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Chrysler Plant
Newark Delaware
Wackenhut (Group 4)
September 14, 2009 Newark Post
Newark Police report they were notified by Wackenhut Security officers at the
Chrysler Assembly Plant that a University of Delaware student spent the night at
one of the buildings in the closed plant in an attempt to find the way back to
her dorm. The student told the officers that she had been at a party last
Thursday and had gotten lost trying to find her room. She spotted the train
tracks and followed them, hoping to find a station and call for help. The tracks
led her to the Chrysler Plant, where she entered one of the buildings and called
the security desk. One of the security officers, thinking the call was a joke,
stated that and hung up on the student.
Delaware Department of Corrections
Correctional Medical Services (formerly run by First Correctional Medical),
Prisoner Transportation Services of America)
May 5, 2010 The News-Journal
Three new vendors will replace the company that provides medical care in
Delaware's prisons, the state's response to five years of criticism and turmoil
over the quality of inmate health care. Correction Commissioner Carl C. Danberg
acknowledged the agreements Tuesday, shortly after he signed a $29.8 million
contract with Nashville-based Correct Care Solutions, which will serve as the
general health care provider. On Monday, Danberg said, he signed a $10 million
contract with MHM Services Inc., of Vienna, Va., and a $700,000 contract with
Correct Rx Pharmacy Services Inc. of Linthicum, Md. MHM Services will provide
mental health and substance abuse treatment to the Department of Correction.
Correct Rx will fulfill pharmacy responsibilities. The two-year contracts, with
optional one-year extensions, go into effect July 1, the day after St.
Louis-based Correctional Medical Services' contract expires. The new contracts
are expected to be announced today. The breakup of the single medical health
care contract was a result of frustration with CMS, the subject of a 2005
investigation by The News Journal. The newspaper's series brought to light
problems with high inmate death rates, especially from AIDS and suicide. It also
pointed out neglect of sick inmates who were in filthy infirmaries that
sometimes lacked beds. Following the series, a federal monitor was appointed by
the U.S. Justice Department to oversee prison health care. The state entered a
three-year agreement in 2006 with the Justice Department to improve inmate
health care.
March 10, 2010 AP
A federal judge in Wilmington has awarded $850,000 to the family of a Delaware
prison inmate who hanged himself in 2004. Judge Joseph Farnan ruled Tuesday that
the widow of Christopher Barkes was entitled to $150,000 for mental anguish
stemming from her husband's death. Barkes' two daughters, meanwhile, were
awarded $350,000 each. The family sued First Correctional Medical Inc., the
former medical care contractor for the state Department of Corrections. Farnan
entered a default judgment against the company in 2008 after a representative
failed to appear at a court hearing. Barkes, who had a history of substance
abuse and suicide attempts, hanged himself with a sheet one day after being
arrested for violating probation.
March 5, 2010 News Journal
Twenty-four companies have submitted bids to provide health care services at
Delaware's prisons. Four of them are from Delaware, and many critics of the
current health care provider, St. Louis-based Correctional Medical Services, say
a local contractor is needed to help lift the Department of Correction from
under the federal scrutiny it's been under for almost four years. "The good news
is that the deplorable tenure and administration of [Correctional Medical
Services] will come to an end," said the Rev. Christopher Bullock, senior pastor
of New Canaan Baptist Church and co-founder of the Delaware Coalition for Prison
Reform and Justice. "Hopefully, this will be the beginning of a new day for
Delaware corrections." Correction Commissioner Carl C. Danberg announced last
year he would end the contract with Correctional Medical Services after it was
criticized for providing inadequate care despite being paid more than $130
million over three years. In place of hiring a single health care provider,
Danberg broke the contract into 10 smaller agreements focusing on specific
services. Last week was the deadline to submit proposals. "We've never had more
than half a dozen vendors participate in either the substance abuse contract or
the medical contract before," Danberg said. "So to have 24 we're doing something
right." In addition to the four local bidders, another 10 are from neighboring
states. Participants could submit bids to provide more than one service, and
eight businesses have done so, including some of the Delaware companies. Names
of the bidders were not released because their abilities have not been verified.
"We're excited, but still a little nervous," Danberg said. "The hard part is
going to be putting this contract together." Danberg said it is too soon to know
if the state will save money under the new bidding format. Meetings with the
bidders will be held later this month. "Ultimately, the proof of whether or not
this whole new system works is going to be in whether or not the provision of
medical health care works," Danberg said. Bullock said he would like to see
local vendors used, as long as they have a proven record. It also is important
that there not be too many companies for the correction department to handle.
"We need a healthy balance to fix an unhealthy system," he said. Delaware
entered an agreement with the federal government to improve prison health care
in 2006 following stories by The News Journal that uncovered problems and high
inmate death rates, especially from AIDS and suicide. The 2005 series also
pointed to poor medical treatment for cancer, meningitis, hepatitis and other
communicable diseases and bacterial infections.
January 3, 2010 The News Journal
Inmate Edward G. Williams has a bulge the size of a cantaloupe protruding
from his abdomen. The 50-year-old believes he is being denied adequate health
care in retaliation for a federal lawsuit he filed nearly two years ago seeking
surgery that was recommended by a doctor in 2005. "They're trying to act like it
doesn't exist," said Williams, who is serving 17 years at Vaughn Correctional
Center for selling cocaine and shooting a man in 1997. Sometimes the pain is so
severe that Williams cannot walk or get out of his bed in the maximum-security
unit, he said. The victim of a shooting prior to his incarceration, Williams was
left with a mesh over the portion of his abdomen wall that was damaged, he said.
A series of scars now covers his stomach, as well as a large bulge in the right
side of his abdomen. At times, he claims, he can feel his intestine flow into
the bulge. When that happens, Williams said, he pushes it back behind the
abdomen wall. Williams' claim comes as the Delaware Department of Correction is
being credited by the U.S. Justice Department with showing significant progress
under a three-year mandate to improve prison health care for its more than 6,900
inmates. When the agreement was extended last month for another two years, the
federal government said the department met 214 of its 217 original health care
mandates. As a result, Baylor Women's Correctional Institution and the medical
care portion at Sussex Correctional Institution were not included under the
extended agreement. Mental health care provided at the Georgetown prison will
continue to be under review. Young Correctional Institution in Wilmington and
Vaughn Correctional Center near Smyrna remain entirely under federal scrutiny.
For Vaughn, a ways to go Though there are still problems, Corrections
Commissioner Carl C. Danberg said prison health care is far better than it was
three years ago when a series by The News Journal revealed high inmate death
rates, especially from AIDS and suicides. And the department is now in a
position to argue whether the Vaughn and Young facilities should be under the
new agreement, indicating progress has been made, Danberg said. "Three years
ago, we couldn't have argued about it," he said, adding that Vaughn is the
prison that needs the most work. "The facility is making progress, but not at
the pace I believe it should be making progress." Despite Danberg's claims,
Williams said, inmates have not seen much improvement. "They're not telling the
truth," he said. Williams points to problems he has with bowel movements, saying
he uses his hands to push at his stomach. The force has caused bloody stools and
hemorrhoids, he said. "They have me on pain medication since 2005 because of the
pain I go through in my stomach," he said. "It's terrible, man." At least two
hernia surgeries and a colonoscopy have been recommended since 2005, according
to documents in Wilmington's U.S District Court. The same document stated that
an abdominal ultrasound performed in August 2005 found that "a nonreducible
hernia is [at] risk for strangulation -- need to move forward [with] repair."
While Williams has undergone colonoscopies, he has not received hernia surgery.
Doctors changed their opinion on Williams' surgery after he filed his lawsuit on
Oct. 9, 2007, he said. District Judge Joseph J. Farnan, who is overseeing the
suit, said the court has concerns about Williams' care. "The delay in providing
[Williams] the colonoscopy, from the time it was first medically determined that
it was necessary, until it was finally performed a few months after the filing
of the lawsuit, raises concerns of a constitutional dimension," Farnan said in
an opinion filed on June 24, 2009. "Moreover, at the time this lawsuit was
filed, hernia surgery was recommended and approved at least twice, but it was
not performed." Because the suit is pending, state officials and their
contracted medical health provider, St. Louis-based Correctional Medical
Services (CMS), would not comment. CMS is being paid $39.8 million by the state
this budget year. When asked why CMS offered to settle the suit with Williams in
September 2009, company spokesman Ken Fields said they were not able to comment
in detail because of the ongoing litigation. "We can tell you that companies
involved in litigation may choose to resolve such cases for a variety of
reasons, including the potential time and expense involved in ongoing court
proceedings," he said. "In addition, in the context of your story about progress
that has been made in the Delaware correctional health care system, it is
important to point out that this case involves care that was delivered to one
patient between 2005 and 2007." Williams, who initially accepted the settlement,
then rejected it, said he deserves to have his medical condition taken care of
even though he admits he is "no angel."
October 14, 2009 The News Journal
After years of criticism and a federal investigation, state officials announced
today they will let their contract with Correctional Medical Services expire and
try to find a new provider. The Department of Correction announced it will take
bids for a new contract with modifications it hopes will provide better care,
including breaking the contract into smaller pieces to allow multiple companies
to provide more specialized service. The new contract will also have a “shared
risk,” with the DOC paying for certain costs in order to prevent medical
providers from limiting inmate care in order to maximize their profits. “The
Department of Correction has used the last few months to prepare for and make an
informed decision about this [Request for Proposals],” Commissioner of
Correction Carl Danberg said. “We have reviewed the best practices from other
states and interviewed medical experts from around the country in an effort to
develop a better contracting model for prison health services. In addition, the
department has interviewed correctional health-care professionals to identify
and eliminate the impediments to competition, which existed in previous
contracts.” In January, Danberg extended the contract with CMS from a 2009
expiration date to June 30, 2010. At the time Danberg said rebidding the
contract would cost the state an additional $4 million on top of the $39 million
it’s already paying for health care. The Department of Correction has come under
scrutiny for its care of inmates in Delaware prisons. Delaware entered into the
agreement with the federal government following a series of articles in 2005 by
The News Journal that pointed to problems with prison health care and high
inmate death rates, especially from AIDS. Other findings by the newspaper's
six-month investigation included an outbreak of flesh-eating bacteria and an
inmate's massive brain tumor – largely ignored by staff – which led to his
death. Independent reports as a result of the agreement with the federal
government repeatedly pointed out that CMS suffers from a "lack of stable and
effective leadership." Independent monitor Joshua W. Martin III said in his most
recent report that the department made some strides in complying with the
memorandum of agreement, or MOA. Martin found the state failed to comply with
six of 217 provisions, and was in substantial compliance with 64 of them. The
state was said to be in partial compliance with the remaining requirements.
Among the improvements was better organization of health records, as well as
up-to-date filing of health documents. Training for guards in suicide prevention
has expanded and the department created a Bureau of Correctional Health-Care
Services to supervise and audit medical programs. However, Martin also said it
is unlikely that the state will be in full compliance when the agreement
expires. In addition to leadership problems with the medical contractor, other
problems cited include shortages of mental health counselors and psychiatrists,
incomplete annual staffing plans, poor treatment plans and a continued lack of
space that results in inadequate privacy.
September 30, 2009 The News Journal
After spending more than $130 million over three years, Delaware's prison system
continues to provide health care to inmates that falls short of federal
requirements, according to a report issued Tuesday by an independent monitor.
Because of that, the state Department of Correction is at risk of remaining
under U.S. Justice Department supervision when an agreement it signed in 2006
expires later this year. While the federal agency declined to comment Tuesday,
it can take the more drastic measure of suing for control of the state's prison
system. When it did that in California, the penal system was taken over by the
federal government, which ordered the release of prisoners because of
overcrowding. In Delaware, prisoners who cannot get adequate health care could
be ordered released if there is a takeover, said Stephen A. Hampton, a Dover
attorney who represents inmates and their families in lawsuits against the
department. Delaware entered into the agreement with the federal government
following a series of articles in 2005 by The News Journal that pointed to
problems with prison health care and high inmate death rates, especially from
AIDS. Other findings by the newspaper's six-month investigation included an
outbreak of flesh-eating bacteria and an inmate's massive brain tumor -- largely
ignored by staff -- which led to his death. "Unfortunately, I'm beginning to
accept that we're not going to be in substantial compliance by the end of the
year," said Carl Danberg, Department of Correction commissioner. "We are still
working very hard to meet that deadline, but I'm beginning to accept that we'll
not make it." The state has until Dec. 29 to comply with 217 provisions mandated
by the agreement, which was signed by Danberg, who was then Delaware's attorney
general, and former Correction Commissioner Stan Taylor. It called on the state
to revamp its prison health care system and report its progress regularly to the
Justice Department. Independent monitor Joshua W. Martin III said in his report
that the department made some strides in complying with the memorandum of
agreement, or MOA. Martin found the state failed to comply with six of 217
provisions, and was in substantial compliance with 64 of them. The state was
said to be in partial compliance with the remaining requirements. Among the
improvements was better organization of health records, as well as up-to-date
filing of health documents. Training for guards in suicide prevention has
expanded and the department created a Bureau of Correctional HealthCare Services
to supervise and audit medical programs. However, Martin also said it is
unlikely that the state will be in full compliance when the agreement expires.
Problems listed in the 210-page report include a "lack of stable and effective
leadership" by the company contracted by the state to provide medical services,
an ongoing problem Martin listed on previous reports. Other problems cited
include shortages of mental health counselors and psychiatrists, incomplete
annual staffing plans, poor treatment plans and a continued lack of space that
results in inadequate privacy. Danberg, who previously said there were problems
with the medical vendor, St. Louis-based Correctional Medical Services (CMS),
extended the group's $39 million contract for another year because it would cost
the state an additional $4 million to seek a new vendor. Danberg said he has
penalized CMS for not complying with its contract. "Last year alone, we
forfeited over a million dollars from them," Danberg said, adding the money was
used on the prisons' medical facilities." We have improved the physical plant
space at Howard Young [Correctional Institution], Baylor [Women's Correctional
Institution] and [Sussex Correctional Institution]." CMS officials said in an
e-mail they are reviewing the monitor's findings and recommendations. "While we
are proud of the accomplishments our team has achieved in partnership with the
DOC, we remain fully committed to working with the state to do more to
strengthen the health care program in Delaware prisons," CMS spokesman Tony
Zagora said. 'Lapses in medical treatment' -- Robert Kern, 69, wonders how much
longer the problems will continue and how many lives will be affected. "I don't
see where any major changes have been affected because the same organization is
there," said Kern, whose 41-year-old son, Daniel, died earlier this month while
serving a one-year sentence for drunken driving at Wilmington's Plummer
Community Corrections Center. Kern said the state Medical Examiner's Office told
him his son died of pancreatitis inflammation or infection of the pancreas. The
younger Kern complained to prison officials, but the illness went undiagnosed
until he was taken to St. Francis Hospital and died, Robert Kern said.
"Apparently their profitability is somewhat related on what they spend" on
inmate health care, Kern said about CMS. "Right there the incentive to treat
people versus having a higher profitability is just in contrast. I'm afraid the
patient will lose nine times out of 10." John Painter, department spokesman,
said that while the state is prohibited under federal law from disclosing
specifics, Daniel Kern's death is "being reviewed in the same manner that all
inmate deaths are addressed. Specifically, the Delaware Medical Examiner will
determine the cause of death and, as of now, no cause has been determined." He
also said the case will be reviewed by the independent monitor and others. "To
the extent lapses in medical treatment are identified, DOC will be take prompt
corrective action," he said.
September 29, 2009 The News Journal
It does not appear the state’s Department of Correction will be able to
provide proper prison health care like it said it would nearly three years ago
when it signed an agreement with the federal Department of Justice, according to
the fifth report by an independent monitor overseeing the state prison system.
“The state has made progress toward reaching substantial compliance with the
terms of the [Memorandum of Agreement],” according to the report issued this
morning by the independent monitor Joshua W. Martin III. “But the state still
has a great deal more to accomplish, and it does not appear that the state will
have reached substantial compliance with all of the provisions of the
[Memorandum of Agreement].” Among problems listed in the 210-page report is “the
lack of stable and effective leadership” at the medical provider level. This has
been an ongoing problem that Martin listed on previous reports. Department of
Correction Commissioner Carl Danberg previously said there were problems with
the medical vendor, St. Louis-based Correctional Medical Services (CMS). Despite
his displeasure, Danberg extended the $39 million contract with CMS for another
year, saying it would cost an additional $4 million to seek a new vendor.
Delaware entered into an agreement with the federal government following a
series of articles in 2005 by The News Journal that pointed to problems with
prison health care and high inmate death rates, especially from AIDS. In March
2006, the Justice Department’s Civil Rights Division launched its probe.
Then-Gov. Ruth Ann Minner tried unsuccessfully to derail the federal
investigation during her second term. Her legal counsel at the time, Joseph C.
Schoell, sent a letter to U.S. Attorney General Alberto Gonzales calling The
News Journal's series "misleading." In December 2006, the Justice Department and
the state of Delaware entered into a memorandum of agreement which requires the
state to take measures to ensure that adequate medical and mental health care is
provided to its inmates. Martin, a Wilmington attorney and former Superior Court
judge, was picked to head the monitoring team. Earlier this year, Gov. Jack
Markell appointed him to serve as chairman of the Delaware Economic and
Financial Advisory Council, the state's revenue forecasting committee. Martin is
expected to issue his final report sometime next year.
January 30, 2009 The News Journal
Poor performance by the Department of Correction's medical vendor continues
to “significantly” hamper the department's efforts to get out from under
supervision by the U.S. Justice Department, according to the fourth report by
the independent monitor overseeing the state prison system. The 236-page report
was issued early this morning. “The Monitoring Team continues to be concerned
over the lack of stable and effective leadership at the vendor-level,”
independent monitor Joshua W. Martin III said in the report. “As the Monitoring
Team emphasized in previous reports, without stable and effective leadership,
the state will be significantly hampered in its attempts to become compliant
with the [memorandum of agreement between the United States Department of
Justice and the State of Delaware].” Since monitoring of Delaware prison health
care started, Martin has been critical of Correctional Medical Services, a
private company Delaware is paying $39 million this year to provide medical care
to inmates. Although Martin found the state to be doing better since his last
report, he still found problems with prison health care. “It should be noted
that, although the State may have received partial compliance ratings in
consecutive reports, that does not indicate that the state has failed to make
any progress,” Martin wrote. “To the contrary, in many situations, the state has
made progress, but still has some work to do before achieving a substantial
compliance rating.” Delaware entered into an agreement with the federal
government following a series of articles in 2005 by The News Journal that
pointed to problems with prison health care and high inmate death rates,
especially from AIDS. In March 2006, the Justice Department's Civil Rights
Division launched its probe. Former Gov. Ruth Ann Minner tried unsuccessfully to
derail the federal investigation. Her legal counsel at the time, Joseph C.
