of the ACLU National Prison Project, told BI. "If you fail to meet a single deadline, or if you worded something in a way that wasn't quite specific enough, the courts will often just throw the cases out."

Legal scholars have described prison grievance procedures as something out of Kafka.

In Colorado, for instance, a grievance can be denied if the handwriting is deemed illegible or if the prisoner uses more than "one line of dialogue" to describe the abuse allegation. In Florida, a grievance can be rejected if more than one issue is discussed in a single form. In West Virginia, only one staple may be used to attach the pages.

Many states require prisoners to use an official grievance form, which prisoners sometimes depend on corrections officers to supply. Once filed, the form may go into oblivion.

"A lot of times, especially in segregation, you give the grievance to an officer," one West Virginia prisoner told BI. "Nine times out of 10 it's going in the garbage."

Andy Malinoski, a representative of the West Virginia Department of Commerce, responding on behalf of the state corrections division, said the agency "adamantly denies" the prisoner's claim and "is committed to the safety, quality of life, and well-being of those in the care of the legal system in our state."

Tiffany Yang, an assistant law professor at the University of Maryland, authored a study last year finding that the PLRA had effectively provided a playbook to prison systems on how to narrow the pathway to judicial relief. She documented instances in which state corrections departments had responded to a successful prisoner lawsuit by amending their grievance requirements to make the rules more complex. She called this cycle the "prison pleading trap."

"Each prison system can define its own internal grievance procedure, and that decision has created a system that is designed to fail the very people that it should protect," Yang told BI. "Even if an incarcerated person is successful in overcoming administrative exhaustion, what prison officials can do with that defeat is to transform it into a blueprint for how to amend the grievance policy to make it more difficult for future litigants."

In her study, Yang discussed a 2005 case in Arkansas in which the courts allowed a prisoner to move his case forward against medical staffers he said had denied him dental treatment, ruling that they were identifiable even though his grievance listed only their job titles, not their names. The state corrections department then updated its procedures to require all Arkansas prisoners to specify, in their first grievance, the full names of each individual involved. As Yang wrote, that alone can prove to be an impossible hurdle in situations in which officials don't wear name badges, hide their badges, or refuse to provide their names to prisoners.

The Arkansas Department of Corrections did not respond to queries.

In a 2022 legal brief, the ACLU joined with other civil-rights groups in arguing that because prison administrators design the procedures that prisoners must follow before suing them, there is "a perverse incentive to make grievance processes as impenetrable as possible."

The statute of limitations for civil suits is typically measured in years. But most prisoners must file a grievance on a much tighter timeline. In Louisiana, prisoners are encouraged to seek an informal solution and then have three months to file a grievance. In Arizona, they have 10 days to make an informal complaint and then five days after that to file the formal grievance. In Michigan, they have two days to resolve the issue informally and then five days after that to submit a grievance form. If they don't file on time, they can't win in court later.

Even when an incident has left a prisoner consigned to the hospital or solitary confinement, the clock can continue to tick.

A former Minnesota prison lieutenant told BI that, at the facilities where she worked, "a fairly high percentage" of prisoners had no idea how to navigate the grievance process. She said that prisoners were alerted to its existence, but only through a "two-second conversation" during intake. Prisoners at facilities in several states told BI they were never instructed by staff on how to properly complete these forms, and instead relied on rare visits to the library or on fellow prisoners — untrained jailhouse lawyers — for guidance.

Paul Schnell, Minnesota's corrections commissioner, said the department continually tries to improve its grievance system. He expressed surprise at the lieutenant's claim, "given the number of grievances we get."

"If the door is closed for people, that's not OK," he said. "We want to make sure people have a mechanism" for exercising their due-process rights.

In any case, filing a grievance comes with risks. The risk of retaliation from other prisoners and staff, as Ornelas feared in Texas. Or the risk of formal punishment. In some states, such as Alaska, officials can hand down disciplinary action if they believe a prisoner has abused the grievance system.

Again and again, a law meant to end frivolous prisoner lawsuits has halted Eighth Amendment claims on technicalities regardless of the underlying merits of their case. Many were thrown out over missed grievance deadlines; others because a prisoner failed to provide the full name of a staffer or use the proper terminology in stating their claim.

Unintended consequences

From the moment it was enacted, the PLRA faced intense criticism. In testimony before the Senate Judiciary Committee in September 1996, an advocate for incarcerated teenagers warned that the law "contains several provisions that hinder efforts to protect children from danger and abuse" in juvenile institutions; the American Bar Association admonished Congress for passing a law that it said contained "unconstitutional" provisions.

David Keene, as chair of the American Conservative Union, called for the law to be reformed, saying in a 2008 op-ed article that "it had the unintended consequence of virtually insulating prison officials from external oversight." In 2014, the United Nations' Committee Against Torture expressed concern that the law was "curbing prisoner lawsuits at the expense of inmates' rights."

One of the most sustained efforts at reform coalesced in 2007, more than a decade after the PLRA was signed into law. The bipartisan SAVE Coalition rallied behind a bill introduced by Rep. Bobby Scott of Virginia that sought to ease some of the law's most onerous requirements. "It needed reform because there's so many instances where legitimate claims couldn't be heard," Scott told BI. "On the meritorious cases, prisoners just don't have rights."

Those who testified on behalf of the bill included a retired federal judge who said the PLRA "unnecessarily constrains the judge's role, limiting oversight and accountability"; a former director of the California prison system, who said the legislation created "often-insurmountable obstacles" for prisoners; and a former Republican attorney general who, after himself spending time in prison for mail fraud, called the PLRA a "deeply flawed" law that "undermines the protection of constitutional rights that all Americans, including prisoners, share."

