AFSC-TUCSON: AZ DOC's DEATH YARDS

For Kini Seawright, and all the other women who bury a loved one due to police or prison violence...

Showing posts with label hepatitis c. Show all posts
Showing posts with label hepatitis c. Show all posts

Thursday, June 27, 2013

Deliberate indifference in AZ DOC custody continues under Corizon.


 
 

Good article today in the Tucson Weekly about the DOC's deliberate indifference to human life and their unnecessary deaths in custody.  Please go to the source and leave your comments, especially if you have personal experience with the DOC. 

This is what I had to say:

"Thank you so much for this article. As one who hears daily from prisoners and their families and fights with the DOC about health care and safety in custody, I can attest to the unconstitutional - the outright inhmane - standard of medical care in AZ prisons. From the deliberate indifference to pain and suffering of cancer patients to the brutal, degrading treatment dished out to the traumatized and mentally ill, the conditions of confinement under DOC director Charles Ryan are horrendous.

Ryan's reputation for running the cruelest system in the country actually invites some pats on the back from thick-headed legislators here, but from the junk laws and sentencing guidelines we pass to the implementation of our penal system, Arizona is exceptionally stupid on crime. What is the logic behind depriving prisoners of access to the resources they need to be rehabilitated while subjecting them to the rising violence, trauma and terror that has caused AZ prison homicide and suicide rates to double under Brewer's adminstration? We are simply inflicting further injury on already-damaged people.


Chuck Ryan seems to implement policy based on his contempt for prisoners and desire to punish rather than his duty to try to rehabilitate any of his charges so they are safe to be released back to the community. He's an embarassment to other law enforcemnt professionals in arizona, many of whom don't subscribe to his ideology. He doesn't seem to know what "evidence-based practice" is, or why it's so important to invest public resoures in corrections programs that are actually proven to increase parolee success and public safety.


For example, despite the fact that 75% of incoming prisoners are identified as having problems with addiction or alcoholism, and the growing epidemic of hepatitis c in the prison system (being spread by the obscene abundance of heroin and lack of access to clean needles behind bars) - only 4% of all state prisoners even got substance abuse treatment last year. That's unacceptable. In their 5-year plan the DOC claims not to have enough funding to increase the number of prisoners to more than 3000 a year who get treatment, either
(that's out of a total of 60,000 prisoners who cycle through there)

The problem with the AZ DOC isn't a lack of money, though - they have a billion dollar budget, and its still growing. Their problem is the failure to spend it responsibly. Instead of fully funding programs to help prisoners transition to the community again, the DOC actively convinced the legislature to take money out of an account for those kinds of services and put it into the building fund to support the construction of their new $50 million supermax to warehouse people in.

In fact, the state is facing a class action suit not only for gross medical neglect, but also for their illegal use of administrative segregation (i.e solitary confinement, which the DOC denies they ever use) to manage the symptoms of priosners with serious mental illness in the current supermax facility. If some of the folks currently filling those cells don't belong there to begin with, why build another one?


The only explanation I can see for that new supermax - other than the financial incentives all the obvious beneficiaries have to push this through - is that Chuck Ryan wants this monstrosity to stand as a monument to his brief reign as the DOC's king-baby. I think it's criminal for the public to have to pay for him to fulfill that immature fantasy, especially while other state DOC's are shutting down prisons AND bringing down crime rates by redirecting resources to supporting the reintegration of prisoners in their communities. If Jan Brewer had any real courage or common sense she would fire DOC director ryan immediately and reconstruct the entire system based on contemporary models of crime reduction and the rehabilitation of offenders."


If you are a prisoner's loved one fighting Corizon and the DOC for their access to health care, here's a link to a post that may help:

Corizon and the AZ DOC: Prisoners Families, Know Your Rights.


 please also feel free to contact Peggy Plews at 480-580-6807 or arizonaprisonwatch@gmail.com


----from the Tucson Weekly-------

Cruel, But Not Unusual


State prisoners say lousy medical care is killing them

A narrow road shadows the outer fence at Arizona's state prison in Tucson. Composed of light gravel, always raked smooth, the lane is a blank palette for the footprints of escape. Yet much of this complex holds only petty offenders—short-termers, really—for whom such capers would seem pointless.

