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

Tuesday, November 27, 2012

AZ DOC:Lightning strikes twice - Botulism at Eyman again.

SOS from AZ prisons, CDC! I can't believe there's more botulism at Eyman The last time this happened was July 2012, and the AZ DOC's claim it was from prison hooch was an outright lie. Those men got sick from something they ate this summer, and three of the four were left to suffer with it for a week without medical attention before being taken to the hospital - check out this post here. That's twice now since Wexford took over that there's been a botulism outbreak.

So before anyone else buys the latest DOC report that their prisoners are just up to no good again, let's look at the other possible reasons for this kind of exceptionally rare outbreak to have occurred twice in the same prison in just a few months period of time (mind you - there were only 110 cases of botulism poisoning in the entire US in 2010 - only 9 of which were food-borne). Even if this batch of botulism really came from an alcoholic beverage cooked up in a cell and not a can of beef stew or something smuggled out of the chow hall, I'd be looking at what they're selling in the canteen theses days, boys. Something those guys are eating in that prison just isn't right.

"SOS from Arizona's other death row..."
 Phoenix, AZ (June 2012) 

 The Arizona Department of Corrections is already facing a class action suit, Parsons v Ryan, for gross medical neglect of its prisoners and the abuse of solitary confinement for managing the mentally ill. For their part, Wexford Health Sources has been outright accused of criminal misconduct in their management of AZ state prisoner health care since wining the contract in July 2012. If the CDC doesn't really look into things this time, who can the public trust to do so?

--------------from Food Poisoning Bulletin----------- 

Prison Hooch Sends 7 Inmates To ICU with Botulism

Food Poisoning Bulletin
November 26, 2012


Prison hooch, or homemade alcohol,  is the likely source of a botulism outbreak at an Arizona prison that sent seven inmates to intensive care. The seven inmates, all from Special Management Unit 1 of the Arizona State Prison Complex Eyman in Florence, were hospitalized over the weekend.

Botulism is not spread through person-to-person contact. Although it can develop in contaminated wounds or through IV drug use, it most often develops after eating or drinking food that is tainted with the toxin. Botulism poisoning  must be treated with a course of special anti-toxin, the stockpile of which is controlled by the Centers for Disease Control and Prevention (CDC).

Health officials in Pinal County, where the prison is located, suspect that the inmates became ill after drinking  hooch made from fermented fruit. After discussions with county health officials, the CDC made a preliminary confirmation of botulism and released the anti-toxin. Samples of the hooch were collected and sent to the CDC lab for testing.

Five of the inmates became seriously ill on Saturday and two more fell ill on Sunday. All seven are in intensive care. Symptoms of botulism poisoning, which can be fatal, include: muscle weakness, difficulty speaking, chewing, swallowing and breathing; and paralysis.

County, state and federal authorities are working on the investigation into the outbreak. This is the second time in four months that such and incident has occurred at the prison. In August, four inmates contracted botulism from prison hooch.

Tuesday, November 20, 2012

Arpaio's deaths in custody: settling Deborah Braillard.

This is hardly justice for what the MCSO did to this woman and her family, and to the many who never manage to hold them responsible for abuse, neglect, and the conditions of confinement. I want to know what happens to the employees most culpable for her death...including Arpaio - does this mean the county (read: the taxpayers)  covers the civil liability, and the people who actually killed her get off scott free? I never even heard anything about personnel being disciplined in this case...

Veteran's Day Phoenix, 2012.


Maricopa County OKs $3.25M settlement in inmate death
By JJ HensleyThe Republic | azcentral.comTue Nov 20, 2012 10:00 AM
Maricopa County on Tuesday approved paying $3.25 million to settle a lawsuit over the 2005 death of a diabetic inmate.
County supervisors, by a 3-1 vote, approved the on-again, off-again settlement involving Deborah Braillard.
The settlement was scheduled to be approved in mid-October, but the vote was postponed after an anti-Sheriff Joe Arpaio protest disrupted a meeting of the Maricopa County Board of Supervisors as the settlement was being considered. At a subsequent meeting, the supervisors deadlocked 2-2, killing the deal and setting the stage for the case to go back to trial.
The county already had spent $2.2 million defending the case.
The lawsuit was filed in 2006 by Braillard’s family after the 46-year-old woman died of complications of diabetes after being booked into the Fourth Avenue Jail on Jan.1, 2005. The lawsuit targets Maricopa County, the Sheriff’s Office and Correctional Health Services, a taxpayer-funded agency that treats county-jail inmates.
Jail health-care workers had noted Braillard’s condition in prior bookings but failed to do so when she was booked on suspicion of drug possession. When she became incoherent while in custody, employees attributed her symptoms to drug withdrawal. The symptoms were, in fact, caused by her diabetes, which went untreated.
In September, a Pinal County Superior Court judge issued a pretrial ruling saying there was sufficient evidence in the case to allow Braillard’s family to be awarded punitive damages if they prevail in the lawsuit, potentially exposing Maricopa County to more legal liability.
But after plaintiffs’ testimonies were completed, and while defense testimonies were under way, the two sides reached the $3.25 million settlement agreement."
 And this was what the court had to say about the MCSO jail that killed this poor woman. Not enough has really changed since then, unfortunately... 
Phoenix New Times 
October 17, 2008
By John Dickerson

