Detroit Federal Jury Awards $307.6 Million Over a Denied $919 Surgery

Kohchise Jackson entered Michigan's prison system with a medical problem that had a simple fix. He developed a colovesical fistula, an abnormal opening between his large intestine and his bladder. Surgeons performed a colostomy that routed waste into an external bag, a step that was supposed to be temporary. The reversal procedure that would close it carried a price of $919.35.

Corizon Health, the company then contracted to provide medical care across Michigan's prisons, would not approve the surgery. Jackson lived with the colostomy bag from 2017 through 2019, more than two years, much of it in cramped quarters alongside other men. "It was horrible," he testified, describing what it was like to share close space while wearing the bag. He was paroled before he finally received the reversal in 2019.

Jonathan Marko of Marko Law, with co-counsel Ian Cross, tried the case as a claim of deliberate indifference: the refusal was driven by cost, not medicine. The defendants were CHS TX, Inc., the entity that took on Corizon's liabilities after Corizon filed for bankruptcy in 2023, and Dr. Keith Papendick, who had served as Corizon's director of utilization management while Jackson was incarcerated.

A central piece of the plaintiff's proof was an internal charting practice. Staff were instructed never to write the word "denied" in a patient's file. In its place they were told to write "Alternative Treatment Plan," language Marko's team argued was meant to hide cost-driven refusals from courts and regulators.

The trial ran in U.S. District Court for the Eastern District of Michigan, at the Theodore Levin Federal Courthouse in Detroit. Jurors deliberated about two hours before returning their verdict on April 2, 2026. They awarded $7.5 million in compensatory damages against CHS TX, $300 million in punitive damages against the same company, and $100,000 in punitive damages against Papendick, for a total of $307.6 million.

"This is a warning shot across the bow to for-profit health care companies" that take in taxpayer money, Marko said after the verdict. The punitive figure far exceeds the compensatory award, and the defendants can ask the trial court or an appellate court to cut it on constitutional grounds. The verdict itself has not been reduced or appealed, but collection is on hold: CHS TX filed for Chapter 11 bankruptcy in May 2026, which automatically stays enforcement of the award.