Schoell, sent a letter to U.S. Attorney General Alberto Gonzales calling The
News Journal's series "misleading." In December 2006, the Justice Department and
the State of Delaware entered into the memorandum of agreement, which requires
the state to take measures to ensure that adequate medical and mental health
care is provided to its inmates.
October 2, 2008 The News Journal
David L. Kalm, a 58-year-old disabled merchant seaman, has filed suit
against Department of Correction officials and the prison system's contract
medical vendor alleging he was denied care and subjected to a "savage beating,"
which included death threats and having a nightstick or similar object forced
down his throat. Department of Correction officials won't say whether they
disciplined any guards over the assault -- none were fired -- and they sent an
internal affairs report about the incident to Attorney General Beau Biden's
office for review. "Results of Internal Affairs investigations are confidential,
but the findings of the Kalm investigation were shared with Delaware State
Police and the Attorney General's Office," DOC spokesman John Painter said in a
written statement. "Additionally, all personnel matters are also confidential,
so I am unable to elaborate any further than to say that the correctional
officers involved in the incident remain with the Department of Correction.
Based upon the pending litigation, any additional comment would be
inappropriate." Biden, who was not willing to be interviewed for this story,
said through a spokesman that his office declined to prosecute any guards. He
wouldn't say why no charges were filed or elaborate about the case. "The
Delaware Department of Justice reviewed this case in April 2007," said spokesman
Jason Miller. "As a result of our review, we determined that no criminal charges
would be filed." As to whether the type of assault Kalm alleged constitutes a
crime in Delaware, Miller wouldn't say. "That's the extent of our statement," he
said. When Biden's office investigates a state agency, it creates an immediate
conflict of interest, according to Dover attorney Steve Hampton, who filed
Kalm's lawsuit Monday. Hampton has represented several inmates or their
survivors in civil suits against the DOC. "They're investigating the same people
they'll be defending if a civil suit is filed," he explained. "Every attorney
knows it's unethical, but it's what we ask the AG's office to do all the time.
They get an [internal affairs] complaint, go after the guards, but then defend
them during a civil suit." A 'mental health history' -- According to the
complaint, Kalm was an inmate in the Sussex Correctional Institution in October
2006, serving a 60-day sentence for DUI. Kalm has struggled with alcohol most of
his adult life. In 2006, he was charged on three separate counts of driving
under the influence. In prison, according to documents filed in Kent County
Superior Court, the medical contractor Correctional Medical Services was on
notice that Kalm had a "mental health history and the likelihood that he was
suffering from alcohol withdrawal." Kalm -- who is legally disabled -- has a
heart condition, high blood pressure, stomach problems and arthritis in his
spine that aggravates his sciatic nerve, causing intense, shooting pain down his
leg, according to his medical records. His lungs were damaged while serving in
the merchant marine, so he uses a "breathing machine" daily to treat a condition
similar to asthma. He was admitted to the prison's infirmary for this breathing
disorder and hypertension. "While he was in the infirmary, the Plaintiff was
essentially in isolation. His anxiety and depression increased daily," the
complaint states. "Despite the fact that neither his mental health issues, nor
his alcohol withdrawal, had been adequately addressed or treated, the CMS
medical staff released Plaintiff from the infirmary to the general population."
Suffering from alcohol withdrawal, which was exacerbated by his mental health
issues, Kalm did not fare well in the general population. Guards and medical
staffers noted his peculiar behavior, but according to the complaint, no one
"took appropriate steps to treat his severe mental health problems and alcohol
withdrawal." "The basic problem is there was no medical protocol in place for
dealing with people suffering from withdrawal or having severe mental health
issues," Hampton told The News Journal, adding that he has deposed several
corrections CMS staffers about conditions at the prison. "The guards have no
training at all in mental health issues," he said. "And CMS is supposed to have
protocols for mental health and alcohol withdrawal, but they don't have them."
Kalm's condition worsened until the evening of Oct. 6, 2006. Guards noted in
their logs he was "displaying anxiety and paranoia." They wrote that he was
acting funny and saying that "someone was going to hurt him." Rather than taking
the inmate to the infirmary, the guards ordered Kalm back to his cell. Kalm
didn't want to go, and a struggle ensued. "During the struggle, Plaintiff
grabbed a cord from a computer monitor for support, causing it to fall on C/O
Lawson cutting his temple," the complaint states. Kalm told a reporter that he
grabbed the supervisor's desk to avoid being sent to a cell. "Then the door
flies open and a whole pile of guards run in, spray me with Mace and start
punching me," he said of the incident last year. "I grabbed onto a computer and
the wires. When they're dragging me out of there, the computer comes off the
desk and hits a guard."
September 17, 2008 AP
A shackled inmate serving a life term for attempted murder escaped from a
private security guard while getting off a commercial flight at Philadelphia
International Airport, police and corrections officials said. Delaware
Department of Corrections officials said they were notified Sunday about Friday
night's escape of Taariq Ali, 43, and the department has suspended all
interstate transport of prisoners until it determines how the escape occurred.
Philadelphia airport police said Ali was still at large Tuesday. Following the
escape, Delaware's corrections commissioner, Carl Danberg, also activated an
emergency response team to aid in search for Ali. Thor Catalogne, a spokesman
for Prisoner Transportation Services of America, the Nashville, Tenn., company
that was transporting Ali, referred all questions to Delaware corrections
officials. Ali was able to escape despite being handcuffed to a waist chain and
was last seen wearing a white T-shirt and khaki pants, the Department of
Corrections said. Ali was convicted of attempted murder in Delaware in 1995 and
was sent to California under a prisoner exchange agreement. He was being
transported back to Delaware when he escaped, the department said. Corrections
spokesman John Painter said transfers have been stopped "because there's
entirely too many unanswered questions about how this happened." Painter said
the delay in reporting the escape was among the department's concerns. The
corrections spokesman said there have only been 10 such transfers since 2004,
all of which have gone without incident except for Friday's escape. The
transfers are usually made because of "real or perceived security threats."
Painter said he was not aware of any other problems with the company, adding the
department uses outside contractors because it is not authorized to move
prisoners across state lines. The company was also involved in a January 2007
escape in which an inmate later stole a tractor-trailer in an attempt to see his
dying mother.
July 30, 2008 News Journal
Continued poor performance by the Department of Correction's medical vendor is
harming the department's efforts to get out from under supervision by the U.S.
Justice Department, according to the third report by the independent monitor
overseeing the state prison system. Correctional Medical Services, a private
company Delaware is paying $39 million this year to provide medical care to
inmates, suffers from a "lack of stable and effective leadership," independent
monitor Joshua W. Martin III wrote in a 221-page report released Tuesday. The
findings are similar to what Martin described in the 229-page report he released
in January. "The Monitoring Team has found that the lack of stable and effective
leadership at the vendor-level remains a concern," Martin wrote. "As the
monitoring team emphasized in the second report, without stable and effective
leadership, the state will be significantly hampered in its attempts to become
compliant with the [Memorandum of Agreement between the Justice Department and
the State of Delaware]." The leadership at CMS is anything but stable. Martin
found that the director of nursing position at the Vaughn Correctional Center,
formerly known as the Delaware Correctional Center, has "turned over three times
in the past year." Also at Vaughn, 75 percent of sick call records reviewed by
the monitors showed that "patients were either not seen in a timely manner or at
all." When the nurse practitioner at the Young Correctional Institution -- the
sole primary-care provider for 700 inmates -- went on vacation, there was no
coverage for two weeks other than for emergencies. "This lapse is not acceptable
and clearly impacted access to care," Martin found. "Specifically, stable and
effective leaders will improve the State's performance by taking responsibility
for ensuring that those staff members that they supervise are performing
adequately," he stated in his report. "Also, stable and effective leadership
will ensure institutional knowledge of appropriate practices according to the
State's policies and procedures." Both reports are replete with horror stories
caused by staffing concerns and ineffective or nonexistent leadership by the
medical vendor. When a licensed practical nurse was running sick call at the
Sussex Correctional Institution -- a practice that contravenes prison rules and
regulations -- she mistakenly recorded an inmate's complaint of "scrotal pain"
on the wrong form, one used for musculoskeletal assessment. As a result, the
nurse "did not perform an appropriate patient history or physical examination
that was pertinent to the complaint," the report states. No LPN should be
conducting sick call, Martin stated in his report. Assessing inmates' medical
and mental health complaints requires the skills of at least a registered nurse.
Despite the prohibition, LPNs routinely perform sick call at Delaware prisons,
the monitoring team found. Additional vacancies at Sussex Correctional, Martin
found, "have resulted in a waitlist for inmates for routine mental health
referrals, which is approximately 100 inmates long. In addition, routine 30-day
visits for mental health caseload inmates are not occurring." Also at Sussex
Correctional, the report indicates a patient "had requested to be seen by a
doctor five times before he was seen. The day after the physician saw him, he
was admitted to the hospital in acute renal failure and is currently undergoing
dialysis." 'Best interest' to keep vendor -- Martin, a Wilmington attorney and
former judge, was selected by the Department of Correction and the Justice
Department to serve as the state's first independent prison monitor. Martin
oversees efforts by the Department of Correction to satisfy a settlement
agreement with the federal government over "substantial civil rights violations"
in four state prisons. Martin declined to be interviewed for this story, as did
Delaware Gov. Ruth Ann Minner and CMS corporate spokesman Ken Fields. In a
written statement, Fields said his firm "values the substantive feedback
provided by the monitoring team in Delaware. We will continue to collaboratively
work with the Delaware Department of Correction and the monitoring team to
evaluate progress as part of our ongoing efforts to enhance inmate healthcare
services." "CMS looks forward to building on the progress made with DOC to
enhance the healthcare system and deliver quality care to inmates housed in
Delaware facilities," Fields wrote. Department of Correction Commissioner Carl
Danberg has no plans to boot CMS from his prisons. "We've got a window of
opportunity to try to correct the medical problem within the framework
negotiated with the U.S. Department of Justice," Danberg said. "We believe it's
in the best interests of the state of Delaware to keep CMS in place. Changing
vendors now would hinder my ability to comply with the agreement." He described
the results in Martin's report as "mixed." "The monitors very clearly expressed
pleasure with some progress they saw, particularly at [Young Correctional
Institution], and they expressed concern in other institutions, particularly at
[Vaughn Correctional Center] and [Sussex Correctional Institution]," he said.
"As you would expect when you start out where we were, as you improve you get
mixed results." 'It's been this way for years' -- Dover attorney Steve Hampton,
who has represented inmates and their families in lawsuits against the
Department of Correction, said the system needs to be fixed, not monitored.
"They're monitoring the constant failure of CMS to provide adequate care, but
they're not doing anything about it," Hampton said. "Everybody in the system
knows it's been this way for years. I don't see the point of monitoring it if
they're not going to do anything about it." Hampton represented the family of
Anthony Pierce, who became known as "the brother with two heads" as an inmate at
Sussex Correctional Institution because of a large tumor growing on his head.
Pierce, who was being treated by CMS staff, died from the brain tumor in 2002.
Hampton regularly receives letters and calls from inmates about health care
concerns. "I'm still getting complaints of people getting tumors. Everything is
just as bad as it ever was," he said. "There's still not enough staff, and if
they get someone who seems like they want to do a good job, they get run off."
Problems with prison health care and high inmate death rates, especially from
AIDS, were examined by The News Journal in a series published in 2005. In March
2006, the Justice Department's Civil Rights Division launched its probe. Minner
tried unsuccessfully to derail the federal investigation. Her legal counsel at
the time, Joseph C. Schoell, sent a letter to U.S. Attorney General Alberto
Gonzales calling The News Journal's series "misleading." In December 2006, the
Justice Department and the State of Delaware entered into the memorandum of
agreement, which requires the state to take measures to ensure that adequate
medical and mental health care is provided to its inmates. Pleas for help
rebuffed -- Several inmates have written Martin letters describing poor
conditions of care within the state prisons he oversees. The News Journal
obtained several copies of the form letters Martin sends back to the inmates,
rejecting their pleas for help. "Due to my role as independent monitor, I am not
able to offer legal advice or act as an advocate for individual inmates," the
letters state. "Therefore, I am unable to provide you with any direct assistance
in response to your letter." The Rev. Christopher Alan Bullock helped found the
Delaware Coalition for Prison Reform and Justice. While the prison health care
advocacy group has achieved many of its goals, Bullock said, the group continues
to meet when they need to. He said he is also in contact with Martin. "I'm in
full agreement with Judge Martin and his team," Bullock said. "Though we are
disappointed, this delay does not mean there will be a denial ultimately for
change at the CMS level. We need a new vendor. Until we get a new vendor, the
ultimate change will not happen until CMS is removed."
April 5, 2008 News Journal
Fifteen current and former inmates at Young Correctional Institution filed a
federal lawsuit Friday alleging their medical care while behind bars was not
only negligent but amounted to cruel and unusual punishment. In at least one
incident in 2006, a prison health care contractor allegedly used the same needle
on multiple inmates, perhaps all 15, to draw blood and inject medicine --
exposing all to blood-borne diseases including hepatitis C and possibly
HIV/AIDS. At least three allege they have contracted hepatitis and possibly
other illnesses since that incident. Attorney Joseph M. Bernstein, who along
with attorney Bruce Hudson is representing the 15, said he didn't know whether
the woman identified in the lawsuit as "Nurse Beth" used the same needle to save
money, because the prison hospital was short on supplies that day, because she
made a mistake, or for some other reason. "Legally, it doesn't matter," said
Bernstein. "They were still entitled to a minimum level of care." And just
because a person is in prison, there is no lower level of acceptable care, he
said. Although inmate Duane J. Williams was not named in the lawsuit, his family
says the exposure led to the 32-year-old's death last month. Ken Fields, a
spokesman for the prison's medical contractor, St. Louis-based Correctional
Medical Services, said Friday the company was aware of the allegations in 2006
but said there was no evidence the nurse did what the lawsuit charges. He added
that even if such a thing happened, it was unlikely -- and there is no evidence
-- that any infection actually resulted. He acknowledged that the company did
contact patients and offer follow-up blood testing, but said it only did so as a
precaution because of the serious nature of the allegations against the nurse.
Department of Correction officials did not return calls for comment Friday. The
Rev. Christopher Bullock, senior pastor of New Canaan Baptist Church and
co-founder of the Delaware Coalition for Prison Reform and Justice, said Friday
the acts of the nurse and her employer CMS were potentially criminal. "We must
decry this kind of behavior. It is not acceptable," he said. Bullock said the
situation described in the lawsuit reminded him of the Tuskegee experiments in
which hundreds of poor black men in Alabama were allowed, without knowing it, to
suffer and die from syphilis by government doctors who were studying the
disease's progression. He said inmates deserve to be treated humanely and their
families should not have to put up with this kind of pain and anguish. The 15
inmates who filed the lawsuit were at various stages in the criminal justice
system when they were exposed, Bernstein said. Some were being held for
probation violations, some were serving sentences for drug violations or crimes
such as theft, and some were being held pending a trial. Some have since gotten
out of jail, but most remain incarcerated, Bernstein said. Normally, he said, a
lancet is used to test a diabetic's blood, then a separate syringe is used to
administer the insulin. Neither is supposed to be re-used. In this case, the
inmates allege, the nurse used the syringe to test their blood, then used the
same syringe to administer the insulin -- potentially contaminating the
multi-use vial. She then re-used the syringe in the same way with other inmates,
potentially compounding the spread of blood-borne disease. The 15 inmates say
their rights were violated and are seeking compensatory and punitive damages and
changes in prison medical care to prevent a repeat of the incident. Attorneys
for the plaintiffs provided a copy of a memo given to the inmate patients
sometime in the summer of 2006, which appears to acknowledge some kind of
contamination incident. The "Patient Information Sheet" states a nurse "may
have" used the same hypodermic needle to draw blood and to administer insulin,
in violation of policy. "A few other inmate patients are now making the same
claim," it states, with a handwritten notation adding that some have tested
positive for hepatitis. The memo offers the inmates a blood screening to check
for infection and says the unnamed nurse denied the charges and had left her job
at Young Correctional. Bernstein said some of his clients who agreed to the
blood screening were never told the results. Harry Williams, the brother of the
inmate who died last month at a Philadelphia hospital, said Friday that his
brother Duane, who was a diabetic and serving a three-year sentence on a drug
and a weapons charge, had received the same Patient Information Sheet and that
"Nurse Beth" was involved in his treatment in 2006 at Young Correctional
Institution, formerly known as Gander Hill. Some 46 other diabetic inmates were
treated from the same multi-use vial. Six subsequently tested positive for
hepatitis, although prison officials said they could not definitively state that
the illness was linked to the allegedly contaminated insulin. One month before
the earliest date of alleged contamination, in March 2006, the Justice
Department's Civil Rights Division launched an investigation of inmate health
care in Delaware. That federal involvement followed a series of stories
published in The News Journal detailing abuses and problems with inmate health
care. The state later signed a settlement agreement with federal authorities
promising to revamp and reform the prison health care system. In February of
this year, a report on the progress of that reform by former Superior Court
Judge Joshua W. Martin III gave the state and CMS poor grades. Bullock said
Friday that CMS and its "incompetent and unethical" practices have to go. "The
coalition will again be calling for the removal of CMS and we will be doing
whatever is necessary -- demonstrations, protest marches -- to bring justice to
an unjust system. Someone must be held accountable. We are talking about the
lives of human beings," he said.
March 13, 2008 News Journal
An inmate mistakenly exposed to blood-borne diseases died Wednesday, months
after his initial complaints of abdominal pain were ignored, his family says.