But it seems even they can face a death sentence of sorts, delivered by a culture of medical neglect.

That's why two top dogs at the Arizona Department of Corrections are currently being sued, not only by the American Civil Liberties Union of Arizona, but also by the potent, San Quentin, Calif.-based Prison Law Office. In 2011, Prison Law scored a resounding U.S. Supreme Court victory that compelled California to reduce prison overcrowding.

The Arizona lawsuit was filed in March against Corrections Director Charles Ryan and his health services director, Richard Pratt. It alleges that "medical, mental health, and dental care" provided to inmates is "grossly inadequate and subjects all prisoners to a substantial risk of serious harm, including unnecessary pain and suffering, preventable injury, amputation, disfigurement and death...

"Critically ill prisoners," the lawsuit continues, "have begged prison officials for treatment, only to be told 'be patient,' 'it's all in your head,' or 'pray' to be cured."

Dan Pochoda is legal director for the ACLU of Arizona. He calls health care in our state prisons "the worst I've ever seen, in terms of clearly increasing harm unnecessarily because of the inadequate care, and the absence of anything except trying to save money on the backs of the prisoners."

Because of its sweeping implications, the case has since evolved into a class action lawsuit. The next step is proving in court just how dire the situation truly is, says Pochoda. "The ideal outcome would be a finding that there is clearly deliberate indifference to the serious medical and mental health needs of the inmate population, that people are dying unnecessarily, that folks who are in for sentences of a few years—not life sentences or death sentences—are coming out with permanent and serious illnesses."

Their ranks include Robert Plasa, now doing three years at the Tucson prison for violating his probation. Back in 2011, before he was sent to jail, Plasa says he was diagnosed with thyroid cancer. He was waiting to have the gland removed when he was arrested.

Today, he's still waiting. "I have been strung along for almost a year-and-a-half here without treatment," he wrote me in a letter this March.

In that time, Corrections has turned its state-run prison medical program over to one private health care provider, and then to another. But for Plasa, apparently little has changed—except that his diagnosis has grown even more grim. "I have recently had blood work done and ultrasound on the thyroid," he wrote. "This revealed that the cancer not only spread through the whole thyroid, it is now in the lymph nodes. The thyroid could have been cut out before, and isolated the cancer. Due to the lack of medical attention and negligence on the part of the Department of Corrections, I have a more serious and maybe life-threatening medical condition."

When I asked Corrections for details on Plasa's plight, spokesman Andrew Wilder referred me to the state's current prison health care provider, Corizon Inc. of Brentwood, Tenn. Citing privacy laws, Corizon also refused to comment on Plasa. But in an email, company spokesman Brian Fulton did issue this boilerplate response: "We can say that since Corizon assumed providing medical services for the Arizona Department of Corrections in March 2013, our caregivers have worked hard every day to provide quality health care services that meet and exceed national accreditation standards."

To Caroline Isaacs, however, Plasa's version sounds much closer to the truth. She heads the American Friends Service Committee's Tucson office, which has long agitated for Arizona prison reforms. "This guy's problem is not an isolated issue," Isaacs says. "There are really serious consequences to this type of incompetence. But prisoners are people that nobody cares about."

Indeed, the ACLU's Pochoda provided a stream of examples in which prison medical care was seemingly riddled with negligence. They include the inmate displaying chronic and mysterious flu symptoms that were never treated. Or the prisoner with a growth on his throat that was left untreated until it burst. Following surgery, his condition was again ignored until it worsened. Only then did the doctors decide that the growth was cancerous; the man has yet to receive standard treatment such as radiation.

