New Federal Rule Makes Neglecting Medical Emergencies in Custody a Crime, Mandates Training for Federal Officers

This legislation, officially titled the Andrew Kearse Accountability for Denial of Medical Care Act of 2025, creates a powerful new federal rule designed to protect individuals in federal custody. Simply put, it makes it a crime for federal law enforcement officers, Bureau of Prisons staff, and U.S. Marshals (defined as "covered officials") to negligently fail to get or provide immediate medical attention to someone in their custody who is clearly in distress. If that failure causes unnecessary pain, injury, or death, the official faces criminal penalties—up to one year in prison, a fine, or both. This is a significant shift, establishing a clear line that medical neglect is not just an internal disciplinary matter, but a federal offense.

The Accountability Overhaul: Who’s Watching the Watchers?

One of the biggest changes here is the massive increase in accountability. The bill mandates that the appropriate Inspector General (IG) must investigate any incident where a covered official’s failure to provide care results in harm or death. Crucially, if the IG concludes the official was negligent, they are required to refer the case directly to the Attorney General for prosecution under this new section. This removes discretion and creates a mandatory path for criminal charges when negligence is found, essentially ensuring that these cases don't just disappear into internal review processes. Furthermore, the bill requires every agency involved to set up confidential reporting systems so incidents can be flagged without fear of retaliation.

Mandatory Training: Closing the Knowledge Gap

For the officers and staff on the ground, the bill mandates a serious upgrade to their training. The heads of these federal agencies must ensure that every covered official receives training on how to properly provide or obtain medical assistance for someone in medical distress. This is a practical measure aimed at prevention, recognizing that sometimes failure to act isn't malice, but a lack of preparation or knowledge. By making this training mandatory, the law attempts to standardize the response to medical emergencies—like difficulty breathing, which the bill specifically mentions as a sign of distress—across all federal holding facilities.

New Power for States: Civil Enforcement

The law also creates a novel mechanism for states to seek justice. If a State Attorney General believes one of their residents was harmed by an official violating this new rule, they are empowered to file a civil lawsuit in federal court. They can seek equitable and declaratory relief—meaning they can ask the court to order the federal agency to change its policies or practices to fix the situation. This gives states a direct legal tool to intervene on behalf of their citizens when federal custody standards fail, adding another layer of external oversight beyond the federal criminal justice system.

The Real-World Impact: What Does 'Negligently Fail' Mean?

While the intent is clearly positive—protecting vulnerable people in custody—the practical application hinges on the term “negligently fail.” This is where the medium level of vagueness comes in. Defining the exact threshold for criminal negligence will be up to investigators and prosecutors, and eventually the courts. For federal officers, this means increased liability and the need for absolute clarity on their procedures during medical emergencies. If an officer waits too long or misinterprets signs of distress, they could potentially face criminal charges, which is a significant professional risk. This provision is meant to deter neglect, but it also places a heavy burden on personnel who must now navigate a clear criminal line when responding to chaotic, high-pressure situations.