"If I die, it's because of the prison," Duane J. Williams said just before he
died, according to his brother. In 2006, a prison nurse administered a
contaminated insulin shot to Williams. Because he wasn't tested for a variety of
diseases and viruses prior to his incarceration for drug and weapons' offenses,
it may never be known whether exposure to hepatitis, HIV and other infections
contributed to his liver problems. But the prison medical staff's failure to act
quickly when pain first developed, his family says, was a deadly mistake. "When
I came into his room for the last time, I actually saw his breath leave his
body," said Harry Williams Jr., Duane's brother. "I told him it was OK to let
go. I saw the life go out of him. He's at peace. He is free now. He is
definitely free." Four days before he died, Duane Williams, 32, told The News
Journal that he first felt a pain in his gut over four months ago but the pain
wasn't taken seriously until this month when a prison guard noticed Williams'
eyes were turning yellow. The officer demanded that a nurse or doctor provide
treatment or transfer the inmate to a hospital. Williams was taken to Wilmington
Hospital and then Philadelphia's Albert Einstein Medical Center, where he died
at approximately 1:30 a.m. His family requested an autopsy, but the exact cause
of death remains unknown. "One of the doctors said he had acute hepatitis," his
brother said. "But no one is telling us anything official." "He didn't deserve
this," wife Megan Williams said through tears. "I will miss him very, very
much."
March 9, 2008 News Journal
Gander Hill inmate Duane J. Williams is clinging to life in a Pennsylvania
hospital, his eyes bright yellow from near-total liver failure. Severe abdominal
pain, which he first reported over four months ago, wasn't taken seriously by
the prison's medical contractor, Correctional Medical Services, until last week,
he says. When a corrections sergeant noticed Williams' eyes, the officer
demanded that CMS staff provide treatment or transfer the inmate to a hospital.
Ten days ago, the inmate was taken to Wilmington Hospital, where he waited for a
week before being transferred to Philadelphia's Albert Einstein Medical Center
on Thursday night for specialized treatment. A diabetic, Williams was exposed to
blood-borne diseases such as hepatitis in July 2006, when a former prison nurse
drew insulin from a multidose vial with a syringe she had earlier used to obtain
a blood sample from another inmate. The nurse, who resigned after the mistake
was discovered, delivered insulin from that vial to Williams and 46 other
diabetic inmates. Six have since tested positive for hepatitis, although prison
officials can't definitively link their illnesses to the contaminated insulin.
Most of the inmates, including Williams, were not tested for hepatitis before
the exposure. To Williams, none of this matters. "My liver's failing me," he
said. He doesn't know how long he will live if he doesn't get a transplant.
"They won't tell me straight out," he said. Like the other exposed inmates,
Williams has lived with the possibility he contracted hepatitis or HIV from the
insulin shot. Because viral infections can take months to appear, nurses
conducted a series of blood tests in 2006 to monitor the inmates' health.
Williams, 32, was retested last week at Wilmington Hospital, but he says doctors
tell him they don't know what caused his liver to fail. While hepatitis C can
cause liver failure, it typically takes longer between exposure and failure than
what Williams has experienced, according to Dr. Robert Fontana, an associate
professor of internal medicine and medical director for liver transplant at the
University of Michigan in Ann Arbor. The rarer former of hepatitis B, also can
lead to liver failure, and progresses much quicker. Other medical circumstances
can shorten or lengthen the progression of either strain. Sentenced to three
years for drug and weapons offenses, Williams is dying six months before his
scheduled September release. "He wasn't sentenced to death," said his mother,
Teri Williams.
February 1, 2008 News Journal
Continued poor performance by the Department of Correction's medical vendor
could hamper the department's efforts to get out from under supervision by the
U.S. Justice Department, according to a new report by an independent monitor
overseeing the state prison system. Correctional Medical Services, a private
company Delaware pays millions of dollars a year to provide medical care to
inmates, suffers from a "lack of stable and effective leadership," independent
monitor Joshua W. Martin III wrote in a 229-page report released Thursday.
"Moreover, there has been consistent turnover at staff-level positions, and, at
[Young Correctional Institution] in particular, there is a problem with staff
insubordination that needs to be addressed because it affects inmate medical and
mental health services negatively," Martin wrote in his report. "The Monitoring
Team has also faced difficulty in receiving consistent and accurate information
from CMS." While Martin found that the DOC has made some improvements, he
concluded that many CMS staff lacked proper credentials or were working outside
their areas of expertise: At the Delaware Correctional Center near Smyrna, a
pathologist is practicing general medicine. The monitoring team also found that
for three months last year, no inmate at the Smyrna prison received a referral
to an outside specialist because "the person who was assigned to schedule
appointments for inmates was on sick leave, and CMS had failed to find a
temporary replacement." Inmate medical files were found stashed in boxes, while
others were out of date, doctored or missing. At the Baylor Women's Correctional
Institution, a book used to keep track of inmates suffering from highly
contagious flesh-eating bacteria was lost, the data irretrievable. Lisa Williams
got out of the women's prison two weeks ago after spending six days there
awaiting extradition to Maryland on a theft charge. Williams was burned over 60
percent of her body when she was a child, after a lighter she was playing with
set her dress on fire. Now 31, she dehydrates easily because of the burns. When
she overheated in a holding cell with 13 other women, just getting to the prison
infirmary was difficult. "I put in a sick call slip, but it was four days before
it was addressed," she said. The CMS nurse gave her an ice pack. "She said I was
just a crackhead withdrawing," Williams said. "I'm not on drugs. I was very
sick. They assume everyone's a crackhead. I saw a girl have a seizure in the
cell. They made her walk to the infirmary, once she stopped." 'Lack of
supervision' -- According to Martin's report, on several occasions the monitors
were told about a practice or procedure staff believed was being adhered to, but
"it often turns out that such practice or procedure is not, in fact, being
followed in spite of the belief of the individual providing information. This is
symptomatic of a lack of supervision of staff, and poor or nonexistent
self-monitoring. The Monitoring Team recommends that CMS begin to self-monitor
for compliance with DOC policies as soon as possible so as to be able to assess
its own compliance, and provide the Monitoring Team with reliable information."
CMS corporate spokesman Ken Fields refused to be interviewed for this story. "I
am not going to respond to any specifics," he said. Fields also refused to allow
CMS employees working in Delaware to be interviewed. "Our healthcare staff are
focused on patient care rather than dealing with news media," he said in an
e-mail. The "report shows clearly that, working together, the Delaware
Department of Correction and CMS have made a great deal of progress enhancing
the inmate healthcare system. The report also notes there is more to be done."
Department of Correction Commissioner Carl Danberg said the monitor's report was
"fair and balanced." "I've made it clear to CMS that I am not satisfied with the
pace of progress, but CMS has been working cooperatively with us, and I will
continue to hold them to the terms of the contract, and push for total
compliance," Danberg said. Danberg's fiscal year 2009 budget proposal includes
$40 million for inmate medical care -- $38 million for CMS. A call for change --
Inmate advocates have urged Minner and other state leaders to sever the state's
contract with CMS. Danberg would not say if that is an option. "I will consider
any change that I believe will lead to improvement of medical care, but at the
moment, I'm not prepared to discuss the potential for changing vendors," Danberg
said. Martin, a Wilmington attorney and former judge, was selected in May by the
Department of Correction and the Justice Department to serve as the state's
first independent prison monitor. Martin oversees efforts by the Department of
Correction to satisfy a settlement agreement with the federal government over
"substantial civil rights violations" in four state prisons. Martin declined to
be interviewed for this story, as did Delaware Gov. Ruth Ann Minner. In
preparing his report, Martin, together with a team of medical and mental health
professionals, reviewed Department of Correction policies and procedures,
record-keeping, medication and laboratory orders, staffing and training,
screening and treatment, access to care, chronic disease care, medication
management, emergency care, mental health care, suicide prevention and quality
assurance. According to the mandates of the settlement agreement, the monitors
must gauge compliance with 217 provisions. The settlement agreement, signed by
Danberg, who at the time was Delaware's attorney general, and former Correction
Commissioner Stan Taylor, called on the state to revamp its prison health care
system and to report its progress regularly to the Justice Department. The
agreement remains in effect for three years, although the state can get off
earlier if it achieves "substantial compliance" with each portion of the
agreement. Martin found the state failed to comply with 17 of 217 total
provisions, and was in substantial compliance with 31 of the 217. The state was
said to be in partial compliance with the remainder of the requirements. "The
assessment of partial compliance that the Monitoring Team has used is a very
broad designation and in some instances reflects minimal progress that the State
has made in eliminating the constitutional deficiencies that motivated the
parties to enter into [the settlement]," Martin wrote. Advocates, families
dismayed -- Prison reform advocates, former inmates and their families didn't
need Martin's report to reinforce their belief that inmate medical care in
Delaware is poor. Francine Wright, whose son died while an inmate, said she
continues to hear complaints from families who have imprisoned family members.
"The medical care is not up to par," Wright said. "People are still not getting
their medical treatment." Wright's son, Darnell Anderson, was serving a
four-year sentence when he was taken to Wilmington's St. Francis Hospital in
2004. During his hospitalization, doctors learned Anderson had pneumocystis
carinii pneumonia, an AIDS-related infection that is usually preventable and
treatable when caught early. He died at St. Francis. "They need to fire the
people over there who are not doing their job," Wright said. Dover attorney
Steve Hampton, who has represented inmates and their families in lawsuits
against the Department of Correction, said the problems outlined in Martin's
report should come as no surprise to DOC officials. "Even with the monitor in
place, very little real improvement is taking place," Hampton said. "Our state
government officials have turned a blind eye to widespread human rights
violations in a program for which they have oversight. It seems that they are
not going to seriously address the problems at DOC unless forced to by the
Justice Department." Hampton represented the family of Anthony Pierce, who
became known as "the brother with two heads" as an inmate at Sussex Correctional
Institution because of a large tumor growing on his head. Pierce, who was being
treated by CMS staff, died from the brain tumor in 2002. The state settled a
wrongful-death lawsuit in a confidential agreement last year. Public health at
risk -- "This report tells me that the state is continuing to pay tens of
millions of dollars for a health care program that routinely breaches the
applicable standards of medicine, violates the human rights of inmates and puts
us all at risk of serious infectious diseases," Hampton said. "The prisons have
become incubators for all sorts of diseases such as MRSA, TB and hepatitis.
These diseases are not stopped by prison walls. Allowing them to flourish in
prison means they will eventually flourish on the outside." Problems with prison
health care and high inmate death rates, especially from AIDS, were examined by
The News Journal in a series published in 2005. In March 2006, the Justice
Department's Civil Rights Division launched its probe. Minner tried
unsuccessfully to derail the federal investigation. Her legal counsel at the
time, Joseph C. Schoell, sent a letter to U.S. Attorney General Alberto Gonzales
calling The News Journal's series "misleading." The Rev. Christopher Bullock, a
founder of the Delaware Coalition for Prison Reform and Justice, said it was
time for the state to terminate its contract with CMS. "Until CMS is replaced
with a Delaware group -- for Delaware from Delaware -- there will be no
significant or sustainable change," he said. "It's now time for the state to act
in the best interest of Delaware and our reputation in this country."
January 4, 2008 News Journal
A former inmate who successfully sued the medical contractor for the state's
prison system, without an attorney, has resolved his case out of court. Richard
Mark Turner, 52, charged that Correctional Medical Services failed to provide
him with adequate care in 2001 and 2002 to treat his hepatitis C. Attorney
Jeffrey K. Martin, who is now representing Turner, said the resolution with CMS
was "amicable" but confidential. He said Turner was pleased with the result. CMS
spokesman Ken Fields said the case was settled to "to avoid further litigation."
Neither side would say if Turner received money as part of the resolution. In
March, District Judge Sue L. Robinson ruled in Turner's favor before his civil
case went to trial, stating the undisputed evidence showed Turner's care was
"obviously inadequate" and violated his rights. The result stunned legal
observers because Turner won the case without formal legal assistance. At the
time he filed the case, in 2003, Turner demanded $14.9 million. Martin joined
the case several weeks after Robinson's ruling. The two sides agreed to settle
the case following mediation sessions with Magistrate Judge Leonard Stark in
late November and Tuesday entered a stipulation with the court to drop the case.
In her March ruling, Robinson said CMS employees did not adequately instruct
Turner on how to give himself injections of Interferon -- a form of chemotherapy
-- and then "turned a blind eye" when they saw him improperly injecting himself
three times a week for seven months. According to court papers, Turner injected
himself in the same spot rather than in different locations -- as medically
recommended -- resulting in serious infections. Martin said his client continues
to suffer significant health problems as a result. Turner had been in prison on
assault and reckless endangerment charges. He was released in 2006 but several
months later ended up in a Pennsylvania prison on assault charges. Martin said
Turner was released on the Pennsylvania charges in September and now lives in
Sussex County. Turner has a second civil case pending in federal courts -- filed
in 2006 -- alleging subsequent medical negligence by the state and CMS related
to the infections. Turner also filed that case on his own, but Martin has agreed
to now represent him in that matter as well.
July 6, 2007 News Journal
The state’s new prison monitor released his first semi-annual report today,
which is highly critical of Correctional Medical Services, the Department of
Correction’s medical contractor. In May, Joshua W. Martin III, a Wilmington
attorney and former judge, was selected by the Department of Correction and the
U. S. Department of Justice to serve as the state’s first independent prison
monitor. As such, Martin will oversee the efforts made by the DOC in satisfying
a settlement agreement with the federal government following an investigation
that revealed “substantial civil rights violations” in four state prisons.
Martin, together with a team of medical and mental health professionals, is
monitoring Department of Correction policies and procedures, record keeping,
medication and laboratory orders, staffing and training, screening and
treatment, access to care, chronic disease care, medication management,
emergency care, mental health care, suicide prevention, and quality assurance.
In addition, the team is providing technical assistance to assist the department
with reaching or sustaining compliance with certain of the requirements under
the memorandum of understanding. Martin spells out that his team’s compliance
checks are in their initial stages, with more detail to come in subsequent
reports. “This report primarily summarizes the obligations of the state under
the MOA, the preliminary observations and recommendations the Monitoring Team
has regarding the state's compliance with the MOA, and the monitoring team's
plan of action for the coming months,” Martin stated in his report. However, the
team did identify several problem areas, such as poor sanitation and chronic
understaffing by Correctional Medical Services. “Staffing by the state's medical
vendor, Correctional Medical Services, of its leadership positions is a serious
concern,” the report states. “Without adequate and consistent leadership, it is
very difficult for the state to implement and maintain the changes necessary to
comply with the MOA.” The reason for the understaffing, Martin’s team
discovered, was an unwillingness by Correctional Medical Services to spend
money. “It is the monitoring team's understanding that CMS has had difficulty
finding appropriate individuals to fill leadership positions. The monitoring
team also has received information that tends to indicate that CMS' regional or
national management has not been willing to take such measures as offering
relatively small increases in pay in order to attract and retain individuals
that would be qualified to fill the vacant positions, nor has CMS' regional or
national management been particularly supportive of facility-level CMS
management regarding staffing concerns.” Dover lawyer Steve Hampton represents
several inmates and their families, including the young daughter of Anthony
Pierce, who became known as "the brother with two heads" as an inmate at Sussex
Correctional Institution. Pierce, who was profiled in a series of articles by
The News Journal, was serving a 14-month sentence from an attempted burglary.
“They’ve identified some problems such as horrible sanitation and understaffing,
which are well known to anyone in the system,” Hampton said. “The question is,
what’s being done about it. I don’t see any details. It’s just another report
that describes deficiencies.” For six months in 2005, The News Journal examined
conditions of care within the state’s prisons. In late September that year, the
newspaper published a series of stories highlighting the findings in a special
report.
March 31, 2007 News Journal
The contractor handling medical services for state prisons violated an inmate's
constitutional rights in 2001 and 2002 through "obviously inadequate" care,
according to a federal judge. Chief Judge Sue L. Robinson further found the
evidence was so overwhelming that she granted inmate Richard Mark Turner's
motion for summary judgment, meaning he has won his case without a trial. What
makes the ruling even more remarkable, according to legal experts, is that
Turner, 51, got the ruling in a lawsuit that he filed and argued without an
attorney. "This is a very rare event," said Elizabeth Alexander, director of the
American Civil Liberties Union's National Prison Project. Turner, who is now
incarcerated in Bellefonte, Pa., could not be reached for comment. Prison
officials and officials with Correctional Medical Services said Friday they had
not read the ruling, handed down late Wednesday, and therefore could not respond
directly to it. "We intend to review the judge's ruling in detail before taking
any additional action," CMS spokesman Ken Fields wrote in an e-mail Friday. He
also noted the case involves events that are more than five years old, a time
when less was known about the treatment of hepatitis C, which Turner had. The
U.S. Department of Justice found "substantial civil rights violations" in
Delaware prisons last year, following a 2005 News Journal series on prison
medical care documenting abuses in the prison. In December, the state signed a
settlement agreement with federal investigators, promising to correct the
problems. On Friday, Corrections spokeswoman Gail Stallings Minor said the
department is continuing to address every issue identified in the report.
According to Robinson's ruling, Correctional Medical Services violated Turner's
rights when its employees failed to adequately train him in how to use a syringe
to inject himself with Interferon -- a form of chemotherapy -- to treat his
hepatitis C and "turned a blind eye" when they observed him improperly injecting
himself three times a week for seven months. Turner injected himself in the same
spot rather than in several different locations as recommended by the
information sheet included with the medicine. As a result of the improper
injections, Turner developed a serious infection, according to court papers.
January 16, 2007 News Journal
Legislation that would guarantee public access to any state agency report
that was paid for with public money was released from a House committee today,
on track for possible action by the full house this month. House Bill 5,
sponsored by Rep. Nancy Wagner, R-Dover North, is virtually identical to
legislation that passed the House unanimously last year but died in the Senate
for lack of action. It was prompted by the Department of Correction’s refusal to
release a performance audit of Correctional Medical Services, the contractor
that provided medical services to the state’s prisons. State officials refused
to release the audit saying to do so would reveal private medical information
that federal privacy laws preclude from disclosure. The state also refused to
release a redacted version of the audit that would have removed patient
identities while retaining the audit's conclusions regarding CMS' performance.
John Flaherty, lobbyist for Delaware Common Cause, told the House Sunset/Policy
Analysis & Government Accountability Committee that House Bill 5 “essentially
makes public what is already public.”