Sarah Hart, as an assistant district attorney in Philadelphia, had assisted Congress in drafting the PLRA and testified against the proposed reforms, arguing that "the current system allows corrections managers to learn of serious problems in the prison, take prompt action to stop them, and remedy past problems."

Keene, who went on to serve as president of the National Rifle Association, told BI that one of the reasons he took up criminal-justice reform was that his son had spent time in a federal prison. During testimony before the House Judiciary Committee in 2007 in support of Scott's bill, Keene said it was impossible for his son to properly file grievances, accusing prison officials of intentionally giving him the wrong forms and of reading his confidential legal mail. "The process is broken," he said, quoting a letter his son wrote from prison. "It feels like I'm playing poker in a rigged game."

In their March 1995 letter in The New York Times, the state attorneys general insisted that the PLRA wouldn't block meritorious cases, that "no reasonable individual would accept that cases of sexual assault by prison guards or unchecked and rampant tuberculosis within the prison population should be dismissed or disregarded as nonmeritorious."

On the contrary, in the decades since the law was enacted, many prisoners accusing guards of assault have had their cases blocked by the PLRA. In BI's sample, PLRA technicalities likewise knocked out cases involving allegations of sexual harassment by a corrections officer, delayed treatment for hepatitis C, and prolonged stints in solitary confinement.

Just months after the PLRA became law, Jon O. Newman, a federal judge on the 2nd Circuit Court of Appeals, authored an article in the Brooklyn Law Review. In it, he examined the three lawsuits attorneys general cited as frivolous in their New York Times op-ed, at least two of which made their way onto the Senate floor. He found that the Nevada prisoner hadn't filed suit because he preferred chunky peanut butter over creamy. He sued because he said that the commissary had charged him $2.50 for the jar — nearly a week's wages for a prisoner — and that he never received the item. "I readily acknowledge that $2.50 is not a large sum of money," Newman wrote. "But such a sum is not trivial to the prisoner whose limited prison funds are improperly debited."

The Missouri prisoner who was ridiculed for wanting a salad bar, meanwhile, had filed suit with dozens of other prisoners alleging major deficiencies at their facility, including insufficient food, meals contaminated by rodents, a lack of proper ventilation, and dangerous overcrowding that the plaintiffs said had resulted in the housing of healthy people together with those with contagious diseases.

"The prisoners' reference to salads was part of an allegation that their basic nutritional needs were not being met," Newman wrote. "The complaint concerned dangerously unhealthy prison conditions, not the lack of a salad bar."

Decades later, it was as if Newman's article had never appeared. In a 2015 brief before the Supreme Court, Michigan's attorney general at the time, Bill Schuette, pulled out the peanut-butter anecdote again to argue that a prisoner's case should be dismissed under the PLRA.

His brief used the word "frivolous" 48 times.

The prisoners write in carefully lettered script or on old electric typewriters. There are sometimes grammatical errors or misspellings. But the language is direct. They describe facing Stage 4 cancer after their symptoms went undiagnosed for years. The denial of orthotic shoes to treat a diabetic condition that led to a severe wound and amputation. Nineteen years locked in solitary confinement.

Some describe beatings and sexual assaults by fellow prisoners that they say corrections officers failed to prevent. Others say they were assaulted by officers themselves.

The Eighth Amendment, which bars "cruel and unusual punishments," was intended by the founders as a bulwark against prisoner abuse. Over the years it came to mean any treatment that "shocked the conscience." But prisoners and civil-rights attorneys have said that it is now nearly impossible to win such claims in court.

To investigate whether that constitutional protection holds, a Business Insider team read tens of thousands of pages of court records for nearly 1,500 Eighth Amendment complaints, including every appeals court case with an opinion we could locate filed from 2018 to 2022 citing the relevant precedent-setting Supreme Court cases and standards. We reviewed hundreds of pages of training materials, medical records, incident reports, and surveillance footage. We read cases from prisoners convicted of violent and nonviolent crimes — some who have spent decades behind bars for murder or sexual assault, others sentenced to short stints for marijuana possession or third-degree assault. We spoke with more than 170 people, including prisoners and their families, attorneys and legal scholars, correctional staff and prison healthcare providers, and current and former federal judges.

We uncovered a near evisceration of protections for this nation's 1.2 million prisoners, largely propelled by legal standards and laws put into place at the height of the war on drugs.

In our analysis, plaintiffs prevailed in only 11 cases, including two class actions — less than 1%.

"If a right is unenforceable, then it's not much of a right," Paul Grimm, a former federal judge for the District of Maryland, said after reviewing BI's findings. "It is essentially unavailable."

One Tennessee prisoner wrote a letter to the court after failing to overcome these steep odds in his own case.

"To everyone I tried to talk to and ask to file grievances and complaints to bring the wrongs to light," he wrote, "I'm sorry that I tried to bring hope and law and order to a place that has no hope or process of order."

Failed oversight

Over decades, federal and state oversight agencies have repeatedly found that US prison systems have failed to protect prisoners in their care. Just this year, an inspector general found that staff in federal prisons had failed to adequately respond to medical emergencies, contributing to 166 prisoner deaths. The Department of Justice recently found that people held in Georgia state prisons had experienced "horrific and inhuman conditions" stemming from what the DOJ called "complete indifference" by the institutions. "Inmates are maimed and tortured," the department wrote, "relegated to an existence of fear, filth and not so benign neglect."

Some years ago, an oversight monitor found that California prisons' system for disciplining officers accused of excessive force was "broken to the core."

For prisoners inside these systems, the courts are often the only backstop left.