Then there's the guy who did have his cancerous prostate removed, but then received no follow-up testing to ensure that the cancer had not returned. Only much later—too much later, it appears—did he receive tests showing that the cancer had not only rebounded, but was now spreading.

In response to their panicky letters, distressed relatives or partners of inmates received cavalier responses from Corizon—at least when they weren't outright ignored. "Please be assured that (your boyfriend) is not going to die," a Corizon apparatchik finally wrote to one worried woman, after she repeatedly tried to get information. "It is important to remember that (the inmate) is an adult and must take some part in his day to day health care."

This current wave of incompetence dates to 2011, when the Legislature directed Corrections to put its health services out to bid. Last summer, a three-year, $349 million contract was awarded to Pittsburgh-based Wexford Health Sources despite the company's troubled history in other states. True to form, Wexford's Arizona tenure soon hit turbulence when Corrections blamed it for poor record keeping and staffing problems. In less than a year, prison medical care had switched over to Corizon.

But for critics such as Pochoda, that's like choosing which train to ride off the rails. "Wexford has a very spotty record, after getting kicked out of other states, and it was a disaster," he says. "After nine months, they got fired or quit, and now (Corrections) has brought in Corizon, also with a spotty record. And we don't believe it will make a bit of difference because the goal is to reduce costs. For the private firms, there's a profit motive: the less they spend, the more they keep."

Ultimately, he blames state lawmakers for privatizing prison health care to save a buck, "but not uttering a peep about how it should be a better service, and not result in so many deaths, etc."

That's hardly news for guys like Robert Plasa.

"I have a good company I work for and a beautiful family waiting for me," Plasa wrote in his letter. "I wasn't figuring that paying my dues to the state of Arizona meant a life sentence from cancer."

Saturday, September 15, 2012

CURING HCV in prison: The new Community Standard of Care.


"Q: Will we be able to wipe out hepatitis C entirely?

A: In contrast to HIV, we do have the capability of doing that - essentially curing everyone who got infected. While we have made tremendous progress against HIV, we still don't have a cure, we still don't have a vaccine. The situation for HCV is dramatically different. A cure is achievable. Someday soon, the cure using an interferon-free cocktail is going to be routine...."

 ----------

Until now, I thought it was likely that this disease would kill not only my imprisoned friend Davon, sick as a dog on interferon right now, but also my big brother, who hasn't been able to get treatment - both I feared would die very painfully, at an early age. 

This news gives me hope, though. We have the capability to wipe out this disease and cure those who are ill right now - the question remains: do we have the collective will? That much, I still don't know.

Nearly 6,000 AZ state prisoners have tested positive for the Hepatitis C virus, but only a fraction are deemed eligible for a miserable course of interferon treatment because it costs so much and takes such a toll on body and mind. Many drop out from the side effects, having to face debilitating and fatal liver disease instead. Most public health estimates put the jail/prison population at being over 50% HCV+. Imagine how hard it is already to see loved one do time and maybe even make amends for their crimes in prison, and come home only to find that they were sentenced to die from an infectious disease, as well. 

For those who don't care about prisoners, though, think about this: since 95% of then return to the free world eventually, that means there's already an epidemic in communities with high rates of poverty, unemployment, homelessness, felonization, incarceration, uninsured persons, IV drug addiction, HIV/AIDS, and other compromised populations. It also disproportionately affects people of color, the LGBTQ communities, and Baby Boomers. That's a huge public health problem that no one in Arizona likes talking about - why are they so silent now, I wonder? Surely they've heard this by now.

It sounds like it's time for the AZ DOC and Wexford to re-write their Hep C treatment protocols, in any case, in order to assure that the standard of care they provide to prisoners with the virus (HCV) is consistent with the community's new standard. Otherwise, they can both expect to be named in a new class action lawsuit soon, I'm sure. I'd think the public at large could even sue the state for having an infected population unleashed on us - uneducated, untreated, unsupported, uninsured, and unwell.


remembering those we have already lost...



  
we must accelerate the fight for the living.