In his ruling Thursday against Sheriff Joe Arpaio, U.S. District Judge Neil Wake cited a litany of unconstitutional problems in county jails: inadequate medical care, poor food, chronic overcrowding, and indifference to inmate health concerns.

Jail medical personnel's prescribing of a Soviet-era drug that causes tremors, spasms and "potentially permanent and disfiguring involuntary movements around the face" was another jail deficiency mentioned in Wake's 83-page "conclusion of law."

The judge's decision in the landmark Graves v. Arpaio case (formerly Hart v. Arpaio and Hart v. Hill) came after he reviewed three weeks of court testimony and thousands of pages of records. Many of the same complaints the judge listed were outlined last December in New Times' story “Inhumanity Has a Price.”
Sadly, the long list of violations in the ruling involved hundreds of inmates who endured cruel and unusual conditions under Joe Arpaio's watch. Some died as a result.

Wake noted that the "Eighth Amendment provides inmates with a right to safe conditions of confinement, including an adequate level of personal security.”

Specifically, failure to ensure this constitutional right led to inmate Robert Cotton's beating death, and to inmate Jeremy Flanders' near death following a jail assault.

Another problem spotlighted by Wake was that Arpaio’s jails do “not consistently ensure that all pretrial detainees actually receive all prescribed medications as ordered.” Another was that the jails' "inadequate medical records may create a risk of unnecessary pain and suffering."

These particular deficiencies cost Deborah Braillard her life when she was denied insulin for her diabetes.
Asked for a comment about the ruling, sheriff's spokesman Paul Chagolla responded, not surprisingly, with an accusation against New Times: "Yellow Journalist: You must be gleaning information from reputable reporters." We're not sure what that means, since New Times was the first to report on Wake's ruling Wednesday.

The sheriff did issue a press release about the ruling, amazingly claiming that it was a victory for him. "This judgment reinforces the excellent work being performed by the detention staff, and we all are always committed to improving the jail system wherever possible,” Arpaio was quoted as saying.

The judge's order should change a number of things in Arpaio's jails. Among them: green baloney, filthy living conditions, and broken plumbing. The order specifically requires Arpaio to address severe overcrowding at the Fourth Avenue Jail, where as many as 35 inmates can be crammed into one cell -- without beds -- for as long as 72 hours.

Subjecting certain detainees to extreme temperatures will no longer be allowed under the order, which should mean that Tent City cannot be as widely used as it is now.

For a look at Wake's entire 83-page order, click here. Highlights from his voluminous list of unconstitutional jail problems are listed below:

Medical Care

* "Prison officials show deliberate indifference to serious medical needs if prisoners are unable to make their medical problems known to the medical staff. Access to the medical staff has no meaning if the medical staff is not competent to deal with the prisoners’ problems. The medical staff must be competent to examine prisoners and diagnose illnesses. It must be able to treat medical problems or refer prisoners to others who can.”

* “The Eighth Amendment prohibits deliberate indifference not only to an inmate’s current health problems, but also to conditions of confinement that are very likely to cause future serious illness and needless suffering...Budgetary constraints do not justify delay in treatment for a serious medical need.”

* “Pretrial detainees frequently are denied access to adequate medical, mental health, and dental care because they do not receive a timely in-person assessment of the urgency of their need for treatment.”

* "Inadequate medical records may create a risk of unnecessary pain and suffering in violation of the Eighth Amendment."