But in the 1980s and 1990s, as the nation's prison population exploded, a new law and a series of revised legal standards radically restricted the ability of prisoners to prevail in Eighth Amendment lawsuits.

The 1996 Prison Litigation Reform Act, passed with robust bipartisan support, effectively carved out a separate and unequal system for prisoners who seek to file suit.

It required prisoners to complete a prison's internal grievance process before filing a claim in court — and then survive a screening process. After that, their claims faced exacting Supreme Court standards. Claims that guards had used excessive force were now decided under a 1986 standard that granted broad protections to prison staff as long as their actions were not "malicious and sadistic." Claims that prison staff have failed to keep prisoners safe — whether from violence, negligent healthcare, or inhumane conditions of confinement — were now decided under a Supreme Court standard, refined in 1994, which says such failures violate the Constitution only if officials were "deliberately indifferent."

Together, the standards shifted the focus away from the underlying claims of abuse, however extreme, and onto the question of prison officials' intent.

David Fathi, the director of the National Prison Project at the ACLU, said the emphasis on mindset has become "an enormous barrier to justice for incarcerated people." If abuse or neglect exists in prisons, he said, "that should be enough to violate the Eighth Amendment."

"You shouldn't have to go looking for someone who was thinking bad thoughts."

Altogether, said Kathrina Szymborski Wolfkot, a former appellate attorney at the MacArthur Justice Center, these laws and standards have made federal courts "inhospitable places for incarcerated people." Though some attorneys turn to state courts instead, there they face another set of challenges, such as caps on damages for malpractice claims or, in some cases, weak state constitutional protections.

The Department of Justice, the ACLU, and other powerful litigators have sometimes succeeded in winning Eighth Amendment cases that usher in reforms through consent decrees or injunctive orders. But such outcomes are rare. The DOJ has secured consent decrees in just four prison cases over the past decade.

A separate and unequal system

In restricting access to the courts, lawmakers in the 1990s argued that most prisoners filed suits over "frivolous" matters. Yet only a few dozen of the claims in BI's sample were over minor complaints, such as being denied shoes to wear in a dirty shower.

Among cases that prisoners lost, we logged 161 claims that guards had failed to protect a prisoner from being beaten or stabbed, including four fatalities. We identified 42 failed cases alleging untreated cancer, heart disease, HIV, or hepatitis C. We logged 78 claims of untreated mental illness, including eight that ended in suicide. There were 21 claims of sexual assault by prison staff. There were claims of confinement in extreme filth, including exposure to poisonous spiders, black mold, and feces.

The vast majority of prisoners, BI found, are navigating all of this without attorneys, in part because of the PLRA, which prevents attorneys from recovering their full litigation costs.

In the outside world, most civil suits settle — about 73%, one study found. In BI's sample, only 14% of prisoner lawsuits did, sometimes for paltry amounts or no damages at all. One North Carolina prisoner who said guards beat him while he was in restraints settled for $250.

By the time the cases were settled or decided in favor of the plaintiffs, those in charge — the wardens and medical directors — had almost always been dropped as defendants, limiting the ability of those judgments to drive institutional change.

Billions of taxpayer dollars go to corrections contractors, to run everything from food services to healthcare to staffing to data management, and the legal obstacles introduced in the 1980s and '90s have shielded these for-profit companies as well. For example, hundreds of private prison health providers or their employees were named as defendants in BI's sample. Of these cases, 14% settled and plaintiffs prevailed in less than 1%. One law-review article concluded that the low risk of liability had influenced companies' cost-benefit analysis and "leads to dangerous, ineffective healthcare that is shielded from constitutional challenge."

More than one federal judge described prisoner claims as tragic — before going on to cite precedent or the narrow standards in deciding against the plaintiffs. Several issued fiery dissents. One was issued in an August 2019 case filed by a prisoner who was denied a transfer he said was necessary for his safety. "We do not sentence people to be stabbed and beaten," Judge Robin Rosenbaum of the 11th Circuit wrote.

"The Eighth Amendment does not allow prisons to be modern-day settings for Lord of the Flies," she went on. "The Majority Opinion condones this behavior and ensures it will occur again."

This project was supported by a grant from Columbia University's Ira A. Lipman Center for Journalism and Civil and Human Rights in conjunction with Arnold Ventures. Data analysis and visualization were supported by the Fund for Investigative Journalism.

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What's on deck

Markets: This $19 billion hedge fund's old-school approach still relies on its founder's big bets.

Tech: AppLovin is a Wall Street darling, with shares up more than 780% this year. Can its incredible run last?

Business: How Sean "Diddy" Combs' professional and personal life crumbled amid a flurry of allegations.

But first, it might be the last one for a while.

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The big story

Here today, gone tomorrow

Enjoy today's rate cut because it might be the last one for a while.

The Fed is expected to make its third-straight rate cut this afternoon, but the certainties end there, write Business Insider's Ayelet Sheffey and Madison Hoff.

Plenty of people on Wall Street believe today marks the end of the Fed's three-month rate-cutting spree, writes BI's Matthew Fox. Yardeni Research and Goldman Sachs both warned the Fed might take a breather when it meets again at the end of January.

Apollo's top economist, Torsten Sløk took things a step further, suggesting a potential rate hike in 2025.

So what's giving the Fed … pause? (Sorry. I had to do it.)

First, inflation is still very much a thing. While prices have improved since 2022, we're not at the 2% target Fed chair Jerome Powell set as a long-term goal. It's also ticked up a bit, with the consumer price index hitting a 2.7% year-over-year growth rate in November.