January 13, 2007 The News Journal
Demetrius Caldwell, a 24-year-old drug dealer, had been undergoing unspecified
treatment for a month in the state's newest prison infirmary before he was found
dead this week, laying on a mattress on the floor of his infirmary cell. A
medical staffer had checked on him 25 minutes before he died. Prison officials
ruled out meningococcal meningitis as the cause of death Friday, after naming it
as a possibility Thursday evening. A less virulent strain of meningitis remains
a slight possibility. "Everything's negative," said James Welch, the Department
of Correction's health services administrator. "There's no trauma, no heart
problems, no brain tumor. We're still waiting on toxicology. We can't find
anything. We're as concerned as anyone else is." The length of time Caldwell
spent in the state's prison infirmary and the lack of an explanation for his
death point to the same medical deficiencies that prompted the U.S. Justice
Department last month to find "substantial civil rights violations" in four
Delaware prisons, said Senate Minority Leader Charles L. Copeland, R-West Farms.
The federal investigation was prompted by a series of articles in The News
Journal that revealed inadequate health care and questionable treatment within
the prisons. In their report, federal prison regulators found "consistent
backlogs with the respect to the treatment of chronic care inmates." Any inmate
who has been in the infirmary for a month meets the "chronic care" definition
and should have been taken to a private hospital, said Copeland, one of the
co-founders of the Delaware Coalition for Prison Reform and Justice. "Someone
should have recognized that the prison infirmary was not the place for him to
be," he said. "The fact they failed to identify that re-emphasizes the
legitimacy of the constitutional violations of prison health care performance."
Federal investigators, who negotiated an 87-point settlement with the state to
improve prison medical care, declined to comment about Caldwell's death.
Correction commissioner nominee Carl Danberg said Friday that doctors from
Correctional Medical Service, or CMS, the prison's contract medical provider,
along with the Department of Correction's medical team, the Chief Medical
Examiner's Office and Public Health are reviewing the case. "Additional outside
expertise might be sought, depending upon what we find in the tests that are
still pending," Danberg said. "We are following Department of Correction
procedures and following Delaware law for a death in custody. All information is
being turned over to the Medical Examiner."
December 31, 2006 The News Journal
Delaware Correctional Center near Smyrna is among the Delaware prisons
looking at major changes in inmate health care after an investigation by the
U.S. Department of Justice found the prison system guilty of civil rights
violations. It's been more than a year since a coalition of concerned citizens,
lawmakers and clergy marched on the governor's mansion and knelt in prayer
asking for better health care for inmates in Delaware's prisons. They were
galvanized by horrific conditions outlined in a series of stories in The News
Journal, the first of which appeared in late September 2005 -- a series
Correction Commissioner Stan Taylor charged was "sloppy reporting" in a
five-page response the newspaper published. What's happened since will bring
groundbreaking changes to Delaware's prison system: • On Friday, following a
nine-month investigation, the U.S. Department of Justice announced that federal
investigators found "substantial civil rights violations" inside four Delaware
prisons. For example, the report noted, flesh-eating bacteria inside Gander Hill
prison went undiagnosed and untreated, placing "inmates and staff at risk of
acquiring the infection and passing it to others in the community." • Taylor and
Attorney General Carl Danberg signed an 87-point agreement with the federal
government that calls for sweeping changes in Delaware's penal institutions. The
state promised to correct the deficiencies and "meet generally accepted
professional standards." However, the state did not admit to violating any
inmate's civil rights or breaking any other federal law. • The 55-year-old
Taylor, who's served the past 11 years as commissioner, announced this month
that he will retire on Feb. 1. On Saturday a prison spokeswoman announced that
Paul Howard, Taylor's longtime bureau chief of prisons, is retiring the same
day. Prison spokeswoman Gail Minor Stallings said Howard's departure had nothing
to do with the federal report that orders the state to completely renovate its
prison health care system. • Trial lawyers say the damning federal findings will
serve as a road map for inmate lawsuits against the state. • Senate Minority
Leader Charles Copeland, R-West Farms, said Saturday the federal government
might have taken a "wait and see" approach, if the state had reacted once
concerns about inmate care were first raised by the newspaper, and by the
citizen coalition he co-founded. "If there had been a positive response from the
state, the feds might have not felt the need to be the hammer," said Copeland,
who estimates that changes ordered by the Justice Department will cost $20
million to $30 million more than the state already spends annually on prisons. •
House Majority Leader Wayne Smith, R-Clair Manor, said he was disturbed about
the agreement being signed in secret. "I am troubled that we (lawmakers) were
not consulted about something this important. By signing this, the governor and
the attorney general have obligated the state to spending money without the
General Assembly's consent -- and I think we should have learned about this from
them, rather than from a reporter." Copeland wasn't alone in suggesting that had
state officials acknowledged serious problems existed, rather than denying their
existence, the pain and suffering among inmates and their families -- as well as
the final cost of taxpayer dollars -- would not have been as high. Sen. Karen
Peterson, D-Stanton, an early backer of the federal probe who wrote a letter in
support of the investigation to U.S. Attorney General Alberto Gonzales, said
it's not as though the state pleaded no-contest to the federal charges of poor
inmate health care. "It's worse than that," Peterson said. "They don't think
they did anything wrong."
October 20, 2006 Wilmington News-Journal
Seven months ago, the U.S. Department of Justice opened an investigation of
the prison health care system in Delaware -- where the rates of inmates dying of
AIDS and suicide have been among the highest in the nation, and where hepatitis
and skin infections are constant problems. Eleven months ago, a former inmate's
breast cancer went undetected while she was forced to wait five months for a
mammogram inside Baylor Women's Correctional Institution, near New Castle.
Twelve months ago, an outbreak of Legionnaires' disease hit Sussex Correctional
Institution, in Georgetown. And yet little has changed for the inmates, a
coalition of prison advocates said Thursday. On the anniversary of the
coalition's founding, leaders of the group gathered in Wilmington's Rodney
Square to lament a year's worth of what they called inaction by the leaders of
Delaware. There has been only "silence" from Gov. Ruth Ann Minner and
"stonewalling" from the General Assembly, said co-founders of the Delaware
Coalition for Prison Reform and Justice. "We are here today to continue to raise
the issue in the consciousness of prison crisis in our state," said the Rev.
Christopher Bullock, pastor of Canaan Baptist Church. "We are going to continue
to fight on behalf of the voiceless, those incarcerated and their families." For
six months in 2005, The News Journal examined conditions of care within the
state's prisons. In late September 2005, the newspaper published a series of
articles highlighting AIDS-related inmate deaths and suicides during the past
four years; allegations by inmates of poor medical treatment for cancer,
meningitis and hepatitis; and a no-bid $25.9 million contract awarded to St.
Louis-based Correctional Medical Services to manage health care in the state's
prisons. The series revealed: •Dr. Janet Kramer, of Wilmington, an expert in
prison health care, said inmates should be screened for hepatitis C and HIV. But
pretrial and convicted inmates in Delaware are not routinely screened when they
are sent to prison or when they leave. Delaware prisons have become incubators
for new strains of the AIDS virus, creating a public health crisis, experts say.
•Former prison doctor Ramesh Vemulapalli said a private medical company ordered
him to treat inmates for HIV or hepatitis C, but not both. •The state does not
routinely conduct autopsies on inmates who die in prison or those hospitalized
at the time of their death, a policy the president of the National Association
of Medical Examiners believes prevents evaluation of the quality of prison
medical treatment. And if it does conduct autopsies, the results are sent to the
medical vendor, not the prison. •Dr. Robert Cohen, an expert in prison health
care whom state and federal courts have appointed to monitor prisons in five
states, said Delaware should investigate medical malpractice claims. Instead,
the state's medical board occasionally takes complaints from inmates and their
families about prison health care professionals, but it is only an advisory
panel.
August 8, 2006 Wilmington News-Journal
The American Civil Liberties Union of Delaware filed a
civil lawsuit today charging the state Department of Correction with refusing to
provide information about how it treats prisoners for with illnesses such as
HIV, hepatitis and high blood pressure. The ACLU, represented by Public Citizen,
filed the suit in New Castle County Superior Court when the prison department
denied its records request. According to the suit, prison officials claimed some
information about treatment is “a trade secret” and “privileged or confidential”
property of the prison’s medical contractor, St. Louis-based Correctional
Medical Services, Inc. The lawsuit maintains that the withholding of documents
relating to the correctional facility’s treatment protocols for certain
illnesses and operating procedures for wellness visits is in direct violation of
the Delaware Freedom of Information Act. The ACLU also said that corrections
departments in other states have provided similar prison health care policy
information to the public. The U.S. Justice Department’s Civil Rights Division
started investigating prison health care in Delaware on March 8 -- a probe
Correction Commissioner Stanley W. Taylor Jr. and Gov. Ruth Ann Minner opposed
and lobbied to stop. Last year, The News Journal published a series of articles
documenting inadequate medical care in Delaware prisons.
July 21, 2006 News Journal
As many as four dozen current and former inmates at the Young Correctional
Institution may have been exposed to blood-borne diseases, including AIDS and
hepatitis, by a former nurse accused of improper needle use. "This is a
potential crisis in our community," said the Rev. Christopher Bullock, a founder
of the Delaware Coalition for Prison Reform and Justice. "It goes to our
original point, that when there is incompetent medical services provided to
those who are incarcerated, it opens up Pandora's Box for things to happen of
this nature." According to the Department of Correction, a licensed practical
nurse who was hired April 10 used a diabetic needle and syringe instead of an
individual lancet to obtain a blood sample from an inmate earlier this month.
The nurse later used the same needle to draw insulin from a multiple-dose vial
-- potentially contaminating the vial -- then used the vial to provide insulin
to other inmates. Department of Correction Commissioner Stan Taylor said the
procedure was completely inappropriate and something any health practitioner
would be taught early not to do. "It is alarming because it is very basic
medical protocol," he said. Taylor would not name the nurse but said she had
resigned. The nurse was hired by St. Louis-based Correctional Medical Services,
or CMS, the state prison's health care provider. A News Journal investigation of
the state prison health care last year pointed out high rates of AIDS-related
inmate deaths. The series, which looked at the quality of medical and mental
health services, is central to an ongoing investigation of the Delaware prison
system by a special civil rights team from the U.S. Justice Department. United
States Attorney Colm F. Connolly refrained from commenting about the new
allegations because of the ongoing Justice Department investigation. 'More of
the ongoing tragedy' Dover Attorney Stephen A. Hampton, who has successfully
sued the Department of Correction on behalf of inmates or their survivors who
alleged improper care, said "this is more of the ongoing tragedy that is CMS and
the DOC." Bullock said the investigation should be comprehensive and that all 48
people involved, as well as those with whom they have had contact, should be
tested. "There needs to be a health alert within the prison and also in the
community due to this unprofessional behavior by this particular nurse," he
said.
June 11, 2006 News Journal
A 56-year-old Hockessin man hanged himself last month hours after he was
taken off a suicide watch by the Department of Correction -- and despite
warnings from family and mental health advocates of a recent suicide attempt. At
4:52 a.m. on May 30, prison guards found Thomas J. Burns hanging from a bedsheet
in his cell. Burns had arrived at Young Correctional Institution on a forgery
warrant. Only days before the prison suicide, Burns was released from Christiana
Hospital, where he nearly died after trying to kill himself by mixing medication
and liquor. Mental health advocates flooded the prison with phone calls, trying
to alert the jailers that Burns would try to kill himself in the prison. Prison
officials initially placed Burns on suicide watch -- a restrictive status
involving constant surveillance during which Burns was allowed only a paper gown
in his cell. But on Memorial Day, a counselor employed by the prison's private
medical contractor, Correctional Medical Services, conducted a mental health
evaluation and ordered Burns placed on the less-restrictive psychiatric
observation. Burns was given several personal items -- including bedsheets --
and guards were supposed to check on him every 15 minutes. Hours later, he was
dead. Suicide is the third-leading cause of death in prisons nationally --
behind natural causes and AIDS-related deaths, which are recorded separately
from natural causes by the U.S. Bureau of Justice Statistics. According to the
bureau's latest report, issued last month, Delaware's prisoner suicide rate for
2001 and 2002 was double the national average of 14 per 100,000 inmates. The
quality of medical and mental health services inside Delaware prisons is central
to an ongoing investigation of the Delaware Department of Correction by a
special civil rights team from the U.S. Justice Department. High rates of inmate
deaths from HIV/AIDS, mistreatment of cancerous tumors and the spread of
flesh-eating bacteria are just some of the factors attracting federal scrutiny.
Burns' death will be reviewed internally, said Correction Commissioner Stan
Taylor, and the findings will be closed to the public. Burns' suicide is similar
to previous deaths in Delaware prisons. As he was booked into Howard Young (then
called Gander Hill prison) in 2004, Christopher Barkes told a mental health
screener that he had attempted suicide before -- when he had earlier served time
in Gander Hill. Barkes provided a list of drugs he was taking for depression,
post-traumatic stress disorder and other forms of mental illness. Instead of
placing Barkes on suicide watch, prison officials put him in a cell, alone and
unsupervised. Hours later, Barkes hanged himself with a bedsheet. His widow,
Karen, has sued the state over the death. "It is very disturbing that after
Chris's suicide, they still aren't going to change anything," she said. "Chris
died and nothing changes." According to the Department of Correction, 11 inmates
have killed themselves since January 2000 -- most by hanging. Experts say
effective mental health care can reduce the number of suicides in the state's
nine prison facilities. In Delaware, Correctional Medical Services provides
medical and mental health treatment. When an inmate arrives in prison, these CMS
counselors use a form that has a series of yes/no questions to determine suicide
risk. If the risk of suicide is high, they may require the inmate to sign a
"suicide contract" promising not to kill themselves. Mental health experts have
described these practices as antiquated and ineffective. Level of expertise.
Neither prison nor Correctional Medical Services officials would name the
counselor who evaluated Burns. They described the counselor as a "master's-level
clinician." "You do not evaluate a person for suicide without a psychiatrist,"
said Rita Marocco, executive director of the National Alliance for the Mentally
Ill in Delaware. "If a person has made a suicide attempt, it certainly must be a
psychiatrist who makes the decisions. I believe they do not have qualified
people doing these evaluations." Dr. Carol A. Tavani, a board-certified
neuropsychiatrist and executive director of Christiana Psychiatric Services,
agrees that a psychiatrist -- not a counselor -- should have conducted the
evaluation. "When you have something of this seriousness, with this kind of
history, especially when there's a prior attempt, that ratchets up the
seriousness of the risk," Tavani said. "Evaluation of suicidality has to be done
very carefully, and it's always the better part of valor to err on the safe
side, particularly if there's previous history. Those calls are always safest
when made by a psychiatrist, and I know they do have them." Patricia McDowell,
Delaware's director of support and outreach services for the National Alliance
for the Mentally Ill, told prison officials about Burns' recent suicide attempt
and warned them he would try it again. After Burns' death, these officials
stopped taking her calls. "We worked very carefully to get to the right people,
to help someone at a very critical point in his life, and the very people we
turned to let us down," McDowell said. "The system failed. His life ended."
May 19, 2006 Delaware State News
The General Assembly's budget committee approved creating three positions
Thursday to provide additional oversight of the Department of Correction's
inmate medical care system. The agency's handling of prisoner health care has
come into question in the past year amid newspaper accounts and lawsuits
questioning the quality. The positions, which will pay a combined $238,900 in
salary, were created by the Joint Finance Committee as it approved the DOC's
operating budget for fiscal 2007, which begins July 1. "We just want more
oversight and supervision," said Sen. Nancy W. Cook, D-Kenton, a JFC co-chair.
May 19, 2006 News Journal
A bill that would require wholesale improvements in Delaware's prison
medical system is dead for this year, crushed by a $30 million annual price tag
attached to it by the General Assembly's staff. The demise of Sen. Margaret Rose
Henry's reform bill, Senate Bill 291, came Thursday when the Joint Finance
Committee included no money in the Department of Correction's budget for next
year to pay for the improvements. The bill has been mired in the Senate
Judiciary Committee, chaired by Sen. James Vaughn, D-Clayton, for months. Henry
and Vaughn said the bill would not be considered this year, in large part
because of the fiscal-impact report from the Controller General's Office. The
committee, which is amending Gov. Ruth Ann Minner's proposed $3 billion budget
for the year that begins July 1, did add some extra money for prison health
care. The panel agreed to pay the state's private health care provider more for
existing services, and for several positions to better oversee Correctional
Medical Services. The panel added $2.9 million as an "inflation adjustment" for
the CMS contract, raising the annual cost by 11 percent to more than $28.8
million. The multiyear contract was transferred to CMS without bidding last July
on an emergency basis. The committee shifted $238,900 to Corrections for prison
health care oversight by the Division of Public Health, and prison care
reviewers. That extends changes begun last fall by Minner and Correction
Commissioner Stan Taylor to address substandard prison care. Those steps
followed the reports in The News Journal. This spring, articles detailed how a
female inmate gave birth to twins in a toilet stall at Baylor Women's
Correctional Institution in March. She said a prison nurse employed by CMS
ignored her complaints of powerful contractions, which began 24 hours prior to
the births. The reform bill also would require CMS to deliver records of inmate
deaths within three days to the Medical Society of Delaware's Prison Health
Committee for review, and make other records available to the state for audit.
Inmate medical grievances would have to be sent to the Department of Correction,
not to the medical service provider. But all of that would be costly, according
to the fiscal analysis. Legislation that would make publicly funded reports open
to public scrutiny -- including an audit of prison health care -- passed the
state House this month without a vote against it. House Bill 320, sponsored by
North Dover Republican state Rep. Nancy H. Wagner, would require the state to
release the audit and other such reports, provided that personal information
such as medical records is withheld. The bill faces an uncertain future in the
Senate.
May 11, 2006 News Journal
State Sen. Harris McDowell III, D-Wilmington North, has added another bill to an
assortment of pending measures designed to address the medical condition of
inmates in Delaware's prisons. Senate Majority Leader McDowell on Wednesday
introduced Senate Bill 306, which would require the state Medical Examiner's
Office to investigate each death in a state correction facility and conduct an
autopsy. The bill follows a series in The News Journal last fall that detailed a
large number of deaths inside state prisons and inadequate medical care. The
series helped prompt an investigation by the U.S. Department of Justice.