* “Thorazine is an antipsychotic medication with potentially severe and permanent side effects, including extremely painful involuntary muscle spasms of the neck, tongue, eyes or other muscles, a profound restlessness and constant movement of the feet and legs, drug-induced Parkinsonism (a resting tremor with some muscle rigidity), and tardive diskenesia (potentially permanent and disfiguring involuntary movements around the face). Although Correctional Health Services witnesses testified they would not prescribe thorazine as a first line of treatment, in fact, Correctional Health Services has prescribed thorazine for many psychotic, and even some not psychotic, pretrial detainees without justification for its use. Correctional Health Services psychiatrists sometimes prescribe thorazine as a sleep aid.”

* “Clinicians at the Maricopa County Jails often cannot provide a professional medical judgment because Correctional Health Services does not have a medical record and information system capable of timely providing health care professionals with the information they need to diagnose and treat pretrial detainees appropriately, including laboratory results and results of specialty consults.”

* “Correctional Health Services does not maintain a list of pretrial detainees with chronic diseases and cannot readily determine where they are housed and what medications have been prescribed for them.”
* "Systemic deficiencies in the screening process significantly impair continuity of care and result in failure to identify pretrial detainees with immediate medical needs."


* At times, the court holding cells [at the Madison Street Jail] are so overcrowded that pretrial detainees do not have room to sit or adequate access to toilet and sink facilities. Overcrowding in the court holding cells causes sanitation problems and health risks to pretrial detainees. Overcrowding in the court holding cells at Madison violates pretrial detainees’ constitutional rights.

* “Often, substantially more than thirty-five pretrial detainees are held in one cell [in the Fourth Avenue Jail holding area]. At times, intake holding cells are so overcrowded that there is not room for all inmates to sit on benches, and at times there is not room for all inmates to sit anywhere, even on the floor. At times, inmates sleep on the concrete floor, and sometimes there is not enough room for inmates to sleep on the floor without coming into physical contact with other inmates. At times, the intake holding cells are too crowded for inmates to move to use the toilet and sink. Overcrowding in the 4th Avenue Intake holding cells violates pretrial detainees’ constitutional rights.”

* “From June 1, 2007, through May 31, 2008, 93,065 pretrial detainees were booked into [Fourth] Avenue Intake. Of these, 21,987 (24%) were in intake more than twenty-four hours, 1,910 were in intake more than forty-eight hours, and 358 inmates were in intake more than seventy-two hours."

* “Regardless of the length of time a pretrial detainee remains in the intake process, Defendant Arpaio does not provide the pretrial detainee with a bed and blanket unless the pretrial detainee is placed in an isolation cell. As previously found, intake holding cells often are overcrowded, without room for all inmates to sit, sleep, or move to use the toilet and sink. At times, the intake holding cells are extremely dirty, and the sinks and toilets unsanitary and inoperable.

At times, the intake holding cells do not have toilet paper, and pretrial detainees are not provided with toilet paper when they request it. At times, the intake holding cells do not have soap for pretrial detainees to wash their hands after using the toilet. During intake, inmates usually have no access to a shower until they receive their jail uniforms. Some inmates have not been permitted to take a shower in intake before putting on their jail uniforms. When inmates are brought into intake, usually little is known about their mental and physical conditions, sexual orientation, and security threat levels."

* "During intake, repeat offenders charged with serious violent crimes may be placed in holding cells with individuals charged with DUI or criminal speeding. There are no panic buttons or intercom systems in the intake holding cells. Pretrial detainees placed in intake holding cells usually can communicate with a detention officer only when the door is opened to move pretrial detainees in or out of a holding cell."

* "Although security cameras record activity within intake holding cells, detention officers do not continuously watch the security cameras. Security staff provide only minimal visual and audio supervision of the intake holding cells. Detention officers do not conduct routine security walks on a regular basis in the intake areas."

* "Detention officers do not continuously monitor the intake holding cells. The intake incident reports do not include every incident that occurs in the intake holding cells, even some that require pretrial detainees to receive medical treatment. Defendant Arpaio does not consistently take reasonable measures to guarantee the safety of the pretrial detainees during the intake process, which constitutes a current and ongoing violation of pretrial detainees’ constitutional rights."

"Overcrowding [in general] can violate the Eighth Amendment if it results in specific effects that form the basis for [a] violation, such as by causing increased violence, diluting constitutionally required services to the extent that they fall below the minimum [constitutional] standards, or by reaching a level “unfit for human habitation.”


* “Rats and/or mice remain a chronic problem in Maricopa County Jails, which Defendant Arpaio has made some efforts to eradicate. Cells are not consistently cleaned and sanitized prior to occupancy by pretrial detainees thereby causing an unconstitutional health risk…There are, therefore, current and ongoing violations of pretrial detainees’ constitutional rights."