Meanwhile, the recent jobs report also shows the labor market is in a decent spot.

Those figures aren't exactly where the Fed would like them to be, but they're also not so bad that the central bank would adjust rates after today's announcement to enact change.

One other factor has market watchers unsure about the Fed's next move: the incoming president.

President-elect Donald Trump has made clear he intends to make big changes once he's in office. Talk of widespread tariffs, in particular, has some investors on edge.

Many economists believe Trump's trade plans will lead to higher inflation, as companies raise prices to pass on the taxes they face to customers.

(It's not a bulletproof prediction. Trump implemented tariffs during his first term and inflation decreased, and some believe that could happen again.)

There's another twist: Trump might not do anything with tariffs. The president-elect's tough talk could be a negotiation tactic to get better terms from China, Canada, and Mexico on various topics.

All that uncertainty puts the Fed in a tricky spot. Powell recently said the Fed couldn't make policy changes based on something that "lies well into the future." Instead, it needs to focus on the here and now.

So that means a rate cut today, and who knows tomorrow.

News brief

Top headlines

• Luigi Mangione indicted on first-degree murder charge 'in furtherance of terrorism.'
• Nima Momeni, the man accused of stabbing Cash App founder Bob Lee in April 2023, found guilty of second degree murder.
• Biden backs congressional stock-trading ban with just weeks left in office.
• Amazon commits another $10 billion to Ohio data centers amid questions about energy costs and supply.
• Verily's plan for 2025: Raise money, pivot to AI, and break up with Google.
• Walmart is testing body cameras for some front-line employees in Texas.
• Nvidia stock's correction has accelerated since Microsoft's CEO hinted the frenzied demand for AI chips may be waning.

3 things in markets

1. Some Citi employees review of the bank's annual review process: Not great! Citi uses a forced curve to evaluate employees, meaning managers rank employees from best to worst and there are a finite number of top ratings. Current and former MDs told BI the bank's promotion process can pit employees against each other. Here's how it works and why some people aren't a fan.
2. In a sea of multistrats, Rokos stands apart. Unlike its peers, $19 billion Rokos largely relies on its billionaire founder making big bets. Its strategy starkly contrasts the rest of the industry, where diversified multistrategy funds rule the roost. Going against the grain has served them well.
3. The best bet for investing in 2025, according to Morgan Stanley's top stock strategist. It's time to hit the gym (sort of), as Mike Wilson recommends a barbell investment strategy. That means a mix of high and low-risk assets, which could be a good bet with potential market uncertainty in 2025.

3 things in tech

1. SantaGPT. Artificial intelligence has been changing the e-commerce game. AI should make the process easier since it's more integrated into online shopping. But BI's Amanda Hoover found you still might have to lend the AI elves a helping hand.
2. Wall Street is lovin' AppLovin. Mobile ads and gaming company AppLovin recently had its market value surpass the $100 billion milestone, and shares are up more than 780% this year. However, some ad industry insiders are skeptical about how long its run can last.
3. A $3 billion AI startup added Stripe's CFO to its board. Vercel, which offers AI tools to developers, said on Tuesday that Stripe CFO Steffan Tomlinson was joining as a director on Vercel's board. Tomlinson has experience taking tech companies public, even though Vercel is early in its life cycle.

3 things in business

1. Rapper unraveled. Since his rise to fame in the late 1990s, Sean "Diddy" Combs had built a business empire and become one of the richest and most well-connected entertainers of all time. But it all began to unravel when he was hit with a criminal indictment — which he pleaded not guilty to — and dozens of civil lawsuits. How his world fell apart in a year.
2. Rich musicians got millions in pandemic relief — and American taxpayers footed the bill. Stadium performers like Lil Wayne and Chris Brown billed US taxpayers for luxury hotels, private jet flights, and shopping sprees. They did it by taking advantage of a pandemic relief program intended for smaller arts organizations, a BI investigation found.
3. Don't trust that Zestimate. Zillow's popular automated home valuation is wrong. A lot. But Americans still love it — and that obsession is a big win for Zillow.

In other news

• The cancellation of 'Freaks and Geeks' broke Linda Cardellini's heart. It also taught her a valuable lesson.
• 56 million Americans don't have access to a retirement plan at work — and Social Security may not be enough to keep them afloat as they age.
• How Alex Karp built the 'cult' of Palantir — 'with no sex and very little drugs.'
• Wealth strategies that used to be reserved for billionaires are becoming more accessible.

• Juror 'misconduct' battle brewing in Trump hush-money case.

  ---

  What's happening today

• Federal Reserve interest rate decision.

The Insider Today team: Dan DeFrancesco, deputy editor and anchor, in New York. Grace Lett, editor, in Chicago. Ella Hopkins, associate editor, in London. Amanda Yen, associate editor, in New York. Milan Sehmbi, fellow, in London.

• This post originally appeared in the Insider Today newsletter.
• You can sign up for Business Insider's daily newsletter here.

Hello there! Have you ever watched a Hallmark movie (it's ok to admit it) and wondered: Where did they film this thing? The answer is usually Victoria, British Columbia. Someone who lives there describes what it's like living in a place built for the perfect happy ending.

In today's big story, we're looking at how the uproar over mysterious drones has people doing some investigating of their own.

What's on deck

Markets: Bitcoin predictions for 2025 are rolling in, and there's a wide range of possibilities.

Tech: Amazon's RTO plans have one problem: There's not enough office to return to.

Business: Not as big and a lot more expensive. Welcome to the new American dream.

But first, what is everyone droning on about?

If this was forwarded to you, sign up here.