April 9, 2006 News Journal
Kimwayna "Kim" Allen gave birth to twins in a toilet stall at Baylor Women's
Correctional Institution last month, after she says a prison nurse employed by
Correctional Medical Services ignored her complaints of powerful contractions,
which began 24 hours prior to the births. Each of the babies -- son Ny-Aire and
daughter Ny-Bree -- weighed barely a pound. They are clinging to life in
intensive care at Christiana Hospital, swaddled in tiny blankets inside
incubators monitored around-the-clock by nurses. Even if Kim's daughter
survives, her prognosis is poor. The likelihood of brain damage and mental
retardation is high. Ny-Bree had no pulse and was barely breathing after
delivery. Her tiny brain was starved of oxygen for about eight minutes, until
two paramedic units and three ambulances raced into the prison grounds after the
nurse called 911. The paramedics began CPR in the prison and continued all the
way to Christiana, but Ny-Bree was still in very rough shape by the time they
got her to the hospital. Kim, a 19-year-old who lives with her mother, has had
to make monstrous decisions about her children's future. "They told me I should
pull the plug on my daughter because she wasn't doing too well," Kim said. "I
couldn't do it." The U.S. Justice Department's Civil Rights Division launched a
federal investigation into prison health care in Delaware on March 8 -- a probe
Correction Commissioner Stanley W. Taylor Jr. and Gov. Ruth Ann Minner opposed
and lobbied to stop. Although Minner agreed to cooperate with the Justice
Department, the governor told U.S. Attorney General Alberto Gonzales that the
federal probe was not necessary. The bathroom prison deliveries occurred four
days before the investigation was launched. Last year, The News Journal
published a series of articles documenting inadequate medical care -- including
prenatal -- in Delaware prisons. Neither Taylor nor Minner returned e-mail or
telephone requests to talk about Kim or her twins, or the care she received
before giving birth in the women's prison bathroom. On March 30, The News
Journal made a request under the Delaware Freedom of Information Act for a copy
of the policy and the lists required as part of the department's health care
accreditation. Welch, in an e-mail response, wrote, "The DOC does not have a
specific policy regarding the care of pregnant inmates." She couldn't explain
why. Correctional Medical Services spokesman Ken Fields couldn't say how CMS
staff should respond if a pregnant inmate complains of contractions. And he
declined to provide a copy of the CMS policy regarding pregnant inmates. Fields
said CMS employees make their own decisions. "Correction health care
professionals are trained to address these types of issues using their own
training and judgment, in their own assessment of each patient's condition to
make decisions about the next step for treatment," he said.
March 9, 2006 News Journal
After years of high inmate death rates due to HIV/AIDS, suicide and poor
medical care, federal civil rights regulators have launched an investigation of
Delaware's prison medical system -- a process that could take years to complete
and forever change the way the state treats its 6,800 inmates. The investigation
comes on the heels of a five-month preliminary inquiry by the Justice Department
during which federal regulators interviewed many of the same medical experts,
inmates and families of dead inmates who spoke to The News Journal late last
year during the newspaper's six-month investigation of prison health care. As
with the newspaper's investigation, the Justice Department uncovered significant
problems at the Delaware Department of Correction. The federal investigation now
may involve FBI agents and grand juries with subpoena power."Thank you, Jesus.
I've been praying for this so hard," said Susie Wilson, whose son, Jermaine
Lamar Wilson, was found hanging in his cell with blood-stained clothes and a
gash on his head. It was Feb. 18, 2005 -- the day his family says he was
scheduled to be released after serving time for robbery. Wilson's death is now
the focus of a federal wrongful death lawsuit, which claims Jermaine Lamar
Wilson was murdered while being held at the Delaware Correctional Center near
Smyrna. The federal investigation will be conducted by the Special Litigation
Section of the Justice Department's Civil Rights Division. A News Journal
special report on inmate health care published in September revealed sometimes
gruesome details of neglect, such as an inmate's massive brain tumor -- largely
ignored by staff -- which led to his death, and an outbreak of flesh-eating
bacteria. Other findings of the newspaper's six-month investigation were inmate
death rates -- specifically AIDS-related and suicide -- far above the national
norm. During the newspaper's investigation, reporters discovered that Minner and
Taylor awarded a $25.9 million no-bid contract for inmate health care to
Correctional Medical Services -- a private medical contractor with a history of
litigation over how the company provides medical care. Minner and Taylor also
refused to release -- publicly or to lawmakers -- an audit of prison health care
they say prompted the emergency hiring of CMS. Former prison doctor Ramesh
Vemulapalli, an AIDS specialist practicing in Dover, said the investigation is
long overdue. Vemulapalli said he quit working in Delaware prisons because he
was not allowed to provide adequate care. "I think the investigation will help
make reforms in the prison system," Vemulapalli said. "It's a good thing. It
will benefit the people of Delaware."
February 18, 2006 News Journal
Correction Commissioner Stanley W. Taylor Jr.'s
failure to properly train his staff to recognize suicidal inmates and properly
care for them allowed Christopher Barkes to hang himself in his prison cell in
November 2004, a federal lawsuit contends. The lawsuit, filed in U.S. District
Court in Wilmington by his family members, said the prison's former medical
provider also failed to properly train staff to recognize and properly care for
inmates who had made previous attempts on their lives. That medical provider,
Arizona-based First Correctional Medical, or FCM, pulled out of its contract
last year. During his time at the Young Correctional Institution in Wilmington,
the suit said, Barkes told prison officials he had attempted suicide before.
Prison staff placed him in a cell alone, though, with no suicide watch, the suit
said. Barkes, 37, was found unconscious the following morning and taken to
Christiana Hospital, where he died. Prison officials determined Barkes used his
bedsheet to hang himself. Taylor often defends his department by noting it is
accredited by the national commission, a process that cost taxpayers $12,400.
Taylor, though, has declined to make public an audit by the commission on prison
health care, saying it contains inmate medical information and peer reviews of
doctors. Lawmakers, who have repeatedly asked for the report, even if elements
are blacked out, are considering legislation to make it public. Barkes' case
came to light during an investigation by The News Journal last year. The
six-month investigation highlighted allegations by inmates of poor medical
treatment for cancer, meningitis and hepatitis; a no-bid $25.9 million contract
awarded to the current health care provider, Correctional Medical Services,
based in St. Louis; and a comparatively high rate of AIDS-related inmate deaths
and suicides over a four-year period. Another lawsuit filed by a prisoner
highlighted in the newspaper articles was settled out of court in October.
Anthony Pierce, also known to inmates as "the brother with two heads," was
serving a 14-month sentence for a parole violation when a small lump appeared on
the back of his head. At the time, a prison doctor employed by Correctional
Medical Services said the marble-size lump was a cyst or an ingrown hair. The
tumor kept growing, and on March 22, 2002, Pierce died from a "brain tumor, due
to osteosarcoma of the skull," according to an autopsy report. The conditions
revealed in the articles are the subject of an inquiry by the U.S. Department of
Justice's Civil Rights Division. "Stan Taylor said that they follow the
guidelines, and it is clear that they didn't," said Barkes' wife, Karen. She
also said "it is discouraging that the lawmakers aren't doing anything to change
the problems in the prisons." The lawsuit targets Taylor and FCM, along with
prison warden Raphael Williams, the Department of Correction and unknown
Correction Department and FCM employees. The suit, which alleges wrongful death
and cruel and unusual punishment, seeks compensatory and punitive damages to be
set by the court. Contact Esteban Parra at 324-2299 or eparra@delawareonline.com.
Contact investigative reporter Lee Williams at 324-2362 or lwilliams@delawareonline.com.
February 16, 2006 Delaware State News
The legislature’s budget-writing committee on Thursday urged the head of the
state Department of Correction to release a 2005 report evaluating prisoner
medical care. Should the report stay under wraps, some of the panel’s members
are ready to include language in the fiscal year 2007 budget bill forcing it to
be made public. The audit, performed by the National Commission on Correctional
Health Care, turned up enough deficiencies that DOC switched care providers. The
contract with Arizona-based First Correctional Medical was terminated and the
state signed a deal with St. Louis-based Correctional Medical Services.
Legislators, the Delaware State News and other news organizations requested
copies of the report last year under the Freedom of Information Act, but were
denied.
January 26, 2006 Wilmington News Journal
Lee McMillan, whose husband nearly died in prison after flesh-eating bacteria
attacked his body, wants to know why the state won't release an audit of
Delaware's prison health care system. So do some legislators, who are backing a
bill that would require the state to release the audit and similar reports -- as
long as confidential information such as personal medical records is withheld.
House Bill 320, sponsored by Rep. Nancy Wagner, R-Dover North, would make
reports that are paid for with public funds open to the public under the Freedom
of Information Act. The News Journal requested the audit, which cost taxpayers
$12,400, while investigating AIDS-related inmate deaths and suicides of Delaware
prisoners as well as reports of poor medical treatment for cancer, meningitis
and hepatitis. Prompted in part by a series of News Journal stories, the U.S.
Department of Justice is conducting an inquiry into the Department of
Correction's management and inmate health care. In defending his record,
Correction Commissioner Stan Taylor pointed to the audit, prepared by the
National Commission on Correctional Health Care, but denied a Freedom of
Information request for the report by the newspaper. Taylor and former Attorney
General M. Jane Brady ruled the accreditation report was not a public document.
Taylor, though, said the audit was critical of the work of First Correctional
Medical, a Tucson, Ariz., company. In July, Gov. Ruth Ann Minner and Taylor
awarded a $25.9 million no-bid contract to Correctional Medical Services of St.
Louis to pick up the provision of medical care in Delaware's prisons. Rep.
Pamela S. Maier, R-Drummond Hill, is a House co-sponsor who said she believes
that "sunshine helps" in governmental affairs. "I think the public needs to
know, and if they're not satisfied, we need to keep the pressure on the
Department of Correction and [prison health care provider Correctional Medical
Services] to improve the health of our prisoners."
November 18, 2005 Wilmington News Journal
A Department of Correction official said Thursday that Medicaid and its former
medical service provider owe St. Francis Hospital less than $500,000 in past-due
bills. That amount is half of what a committee reported they owed the hospital
two months. But exactly how much Medicaid and Arizona-based First Correctional
Medical, which provided services to the prison until July, owe St. Francis and
other health care providers remains unknown, said Joyce Talley, the department's
bureau chief of management services. It's also unclear what portion of the
unpaid bills is owed by Medicaid and by First Correctional Medical of Tucson,
Ariz. "I still don't have my arms around the whole thing," Talley
said. First Correctional Medical's owner and founder, Dr. Tammy Kastre, did not
return calls made to her firm Thursday.
November 16, 2005 Wilmington News Journal
The Delaware Department of Correction has hired longtime HIV/AIDS educator and
advocate James Welch from the Department of Public Health, to serve as the
health services administrator for the state's prison system. Welch, a registered
nurse, currently serves as the Department of Public Health's HIV/ AIDS/STD
director in a program he created 20 years ago to coordinate prevention and
treatment of HIV/AIDS and other diseases. "Jim will oversee the DOC's
day-to-day medical operation," said Ed Synoski, the Department of
Correction's deputy chief of the Bureau of Management Services, which oversees
the department's medical services contracts. Taylor announced the creation of
Welch's position during a public hearing last week called by lawmakers to
examine a series of articles in The News Journal highlighting AIDS-related
inmate deaths and suicides during the past four years, and allegations by
inmates of poor medical treatment for cancer, meningitis and hepatitis. Prompted
in part by the series, the U.S. Department of Justice has launched a preliminary
inquiry into the Department of Correction's management and inmate health care.
Welch previously has played a behind-the-scenes role in the inmate health care
debate -- lobbying in 2002 against allowing Dr. Keith Ivens to remain as the
prison system's medical director when Correctional Medical Services (CMS) of St.
Louis, Ivens' employer, was replaced by another medical contractor. In July,
Taylor brought CMS back to Delaware with a $25.9 million no-bid contract to
manage inmate health care. In a sworn deposition, Kathy English, the former
deputy bureau chief of management services for the Department of Correction,
said Ivens was a frequent source of inmate complaints. English testified that
Welch expressed "informal concerns" about the physician and told the
incoming contractor to not allow Ivens to continue as medical director. The Rev.
Christopher Bullock, pastor of Canaan Baptist Church in Wilmington, is one of
the founding members of the Delaware Coalition for Prison Reform and Justice.
"The DOC doesn't need to be hiring new people," Bullock said.
"They need to be firing people. This appears to be another effort to cover
up and conceal the real issue."
November 8, 2005 Wilmington News Journal
Family members of dead, dying or grievously ill inmates lashed out at Correction
Commissioner Stan Taylor on Monday night, accusing Taylor and the prison's
medical vendor of causing illnesses and deaths by providing inadequate medical
care to the state's 6,800 inmates. Some of those who testified said the state
treats its inmates worse than animals. The public scolding occurred at an
"informational" hearing called by Speaker of the House Terry Spence,
R-Stratford, and Rep. Pamela S. Maier, R-Drummond Hill, who sought to educate
lawmakers about prison conditions before the upcoming legislative session.
"It's your facility -- clean it up," Matilda Carello, whose son is an
inmate with Grave's disease, yelled at Taylor, who was sitting by her side. Also
in the audience were representatives from Correctional Medical Services, the
company Taylor recently awarded a controversial $25.9 million no-bid contract to
run inmate health care. "CMS -- you're a liar," Carello said.
"Stan Taylor -- you are a liar!" After about 50 witnesses from the
public testified at the hearing, Spence said "it's time for a gut
check." "We've lost confidence in the department," he said.
"We've lost confidence in CMS." Spence called for an independent
oversight panel for the department and CMS. Ann Mac, a nurse practitioner and
CMS vice president of operations, told lawmakers and inmate family members that
"delivering health care in prisons is a uniquely challenging but very
rewarding field." Her message was not well received. "I am sorry, but
the things being said from this lady -- this is not what's really going on
inside," said Lee McMillan, who says her husband, an inmate, nearly died
when flesh-eating bacteria ravaged his body. Monday night's hearing was
scheduled after a six-month investigation by The News Journal found a high rate
of AIDS-related inmate deaths and suicides over the past four years, and
uncovered allegations of poor medical treatment for cancer, meningitis,
hepatitis and other communicable diseases and bacterial infections. Prompted in
part by the newspaper's series, the U.S. Department of Justice has launched a
preliminary inquiry into the Department of Correction's management and inmate
health care. Maryanne McGonegal, secretary of Common Cause, criticized Gov. Ruth
Ann Minner for failing to address evidence of negligent inmate care. On Oct. 3,
Common Cause of Delaware asked U.S. Attorney General Alberto Gonzales to open a
federal investigation. "The lack of response by our governor is the
strongest indication of the need for outside oversight of prison
conditions," McGonegal said Monday night. Several of those who testified
said after the hearing that Taylor should release a recent audit of inmate
health care under the state's former prison medical vendor, First Correctional
Medical. Performance audited: Taylor asked a medical accreditation firm to audit
FCM's performance from December 2004 to January 2005. According to documents
Taylor provided to lawmakers, the audit showed "several problems with
medical administration and clinical practices including record keeping,
utilization management, medical history and sick call follow-up." The News
Journal submitted a request under Delaware's Freedom of Information Act for the
audit, which cost Delaware taxpayers $12,400, but Attorney General M. Jane Brady
denied the newspaper's request. Former CMS substance abuse counselor Denise
Rodriguez said she supports punishment for those who break the law. "But
that punishment should not be neglect, humiliation or death," Rodriguez
said. Rodriguez, who worked for CMS at Gander Hill from 1999 to 2002, told The
News Journal in a previously published story that a CMS official ordered her to
falsify documents so state inspectors would not pull the company's license to
run a prison treatment program. "Stan Taylor, I always told my clients that
in order to make changes in your life, you have to hold yourself
accountable," she told Taylor at Monday's hearing. "Someone needs to
hold you accountable."
November 7, 2005 Delaware State
News
The state's correction chief and the medical company hired by the agency
defended the level of medical care inmates receive Monday during a hearing at
Legislative Hall. Commissioner of Correction Stanley W. Taylor and Ann Mack,
vice president of operations for Correctional Medical Services, made their
presentation to a hearing called by the House of Representatives' Health and
Human Development Committee. Mr. Taylor and CMS have come under heavy criticism
recently after news reports questioned the quality of care in prisons based on
lawsuits and anecdotes from prisoners and their families alleging poor medical
treatment. Scores of members of the public spoke at the hearing and ripped into
Mr. Taylor and CMS. "I believe a person needs to be punished when they
break the law of the land, but the punishment does not include neglect,
humiliation and death," said Denise Rodriguez, a former CMS employee who
worked at Gander Hill Prison in Wilmington. "Stan Taylor, I always told my
clients that to make changes in your life, you have to hold yourself
accountable. Someone needs to be held accountable." Dover residents Lynn
and Robert Sadusky, who mentor a Delaware inmate, said the prisoner has relayed
a series of complaints about health care inside the walls. The issues include,
Mrs. Sadusky said, prisoners being overcharged for care, having their requests
for medical attention ignored and misdiagnosis of conditions. The inmate she
mentors has been waiting two weeks to be seen by a doctor to determine whether
he is suffering from lung cancer, she said. "I understand this is a
difficult population to serve, but I hope those at the top will fix these
problems," Mrs. Sadusky told the committee. "Denial will not fix these
problems, but that is what I am hearing tonight." The Rev. Christopher A.
Bullock, chair of the Delaware Coalition for Prison Reform and Justice, said DOC
should stop using out-of-state companies to provide medical care. CMS is based
in St. Louis. Its predecessor, First Correctional Medical, is based in Arizona.
Mr. Bullock advocated state support for creating a Delaware-based business to
handle prison medical care. "Let us do what is right and what is
just," said Mr. Bullock, who is the pastor at Wilmington's Canaan Baptist
Church.