* “If a prison’s plumbing is in such disrepair that it deprives inmates of basic elements of hygiene and seriously threatens their physical and mental well-being, it constitutes cruel and unusual punishment under the Eighth Amendment.”

Sunday, November 18, 2012

Veterans Day, Phoenix, 2012: For Marty Atencio.

The following photo is from the Veterans Day parade in Phoenix, where Maricopa County Sheriff Joe Arpaio rolled out his biggest toy to honor our dead soldiers. I stopped to leave him a message for one dead Army veteran he should be especially mindful of: Marty Atencio. That man should be held criminally liable for the death of his prisoners given the dehumanizing treatment he encourages and the culture of contempt he's cultivated among his officers. 

The chalk is mine, but I can't take the credit for the shot: Lisa Blank took it, and it's all over Arizona Community Press's Community Free Press Facebook page.

Remember Veterans like Marty, Sheriff Joe.
Veterans  Day 2012: Phoenix

Thanks to Stephen Lemons at the Phoenix New Times for this series about Marty's brutal killing by Phoenix Police and Joe Arpaio's deputies at the 4th Avenue Jail last year...

------from the Phoenix New Times----

Joe Arpaio's U.S. Veteran Victim Marty Atencio: Family Files Suit in Superior Court

By Stephen Lemons
Published Tue., Oct. 23 2012 at 12:24 PM

The family of U.S. Army veteran Marty Atencio is filing suit today in Maricopa County Superior Court over his brutal death late last year in Sheriff Joe Arpaio's Fourth Avenue Jail.

Atencio, who suffered from mental illness, was off his meds and wandering the streets in a daze on December 15, when he was picked up by Phoenix cops, allegedly because he had frightened a woman with his bizarre behavior.

Read the Atencio family's lawsuit.

That woman later stated that she'd hoped Atencio, 44, would receive the help he needed if he was in custody.

Instead, he received a one-way ticket to a military funeral.

See also:
-Joe Arpaio's Victim Marty Atencio: Family Files Notices of Claim Totaling $20 Million in Wrongful Death Case
-Jailhouse Goons Make Fun Of and Kill a Mentally Ill Inmate
-Joe Arpaio's Victim Marty Atencio Killed by "Law Enforcement Subdual," Among Other Factors, Says Medical Examiner (w/Update)
Joe Arpaio's Victim Ernest "Marty" Atencio Laid To Rest
-Joe Arpaio's Latest Victim Marty Atencio: MCSO Video of His Detention

Though Atencio was processed first without incident at the Phoenix Police Department's southern command station, his experience later in Fourth Avenue would be brief, humiliating and fatal.

There, Atencio was taunted and made fun of by MCSO detention officers, as is recounted in the suit:

After going through the medical screening, Marty was taken to have his mug shot
taken. While Marty was having his mug shot taken, the D.O.s were taunting him, asking him to "clown" for them, telling him to "turn left," "turn right," and making fun of Marty's
inability to follow instructions. 

As the guards made fun of Marty, they told him to make funny faces and the photographer, and a female Detention Officer, kept saying "let's make this one the Mug Shot of the week." After they took a particularly humiliating mug shot, the D.O.s had finished their fun with Marty and took him back to the holding tank.

Along the way, Atencio was escorted by Phoenix Police Officer Patrick Hanlon, who, according to the complaint, led Atencio "with his hands and arms bent in a position which caused Marty pain."
The complaint continues, stating that, "While Officer Hanlon was escorting Marty to the Linescan Room, Marty said `you're making Tony angry, you're making Tony angry.' Marty was telling Officer Hanlon that the officer was hurting him."

Shortly thereafter, in the jail's so-called "linescan room," as millions have now witnessed in video released by the MCSO, Atencio essentially did not remove his shoes fast enough for the officers present, with deadly consequences.

Atencio crossed his arms in front of him, in a non-violent stance. And that's when they pounced, piling onto Atencio, wailing on him and Tasing him, in what the suit refers to as a "jailers riot."

The complaint relates how these goons then dragged Atencio to a so-called "safe cell," where, as Atencio was held down, he allegedly was kneed more than once by MCSO detention officer Anthony Hatton.
Atencio was stripped of his clothes, and left to die. The jail's video system captured a naked Atencio breathing what looked like his dying breath on camera.

Outside the cell, as I've previously reported, Phoenix cops and MCSO detention officers partied like it was 1999.