The big story

It's a bird, it's a plane, no it's…

Mysterious aircraft have taken over the night sky this month, but they probably aren't bringing us gifts on the 25th.

Santa Claus might have some company in the sky as dozens of unidentified aircraft continue to pop up across the East Coast. See for yourself some videos of the sightings that are sparking concern.

The good news: Officials have stressed drones aren't the work of a foreign adversary or a public threat. The bad news: That's about all they are saying.

Donald Trump addressed the buzzy topic Monday during his first press conference since his election win. The president-elect criticized the government for not providing more details to the general public and said he canceled an upcoming weekend trip to his golf club in Bedminster, N.J.

The entire episode also reflects a growing challenge for the US military, writes Business Insider's Jake Epstein. Multiple military installations have spotted drones in their area, which could be spying on military bases or become a hazard to their operations.

The lack of information isn't stopping people from taking matters into their own hands.

Videos captured with Ring doorbells of potential drone sightings are being widely shared, writes BI's Ana Altcheck. The app's "Neighbors" section, typically for sharing info about lost pets or stolen packages, has become inundated with written reports and videos speculating about mysterious aircraft.

Of course, give the internet an inch, and it'll take a mile. While some of the posts are earnest, there's plenty of trolling going on. In some cases, users have gotten annoyed they're being bombarded with notifications about drone posts.

Trying to explain the phenomenon behind the drones represents the perfect thread for conspiratorial minds to pull on, writes BI's Katie Notopoulos.

To be fair, it's only natural to want to do a bit of investigating. I admit, I've spent a bit more time staring at the sky than I normally would, hoping to glimpse our new "friends" (hopefully).

If you do decide to do a bit of sky gazing, it's important to remember there are plenty of things up there that aren't mysterious. The Federal Aviation Administration handles 45,000 flights every day.

So before you get excited about what you think is another drone flying over your backyard, check out this piece from BI's Taylor Rains on how to distinguish what's flying overhead.

News brief

Top headlines

• Trump's hush-money conviction survives his 'immunity' challenge — for now.
• Bernie Sanders says Amazon's warehouse worker injury rates are far worse than the company lets on.
• Elon Musk wants to turn SpaceX's Texas 'Starbase' into its own city.
• Trump is threatening the press. We should take him seriously — and literally.
• Ads took over streaming this year — and they're just getting started.
• The head of Russia's chemical weapons was killed when a scooter bomb exploded in Moscow.
• TikTok's CEO met with Trump as the fight to delay the app's ban heads to Supreme Court.
• The latest change for Starbucks under its new CEO? Baristas can get triple the amount of paid parental leave.

3 things in markets

1. Enjoy this week's rate cut because it might be the last one for a while. Wall Street forecasters aren't banking on the string of rate cuts to continue into early next year. A strong economy coupled with sticky inflation has experts projecting the central bank will pause easing its policy for a bit.
2. Two sides of the same (bit)coin. The crypto bears see bitcoin dropping to $45,000 in 2025 (BCA Research), while the bulls see the asset climbing as high as $500,000 next year (Fundstrat). President-elect Donald Trump's plan for bitcoin will have a massive impact, but there are also big moves being made at the state level.
3. SoFi's head of investment wants to vibe-check the market. Liz Young Thomas told BI it's hard to ignore all the positive signals in the market. However, aggressive speculation that the rally won't end despite stocks being overvalued could create a situation where the market gets too "frothy," she added.

3 things in tech

1. Exclusive: Amazon delays its five-day RTO mandate for some employees. The retail giant doesn't have enough office space in certain locations, and internal notifications reviewed by BI show some RTO policy delays stretching as late as May. But this isn't the first time Amazon has run into workspace capacity issues.
2. Inside Wiz's plans to become the world's biggest cybersecurity company. The cloud security startup has expanded at a breakneck pace, raising $1.9 billion in just four years and passing on a $23 billion acquisition offer from Google. Raaz Herzberg, Wiz's VP of product strategy, told BI where it plans to go from there.
3. Klarna says it will start drug testing workers in Sweden. The buy-now, pay-later firm, which is gearing up for an IPO, said the move was part of a wider effort to "strengthen security" in an internal Slack message sent Monday.

3 things in business

1. The American dream is a lot smaller these days. Fewer kids. Smaller homes. Less free time. Oh, and everything costs a lot more, and you probably won't be happy. The American dream sure looks a lot different than it used to.
2. Move over, Bluesky. Thousands of users have ditched X in the wake of the 2024 presidential election, with many flocking to platforms like Bluesky. But instead of shouting into the void and giving in to doomscrolling, some are turning to their group chat with friends for more meaningful interactions.
3. Introducing BI's 10 industry innovators of 2024. What do the CEO of Nvidia, the commissioner of the WNBA, and the head of Amazon Prime Video have in common? They're all shaking up and transforming their industries in their own ways.

In other news

• Why Arm and Qualcomm's legal battle could have big implications for the chip world.
• How rising US debt could compound into a crisis, according to 'bond king' Jeffrey Gundlach.
• Reid Hoffman says he's not planning on leaving US, but puts odds of Trump retaliation at over 50%.
• Chipotle's new CEO is trying to keep robots out of your burrito assembly line.

• Apple is working on a foldable iPad that has no screen crease, reports say.

  ---

  What's happening today

• Electoral College meets to certify presidential election results.
• Federal Open Market Committee meeting.

The Insider Today team: Dan DeFrancesco, deputy editor and anchor, in New York. Grace Lett, editor, in Chicago. Ella Hopkins, associate editor, in London. Amanda Yen, associate editor, in New York. Milan Sehmbi, fellow, in London.