November 6, 2005 Wilmington News
Journal
Sharon Wall, a waitress and bartender from Claymont, was arrested on Lancaster
Pike in Hockessin around dusk 4 1/2 years ago. She had been involved in a minor
accident, and a state trooper suspected Wall had been drinking. A breath test
administered at the scene confirmed Wall was drunk and she was booked into
Baylor Women's Correctional Institution, a 380-bed facility near New Castle that
houses adult female inmates in Delaware. About a week after the arrest, Wall
complained of pain near her breast. Suspecting she might have broken a rib and
worried about a pea-size bump in her right breast, she was examined by a prison
nurse employed by Correctional Medical Services (CMS), one of the largest prison
health care companies in the country. In a record of the visit, on May 22, 2001,
the nurse notes a "mass" of the right breast and suggests Wall be
scheduled for a mammogram. In the days and weeks that followed, Wall repeatedly
asked prison officials when the procedure would take place. Five months later,
she rolled over in her cell bunk and was frightened by the size of the expanding
mass. On Oct. 16, 2001, Wall sent a note to the prison's medical staff. "I
am writing again to ask when I will be given a mammogram. ... It is a very big
concern and I would like to know when it will be done. Please let me know
something." According to CMS spokesman Ken Fields, mammograms for female
inmates in Delaware are routinely scheduled within two weeks after an
examination determines a test is necessary. The tests are performed in a mobile
laboratory owned by the Division of Public Health. State records indicate that
in 2001, the mobile mammography unit stopped at the Baylor prison three times --
Jan. 24, Feb. 20 and Oct. 19, the day Wall finally received the mammogram
ordered by a nurse five months earlier. Fields would not comment on why it took
so long. 'A fairly aggressive tumor" By the time Wall's test results were
returned, and a diagnosis of cancer was determined to be likely, it was too late
to save Wall's breast, says Dr. Irving M. Berkowitz. "It was a fairly
aggressive tumor." The delay was inexcusable, said Berkowitz, Wall's
oncologist. "That's wrong. That's bad medicine. No matter who it is,
whether the person is 25 or 75, that's a little long." After weeks of
requests from The News Journal to comment on Wall's care, Department of
Correction spokeswoman Beth Welch said late Friday the prison is reviewing the
case. "The care received by Miss Wall has raised some questions,"
Welch wrote in an e-mail. "We are discussing this issue with CMS."
Treatment delays similar to Wall's have plagued Delaware's prison health care
system over at least the past five years, according to inmates, civil rights
advocates and a growing number of Delaware lawmakers. One of the key issues for
lawmakers has been a $25.9 million no-bid contract awarded in July to CMS, the
St. Louis-based company that held the prison's health care contract from
2000-2002, the period of Wall's incarceration and treatment. Corrections
Commissioner Stan Taylor negotiated the current contract with CMS outside of the
normally required competitive bid process and contract review, citing a national
accreditation team report on "problems with medical administration and
clinical practice" at First Correction Medical (FCM), a Tucson, Ariz.-based
company that provided inmate care in Delaware from 2002-2005. Before Taylor
brought CMS back to Delaware to replace FCM, Gov. Ruth Ann Minner approved the
no-bid contract. Questions surrounding the contract, as well as reports of
misdiagnosed tumors, Legionnaire's disease, high rates of inmate deaths due to
AIDS and suicide and the unchecked spread of flesh-eating bacteria in Delaware
prisons, convinced the U.S. Department of Justice's Civil Rights Division to
launch an ongoing inquiry into the state's prison system. Six days before
Christmas 2001, Wall -- destitute and in need of thousands of dollars of
life-saving procedures -- was released from prison, put on a bus to Wilmington
and ordered into home confinement. She moved in with friends. "I feel like
my life was put in jeopardy," said Wall. "I did something wrong and
should be punished. But I shouldn't have to pay with my life." On her first
day out of prison in 2001, Wall contacted the American Cancer Society. She also
wrote a will, believing she was going to die. The Cancer Society directed her to
a Wilmington physician, Dr. Christopher J. Whitney. During an early examination,
Whitney discovered portions of the tumor remained, a common complication. A
second surgical procedure also failed to eliminate the tumor. A mastectomy was
scheduled. On Feb. 5, 2002, Wall's right breast was removed during an operation
that combined a mastectomy with reconstruction. Tissue from Wall's lower abdomen
was used to form a new breast in a procedure called a TRAM flap, or transverse
rectus abdominis muscle reconstruction. Today, Wall visits the doctor every
three months to check for a relapse. So far, the cancer has not returned.
November 3, 2005 Wilmington News Journal
In a two-hour meeting Wednesday with the House Democratic Caucus, Correction
Commissioner Stan Taylor said he had solutions to improve inmate health care in
the state's prisons. Those solutions include seeking an additional $150,000 for
contract medical consultants, two more full-time medical employees and a peer
review by the Department of Public Health of 50 to 100 cases a year. Taylor
answered questions about prison health care from the 15-member caucus for nearly
two hours behind closed doors. He explained how St. Louis-based Correctional
Medical Services was awarded a $25.9 million contract to replace First
Correctional Medical of Tucson, Ariz., without the need for a competitive
bidding process. According to the presentation, First Correctional Medical was
awarded the Department of Correction contract in June 2002, but two years later,
the prison's Medical Review Committee identified "problems with First
Correctional Medical's performance." The Department of Correction asked its
medical accreditation firm to audit First Correctional Medical's performance
from December 2004 to January 2005. According to documents Taylor provided to
the caucus, the audit showed "several problems with medical administration
and clinical practices including record keeping, utilization management, medical
history and sick call follow-up." The News Journal submitted a request
under Delaware's Freedom of Information Act for this audit, but Attorney General
M. Jane Brady denied the newspaper's request. Prompted in part by the
newspaper's series, the U.S. Department of Justice has launched a preliminary
inquiry into the Department of Correction's management and inmate health care.
Taylor was accompanied by Mark Brainard, Gov. Ruth Ann Minner's chief of staff,
and Robert Byrd of Wood-Byrd Government Relations, a Wilmington lobbyist firm.
Bird said his firm was hired by Correctional Medical Services. Wood-Byrd has
also lobbied for The News Journal.
October 30, 2005 Wilmington News Journal
A former drug and alcohol counselor who worked for Correctional Medical Services
at Gander Hill prison claims company officials ordered her to falsify documents
so state inspectors would not pull the company's license to run a prison
treatment program. Denise Rodriguez, who worked for Correctional Medical
Services at the prison's drug and alcohol treatment program from 1999 to 2002,
said she would have been fired if she refused orders to fabricate entries
contained in inmate files. "I was told to do progress notes on people who
were not my clients," said Rodriguez, now a substance abuse counselor at
the Latin American Community Center in Wilmington. "I told them I didn't
want to falsify the charts." The order, she said, came from a supervisor at
CMS, one of the largest correctional health care companies in the country.
"I received a chart that wasn't touched for four months," Rodriguez
said. "I was told to 'catch the chart up' using previous statements from
the client." If an inmate had admitted a cocaine addiction, for example,
Rodriguez said she was told to write that the client was making progress
overcoming the problem -- without ever talking to the inmate about the
addiction. Other documents were back-dated or altered with correction fluid, she
claims. Rodriguez, a 37-year-old mother of three, said she decided to talk about
her work at Gander Hill after reading a series of News Journal stories detailing
problems with the delivery of health care to inmates in Delaware. The St.
Louis-based CMS no longer runs the drug and alcohol program, called Key, but
last July received a $25.9 million no-bid contract to provide health care for
the more than 6,600 inmates in Delaware's prison system. Lucian Gambino,
Rodriguez's former supervisor, said when he worked in the prison he was aware
counselors were updating records at a furious pace and that other supervisors
ordered the changes. Gambino worked in the Key program from December 2001 to
December 2002. "I knew our people were trying to update records that were
very delinquent, that had not gotten through the previous state licensure, or
for some reason were just not completed at all," Gambino said. "The
pressure on all of us was really great. We had lots of catch-up work to do. We
had work that had not been done by folks from previous years." Gambino,
however, said he never personally ordered anyone to do anything wrong. He, too,
was acting under orders from the same CMS official named by Rodriguez, he said.
When contacted by The News Journal, that official declined to comment. CMS
administered the Key program from 1987 through June 2002 under a contract, worth
as much as $1.6 million annually, that required a valid state license. If
Delaware regulators uncovered falsified information, the contract would have
been at risk. Rodriguez said she never received personal security or
self-defense training. Despite the rigors of the treatment program, inmates with
AIDS and other medical problems were forced to participate. "The AIDS
patients had it the worst," Rodriguez said. "There were times they
couldn't get out of bed, and the guards wouldn't let them go to medical. The
guards made the decisions about who was sick. They decided who went to
medical." "We were told to change the files when the inspectors were
coming, or if we even thought they were coming," Rodriguez said. Reports
over a period of five years, obtained by The News Journal, demonstrate a
recurrence of either conflicting or missing information in patient charts. A
sampling of the problems includes: oOn June 15, 1999: "The progress notes
often did not include the actual date services were provided or the length of
time the group was held. Notes frequently included non-clinical jargon, i.e.
'Client appears plugged into the process.' and anticipated treatment that is
expected, i.e. 'I will continue to work with this client on his problems.'"
oOn Nov. 28, 2000: "In one chart the notes were conflicting. The assessment
section of the progress note summarized self disclosure statements made by the
client, but the plan section of the same note stated that the client was not
sharing and unwilling to do so. In one chart there were four weeks of progress
notes that were blank except for dates that had been written at the top."
oOn Jan. 25, 2001: "In ten charts the progress notes did not contain facts,
impressions and anticipated treatment and at times reflected a lack of clinical
knowledge and experience. For example, one note indicated, 'Being that I just
started the caseload with this client I will need more time because I believe
that he is mental.'" oOn Nov. 12, 2001: "In thirty charts (of the 33
examined) the progress notes did not reflect the progress being made in meeting
current treatment plan goals." oOn Feb. 22, 2002: "In one chart the
entire note for one week of services, over 13.5 hours of treatment, stated,
'Client attended participated in staff seminars and attended and participated in
Encounter group to confront and address negative behavior and attitudes.'"
oOn March 9, 2004: "In 21 charts (of 22 examined) progress notes were
missing."
October 22, 2005 Delaware State News
The Medical Society of Delaware on Saturday urged lawmakers to create a prison
health care oversight committee and implement mandatory HIV and hepatitis C
testing for inmates. The medical society's voting body, the House of Delegates,
approved the two prison health resolutions unanimously at the society's annual
meeting, which about 240 physicians attended. Delaware's prison health care
system has come under fire of late, with accusations of inadequate care
prompting an inquiry by the U.S. Department of Justice's Civil Rights Division.
The St. Louis-based Correctional Medical Services has a contract with the state
to provide health care to inmates. Delaware physicians currently serve in an
advisory capacity, but Dr. James P. Marvel Jr., president of the medical society
and an orthopedic surgeon in Lewes, said they need actual authority to oversee
the care provided behind bars. Physicians on the society's Prison Health
Committee are responsible for reviewing the medical records of inmates who have
died while incarcerated, Dr. Marvel said. "We're supposed to review the
deaths. But we often don't have all the records available to us. "We're
sort of working with one hand tied behind our back." The resolution calls
for an independent oversight committee authorized to review the quality of
health care services. The committee would consist of doctors, psychiatrists,
nurses, lawyers, pharmacists, members of the Delaware Center for Justice, and
representatives from the prison care provider, according to the resolution. Dr.
Joseph F. Hacker III, chairman of the society's legislative committee and an
upstate gastroenterologist, said the oversight body should report to the
legislature, rather than the governor.
October 23, 2005 Wilmington News
Journal
Democratic lawmakers want Correction Commissioner Stan Taylor to answer
lingering questions about health care in his prisons. In a letter sent Thursday
to Taylor -- signed by 16 senators and representatives -- the lawmakers
requested both answers and a personal briefing by the commissioner "as soon
as you are able to gather this information." "It is not intended as
criticism of the administration," said Sen. Patricia M. Blevins, D-Elsmere,
who signed the letter. "At this point, we are seeking information on policy
and procedure." Attached to the letter were 21 questions, including what
criteria are used to approve or deny an inmate's request for health care and
policies regarding HIV testing and treatment. They also want to know what
continuing medical responsibility the Department of Correction takes after a
prisoner is released. The letter was sent after a series of News Journal
articles highlighting AIDS-related inmate deaths and suicides over the past four
years; a no-bid $25.9 million contract awarded this year to St. Louis-based
Correctional Medical Services to manage health care in the state's prisons; and
allegations by inmates of poor medical treatment for cancer, meningitis and
hepatitis.
October 21, 2005 Wilmington News Journal
The Department of Correction's former medical provider owes nearly $1 million to
St. Francis Hospital and late last month other state health care providers were
boycotting the department's current provider because of past-due bills,
according to documents obtained by The News Journal. The unpaid medical expenses
were run up by First Correctional Medical of Arizona, which held the contract to
provide inmate health care in Delaware prisons from 2002 until July. The firm's
owner and founder, Dr. Tammy Kastre, did not return calls for comment. Delaware
taxpayers may be asked to pay the prison's delinquent bills, state Auditor R.
Thomas Wagner Jr. said. "The fact that the government is stiffing the
public bothers me greatly," said Wagner, who is considering an audit of
medical spending by the DOC. The $1 million owed to Wilmington's St. Francis was
disclosed in the minutes of the DOC's Medical Review Committee, which is
composed of correction officials and private medical providers. According to the
minutes, CMS regional manager Mike Hooper told members of the committee the
company is having difficulty contracting "with a number of providers in the
community ... [and would] provide an updated list of vendors refusing to sign
with CMS due to FCM."
October 18, 2005 Delaware News Journal
While in a state prison last year, Delaware's private health contractor gave
Motrin to Ed Brittingham to treat the bacteria that was eating away at his
flesh. A concerned guard eventually sent the inmate to St. Francis Hospital in
Wilmington -- where doctors administered massive doses of antibiotics. Today,
Brittingham is free of the bacteria that nearly killed him -- but he's still
getting hospital bills. Current and former inmates are being billed thousands of
dollars for medical care they received while incarcerated by the Delaware
Department of Correction, which contracted with the Tucson, Ariz.,-based First
Correctional Medical, a private health care provider. Brittingham's bills are
estimated at $2,100. His common-law wife, Lee McMillan, says those bills are the
responsibility of FCM, the private health contractor. "What happened to all
the millions of dollars the state paid FCM to take care of Ed and the other
inmates?" asked McMillan. "Where did all that money go?"
Department of Correction spokeswoman Beth Welch, responding in an e-mail, wrote:
"The DOC is aware of the billing issues. We have been pro-actively working
with the Budget Office, the Attorney General's Office, the Medicaid Office and
the sub-vendors to address outstanding FCM bills as well as bills being received
by inmates and/or inmate's family members. Also, the DOC is working with several
inmates and inmate's family members on this issue." Welch did not know the
total amount FCM owes clinics and hospitals. "I've got an inquiry
out," Welch wrote.
October 12, 2005 Delaware State News
Acting on advice from the Delaware attorney general's office, the Department of
Correction on Tuesday rejected a request from the Delaware State News to provide
a copy of an audit performed earlier this year on the prison healthcare system.
After a State News reporter orally asked DOC spokeswoman Elizabeth Welch for the
audit, she told the reporter to file a written request under the Freedom of
Information Act. The DOC asked the National Commission on Correctional Health
Care to perform the audit in January after the agency uncovered problems with
the company providing medical care to prisoners. The audit's results led to the
state terminating its contract with First Correctional Medical Delaware
effective July 1. Commissioner of Correction Stanley W. Taylor, during an
interview last week, declined to give specific examples of deficiencies in First
Correctional Medical's performance. John D. Flaherty, a lobbyist for the
good-government group Common Cause, said the audit should be released because of
the public interest in the prison healthcare system and recent newspaper reports
questioning the quality of care. "I would think they would want to err on
the side of public welfare and release this document," Mr. Flaherty said.
"I can see no reason why this should not be a public document."
October 5, 2005 Delaware State News
The U.S. Department of Justice will review claims that the state Department of
Correction has exhibited a pattern of providing inadequate medical care to
inmates. U.S. Attorney for Delaware Colm F. Connolly said Wednesday that the
justice department's Civil Rights Division has opened a preliminary inquiry into
the allegations. Mr. Connolly said the division would collect information and
"see if it warrants a full-blown investigation." The inquiry, Mr.
Connolly said, stems from a series of articles in a Wilmington newspaper, which
he forwarded to the Civil Rights Division in Washington. Articles in The News
Journal highlighted inmate suicides and AIDS-related deaths over the last four
years, allegations by inmates of poor medical treatment and a no-bid $25.9
million contract awarded this year to St. Louis-based Correctional Medical
Services to provide medical care to inmates.
October 5, 2005 Wilmington News
Journal
The Civil Rights Division of the U.S. Department of Justice has opened a
"formal inquiry" into medical care and other systemic issues inside
Delaware prisons, U.S. Attorney Colm Connolly said Tuesday. A formal inquiry is
a precursor to an investigation by the Justice Department. During an inquiry,
the Civil Rights Division reviews allegations to determine merit. Depending on
the findings, a formal investigation can be launched. The newspaper's six-month
investigation highlighted AIDS-related inmate deaths and suicides over the past
four years; allegations by inmates of poor medical treatment for cancer,
meningitis and hepatitis; and a no-bid $25.9 million contract awarded this year
to St. Louis-based Correctional Medical Services to manage health care in the
state's prisons. Susie Wilson, whose son Jermaine died in a Smyrna prison, said
a federal investigation is needed because the state is not capable of
impartially investigating itself. "I believe it will make the [Minner]
administration shape up or ship out," Wilson said. Wilson's son was found
Feb. 18 hanging from a bedsheet in the Delaware Correctional Center eight days
after court documents indicate he was supposed to have been released. Most
inquiries focus on medical care. However, complaints about excessive force,
mental health care, safety, AIDS care and screening, environmental health and
safety, sanitation and food service also are covered. When problems are found,
the Justice Department can sue the prison in federal court for relief. The
Special Litigation Section, the arm of the Justice Department's Civil Rights
Division responsible for enforcing CRIPA, has never lost a case.
October 4, 2005 Wilmington News Journal
A private medical company running health care in Delaware's prisons has settled
a wrongful death lawsuit brought by the family of Anthony Pierce, a 21-year-old
inmate known by cellmates as "the brother with two heads." Terms of
the settlement were not disclosed. Pierce was serving 14 months for a parole
violation stemming from a burglary charge when a small lump appeared on the back
of his head. At the time, a prison doctor employed by St. Louis-based
Correctional Medical Services said the marble-size lump was most likely a cyst
or an ingrown hair. The tumor kept growing, though, and on March 22, 2002,
Pierce died from a "brain tumor, due to osteosarcoma of the skull,"
according to an autopsy report. On behalf of Pierce's estate and his daughter
Sardia, Dover attorney Steve Hampton filed suit against CMS on Sept. 29, 2004.