Fight the spread of HEP C today: 









Phoenix Art Museum: Art of Resistance
Prisoners' Justice Day Guerilla Installation
August 10, 2012







--------from the San Francisco Chronicle----------

Hepatitis C fight - 'watershed moment'

Erin Allday / San Francisco Chronicle
Tuesday, September 11, 2012
Earlier this year, an editorial in the New England Journal of Medicine declared that the world was in a "watershed moment" in the history of treatment for hepatitis C, a virus that is believed to infect roughly 180 million people globally. Dr. Warner Greene, director of the Gladstone Institute of Virology and Immunology in San Francisco, agrees wholeheartedly - and believes that with recent advances in treatments and a cure, the world could be on the cusp of nearly wiping out the virus.

Q: What does the hepatitis C virus do to the body?

A: This is an RNA virus that infects hepatocytes, cells in the liver. That's why you ultimately get hepatitis, or inflammation in the liver, and that can progress on to cirrhosis. About 20 percent of people spontaneously clear the hepatitis C virus, and of the rest, about 20 to 25 percent will progress to cirrhosis, and eventually end-stage liver disease. Hepatitis C is the leading reason behind liver transplants in the United States.

Q: For many years, hepatitis C has been treated with interferon. What is interferon?

A: Interferon is a type of protein called cytokine. It normally triggers an antiviral response in the body. It inhibits key steps in the (hepatitis C) virus life cycle that allow it to replicate. But it's doing it at a cost. Cytokine is pretty toxic. It makes patients very sick.

Q: Last year the Food and Drug Administration approved new drugs to treat hepatitis C. How do they work?

A: It's just like with HIV - you're attacking multiple, key proteins needed for the hepatitis C virus lifecycle. Now you have these small molecules that are attacking the virus itself, as opposed to trying to induce an antiviral response, like with interferon.

These drugs are proving to be just dynamite. We're very close to being able to cure everybody of hepatitis C. The natural history of hepatitis C virus infection has been fundamentally changed.

Q: Why has hepatitis C been so hard to treat historically?

A: One thing that limited progress was the lack of an infectious molecular clone to use in the laboratory to test drugs. It was only in the last few years that an infectious molecular clone came out of Japan. Before that, none of them fully replicated (in the lab). When the molecular clones came along progress just took off at light speed.

Then the blueprint for working on HIV became very informative - protease inhibitors, polymerase inhibitors, they were all targeted very quickly, by multiple pharmaceuticals. Many of the pharmaceuticals just moved their HIV discovery teams into HCV. Progress has been made so rapidly here because the trail had been blazed by all of the HIV drugs.

Q: Will we be able to wipe out hepatitis C entirely?

A: In contrast to HIV, we do have the capability of doing that - essentially curing everyone who got infected. While we have made tremendous progress against HIV, we still don't have a cure, we still don't have a vaccine. The situation for HCV is dramatically different. A cure is achievable. Someday soon, the cure using an interferon-free cocktail is going to be routine.

Then it becomes more of an implementation issue - how you distribute these drugs, what you charge for them. There are 180 million people infected worldwide, five to six times the size of the HIV epidemic, and many are living in resource-poor settings. We're going to have to figure out how to deal with the developing world.

Hepatitis C drugs offer hope for cure

Erin Allday / San Francisco Chronicle
Updated 4:09 p.m., Wednesday, September 12, 2012
Scientific breakthroughs, one piled on top of another at breakneck speed over the past few years, have put medical researchers on the cusp of curing almost everyone who suffers from hepatitis C, if not wiping out the disease entirely.With 180 million people in the world thought to be infected with the virus - 12,000 of them in San Francisco alone - that's potentially a huge public health coup, doctors and scientists say.
In a little more than a decade, a virus that was once almost untreatable could be made nearly extinct.
"It is just a remarkable moment in the history of hepatitis C," said Dr. Warner Greene, director of the virology and immunology division at the Gladstone Institute in San Francisco. "I think hepatitis C and its sequela - liver cancer, cirrhosis, liver transplants - can largely be gone in the future. We just won't have to worry about it."