• New regional price parity data showed the varying cost of living in the US.
• California and Washington, DC, had the highest cost of living, largely driven by housing costs.
• Most of the states with the lowest relative cost of living were around the middle of the country.

Many states have a lower cost of living than the national average, but the West Coast and Northeast are still pricey.

The Bureau of Economic Analysis published new regional price parity data on Thursday that showed how expensive it is to live in different areas of the US.

"Regional price parities measure the differences in price levels across states for a given year and are expressed as a percentage of the overall national price level," BEA said in a news release.

The new 2023 data showed 16 states and Washington, DC, had more expensive goods and services than the national average. The states with the lowest cost of living were mainly around the middle of the country, including some states in the South.

The following map shows overall regional price parities, where a value over 100 means it was above the national average. Hawaii's figure of 108.6 means goods and services were about 9% more expensive than the average.

California had the highest relative cost of living; the state is 12.6% more expensive than the average. California metros also made up the majority of the top 10 that had the highest all-items regional price parities in 2023. The metro area of San Francisco-Oakland-Berkeley had the highest at 118.2, meaning it was almost 20% more expensive than the national average.

Washington, DC, had an ever-so-slightly higher figure than California in 2022 but fell short of California's in 2023. DC was 10.8% more expensive than the average. New Jersey ranked right below DC.

Relatively high housing costs contributed to the overall high regional price parities in those two states and DC. BEA said rents are usually "the main driver in differences in RPPs." DC, California, and New Jersey had the highest regional price parities for rents.

Arkansas continued to have the lowest regional price parity and was 13.5% less expensive than the national average in 2023. Alabama, West Virginia, and South Dakota were among the 10 states that were at least 10% less expensive than the national average.

• Inflation increased as expected in November.
• The consumer price index increased 2.7% for the 12 months ending November.
• The Federal Reserve will likely decide to cut interest rates in the last FOMC meeting of the year next week.

In November, inflation sped up once again.

The consumer price index increased 2.7% from a year ago as expected, higher than October's 2.6% rate and the highest reading since July, when the rate was 2.9%.

Matt Colyar, an economist at Moody's Analytics, told Business Insider before the new data was published that an acceleration wouldn't be concerning because November's increase would likely be because of housing inflation. Shelter inflation has mainly been cooling from its peak of over 8% in March last year but is still high compared to the pre-pandemic rate.

"If inflation were to accelerate because prices for cyclical, demand-driven things like hotels, vehicles, airfare, etc. jumped, then policymakers at the Federal Reserve will start to look at the US economy with a bit more caution," Colyar said. "That shouldn't be overstated, however. It takes more than one monthly data point to be a trend and we haven't yet seen that kind of dynamic emerging."

While shelter was the biggest contributor to inflation overall, housing price growth has slowed. "The shelter index increased 4.7 percent over the last year, the smallest 12-month increase since February 2022," a Bureau of Labor Statistics news release on Wednesday said.

Members of the Federal Open Market Committee will meet once more this year next week on December 17 and 18 and will likely announce another interest-rate cut. CME FedWatch showed after the new inflation data was published traders expected a nearly 100% chance of an interest rate cut of 25 basis points next week, up from a nearly 90% chance before the report.

The CPI increased 0.3% over the month in November from October, the same as the forecast and an uptick from October's increase of 0.2%. The news release said that the rise in the shelter index over the month accounted for almost 40% of the overall increase.

Core CPI, which excludes volatile food and energy prices, increased 3.3% from a year ago as expected. That's the same year-over-year rate as in October.

The energy index fell 3.2% year over year in November after declining 4.9% in October. Gas tumbled by 8.1% in November.

The food-at-home index rose 1.6% year-over-year in November after rising 1.1% in October, and the food-away-from-home index increased 3.6% in November after rising 3.8% in October.

Cory Stahle, an economist at the Indeed Hiring Lab, told BI following the jobs report that "there are still many reasons to be optimistic about the labor market," like the layoff rate being less than the pre-pandemic low. However, Stahle added, "As a Federal Reserve policymaker, you don't want to wait until things start looking bad to react to that because then by then you might be too late."

• This post originally appeared in the Insider Today newsletter.
• You can sign up for Business Insider's daily newsletter here.

(Slightly) new name, who dis? I didn't catch enough sun in Florida to get a proper tan, but I am bringing a fresh look to the newsletter. All your favorite parts are still here, just with an updated feel. Like that friend who suddenly has a great hairline a few months after their trip to Turkey.

In today's big story, Luigi Mangione, the 26-year-old charged with the killing of UnitedHealthcare CEO Brian Thompson, made a vocal first appearance in court.

What's on deck

Markets: Microsoft investors take a pass on holding bitcoin on the balance sheet.

Tech: Amazon's pharmacy business is quietly crushing it.

Business: It turns out taking it easy during retirement isn't all that easy.

But first, all rise.

If this was forwarded to you, sign up here.

The big story

Heading to the courtroom

The case against the man accused of killing UnitedHealthcare CEO Brian Thompson is coming into focus.

Luigi Mangione appeared in a Pennsylvania court Tuesday for a hearing about his extradition to New York, where he faces a second-degree murder charge in the death of Thompson last week.

The high-profile case already included fireworks, as Mangione shouted at the press while being escorted into the local courthouse. Although it wasn't entirely intelligible, Mangione called something "completely out of touch" and "an insult to the American people." There was also a reference to a "lived experience."

Mangione brought some of that fight into the courtroom, as his lawyer, Thomas Dickey, said he was contesting his extradition to NY. Doing so won't ultimately stop him from being brought back to New York to be arraigned, but it could delay the process by weeks.