"After this event," reads the complaint, "the jail's surveillance video outside `Safe Cell 4' shows D.O. Hatton, with a smile on his face, talking to other Officers, while two MCSO women danced and bumped their buttocks together."

Later, Atencio's brain-dead body was revived by officers and rushed by paramedics to a local hospital, where his family ultimately decided to remove him from life support.

The Atencios lawyer, tort titan Mike Manning, who just won a $3.2 million settlement for the family of diabetic mom and Arpaio jail victim Deborah Braillard, observes in the suit that Atencio's death is the direct result of the "culture of cruelty" in Arpaio's vast incarceration complex.

Also, the complaint makes clear, the MCSO is in direct violation of federal court orders instructing Arpaio and the county to provide proper medical screenings of prisoners for mental and physical illness.

Because the MCSO is not in compliance with these orders, Atencio was not properly screened on arrival at Fourth Avenue, where the health care "professional" who examined him noted signs of psychosis, yet did not provide Atencio with the medical help he needed.

Unfortunately, all the court orders, lawsuits and multi-million dollar payouts seem to do nothing to change the reality of Arpaio's disastrously-run jails.

The only real change will come if the voters wake up, and retire Arpaio on November 6 by voting for his Democratic rival Paul Penzone.

Otherwise there will be more victims, more Marty Atencios, and a lot more lawsuits.

Wednesday, November 14, 2012

AZDOC: Violent prisoners or violent places?

The following article gives us a good starting point for discussing the increase in prison violence in AZ. It's authored by the director of the Prison Law Office in California, which is one of the entities suing the AZ DOC right now for gross medical neglect and the abuse of the mentally ill in solitary confinement (see  Parsons v Ryan)

 I've been getting a lot of mail lately from prisoners fleeing gang violence at the AZ Department of Corrections - the gangs appear to control the mileu on virtually all medium and close custody yards these days, and it's unclear just what the DOC is doing about it, short of punishing those who are speaking out against it. The detention units are full of prisoners seeking protective custody for fear of being hurt or killed, rather than being full of those who are assaulting and extorting them. Maximum security cells are also filling with low-risk prisoners who are being repeatedly ticketed for "refusal to house" - which means they are too afraid to enter general population yard. That jacks up their security score and custody/classification. 

Chad, here, a non-violent burglar who is now treated as a maximum security risk, is just one example of who we're building that new Supermax for - NOT the "worst of the worst", as the DOC would have everyone believe. It's being built because Charles Ryan's crew ceded total control to the gangs, and prisoners are intentionally getting ticketed to get maxed out - losing all their good time in the process - just to find a safe place in the system to finish their sentences. That or they're assaulting other prisoners who get too close to them simply because they are so afraid that they will be hurt first. Then there are those who kill themselves to avoid what they fear is a worse fate.

The AZ DOC wants us to believe that the prisons are just getting more violent people committed these days - but their own data shows only a fractional increase in prisoners committed for violent offenses over the past few years, which may well be because there's an increase in repeat offenders coming through as well. That's just another sign, in addition to the violence, that the DOC has been failing at its rehabilitative mission as well as it's duty to protect the public - all that's happening now is that vulnerable people are being thrown in with the real bad guys to give them a little target practice until they come home to act out their rage on the rest of us. Something really needs to change in the way Arizona is running its prisons...

 Community mural remembering the victims of prison violence, 
neglect and abuse at the AZ Department of Corrections.
Firehouse Gallery (June 2012).

Making Prisons Safe: Strategies for Reducing Violence

Donald Specter

Journal of Law & Policy 2006 (Vol. 22:125)

This article is based on testimony to the Commission on Safety and Abuse in America’s Prisons, April 2005. Donald Specter, J.D. is the Director of the Prison Law Office, a nonprofit public interest law firm located near San Francisco, California. The Prison Law Office provides free legal services to California state prisoners related to the conditions of their confinement. During the past thirty years the office has successfully sued California adult and juvenile facilities over virtually all prison conditions, many of which directly relate to the safety of prisoners, the excessive use of force, and the state’s response to prison gangs. More information about these cases is available at the Prison Law Office website. See Prison Law Office, (last visited July 8, 2006).


Most people assume that prisons are dangerous because they house violent convicts. In California, for example, the union representing prison guards emphasizes the danger by calling the job “the toughest beat in the state.”1 Yet, in the last twenty years in only one California prison guard has been killed by a prisoner, but hundreds of prisoners have died from medical neglect, suicide, or guard brutality. Prisons are dangerous, but they are far more dangerous than they need to be.