In the past year, new treatments have come out that already have doubled the number of people who can be cured of hepatitis C. Now the race is on among drug developers to market the first medical cocktails that would cure almost everyone on the planet, and do it safer and faster than the best treatments currently available.

New treatments - both those already available and those expected to be approved in the next five or so years - were a large part of the reason the U.S. Centers for Disease Control and Prevention recommended this summer that all Baby Boomers get screened for hepatitis C.

That generation is thought to have the largest number of undiagnosed cases of the disease, with so many of them potentially exposed to the virus in the wild, drug-friendly hippie years of the '60s and '70s. Until recently it wasn't practical to screen millions of people for possible cases of hepatitis C because few good treatments were available.

Hepatitis C's spread

Hepatitis C is a virus transmitted through the blood, similar to HIV. It's often spread through shared needles used by intravenous drug abusers. Decades ago, and even still in some developing parts of the world, people were exposed to hepatitis C through unsterilized equipment used for tattoos or surgical procedures. Also, the U.S. blood supply wasn't screened for hepatitis C until the early 1990s, so people sometimes became infected from a blood transfusion or organ transplant.

In roughly 20 percent of hepatitis C cases, the body's immune system fights off the virus without any medical intervention and probably without the individual ever being aware of having it. The remaining cases develop into chronic hepatitis C.

In some of those cases, the virus may lie dormant for decades, or even a lifetime, but in about 1 in 5 chronic cases, the virus will attack the liver, scarring it and causing cirrhosis, and potentially leading to liver cancer and liver failure. The infection causes about 10,000 deaths a year in the United States, and it's the leading reason for liver transplants. Hepatitis C is especially prevalent in people who also have HIV infections; in fact, HIV-positive patients are more likely to die of hepatitis-caused liver disease than of AIDS or HIV.

Antiviral drugs

It's only in the past seven years or so that doctors and scientists discovered the first antiviral drugs that can stop the virus, giving the body's natural immune system a chance to fight it off. The cure rate with those drugs is 75 to 80 percent, but they require that patients also take interferon, a toxic medication that can cause disabling side effects for a year.

In the next five years, researchers expect to develop even more potent antiviral medications - drugs that will cure more than 90 percent of patients, and do it in half the time and without the interferon.

"There's no question that with these new treatments, cure is going to be the rule and not the exception," said Dr. Brad Hare, medical director of the HIV/AIDS ward at San Francisco General Hospital, who studies HIV and hepatitis C co-infections. "It's more important than ever to identify people with hepatitis C, because we have something even better to offer them."

That said, Hare added, it's unlikely that the virus will ever be eradicated. There will always remain a pocket of people who don't respond to drug therapy or aren't able to take it for some reason. Those who have been cured can be reinfected.

And getting new medications to the tens of millions of people affected by hepatitis C won't be easy, especially because the drugs will almost definitely be expensive.

Strains on the system

Just screening the millions of Baby Boomers in the United States, and getting those who test positive for hepatitis C into treatment, could be an overwhelming strain on the health care system, public health experts say. Drugs in development could ease some of that burden if they're easier to take and more effective than the current treatments.

Hepatitis C was discovered in the late 1980s, although scientists had known for years that a virus existed that was causing inflammation in the liver and that wasn't the hepatitis A or B viruses.

The U.S. Food and Drug Administration approved the first treatment for hepatitis C - the chemotherapy drug interferon - in 1991, and added a second drug, ribavirin, in 1998. Those two medications were considered a breakthrough therapy for a virus that had previously been untreatable, but the treatment itself was rough and not all that effective.

The ribavirin comes in pill form, but the interferon has to be given intravenously three times a week for 48 weeks. Both drugs, especially the interferon, often come with awful side effects - major depression and, sometimes, suicidal thoughts, plus fatigue, nausea and flu-like symptoms.