A key piece of the case will likely be a "ghost gun" — or untraceable firearm that can be assembled at home — that police say they found on Mangione. Joseph Kenny, the New York Police Department's chief of detectives, previously told reporters the gun could have been made on a 3D printer.

Shares in health insurers have also taken a dip as the market wonders if Thompson's death will lead to wider scrutiny of the industry.

One thing that does seem clear is the gap between how much health insurance companies spend on executive security compared to their Big Tech peers.

In the meantime, details on Mangione continue to emerge.

A review of Mangione's deleted X posts by Business Insider's Jack Newsham and Katherine Long offers a look inside the 26-year-old's mind.

His deleted social media posts show skepticism toward doctors, President-elect Donald Trump, and President Biden. One repost also suggests he supported Robert F. Kennedy Jr.

It's just some of the vast online trail the Ivy League graduate created. An app founder who talked about AI on X, Mangione attended elite schools and wrote a favorable review of the Unabomber Manifesto.

News brief

Top headlines

• Bankruptcy judge rules against The Onion's acquisition of Infowars.
• GM gives up on robotaxis after a string of troubles with Cruise.
• Jay-Z's response to sexual assault allegations was missing one key thing, according to PR pros.
• Scoop: Particle Health lands $10 million in funding after lobbing antitrust lawsuit against medical records giant Epic.
• The US is striking targets across Syria, and it isn't the only one dropping bombs in this uncertain moment.
• Trump said he'd consider raising the minimum wage. Here's where it stands in every state and the raises both parties have proposed.
• LinkedIn wants to have its TikTok era.

3 things in markets

1. Microsoft shareholders shut down a bitcoin investing bid. A think tank proposal called for Microsoft to evaluate the benefits of adding bitcoin to its corporate balance sheet. But investors shut the proposal down, saying it prefers to stick with less volatile assets.
2. The market's green flags could actually be red ones for 2025. Contrarian investor Edward Yardeni explains why seemingly strong market indicators, like an elevated Bull/Bear ratio and the S&P 500 trading above its 200-day moving average, might lead to a pullback.
3. Speaking of cautious outlooks… Some Wall Street forecasters see the stock market's good times hitting a wall in 2025. Whether it's concerns over consumer spending waning or a feeling that stocks are just too pricey, some experts see a market correction coming early next year.

3 things in tech

1. Amazon Pharmacy's potential sales boom. A record 45% of Amazon's customers are "very interested" in buying medications from its pharmacy business, an Evercore analysis found. As shopper interest skyrockets, Amazon Pharmacy's revenue is expected to reach $2 billion this year, according to the report.
2. YouTube star Marques Brownlee has some questions for OpenAI. The AI giant recently released Sora, an AI video generator, to help creators like popular tech reviewer Brownlee. But Brownlee didn't sugarcoat his skepticism in his review of the AI tool and wanted to know if OpenAI used his videos to train Sora without his knowledge.
3. Google's Gemini woes. As Google pours money into AI, the tech giant is hoping products like Gemini for Google Workspace will turn the investment into revenue. However, according to internal documents reviewed by BI, Workspace's Gemini tools trailed its key rivals when it came to brand familiarity and usage.

3 things in business

1. Kroger's $25 billion acquisition is not to be. Kroger's proposed acquisition of Albertsons was blocked by a federal judge, who agreed with the FTC that the merger would weaken competition for US grocery shoppers. It would be the largest supermarket merger in history, but the ruling could ultimately sink the deal.
2. Ball is not life, after all. Warner Bros. Discovery CEO David Zaslav was widely criticized by Wall Street after losing NBA rights to competitors. But WBD is doing just fine, securing higher rates for most of its TV networks from Charter and Comcast, the two largest cable providers in the US, people familiar with the terms of the deals told BI. (NBA execs, on the other hand, are fighting an early-season ratings slump with an NBA Cup they hope will reignite interest.)
3. America is doing retirement all wrong. Plenty of older Americans envision themselves strolling through golf courses, lounging by pools, or binge-watching TV shows in retirement. But research suggests a life of pure leisure doesn't make you happier or healthier. In fact, it may even prevent you from living longer.

In other news

• Timothée Chalamet's Bob Dylan can really sing, even if 'A Complete Unknown' doesn't hit all the right notes.
• I asked ChatGPT to help me decide what to get my family for Christmas. It gave me suggestions I never would've thought of.
• Ex-Abercrombie and Fitch CEO requests a hearing to determine if he's mentally fit to be tried on sex trafficking charges.

• Was your 2024 Spotify Wrapped disappointing? A former engineer explains why it felt like a flop this year.

  ---

  What's happening today

• Macy's reports earnings.
• The White House hosts a conference on women's health research.
• CPI data is released.

The Insider Today team: Dan DeFrancesco, deputy editor and anchor, in New York. Grace Lett, editor, in Chicago. Hallam Bullock, senior editor, in London. Ella Hopkins, associate editor, in London. Amanda Yen, associate editor, in New York. Milan Sehmbi, fellow, in London.

• This post originally appeared in the Insider Today newsletter.
• You can sign up for Business Insider's daily newsletter here.

Hello. Luigi Mangione, a 26-year-old Ivy League graduate, has been charged with murder in the fatal shooting of UnitedHealthcare CEO Brian Thompson.

Mangione was arrested in Pennsylvania on Monday and initially faced local gun and forgery charges. Our team has been covering this developing story — keep up with our coverage here.

In today's newsletter, the $13 billion Omnicom-IPG megamerger reflects a new era as Big Tech and AI upend the ad industry.

