New Federal Law Mandates Immediate Medical Care for Detainees in Distress, Criminalizes Negligent Failure to Act

The “Andrew Kearse Accountability for Denial of Medical Care Act of 2025” is straightforward: it creates a new federal law requiring federal law enforcement officers and employees of the Bureau of Prisons (BOP) and U.S. Marshals Service (USMS)—what the bill calls "covered officials"—to immediately provide or get medical attention for anyone in their custody showing signs of "medical distress," such as trouble breathing. The core change here is the introduction of criminal liability: if a covered official negligently fails to provide this immediate care, and that failure causes unnecessary pain, injury, or death, they could face a fine, up to one year in prison, or both.

The New Standard: From Policy to Penalty

This bill doesn't just restate existing policy; it puts teeth into it by making the failure to act a federal crime (Section 251 of Chapter 13 of title 18, U.S. Code). For the average person, this means a significant increase in accountability for federal agencies responsible for holding detainees. If someone in BOP custody, for example, is clearly struggling to breathe, the official on the scene is now legally required to act immediately. Negligence is the key word here, meaning officials aren't penalized for honest mistakes, but for carelessness that leads to serious harm. This is a big deal for families concerned about the welfare of loved ones in federal custody, as it moves the standard from internal disciplinary action to potential criminal prosecution.

Who’s Watching the Watchers?

The bill sets up a robust system for oversight and investigation. First, the appropriate Inspector General (IG)—either the agency’s own or the Department of Justice IG—must investigate any time a covered official fails to provide care and the person suffers unnecessary harm. If that IG investigation finds the official was negligent, the case must be referred to the Attorney General for potential criminal charges. Think of the IG as the internal auditor here, now required to perform a specific function that could lead directly to prosecution.

State Rights and Mandatory Training

Beyond federal oversight, the bill introduces a unique power for states: a State Attorney General who believes a resident was harmed by an official violating this rule can sue the federal official in federal court to fix the situation or get a declaration of the violation. This creates a new avenue for state-level checks on federal custody practices. On the practical side, the bill requires the head of every agency employing these officials to establish mandatory training on how to provide or get medical help for people in distress. They also have to set up a confidential system for people to report incidents where medical care was denied. This means the rules of the road for emergency response are about to get standardized and mandatory across the board for federal law enforcement and correctional staff.

The Trade-Off: Increased Safety vs. Legal Exposure

For those in federal custody, the benefit is clear: a legal mandate for immediate, life-saving care when they are in distress. For the federal officials involved (BOP officers, USMS deputies, etc.), the situation gets more complicated. While no one wants to see someone die, this bill significantly raises the stakes of their job. They now face potential criminal liability and increased scrutiny from both federal IGs and State Attorneys General if they misjudge or negligently ignore a medical emergency. The standard of “negligently fail” is where things could get murky, as it will be up to the courts to interpret exactly what constitutes negligence in a high-stress, often chaotic custody environment. However, the mandatory training provision aims to mitigate this risk by ensuring all officials know exactly what is expected of them when a detainee shows signs of medical distress.