If prison administrators provide humane conditions and require strict adherence to commonly accepted and nationally recognized techniques for regulating the unnecessary use of force, prisons can be reasonably safe for both prisoners and staff. Although the threat posed by gangs presents special problems, the traditional approach to correctional safety—suppression and isolation—has not been successful. The experiences of some innovative programs around the country, as  discussed below, suggests the success of a radically different approach: closely monitored integration coupled with incentives and tools to help prisoners leave the gangs.


The Supreme Court recently stated that “[p]risons are dangerous places.”2 The Court implied that prisons are dangerous because prisoners are violent.3 Some prisoners are violent and will be violent no matter what the circumstances, but the degree of institutional violence is not dependent on the prisoners. It is a direct product of prison conditions and how the state operates its prisons.

American prisons promote violence and abuse by their design and operation. The anti-social nature of the prisoners themselves is not solely responsible for violent and abusive behavior. In the Stanford Prison Experiment otherwise psychologically healthy, normal Stanford college students changed dramatically after spending six days as guards and prisoners in a mock prison.4 The “prisoners” began to perceive each other as the guards perceived them and progressively expressed more frequent intentions to harm others: The guards, too—who also had been carefully chosen on the basis of their normal-average scores on a variety of personality measures—quickly internalized their randomly assigned role.

Many of these seemingly gentle and caring young men, some of whom had described themselves as pacifists or Vietnam War “doves,” soon began mistreating their peers and were indifferent to the obvious suffering that their actions produced. Several of them devised sadistically inventive ways to harass and degrade the prisoners, and none of the less actively cruel mock-guards ever intervened or complained about the abuses they witnessed.5

The conclusions of this experiment have profound implications for the control of violence in our prisons: The negative, anti-social reactions observed were not the product of an environment created by combining a collection of deviant personalities, but rather the result of an intrinsically pathological situation which could distort and rechannel the behaviour of essentially normal individuals. The abnormality here resided in the psychological nature of the situation and not in those who passed through it.6 In other words, the Stanford Prison Experiment teaches that prisons, as an institution, tend to promote aggressive and violent behavior by correctional personnel.7

The state is responsible for controlling that type of behavior. The elements necessary to control the use of force in prisons are well known. To prevent abuse, the use of force must be controlled through (1) clear policies; (2) meaningful and constant supervision of all uses of force; (3) timely and truthful reporting of all uses of force by the officer involved and anyone who witnessed the incident; (4) an accurate and unbiased investigation into allegations of excessive force; and (5) the consistent imposition of progressive and proportional discipline when excessive force is used or when it is not reported.8 A breakdown in any one of these components will inevitably lead to abuse.9

Unfortunately, it is not uncommon for correctional supervisors to lose control over the use of force, resulting in abuse. Abu Ghraib,10 Pelican Bay State Prison in California,11 the entire prison system of Texas,12 and Rikers Island in New York City13 are prime examples of prisons that became more dangerous not because of the prisoners, but because of management breakdowns that let guards mistreat and dehumanize their captives.

The abuse at Abu Ghraib is especially important to consider because two factors distinguish it from other situations. Like the Stanford Prison Experiment, and unlike maximum security prisons where prisoners are considered extremely dangerous, in Abu Ghraib there was no public suggestion that the prisoners were especially threatening or that their conduct caused the guards to act abusively. This is a clear demonstration that the situation, rather than the prisoners themselves, was responsible for the guards’ misconduct.

The United States Army’s investigation into the abuses at Abu Ghraib revealed another factor that can cause an institution to spiral out of control: the injection of an external rationale for mistreatment.14 In addition to finding the usual management breakdowns in the control of force the Army investigators also recognized that the “war on terror” and the corresponding need to obtain intelligence were perceived by the soldiers at Abu Ghraib as a license to exceed the bounds of sanctioned conduct.15

A similar license was granted to guards in California that led to even more serious abuse, often causing permanent injury and death. At Pelican Bay, guards were led to believe that extreme force was justified by the need to punish and control the “worst of the worst.”16 As soon as the prison opened, officials let the guards know that the standard rules of conduct would not apply at Pelican Bay. What followed were not only individual instances of brutality, but a deliberate practice of using violence and pain to control prisoners’ behavior.17