And the worst of it is that the treatments lead to a cure only roughly half the time - less than half for patients with the most common strain of hepatitis C.

"A lot of us didn't have bad symptoms before we went on treatment," said Daniel Berrner, a San Francisco resident who was diagnosed with both HIV and hepatitis C in 2005, and underwent successful treatment for the latter in 2009. "People maybe feel some fatigue, but that's it. So to convince them to feel awful for a year when they're not feeling that bad to begin with is a really hard thing to do."

Because treatment was, for many people, tougher to endure than the virus itself, many doctors over the years have "triaged" patients by performing liver biopsies or blood tests to determine if hepatitis C was causing severe enough damage to treat even at the risk of failure. If patients weren't experiencing acute symptoms and their livers seemed relatively healthy, they'd often postpone treatment.

More seek treatment

Whether to get treatment for hepatitis C is still a personal decision and best made after a thoughtful conversation with a primary care doctor or a liver expert, doctors said. But increasingly patients are being encouraged to get treatment, even if their infection isn't particularly virulent.

"I still try to triage based on the risk of end-stage liver disease. But now more patients are willing to be treated," said Dr. Natalie Bzowej, a liver disease specialist at California Pacific Medical Center.

Bzowej helped lead national research into one of the first antiviral treatments that targeted hepatitis C, a protease inhibitor called telaprevir made by Vertex Pharmaceuticals, which was approved by the FDA in June 2011. A similar drug, boceprevir from Merck, also won FDA approval last year.

Remarkable success

In clinical trials, about 80 percent of patients with the most common strain of hepatitis C who took one of those drugs, plus the usual interferon and ribavirin combination, were cured. That was a remarkable improvement over the previous 40 to 50 percent cure rate.

Also encouraging: Most of the patients who were cured were able to stop taking the medications after just 24 weeks, cutting the treatment time in half.

The reason for the difference is that the new drugs single out the hepatitis C virus specifically, whereas the interferon and the ribavirin essentially just give a boost to the body's natural immune system. For many people, the immune system is not strong or fast enough on its own to fight off the virus.

Protease inhibitors are best known as a class of drugs used to treat HIV infection. They work by attacking specific enzymes, or proteases, in a virus that are a key part of the replication process. By inhibiting those enzymes, the virus is unable to reproduce and eventually dies off.

Now, scientists are looking for the next line of drugs to attack other points of the hepatitis life cycle. The pharmaceutical industry is racing toward clinical trials - companies battling to be the first to get new drugs, especially those that would make interferon obsolete, to the market.

Multidrug attack

Doctors and scientists alike expect the first of the new wave of drugs to be available in four or five years. Part of the reason not everyone can be cured of hepatitis C is that, like many viruses, it mutates so quickly and becomes immune to drugs. So ideally, doctors will have at their disposal several drugs - maybe dozens - that will attack the virus on several fronts at once.

If those drugs are strong and fast enough, they could cure patients without the need for interferon. Protease inhibitors and other antiviral drugs aren't without side effects, but the symptoms are much less severe than those from interferon, and the newest classes of drugs may work in as little as 12 weeks, or about half the time it takes telaprevir, the protease inhibitor, to do the job.

"I feel like we are glimpsing the beginning of the end for hepatitis C," said Dr. Cami Graham, vice president of global medical affairs at Vertex. "We really are beginning to see what that path to eradication is going to look like."

Long incubation period

Both drug developers and doctors alike said they are advising patients not to raise their hopes too high. Almost all of the clinical trials are in their earliest stages, and for the Baby Boomers especially, patients with decades-old infections may not have even a few years to wait for new treatments.

"What we have now is better than anything we've had in a long time," said Dr. Joanna Ready, chief of gastroenterology at Kaiser Santa Clara. "What will be even better is interferon-free therapies, and the early studies have been very, very, very promising. But the disease has such a long incubation period and damages the liver over decades, so we really need to be following people over time.
Still, Ready said, she's hopeful.