The lawsuit had been scheduled for a jury trial next month. Hampton said Monday
the case was "resolved to the satisfaction of all parties." Earlier
this year, Delaware Correction Commissioner Stan Taylor awarded CMS a no-bid
$25.9 million contract to replace outgoing prison medical contractor First
Correctional Medical of Tucson, Ariz. Gov. Ruth Ann Minner approved the deal,
although she called the CMS deal an extension of the old contract. Pierce's
death was never reported to the public or to federal prison regulators by the
Department of Correction because he was released to his family before brain
cancer killed him.
September 30, 2005 Wilmington News Journal
The extraordinary four-part News Journal series about myriad problems within
the Department of Correction health care system cries out for response from the
governor and state lawmakers. The series detailed the spread of AIDS and other
infectious diseases inside the prisons, high-rates of suicides and AIDS-related
deaths, minimal oversight of medical care and numerous reports of inadequate
medical attention to inmates' conditions. But instead of outcries, with only a
few exceptions, the public is confronted with a deafening silence. Those whose
legislative record would suggest they would embrace concern for the plight of
inmates victimized by substandard health care are mute. Where are the liberal
Democrats like Sens. Harris McDowell, Karen Peterson and Robert Marshall? Where
is Gov. Ruth Ann Minner, who vowed last year to aggressively address prison
correction officers' low pay and mandatory overtime? So far, we've heard from
two potential Republican gubernatorial candidates, Sen. Charles Copeland of
Greenville and House Majority Leader Wayne Smith of Brandywine Hundred, and
conservative Sussex Democratic Sen. Robert Venables of Laurel. They certainly
aren't among the usual cast of characters lobbying for prisoners' rights. The
three called for various levels of investigations. Democrat Rep. Hazel Plant of
Wilmington wants Correction Commissioner Stan Taylor fired and an outside
investigation. Two other Republican officials, U.S. Attorney Colm Connolly and
state Public Defender Lawrence Sullivan spoke out. Mr. Connolly said he passed
on complaints. At least Mr. Sullivan has standing on the prison health issues
since many of his clients have been affected. The silence of Gov. Minner and her
Democratic leaders brings to mind the governor's comment last year in the wake
of a kidnapping-rape-hostage incident involving prison counselor Cassandra
Arnold. "This isn't something that is unique to Delaware," the
governor said. "In prisons, you almost expect this to happen." No,
governor, we didn't then, and we don't now.
September 30, 2005 Wilmington News
Journal
A day after four Delaware lawmakers called for independent investigations of
medical care in the state's prisons, Department of Correction Commissioner Stan
Taylor admitted there were problems and promised to cooperate with any inquiry.
"I am not saying that nothing is wrong," said Taylor, who met with
some of Gov. Ruth Ann Minner's senior staff Thursday. "We take our
responsibility seriously." Minner declined to specifically address a series
of News Journal articles published this week that examine the state's
AIDS-related inmate death rates -- the highest in the nation in 2001 and 2003;
an inmate suicide rate in 2000 and 2001 that was twice the national average;
reports of undiagnosed flesh-eating bacteria, poorly treated cancer, hepatitis,
meningitis and pneumonia; and a no-bid $25.9 million contract awarded this year
to St. Louis-based Correctional Medical Services to manage health care in the
state's prisons. Outrage about the stories spread Thursday from Delaware's
capital to community leaders. The Rev. Christopher Bullock of Wilmington's
Canaan Baptist church said his congregation and other clergy plan to march
outside the governor's mansion Monday, calling their protest the "March for
Justice and Prison Reform in Delaware." "I'm doing this because it's a
moral outrage that the Delaware prison system is sick, in need of healing and
repentance," Bullock said. "And I'm concerned about the reputation of
the state as it relates to how we treat these people." Sen. Robert L.
Venables, D-Laurel, said the images of inmate mistreatment were hard to ignore.
There have been similar problems with contract medical services in other state
prison systems, Venables said. "I'd like to know how much those companies
are making this year," he said. "I'd like to know how well the
shareholders are sleeping, if they know what's being done to save money."
Calling for investigations of prison medical care are Smith, Rep. Hazel D.
Plant, D-Wilmington Central, Sen. Margaret Rose Henry, D-Wilmington East, and
Sen. Charles L. Copeland, R-West Farms. U.S. Attorney for Delaware Colm F.
Connolly said he has forwarded allegations of inmate abuse to the U.S.
Department of Justice to review. Sen. James T. Vaughn, D-Clayton, is comparing
contracts Maryland and Delaware have with Correctional Medical Services. Forming
an independent committee to examine prison health care may be the smartest
option, said Delaware Public Defender Larry Sullivan. He said the panel should
include doctors and medical malpractice lawyers so the consequences of this kind
of treatment are stated as strongly as possible in any report. "I believe
that some of the decision makers may have no idea as to the extent of liability
exposure the state may have, if this kind of practice is permitted to
continue," Sullivan said. "Unless the possible and probable
consequences of all of these events are fully understood, there may be an
inclination on the part of some decision makers to remedy this 'on the cheap.'
" During its six-month investigation of prison medical care, The News
Journal submitted a Freedom of Information request to Taylor for the most recent
audit report by the commission, which was completed in February. The request was
refused. Taylor and Minner have pointed out that prison medical care is
scrutinized by the Medical Society of Delaware. But Dr. James Marvel, president
of the Medical Society of Delaware, said the state's account of his group's
prison work may be overblown. "We don't have any plans to do
anything," Marvel said. "We do not have an investigative body. Our
prison health committee is simply advisory.
September 29, 2005 Wilmington News Journal
A Senate Republican leader and three fellow Delaware lawmakers on Wednesday
called for independent investigations of medical care in the state's prisons.
"We have a crisis now," said House Majority Leader Wayne A. Smith,
R-Clair Manor. "The system is broken and it needs to be fixed. If I was
governor, I would have immediately raked someone over the coals." Federal
investigators also have been alerted to allegations of poor medical care
provided to the state's 6,600 inmates. The bipartisan response follows a
four-day series of News Journal articles detailing the spread of AIDS and other
infectious diseases behind bars; the award of a no-bid $25.9 million contract
for medical care approved this year by Correction Commissioner Stan Taylor and
Gov. Ruth Ann Minner; high rates of AIDS-related deaths and suicides; gaps in
independent oversight of the prison's private medical contractor and the
prison's medical grievance process; and numerous allegations of inadequate
medical care. Rep. Hazel D. Plant, D-Wilmington Central, asked to convene a
special House committee to investigate prison medical care. "I would rather
see a federal investigation, but if that takes too long, then we need an
independent investigation," she said. "I want it to start
yesterday." Taylor, Plant said, must go. In a written release to the
newspaper, one of Minner's spokespersons wrote: "Providing quality health
care services to an inmate population is a very demanding task and a very
difficult service to deliver, but it is a program that Commissioner Taylor and
the Governor have been working to improve for the past few years, and it will
continue to be a priority in the years ahead." U.S. Attorney for Delaware
Colm F. Connolly said he's known since September 2004 -- when a local defense
attorney told him about poor medical care for a client -- about allegations of
mistreatment within Delaware's prison system. "As a result of that
complaint, we forwarded it to the Civil Rights Division in Washington," he
said. "I've also forwarded the [News Journal] articles." Sen. Margaret
Rose Henry, D-Wilmington East, wants to lead a Senate investigation into prison
conditions. She hopes to organize a diverse panel that will include legislators,
health professionals, prison reform advocates, prison staff and local citizens.
She believes such a group should find the root causes of the breakdown in the
health care system in our prisons, she said, and how it can be corrected.
September 28, 2005 Wilmington News
Journal
There were two Jermaine Wilsons doing time at Gander Hill prison in Wilmington.
They were young black men who were unrelated. One, in prison for a robbery
charge, had served about three years and was due to be released in February of
this year. His mother was picking him up. The other, doing time for violating
parole stemming from drug charges, was facing new charges associated with a
cocaine bust. He was scheduled in February to be transferred to the maximum
security wing of the Delaware Correctional Center near Smyrna -- the state's
roughest prison, built for the most incorrigible offenders. But corrections
officials sent the wrong Jermaine Wilson to Smyrna. And days later -- when he
should have been free, guards found 20-year-old Jermaine Lamar Wilson dead,
hanging from a bedsheet in his cell. Because he had a cut on the back of his
head, his family suspects he was murdered. "There was blood all over his
clothes," said Laretta Wilson, Jermaine Lamar Wilson's aunt. "There
was blood in his underwear and all over his pants. Maybe someone hit him on the
back of his head?" The Delaware Medical Examiner's Office called the wound
"superficial" and ruled the death a suicide. Wilson's family received
little information from the Delaware Department of Correction. No apology. No
excuse. Just Wilson's blood-soaked clothes. Correction Commissioner Stan Taylor
declined to comment on specific inmate deaths, including Wilson's. During a
six-month News Journal investigation, a former doctor and two nurses who worked
in Delaware prisons and dozens of inmates and their families claimed prison
health care in Delaware is dangerously substandard -- leading to needless
deaths, prolonged suffering and the spread of infectious diseases inside and
outside prison walls. Wilson's death raises a larger question: Are standards
throughout Delaware's prison system too low? There are few safeguards in
Delaware prisons: oDr. Janet Kramer, of Wilmington, an expert in prison health
care, said inmates should be screened for hepatitis C and HIV -- but pretrial
and convicted inmates are not routinely screened when they are sent to prison or
when they leave. Delaware prisons have become incubators for new strains of the
AIDS virus, creating a public health crisis, experts say. oFormer prison doctor
Ramesh Vemulapalli says a private medical company ordered him to treat inmates
for HIV or hepatitis C, but not both. Delaware led the country in two of the
past four years in the rate of inmates dying of AIDS. oInmates in Delaware kill
themselves at twice the national rate. Dr. Carol A. Tavani, a neuropsychiatrist
and executive director of Christiana Psychiatric Services, said new inmates
should be counseled in person about suicidal tendencies, not simply given a
"contract" to sign promising not to kill themselves. oUnlike
Pennsylvania and other states, Delaware does not have a medically trained state
employee overseeing contract health providers. Maryland has its own statewide
correctional accrediting agency, Delaware does not. oThe prison's grievance
system is overseen by the medical vendor, not prison officials or an independent
medical professional. oCommissioner Taylor awarded the current $25.9 million
medical contract -- signed this year with Correctional Medical Systems (CMS) of
St. Louis -- without putting the contract out for bid. Gov. Ruth Ann Minner
approved the decision, but insisted it was a contract extension even though CMS
replaced First Correctional Medical of Tucson, Ariz., a different company. oThe
state occasionally discharges convicted inmates early so neither the state nor
its prison health care contractor has to pay medical costs, leaving the payments
to families or the federal Medicaid program. Neither federal prison regulators
nor the public is told about inmates who die after such discharges. oThe state
does not routinely conduct autopsies on inmates who die in prison or those
hospitalized at the time of their death, a policy the president of the National
Association of Medical Examiners believes prevents evaluation of the quality of
prison medical treatment. And if it does conduct autopsies, the results are sent
to the medical vendor -- not the prison. oDr. Robert Cohen, an expert in prison
health care whom state and federal courts have appointed to monitor prisons in
five states, said the state should investigate medical malpractice claims.
Instead, the state's medical board occasionally takes complaints from inmates
and their families about prison health care professionals, but it is only an
advisory panel. The board's findings are confidential and given to the private
medical vendor. Every institution in the Pennsylvania Department of Corrections
has a correctional health care administrator whose role is to oversee the
medical vendors and investigate grievances and other complaints made against the
state's medical vendor -- Prison Health Services. Shirley Laws-Smith -- a
registered nurse -- is the correctional health care administrator at SCI
Chester. She has counterparts at every facility in the state. If she questions a
vendor's procedure, she can take immediate action. "If they make a decision
and I don't agree with it, I will contact the central office at the Bureau of
Health Care Services," she said. Delaware's inmate grievance process is
quite different. In Delaware, no one with any medical training oversees the
actions of the medical vendor, and the vendor controls any complaints. When an
inmate files a grievance about poor care, it goes straight to the vendor. When
an inmate appeals the decision, the grievance eventually goes back to the
vendor. All mental health workers in Delaware prisons are contract workers
employed by medical vendors.
September 27, 2005 Wilmington News
Journal
A Delaware prison inmate serving time for traffic violations -- including
driving under the influence of alcohol -- Bernadette Fogell said trouble with
her pregnancy started weeks before birth. Prison documents show that she
complained to nurses at Delores J. Baylor Women's Correctional Institution in
New Castle. But in a lawsuit filed against Delaware's prison medical provider
and the state, Fogell claims nothing was done. "What could I do?"
Fogell asked. "You're helpless. It's not like you can get in your car and
leave looking for competent medical care." Her water broke at 11 p.m. on
March 19, 2001. Several inmates on her wing changed Fogell into dry sweat pants.
Two nurses arrived and one scolded her, Fogell claimed, suggesting that Fogell's
water had not broken. Rather, the nurse suggested, Fogell had urinated in her
pants. Fogell was taken to the infirmary, where she was left alone in a filthy
room with no sheets, blankets or pillow, she claimed. Prison documents included
in the federal lawsuit Fogell filed in 2001 against First Correctional Medical,
the state, a local doctor and St. Francis Hospital in Wilmington (which has
since been dropped from the suit) show that nurses checked on Fogell until 2:25
a.m. Those same records indicate that Fogell went unchecked between 2:25 a.m.
and 8:30 a.m. "I just couldn't figure out why I wasn't going [to the
hospital]," Fogell said. At 8:40 a.m. an ambulance was called, and Fogell
was admitted to St. Francis Hospital, where doctors told her she would be
transferred to Christiana Hospital. Health care workers said they would try to
prolong the delivery to allow time for the transfer, Fogell said. It never
happened. A doctor arrived about 4:30 p.m., more than 17 hours after her water
broke. According to medical records, the doctor wrote there had been "no
prenatal complications til now." An hour and a half later, "The nurse
came in and told me they were inducing the baby," Fogell said. Twenty-two
weeks after conception, Anna Lee was born at 11:27 p.m. -- 24 hours and 27
minutes after Fogell's water broke. Fogell cradled her newborn daughter, who was
dressed in a light blue gown. The infant, whose eyelids were fused, wasn't
breathing. Anna Lee jerked several times, and her heart continued to slow,
medical records show. Fogell said she called for help, but claimed nurses nearby
wouldn't respond. She placed her mouth over Anna Lee's tiny lips and nose and
tried to resuscitate her. But the baby continued to fade. "There was no
attempt to save her," Fogell claimed. "Nobody was doing anything. I
kept crying and singing to her, 'You are my sunshine.' I just didn't know what
else to do." As she held the baby in her arms, Fogell realized it would be
the last time she ever saw her. The same doctor reached inside her womb and
removed the placenta -- or at least he thought he did. Two hours after the
doctor finished with what he thought was the last of the placenta, at 3:10 a.m.,
Anna Lee died. Days later Fogell contracted an infection that led to her being
hospitalized again, where the remainder of her placenta was taken out. Prison
officials and the state's medical vendor at the time, FCM, declined to comment.
September 26, 2005 Wilmington News Journal
Bernard Coston was taken to prison in March 2002 on charges he stole a $50
jacket from an elderly woman. Coston was released from prison 18 months later on
a slab. Dirt and feces covered his body. Insects had been gnawing on his corpse.
Diagnosed with AIDS before he went to prison, Coston spent his last four months
in the infirmary of Wilmington's Gander Hill prison -- at least that's what is
written on a state medical examiner's autopsy report. But Coston's sister,
Victoria Trice, said she was told by a prison counselor that her brother wasn't
in the infirmary, that he withered away, alone in a cell with no food or medical
attention. He was too weak to bathe. "They are more humane to an animal
than to my brother or anyone else who died in there," Trice said.
"It's a disgrace," said Dr. David M. Cohen, an AIDS specialist with
the Christiana Care HIV Wellness Clinic. "Because they're prisoners, the
government has the right to take away their liberty. But they do not have the
right to take away their health." Coston's death certificate states simply
that he died of AIDS. The external examination from the autopsy paints a more
gruesome picture: •"The scalp is dirty" •"Examination of the
skin on the back reveals a layer of dirt" •"Dirt is noted under the
fingernails" •"Fecal material is smeared on the buttocks."
"It's obvious he got poor, poor, poor medical care," said Lynda R.
Kopishke, a forensic nurse and branch director of Interim Health Care in Newark.
At the request of The News Journal, Kopishke agreed to review Coston's autopsy
report, prepared by Dr. Adrienne Sekula-Perlman, Delaware's deputy chief medical
examiner. Kopishke found it hard to believe that Coston had been treated for
four months in a prison infirmary. "I struggle to understand the
inconsistencies surrounding these findings," Kopishke said. "If I did
not know this individual was in the infirmary, I would wonder if he had been
buried under dirt at some point in time." The last AIDS doctor employed in
the state's prisons -- Dr. Ramesh Vemulapalli of Dover, an infectious disease
specialist -- quit in 2003. The state's current private medical provider, St.
Louis-based Correctional Medical Services, employs an infection-control nurse.