What's on deck:

• Markets: Nvidia shares fell after China hit the chipmaker with an antitrust probe.
• Tech: Former Google employees on being laid off from the tech giant and their advice for those in a similar position.
• Business: Rupert Murdoch lost a 'Succession-like' legal battle over future control of his media empire.

But first, a new ad-venture.

If this was forwarded to you, sign up here.

The big story

The ad industry's new era

It's already been a big week for the ad industry.

Omnicom Group said it had reached an agreement to acquire Interpublic Group, a merger worth more than $30 billion that would create the world's largest ad conglomerate.

Across the pond at Paris-based Publicis Groupe, the party hats might be staying in the drawer. Just last week, Publicis recruited Snoop Dogg for a video to help celebrate the firm usurping London's WPP to become the world's largest ad holding company.

But it's not just about being No. 1. For ad industry insiders, the proposed takeover reflects an ad sector under threat from Big Tech and AI, writes Business Insider's Lara O'Reilly. By creating a larger company, Omnicom-IPG will have a bigger base to deploy data and technology, which could give it leverage to secure beneficial and exclusive deals with partners such as cloud providers.

Keep in mind, however, that in the short term mergers can be highly disruptive.

Concerned clients. Bruised egos. Job cuts.

Integrating two companies with 100,000 people combined, dozens of different agency brands, and hundreds of offices across the globe will not be a simple task. There will likely be synergies — including job cuts. "It will be harder to climb the career ladder. Superstar creators and creatives will also be in demand, as well as good strategists, in all disciplines. But, lots of other roles will become diminished," Simon Francis, who leads the marketing consultancy Flock Associates, told BI.

However, as Lara highlights, that could create opportunities for smaller agencies, especially as the merged company works its way through the disruption caused by integration, egos being knocked out of joint (it wouldn't be the first time), and potential client conflicts where the new entity suddenly works with two or more fierce rivals in the same sector.

"From an M&A perspective, it's only going to add fuel to the fire."

That's according to William Ritchie, founding and managing director of advisor firm WY Partners. "I'd expect there is going to be more competition for the best assets and more focus on building a streamlined data and tech-first offering which can compete," he told BI.

Private equity has been circling the ad industry, too. Apollo, KKR, and Blackstone have shown interest in media and entertainment. Industry insiders have speculated for months that WPP could be taken private — or at least some parts of it could be.

News brief

Top headlines

• What we know about Luigi Mangione, the Ivy League grad charged with murder in UnitedHealthcare CEO's killing.
• Jay-Z asks judge to unmask Jane Doe who said in a lawsuit that he and Diddy raped her when she was 13 years old.
• Trump says he's 'having dinner' with Jeff Bezos. It's the latest development in their long history.
• AMD downgraded after BI report on weak demand for its AI chips among AWS customers.
• Post-Assad Syria will be a new challenge for America's Middle East strategy.

3 things in markets

1. Nvidia stock drops as China probes the chipmaker over potential antitrust violations. China's government is looking into Nvidia's acquisition of chip design firm Mellanox, which it previously approved. Nvidia stock fell by more than 2.5% early Tuesday.
2. Microsoft and Amazon investors are eyeing pieces of the bitcoin pie. Shareholders at Microsoft and Amazon will decide this week if their respective companies should consider investing in bitcoin. The cryptocurrency recently blew past a $100,000 milestone that bestowed great gains on MicroStrategy, which saw triple-digit gains after buying up bitcoin this year.
3. Some advice from Citi's newly minted MDs. Citi appointed its largest class of managing directors under CEO Jane Fraser last week. Five of the new MDs told BI their best career advice and reflected on the bank's massive transformation.

3 things in tech

1. Life after Google. The past few years have been rough for those in the tech world as the industry faced historic layoffs. Eight ex-Googlers — including one who has since returned — shared what it was like to lose what some considered their "dream job," and how they found their footing after.
2. Inside MrBeast City. Jimmy Donaldson, the creator better known as MrBeast, shared photos of the "city" he built for his upcoming "Beast Games" show. He said it cost more than $14 million to build.
3. OpenAI's shiny new video generator is open to the public. Sora, which can generate videos up to 20 seconds long from written prompts, went live Monday. Its product lead said a team of about five or six engineers built the generator in months.

3 things in business

1. Murdoch's "Succession" battle. Life imitates art, or perhaps, art imitates life. Rupert Murdoch lost a legal case over the future of his media empire in a real-life succession battle on Monday. Rupert, 93, and his son Lachlan took on three other Murdoch children in court — and lost, for now.
2. Thinking outside the deck. For better or worse, slide decks have been at the crux of how Americans work in the nearly four decades since PowerPoint launched. But they've also faced a lot of backlash, including from CEOs like Elon Musk and Sundar Pichai. Does that mean the deck is in jeopardy? Next slide.
3. AI's pollution price tag. AI-related emissions will soon rival that of all the cars in California, according to a new study. In just six years, the study found, AI electricity consumption could pollute the air so much that asthma-related deaths could spike by more than a third. By 2030, researchers calculated, AI's health impact could total up to $20 billion.

What's happening today

• Israeli Prime Minister Benjamin Netanyahu testifies at his corruption trial in Jerusalem.
• Treasury Secretary Janet Yellen speaks at Wall Street Journal CEO Council Summit.
• Nobel Prizes, including the Nobel Peace Prize, are presented in Stockholm, Sweden.

The Insider Today team: Hallam Bullock, senior editor, in London. Grace Lett, editor, in Chicago. Ella Hopkins, associate editor, in London. Amanda Yen, associate editor, in New York. Lisa Ryan, executive editor, in New York Milan Sehmbi, fellow, in London.