Ruling on a constitutional challenge to the excessive use of force at Pelican Bay, the Federal District Court for the Northern District of California catalogued unnecessary and excessively violent cell-extractions, hog-tying of prisoners, caging of naked prisoners outside for long periods of time in cold and rainy weather, and staff beatings of prisoners.18 It concluded that violence was used by staff “not only in good faith efforts to restore and maintain order, but also for the very purpose of inflicting punishment and pain.”19

This attitude pervaded other California maximum security prisons as well. In the mid-1990s California was confronted with the gruesome spectacle of guards in the Security Housing Unit at Corcoran State Prison purposefully releasing rival gang members in small exercise yards and betting on which of the “gladiators” would be victorious.20 And in 2004 a videotape showed “counselors” at the California Youth Authority’s maximum security prison mercilessly beating wards as they lay passively on the day room floor.21

These and other scandals that have plagued California’s prison system for the last fifteen years were not hidden, nor were they accidents. They were known and tolerated by high-level correctional administrators who showed complete indifference to the lives and well-being of prisoners. Their utter failure to strictly and appropriately regulate the use of force in a manner consistent with nationally recognized principles of correctional administration was responsible for untold suffering.

The regulation of force is, by itself, insufficient to prevent abuse. Prison conditions can and do breed violence. Many prisoners have committed violent crimes, and many suffer from mental illnesses that inhibit their ability to control their own behavior.22 When such inmates are placed together in overcrowded, antiquated facilities with inadequate mental health services and nothing constructive to do violence is inevitable.23

The California Inspector General made clear the connection between conditions and violence when he found that deplorable conditions and poor management practices contributed to the murder of a correctional officer at the California Institution for Men.24 The Inspector General found that the prison violated basic classification procedures by permitting the prisoner, who was incarcerated for attempting to kill a police officer and had a history of recent and serious assaultive behavior, to remain in the general population.25 Poor maintenance and tool control procedures permitted prisoners to obtain and conceal weapons.26 The victim failed to follow specific security directives initiated after a race riot, the stabbing of a prisoner, and the discovery of weapons in the same unit.27 Additionally, the warden and her subordinate supervisory staff failed to ensure compliance with those directives.28 Finally, nobody addressed the prisoner’s clearly identified need for immediate mental health treatment.29

The Inspector General’s findings express in detail what is common sense to most correctional administrators: well-run prisons are relatively safe, while those that are poorly managed are not. The control of violence, therefore, depends not only on executing accepted policies for regulating the use and supervision of force, but also on the overall management of the facility. All of the prison’s operations, including mental health care, must be integrated and functioning properly if prisons are to perform their primary purpose of incarceration and not subject their inhabitants—both prisoners and officers—to an unacceptable risk of injury or death.


The problem of gang-related violence in America’s prisons is both well known and well documented. Both prison and street gangs are reportedly responsible for drugs, violence, and intimidation within prison walls.30 The traditional prison response to gang behavior is suppression and isolation. Gang members are forced to spend long, indefinite terms in segregated housing units in maximum or super maximum (supermax) security prisons and their misconduct is often
targeted for administrative or criminal prosecution.

While the success of these strategies in reducing violence is uncertain, it is clear that they have not succeeded in eliminating gangs or their influence. It is commonly understood that, while locked in segregation, gang leaders continue to control the illegal activities of their members both within the prison and in the outside community. Perhaps the most graphic example of this is the fact that several California prison gang leaders are now facing the death penalty for federal criminal charges arising from their activities while imprisoned in the Security Housing Unit (SHU) at Pelican Bay, a supermax facility.31

Prisoners in restricted units such as Pelican Bay’s SHU are not provided any form of meaningful recreation, education, vocational training, or rehabilitative services.32 They are left in their cells every day for up to twenty-three hours, with the remaining hour being spent either alone or with their cellmate in a small enclosed space that approximates a dog run.33 In this environment normal social relationships are impossible and these inmates are left to associate with other gang members. It is not surprising, therefore, that they will continue to perpetuate the gang and its activities; they have nothing else to do.

Recently, some correctional systems have developed successful programs that use the opposite approach. Instead of using extreme forms of isolation these programs actively promote integration. Their aim is to reintegrate the gang member into the general prison population. In the few programs that take this approach, the strategy has proven surprisingly successful. 

These programs—utilized in Connecticut,34 Missouri’s Division of Youth Services,35 and the Pelican Bay Transitional Housing Unit36—have several things in common. First, they create housing units that are relatively small, consisting of between fifteen and twenty prisoners. Second, the adult programs allow the prisoner to choose to participate, although one program conditions that choice on the decision to inform against his former gang. Third, they create a set of expectations that include mandatory integration with prisoners of other races and gangs, and a very low tolerance of misbehavior. Fourth, prisoners are given extensive orientation about these expectations. Fifth, prisoners are provided with counseling services to help them control anger and violence and foster healthy relationships.

