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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 31, 2014 usatoday.com
WILMINGTON, Del. — Nine inmates
have filed a civil lawsuit in Superior Court against a former doctor at
Sussex Correctional Institution alleging the doctor sexually assaulted them
on numerous occasions "under the pretext of performing medical
exams." The suit claims there was no medical reason for the contact and
the doctor, Lawrence McDonald, acted "to satisfy his own prurient sexual
desires." Dover attorney Stephen Hampton filed the lawsuit on behalf of
the inmates this month and said the doctor's practices were so well known at
SCI that correctional staffers referred to him as "Dr. Feelgood" and "the finger." Hampton said
prison officials ignored repeated complaints about McDonald from both inmates
and staff, defended him against the charges and retaliated against inmates who
complained. Department of Correction spokesman John Painter said the
department does not comment on pending litigation. McDonald could not be
reached for comment and an attorney who previously has represented the doctor
said he could not comment until he was authorized. The inmates claim in the
lawsuit that McDonald performed unnecessary rectal exams, often without
gloves, and fondled their genitals without any medical purpose. In one case,
an inmate reported McDonald fondled him when he sought medical treatment for
a rash on his face. In a different case, McDonald reportedly made the inmate
say "thank you, doctor" after he performed rectal exams. Another
inmate claims despite years of invasive examinations — that included
inappropriate contact by McDonald — it was only after McDonald left the
prison that he was diagnosed with hepatitis C. The suit charges that McDonald
ignored or was indifferent to the prisoner's actual medical issues. A fourth
inmate claimed McDonald stuck him in the groin with a needle, allegedly to
draw blood, but no blood was drawn. The lawsuit is the latest reported
problem at the Sussex County prison. A former guard, Christopher Peck,
pleaded guilty earlier this month to six counts of having sexual relations in
a detention facility. He was charged in November with having sex with at
least three female inmates on 11 occasions. In July, a guard was suspended
with pay on charges that he had sickened several inmates by baking Ajax or
Comet into bread. Hampton said this latest lawsuit "is just another
symptom of the malaise at SCI." Hampton charged that the prison and
state officials had been put on notice about McDonald in 2008 when inmate Ben
Roten filed afederal
lawsuit alleging that McDonald had molested him. In 2007, a part-time psychiatrist
resigned from SCI in protest because superiors ignored her when she reported
several inmates accused a medical colleague of sexual abuse. "I was told
... that I should be a team player and let those allegations pass. ... I felt
I had to resign and seek the opportunity to discuss these issues with
you," wrote the psychiatrist in a letter to former DOC Commissioner Carl
Danberg, according to the suit. Danberg
replied that the allegations were investigated by Internal Affairs and the
Medical Society of Delaware and determined to be unfounded, according to the
suit. Roten's federal lawsuit was ultimately
dismissed, though the suit notes that Roten,
"as an unrepresented inmate, was unable to retain medical experts to
contradict those employed by McDonald." McDonald no longer works at the
prison. The suit alleges prison officials fired McDonald after hearing
allegations made by inmate Theodore Barrett, a plaintiff in the case. The
suit states Barrett was later a target of prison staff who called him "the
snitch of the month" over the intercom. The prisoners who filed the suit
include Barrett, Ronald Keis, Wilbur Medley, Victor
Talmo, Raymond Brown, Gene Schultz, David DeJesus, Derrick Jackson and Joseph Vincent. Hampton said
all had ongoing, serious medical issues that required them to frequently
visit the infirmary. All nine are still incarcerated. The suit also names
Correct Care Solutions LLC — the private company that employed McDonald and
took over from Correctional Medical Services — along with Jill Mosser, identified as McDonald's supervisor, and Warden
G.R. Johnson, Deputy Warden Linda Valentino and Correctional Officer Lamont
Hammond. The lawsuit charges McDonald with battery and the intentional
infliction of emotional distress and alleges constitutional violations
against the remainder of the defendants, including a prisoner's Eighth
Amendment protection from cruel and unusual punishment.It
seeks unspecified compensatory and punitive damages and court costs.
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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