The real death panels––withholding medical care in prison
Harold Millican believes that the Texas prison system and a jail warden are guilty of “callous indifference.” He is suing them because, he says, when he was doing a short jail stint for drugs, officials refused to take him to the hospital to treat a flesh-eating bacteria infection, letting it fester for a week. In a federal claim filed last month, Millican says he was not cared for until he went into shock and fell unconscious. He had told staff about the injury, and his mother made calls, but was told there was “no one available to take him to the hospital.” The lawsuit demands the Texas prison system improve training so officers facilitate adequate medical treatment. Some experts say this case shows how chronic understaffing can lead to prisoner harm; others say it highlights the need for independent oversight, a need underscored by a Texas prison spokesperson’s comment: “The offender received both appropriate and timely medical care.” [Keri Blakinger / Houston Chronicle]
When Jennifer Addison, a woman imprisoned in Virginia, developed a similar infection to Millican’s, she was not as lucky. Last March, she submitted a request for medical attention, writing, “My throat is sora [sic], Im having hot/cold sweats, and throwing up everything I eat or drink.” On an emergency grievance form two days later, she wrote, “I still can’t keep anything down and my throat is still hurting me. I need some help please.” A nurse responded by checking a box: “Your grievance does not meet the definition for an emergency.” Two days later, Addison was dead. Her cause of death was listed as the flu and MRSA—a bacterial infection that led to a blood infection. “She shouldn’t have died of that. That’s totally treatable,” said Deborah Golden, an attorney at the Human Rights Defense Center. “Anyone who wasn’t holding food down for six days would have gone to the ER.” [Katherine Hafner and Gary Harki / Virginian-Pilot]
In 2012, a lawsuit against a nearby women’s facility, Fluvanna, alleged a “systemic, pervasive and on-going” failure to meet minimum standards of medical care, including refusing medication and doctor visits. They reached a settlement that installed a compliance monitor, but two years later, plaintiffs in a new lawsuit say officials have failed to improve care. A Miami-based contractor, Armor Correctional Health Services provides medical services, but plaintiffs argue that they are unable to do so sufficiently. “We do not have the resources to adequately address this settlement agreement,” Fluvanna’s then-Warden Jeffrey Dillman said in an internal letter in 2017. “We are destined to fail.” The problems stem in part from a flawed grievance system, a very real version of the much-feared “death panels” that the Tea Party invented to stir up fear of the Affordable Care Act: Once a prisoner asks in writing for help, the form is reviewed by prison staff, who accept or reject the request. “I think the system [is] designed to discourage people from seeking care and to encourage staff to find the quickest, least expensive way to get rid of the complaints,” said the plaintiffs’ attorney, adding that corrections officials have resisted changes, clinging to a system whereby the bar for what constitutes emergency is far too high: “Basically, if it were a true emergency you probably wouldn’t be able to fill out an emergency grievance.” [Katherine Hafner and Gary Harki / Virginian-Pilot]
In her experience as a public defender, this writer has seen her sick clients failed over and over by inadequate resources, but she has also seen clients failed by a culture that treats incarcerated people as fakers and liars, not as people who need care. As she heard one prison official say, on a tour, about the Prison Rape Elimination Act, “That is just a tool that prisoners use to manipulate staff.”
In the case of a 23-year-old Georgia man who suffered two seizures right after being booked into a jail, the doctor and nurses ordered medical treatment “immediately,” but officers simply dumped him in a cell for almost an hour, for “observation.” A nurse finally found him, but by then it was too late. “Unfortunately, we’ve had so many seizures around here it’s kind of like, I relate it to the story of the boy who cried wolf,” explained Sgt. Martin Campbell. [Randy Travis / Fox 5]
In Connecticut, where prison doctors’ requests for patients to see specialists were often delayed and denied, and where state funding for prisoner healthcare had been cut drastically, officials are looking for solutions. Last year, the state corrections department, led by progressive Scott Semple, took over managing healthcare in its facilities; the department decided to approve every request prison doctors make for specialized treatment. “Now if a doctor decides they need something … they just get it. That has been an improvement,” said a nurse supervisor. But it won’t be this way for much longer because the department is setting up a system that will determine “community standards of care” to determine what treatments will be provided. “Hiring the staff we need would mean that an inmate could see a doctor in days rather than waiting for months,” said David Pickus, president of the union that represents medical staff. “This decision to underfund services has serious consequences for human lives.” A local social worker said: “We can only do so much in a shift. We can only help so many people. This is not why we went into this profession … We’ve been very quiet for a lot of years [about] how the budget cuts have impacted the prisons.” [Jacqueline Rabe Thomas and Clarice Silber / Connecticut Mirror]
The good news is that even where funding is unavailable, progress can be made with cultural shifts: One of them might be to take medical complaints seriously. That is something that officers and medical staff alike can do, today.