"If we don't wipe out hepatitis C entirely, we can probably make it go away like polio, where you haven't gotten rid of it but you've really beaten it down," she said. "The science behind these treatments is improving every day. And the more we know, the better we are at treating it."

Erin Allday is a San Francisco Chronicle staff writer. E-mail: eallday@sfchronicle.com 

---------------------

FIGHT THE SPREAD OF HEP C TODAY. 



Wednesday, September 5, 2012

UPDATE: ASPC-Lewis Hep C exposure incident.

excellent report by Craig Harris at the AZ Republic is at the bottom.

 --------------------
Bury Hep C, Not People.... 

Wexford Health Sources, Phoenix (JULY 2012)

Wexford connection for prisoner health information:
toll free 1-855-890-6307, or email your request to azcorrections@wexfordhealth.com

This media release comes to us this afternoon from Wendy Halloran at KPNX Channel 12 News. They will be covering the story tonight at 5pm and 6pm. Wendy was recently nominated for an Emmy for her investigation of the highly preventable suicide of Tony Lester.

Hep C is already a leading killer in our state prisons. Nearly 6,000 prisoners are already diagnosed with it, and another 20-30% of the prison population likely have it but don't know it yet...

From: LAMOREAUX, BILL [mailto:BLAMOREA@azcorrections.gov]
Sent: Tuesday, September 04, 2012 11:35 AM
To: Halloran, Wendy
Subject: RE: MEDIA REQUEST FROM WENDY HALLORAN AT 12 NEWS

Ms. Halloran:

On August 27, 2012, a potential exposure event occurred at the Arizona State Prison Complex – Lewis while administering medication. A vial of medication, which may have been compromised with a previously used syringe, was subsequently used to treat additional inmates.

Review of this event determined the potential exposure to Hepatitis C and involved up to 105 inmates. As a result, these inmates were notified and are currently being screened for infectious diseases as per protocol in such an exposure event. An independent laboratory, under contract with Wexford, will provide continued medical monitoring and testing of these potentially exposed inmates over the next several months. All patients will be informed of the results of the testing.

The medical protocols related to this potential exposure have been reviewed to ensure that subsequent events do not occur. The initial event remains under review by Wexford Health, the contracted provider responsible for inmate health care.

The nurse who violated the basic infection control protocols is an employee of a staffing agency under contract with Wexford Health. Wexford has banned the nurse from working under any of its contracts and has also requested that the individual be referred to the State Board of Nursing for investigation.

Regards,

Bill

---------from the AZ Republic------------

Prison nurse tied to hepatitis C exposure



A nurse for the new medical provider for Arizona prisons may have exposed 103 inmates at the Buckeye state prison to hepatitis C by contaminating the prison's insulin supply, and state and local health officials were not alerted for more than a week.

Officials with the state and Maricopa County health departments, who confirmed to The Arizona Republic on Tuesday that they had not been informed by Wexford Health Sources Inc. of the problem, said they will launch investigations into the incident.

Official notification of the Aug. 27 error only came late Tuesday afternoon, hours after an inmate's family member had told 12 News of the potential health risk.

State rules require health-care providers and correctional facilities to notify health departments within five business days of a hepatitis C diagnosis, treatment or detection.

Wexford said it suspended the nurse on Aug. 27, immediately after learning the person "had violated basic infection-control protocols while administering medication that day."

"In talking with the Department of Health Services, they believe it should have been reported first to the county," Corrections Director Charles Ryan said late Tuesday. "That is a question we will have of Wexford -- as to the lack of notification or an explanation as to why that did not occur.

"The department has concerns about this issue, and we will be having further discussions with Wexford in terms of this requirement and some other issues as well."

Ryan said the incident occurred when a diabetic inmate who also has hepatitis C was administered a routine dose of insulin by the nurse on Aug. 27. The needle used on that inmate was inserted into another vial to draw more insulin for the same inmate.