Louis W. Chance Jr. died in 2003 -- seven days short of freedom. Chance, 37, was
serving a six-month DUI sentence at the Webb Center, a work-release facility in
Prices Corner, when he developed a severe headache. At his first medical visit,
Chance told nurse Beverly Anderson that he had had a headache for three days,
according to a medical malpractice lawsuit filed against the state and First
Correctional Medical, Delaware's medical provider at the time, in U.S. District
Court in Wilmington. Anderson gave him six Excedrin and sent him back to his
cell. The next day, Chance reported no relief and was prescribed Motrin. After
three more days, a correctional officer reported Chance was confused and had
possibly "overdosed." Chance was transferred to Gander Hill prison in
Wilmington, where, his attorney says, the pressure inside his head from
cryptococcal meningitis affected his hearing. Unable to respond to nurses,
Chance was reported to be disoriented, uncooperative and hostile. Officers
subdued him, put him in a straitjacket and left him in a cell under suicide
watch. Chance, who had not yet been examined by a doctor, was prescribed Ativan,
Benadryl and Haldol. The drugs are used to treat panic attacks, allergies and
psychosis, respectively. Together, they can calm a person. About three days
later, Dr. Niranjana Shah, a contract physician with First Correctional Medical
working at Gander Hill, prescribed Tylenol and a daily cup of coffee because,
Chance's medical records state, caffeine helps combat headaches. On Sept. 18,
2003, Chance was sent back to the work-release facility at Prices Corner. Five
days later, Chance died. Had Shah and Dr. Jose A. Aramburo followed protocol for
a patient with HIV, Chance could have lived, claims Ken Richmond, a Philadelphia
attorney representing the Chance family in the lawsuit against FCM and the two
doctors. "It appears to be a concerted effort to avoid treating someone who
was HIV-positive," Richmond charged. "This is gross negligence."
Months before Chance got sick with cryptococcal meningitis, FCM employees
performed a blood test on him, Chance's medical records say. He tested positive
for hepatitis C and was given brochures on hepatitis and HIV, according to the
lawsuit. About a quarter of people in the United States who have HIV also have
hepatitis C, according to the CDC. Because HIV patients are especially
susceptible to cryptococcal meningitis, Richmond said, FCM should have tried to
rule out the condition before trying other treatments. "That's the sad part
about this," he said. All four classes of antiviral treatments are
available in Delaware prisons, said Dr. Vemulapalli, an infectious disease
specialist who worked a little more than a year at the Delaware Correctional
Center near Smyrna. But inmates, he said, did not always receive them.
"Most patients who come to the hospital from the Department of Corrections
are generally far too advanced," said Vemulapalli, who is now in private
practice in Dover. "I've seen several cases from the prison -- all patients
who have died -- that didn't get referred to the hospital at the appropriate
time. They're not providing adequate care." Vemulapalli, who worked for
Tucson-based FCM, claims company owner Kastre ordered him to treat AIDS or
hepatitis C -- but not both, even though many patients have both. The reason,
Vemulapalli said he was told, is that "it was too expensive to treat
both."
September 26, 2005 Wilmington News
Journal
Doctors and nurses at Gander Hill prison, in Wilmington, never treated Ed
Brittingham for the flesh-eating bacteria that scarred his body. They thought
the 47-year-old inmate had a broken arm. Nearing the end of his 13-year sentence
for second-degree burglary, Brittingham was enrolled in a drug treatment program
and was allowed to leave the prison for furloughs home and for work release. The
frequent trips outside the wire, it turns out, exposed his wife, friends and the
public to the lethal disease that was eating away his shoulder. Just one cough
or sneeze could have spread the infection. Brittingham first noted an intense
pain in his shoulder on a weekend furlough in December 2004. When he returned to
prison the following Monday, he reported to sick call, which was managed by
First Correctional Medical, a Tucson, Ariz.-based private medical company
working in Delaware prisons under contract with the Department of Correction. At
sick call, an employee with FCM gave Brittingham a sling, took some blood and
scheduled a few tests. "When the X-rays showed I didn't have any broken
bones, they wrote me up for faking," Brittingham said. "I knew it
wasn't a broken bone. I told them this. They gave me Motrin, but the pain was
pretty awful so I took a double dose. They wrote me up for that, too."
Severe abdominal pain followed. There was blood in his urine. The medical staff
assumed Brittingham was passing a kidney stone. They issued him a strainer and
more Motrin. "I was drinking five gallons of water a day, but I never
passed any stone," he recalled. "I kept trying to get to medical,
filling out sick call slips." Brittingham stopped eating. He couldn't hold
down food; the pain in his shoulder, stomach and leg were too intense. "On
a scale of 1 to 10, it was a 20," Brittingham said. Necrotizing fasciitis,
also known as flesh-eating bacteria, is a condition caused by strep A bacteria,
which is the same bacteria that causes strep throat. Brittingham said,
"They told me if I went to the hospital while on a home furlough, they'd
consider it an escape, and I'd get sent back to prison to serve the remainder of
my sentence." The prison staff gave the same warning to his wife, Lee
McMillan, she said. "They told me if he had a heart attack and fell to the
floor, I wasn't supposed to call 911," she said. "I was supposed to
bring him back to the prison." Weeks passed. The pain became torturous. In
January, Brittingham did the unthinkable. He ended a home furlough on his own
and went back to prison early. The bacteria was eating its way through to the
surface of the skin, causing massive red lesions on his leg, foot and shoulder.
His face was swollen, and he was burning up with fever. He had difficulty
communicating with his wife. It hurt to move, sit or lie in bed. Rather than
heading to the prison infirmary, where his complaints had been ignored,
Brittingham went to a prison guard, stripped off his clothes and showed him the
lesions. "Thank God they thought they were blood clots, because they sent
me to St. Francis Hospital," he said. "Once I got to the hospital I
went blank. I was there for 11 days. I don't remember much." In late
January, Brittingham was discharged from the hospital and transferred back to
Gander Hill. "I spent my first four days without any pain meds,
antibiotics, physical therapy or wound care information," he said. "My
leg started swelling up again. I thought I was having a reoccurrence. I swear to
God I didn't want to go through that again." Brittingham was eventually
given medication and has since been released. He now lives with his wife in New
Castle. The couple hasn't filed a lawsuit, but they want the prison staff and
First Correctional Medical held accountable. "These people should be
prevented from practicing medicine and from making decisions that affect
people's lives," he said. "What they did to Ed was a crime,"
McMillan said. "If these prison doctors would have suffered like Ed
suffered, it would have stopped." Brittingham spends his days looking for
work. His wife has recently completed a medical transcriptionist course. They
spend their free time researching necrotizing fasciitis on the Internet.
September 25, 2005 Wilmington News Journal
Some inmate deaths are harder than others for Drewry Fennell to discuss. Charles
Blake's is the worst. Blake pleaded guilty in November 2000 to possessing
cocaine within 1,000 feet of a school. Three years later, while at the Delaware
Correctional Center in Smyrna, Blake became sick. "He had an operation on a
kidney. They put a stent in the kidney to hold the ureter open. He was released
back to the prison," said Fennell, executive director of the American Civil
Liberties Union of Delaware. "He started calling his mom. He was in intense
pain. He later passed the stent through his penis and died ... from that and
other complications. They were treating him with an analgesic -- Motrin. They
wouldn't send him back to the doctor. He lingered for weeks in the infirmary,
before they sent him to the hospital." Blake died Sept. 7, 2003, at St.
Francis Hospital in Wilmington. He was 36. Some seriously ill inmates are
granted a medical discharge by the Delaware Department of Correction, a move
that can shift the cost of mounting hospital bills to family members or
Medicaid. In its former contract with First Correctional Medical (FCM), the
state agreed to provide Medicaid to inmates who are hospitalized for more than
24 hours. But when this happened, the state was allowed to reduce its monthly
payment to the medical vendor, so the state's overall expense remained the same.
Shortly before her son died, Francine Anderson said, a friendly guard told her
prison officials wanted to release Darnell to the family so his death would go
unreported to federal prison regulators -- and so the family would be
responsible for some of the medical bills. Anderson considered taking her son
home from St. Francis Hospital, in Wilmington, but he died before she could
arrange it. After an inmate dies, the medical vendors conduct an internal
"peer review" led by the contract medical director -- not by an
independent board. Occasionally, the vendor will bring in outside physicians to
look at the patient's medical records, Taylor said. Under Delaware law, the
entire process is confidential. Not even the inmate's family can see the
findings. When the peer review is completed, the results stay with the medical
vendor. It's not known what, if anything, the vendor does with the findings.
When an inmate is autopsied, which happens in roughly 15 percent of prison
deaths, the medical examiner's office does not send the report to Taylor or the
warden. The autopsy reports go straight to the medical vendor.
September 25, 2005 Wilmington News Journal
Pierce was serving 14 months for a parole violation stemming from a burglary
charge at the Sussex Correctional Institution in Georgetown when a small lump
appeared on the back of his head. It was January 2001 and a prison doctor
employed by a private medical contractor said the marble-size lump was most
likely a cyst or an ingrown hair. Seven months later, when the growth had become
like a second head, Delaware's contract prison medical director, Dr. Keith Ivens
of Correctional Medical Services, stabbed the bulging tumor five times with an
18-gauge needle, withdrawing a bloody fluid. Rather than keeping the sample for
analysis, Ivens emptied the syringe into a trash can, according to Michelle
Thomas, a former prison counselor who was holding Pierce's hand during the
examination. The News Journal gained access to Pierce's medical file through his
family, and there was no record of a biopsy performed before cancer ate into the
21-year-old's skull. Asked about the case in a telephone interview, Ivens said,
"I'm trying to remember who Anthony Pierce is." He declined to comment
further. Near the end of Pierce's life, the tumor stretched the skin around his
face, pulling his right eye closed, causing muscle spasms and crippling pain.
The medical staff still ordered no tests or treatments, claims a lawsuit that
Pierce's family filed against Ivens, CMS and the state of Delaware. On March 22,
2002, Pierce died from a "brain tumor, due to osteosarcoma of the
skull," an autopsy report stated. A six-month investigation by The News
Journal shows that the lack of care suffered by Pierce is all too common inside
Delaware prisons. AIDS, hepatitis, flesh-eating bacteria and other communicable
diseases percolate behind the wire. Inmates in their 20s and 30s die from
diseases that people outside prison routinely survive. Like other states,
Delaware has turned over health care inside its prisons to private companies
specializing in inmate medical care. There are two significant differences,
however: •Whether they have been convicted or are awaiting trial, inmates in
Delaware depend on the state for medical care. In states with county and city
jails, care in smaller facilities usually is provided through a local hospital
or physicians' group. •National experts say most states employ a medically
trained staff to monitor the medical vendors. Delaware does not. Here, the
medical vendors oversee death investigations, regulate access to care, and
control any complaints that arise over their work. Dr. Robert Cohen, an expert
in prison health care whom state and federal courts have appointed to monitor
prisons in five states, said all states are constitutionally required to provide
adequate medical care for inmates. If Delaware "outsources" that
responsibility, it is still obligated to monitor its medical vendors, Cohen
said. That doesn't happen. The Medical Society of Delaware, a physicians group,
is occasionally called -- at the warden's discretion -- to investigate an inmate
death. Yet its investigation is led by the vendor's medical director. And the
society's report is confidential under Delaware law; it remains in the custody
of the medical vendor. "It's surprising to me that Delaware just lets the
vendor do it by themselves," Cohen said. Under the current $25.9 million
annual contract with Correctional Medical Services, state prison officials are
indemnified against wrongful death and medical malpractice lawsuits. If an
inmate or survivor sues the state, the medical vendor pays the state's attorney
fees and any settlement. However, Cohen said, the indemnification will not
protect the state from federal civil rights lawsuits filed by inmates or their
survivors. "It's going to cost the state a lot of money in the long
run," Cohen said. Correctional Medical Services of St. Louis held
Delaware's $12.45 million annual contract from 2000 to 2002, when it asked to be
released from its obligations. At that point, Taylor accepted a bid from First
Correctional Medical, a Tucson, Ariz., firm, for a $16.44 million annual
contract. FCM left the state in July after explaining that it wanted to be
released from its contract. FCM's owner and founder, Dr. Tammy Kastre, did not
return numerous calls for comment. Taylor would not discuss reasons for the
departure, but added that FCM owes thousands of dollars in unpaid bills to
private clinics, hospitals and physicians. The exact amount is in dispute.
Taylor said he was forced to move fast to find a replacement. He turned to a
company he knew well: CMS, the same company that cared for Anthony Pierce while
his tumor grew to the size of a grapefruit. Delaware Gov. Ruth Ann Minner said
the contract awarded to CMS was not a "no-bid" contract, as described
by Taylor. She argued that, even though CMS asked to be released from its
contract in 2002, forcing the state to hire another vendor, CMS' return to
Delaware came by piggy-backing on the contract of the vendor it replaced, FCM.
It's unclear how the "extension" resulted in an annual price hike of
$9.5 million. Taylor declined to answer that question. CMS provides medical care
for some 285,000 inmates in more than 360 prisons in 25 states. It is named in
many lawsuits filed in state and federal courts across the country, although the
exact number of suits filed against the 25-year-old St. Louis firm is difficult
to obtain. There have been 53 lawsuits filed in Wilmington's U.S. District Court
against CMS since 2000. Twelve are still active. Former CMS medical director
Ivens, has been sued 15 times in U.S. District Court by Delaware inmates or
their families. Each of the federal lawsuits against Ivens has been dismissed,
but at least two state Superior Court court cases naming Ivens as a defendant
remain active. Michelle Thomas, who worked for Spectrum, a CMS subsidiary that
provided substance-abuse treatment to inmates, helped establish the treatment
program that inmate Pierce attended before he contracted the cancerous growth on
his head. "They're the scum of the earth," Thomas said of her former
employer. She quit CMS shortly after Pierce died. Thomas said she watched in
horror as Pierce's tumor grew. Thomas said she repeatedly questioned the medical
staff about the lack of treatment, but she never got an answer. Yet Dr. Sitta
Alie, the former medical director for FCM, who, like many of its employees, was
hired by CMS when it took control of Delaware institutions in July, said this
about the two companies: "They're both awful." Alie was an employee of
FCM when interviewed by the newspaper. Contacted again after CMS took control,
she declined to comment further. Before 1978, Delaware's Department of
Correction had a long tradition of hiring its own doctors and nurses, or guards
who were former military medics, to provide health care for adult and juvenile
offenders. But two years after the 1976 U.S. Supreme Court ruling that inmates
deserve health care equivalent to community standards, Delaware signed a
contract with Sacred Heart Hospital of Chester, Pa., to provide care for state
prisoners. In 1981, then Correction Commissioner John L. Sullivan hired
Claymont-based Prison Health Services, following a national trend of states
privatizing prison medical services. The new company was founded by Delaware
nurse Doyle H. Moore, who had been Sacred Heart's prison health care program
coordinator. A year later, PHS ended its 23-month contract, citing a spike in
incarceration rates. Eleven private prison companies bid for the open contract.
Decisions about performing medical tests or procedures on inmates in Delaware
are not made here, but by company executives at the corporate offices. When an
inmate dies in Delaware, the autopsy -- if there is one -- and other
investigative reports go to the vendor, not to any state official. And Taylor
does not review inmate autopsies.
August 30, 2005 AP
The
family of an HIV-positive man who died while serving a six-month sentence at
Gander Hill prison in Wilmington, Del., is suing First Correctional Medical, the
prison system's health care provider, and two of its doctors over allegations
that they did not take adequate steps to diagnose or treat the inmate's disease,
the AP/WBOC reports. The lawsuit alleges that prison health care providers
ignored 37-year-old Louis Chance's health complaints in September 2003 and
should have ordered a CT scan or an MRI to help diagnose and treat his
cryptococcal meningitis, according to attorney Ken Richmond, who is representing
Chance's family. Chance became comatose and was admitted to a Wilmington
hospital, where he died of the opportunistic infection. Family members said they
were unaware that Chance was HIV-positive and said he might not have known his
status either. "It's our belief that the death of Chance resulted from
cost-containment policies," Richmond said. The inmate's relatives are among
several critics of First Correctional and the Delaware Department of Correction
who think health care providers are putting financial concerns before medical
care. More than 40 lawsuits have been filed against Arizona-based First
Correctional since 2002, when it was awarded a six-year contract to provide
health care for Delaware's inmates. First Correctional pulled out of the
contract in June after DOC officials requested an inspection of the provider by
the National Commission on Correctional Health Care. DOC Commissioner Stan
Taylor said the department's medical review committee and NCCHC identified
"some issues" with First Correctional. Officials from First
Correctional declined to comment.
August 29, 2005 WBOC
Louis Chance Jr., serving six months behind bars for his
fourth drunken driving conviction but hoping to start a new life when he got
out, was only a few weeks away from his release date when he began suffering
severe headaches. The headaches grew so agonizing that Chance became disoriented
and incoherent, but his family says his pleas for help from prison medical
workers went mostly unheeded. Instead, according to a lawsuit the family filed
in federal court, Chance was deemed uncooperative and hostile and accused of
trying to overdose on pain medication. At one point, a doctor at Gander Hill
prison in Wilmington prescribed "Tylenol and one cup of coffee per
day," according to the lawsuit. More than two weeks after he first reported
feeling sick in September 2003, Chance, 37, lapsed into a coma and was sent to a
Wilmington hospital. He died of cryptococcal meningitis, an infection and
swelling of the membranes surrounding the brain that is one of the opportunistic
infections associated with HIV. Chance's family and other critics say too many
inmates with HIV- and AIDS-related illnesses are dying because prison medical
providers are more concerned about holding down costs than providing adequate
medical care. Department
of Correction Commissioner Stan Taylor declined to comment on individual
inmates' cases. Asked whether he was satisfied with First Correctional Medical
Inc., the system's medical provider when Chance died, Taylor said noted the
company maintained Delaware's National Commission on Correctional Health Care
accreditation.
The privately held company, based in
Arizona, operates in a handful of other states. Its six-year contract with
Delaware was worth more than $17 million a year. In June, First Correctional
Medical pulled out of the contract, forcing the department to sign a $25.7
million-a-year, no-bid contract with its previous medical services provider,
Correctional Medical Services of St. Louis. Ken
Richmond, a lawyer suing First Correctional Medical and two of its doctors on
behalf of the Chance family, said Chance's condition could have been diagnosed
and treated had the contractor's doctors scheduled a CT or MRI brain scan.
The
end of First Correctional Medical's contract came after DOC officials requested
an inspection earlier this year by the National Commission on Correctional
Health Care. Taylor said both the NCCHC and the DOC's medical review committee
had identified "some issues," but he declined to provide details.
Since coming to Delaware, a move that more than doubled the
number of inmates for whom the company was responsible, First Correctional
Medical has been the target of more than 40 lawsuits, the vast majority filed by
Delaware inmates. Several have been dismissed for a variety of reasons -
including the fact that inmates must go through an internal grievance process
before they can seek relief in the courts. Since
January 2000, 190 Delaware prison inmates have died while in custody, many,
according to DOC press releases, "after a lengthy illness."
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