“The absence of the medical records itself creates an unreasonable risk of harm and the defendants are aware of that risk as well,” Laughrey wrote in a 33-page opinion.

Sara Bartosz, a lawyer for Children’s Rights, said the lawsuit and its proposed settlement, which still needs a federal judge’s final approval, was about restoring “basic and fundamental” procedures into Rhode Island’s child welfare system.

The state of Rhode Island has agreed to settle a long-running lawsuit brought by Children’s Rights alleging systemic abuse and neglect of the nearly 2,000 children living in state custody.