Ryan said the contaminated needle was inserted into a vial which was then put back among other vials in the prison's medication refrigerator. It got mixed up with other vials used throughout that day to administer insulin injections to more than 100 other diabetic inmates. Later that day, Ryan said, officials realized that the vial that potentially had been tainted with hepatitis C may have been used to dose other inmates.

At that point, the nurse in question was suspended and prison officials sought to determine how many inmates may have been exposed.

All the vials of medicine were destroyed after the discovery.

Wexford spokesman Larry Pike on Tuesday minimized the potential exposure of other inmates. He said that the company acted "expeditiously" to identify those who were potentially affected and that the company believes the potential for their exposure was small.

Though corrections officials and Wexford declined to name the nurse, the Arizona State Board of Nursing identified her as Nwadiuto Jane Nwaohia. She has been under state investigation since June 2012 for unsafe practice or substandard care, but the board would not provide additional information on the nature of the previous problem.

Corrections officials first acknowledged the matter Tuesday morning after 12 News asked about the incident at the Arizona State Prison Complex-Lewis, which houses 5,382 inmates in minimum- to maximum-security facilities.

Hepatitis C is the leading cause of liver transplants and causes liver cancer. Seventy-five to 85 percent of people with hepatitis C develop a chronic infection, according to the U.S. Centers for Disease Control and Prevention.

Shoana Anderson, head of the state Office of Infectious Disease Services, said one of the biggest dangers for those infected with hepatitis C is "it sits in the liver quietly, and 20 years later, a person can develop severe liver disease."

Anderson and Jeanene Fowler, a spokeswoman for the Maricopa County Department of Public Health, said Wexford should have notified them of the issue.

"It's extremely disturbing that something like this could happen. It calls for a thorough investigation to determine all of the surrounding causes of the mistake or the negligence," said Don Specter of the Prison Law Office, a prison watchdog group based in Berkeley, Calif.

Ken Kopczynski, executive director of the Private Corrections Working Group in Tallahassee, Fla., called the incident "scary" and said it shows a lack of oversight by corrections officials.

"This is a problem with privatization," Kopczynski said. "They are just accepting who Wexford will hire."

Wexford, which has previously lost contracts for poor service in other jurisdictions, this spring won a $349 million, three-year contract to provide health care for Arizona inmates. The company began providing services for nearly 40,000 Arizona inmates on July 1.

In a written statement, the Pittsburgh-based company said it suspended the nurse immediately upon learning she "may have compromised a vial of medication by placing it in contact with a previously used syringe."

Wexford, in its statement, said a local staffing agency assigned the nurse to the prison complex. The company said that at no time was the same syringe and needle used on more than one patient and that no staff members were exposed.

Wexford said it reported the nurse to the state nursing board for investigation, but that did not occur until late Tuesday afternoon, after the news had been reported. The company also banned the nurse from working under any of its contracts in the future. Wexford provides health-care services nationwide to roughly 124,000 inmates and other residents at more than 100 institutions.

The state said inmates exposed were notified and are being screened for infectious diseases. An independent laboratory under contract with Wexford will provide continuing medical monitoring and testing of the potentially exposed inmates over the next several months, the state said. All patients will be informed of their results, though Ryan noted that some inmates may previously have been exposed to hepatitis C.

Before the problem at the Buckeye prison, Wexford had issues in other states. Clark County, Wash., declined to renew a contract with Wexford in 2009 at its county jail and juvenile-detention center after complaints that Wexford was not dispensing medications to inmates in a timely fashion.

Sunday, February 5, 2012

STOP PRISONER ABUSE: The Lou Show #106.

Julie Acklin, prisoner rights activist and mom, and Patti Jones (the aunt of former state prisoner Tony Lester), are interviewed on the Lou Show (February 5, 2012) about the abuse and neglect of prisoners at the Arizona Department of Corrections

Please take the time to listen now, then join us all at for the Stop Prisoner Abuse March at the state capitol on March 9 at 10am.