These services come in the form of formal group sessions, but also informally through guidance provided by specially selected staff in the units. Finally, prisoners are provided with real and substantial incentives to complete the program. This may include contact visits with their family, jobs and a safe environment when they return to the general population.

The success rate in each of these three programs is reportedly very high. Connecticut and Missouri report that the recidivism rate of gang members is under 10%.37 In California, prison officials report that only 5% of prisoners fail to complete the program, the recidivism rate sent back to segregation for gang-related activities.38 These successful programs place the prisoner or ward in a culture where violence is not “business as usual” and provide them with the tools they need to succeed. They prove to prisoners who have never had a meaningful conversation with a rival gang member or a prisoner of another race that they can live a different, less violent, and more meaningful life. Instead of creating a culture of suppression and isolation, they provide a transition to a more normal way of life, even if it is limited to the confines of the prison. Given time and help, the prisoners adapt to this culture and recognize its value.

These promising programs should be studied, evaluated, and replicated. They offer positive alternatives to the traditional reaction to prison gangs. It is an approach that uses the institution of a prison to create positive change rather than to promote further violence.


It is easy to blame prisoners for prison violence. But, the lessons of the last few decades of court intervention and academic research have demonstrated that the amount of violence in a prison is a function of its culture, the effectiveness of its management, and, at times, the political reality that excuses the mistreatment of prisoners. No prison illustrated this better than Pelican Bay in the early 1990s. It suffered from an administration that condoned and perpetuated violence, it opened at a time when being tough on crime meant brutalizing prisoners and there was no effective management of the prison. The violence in that institution has largely subsided through better management required by intensive court intervention, and promising inroads have been made into gang membership through the Transitional Housing Unit program, demonstrating clearly that it is not the prisoners but the prison as an institution that is the key to safety in correctional facilities.


1. See California Correctional Peace Officers Association, (last visited July 8, 2006).

2. Johnson v. California, 543 U.S. 499, 515 (2005).

3. Id. Threats to the safety of prisoners also spring from other, less obvious sources. In our experience, the single biggest threat to prisoners’ lives is the absence of adequate and appropriate health care. Neglect and malpractice kills more prisoners than do guards or other prisoners. Although difficult to quantify, death and serious injury due to medical neglect, preventable suicides, and mental decompensation far exceeds the harm caused by the more overt uses of force. For example, in 2003 only fourteen California prisoners were killed by other prisoners or staff. CALIFORNIA DEPARTMENT OF CORRECTIONS, INMATE INCIDENTS IN INSTITUTIONS: CALENDAR YEAR 2003, at 15 (2004), available at (follow “December 2003”hyperlink). In a recent independent review of 193 recent deaths in California’s prisons, court-appointed medical experts found eleven cases of terrible medical care in 2003. A review by a court appointed special master of suicides within California’s prisons in 2003 found that out of thirty five suicides, twenty-five (74%) received inadequate treatment and were foreseeable or preventable. Coleman v. Wilson, Special Master’s Report on Suicides Committed in the California Department of Corrections in Calendar Year 2003, at 8 (2004). Therefore, although it is beyond the scope of this presentation, any analysis of safety failures and abuse must consider the effects of ineffective prison health care systems.

4. Craig Haney & Philip Zimbardo, The Past and Future of U.S. Prison Policy, 53 AM. PSYCHOLOGIST 709 (1998).

5. Id. at 709.

6. Id. at 710 (citation omitted).

7. Craig Haney et al., Interpersonal Dynamics in a Simulated Prison, 1 INT’L J. CRIMINOLOGY & PENOLOGY 69, 93–94 (1973).

8. See, e.g., Madrid v. Gomez, 889 F. Supp. 1146, 1199 (N.D. Cal. 1995), rev’d and remanded by 150 F.3d 1030 (9th Cir. 1998); U.S. ARMY SPECIAL REPORT, INVESTIGATION OF INTELLIGENCE ACTIVITIES AT ABU GHRAIB 2–5 (2004), available at (citing lack of effective leadership, ambiguous policies, inadequate resources, and ineffective supervision and discipline as reasons for the abuses).

9. This was proven true in California by the special master appointed by the federal court to monitor the conditions at Pelican Bay who conducted an inquiry into the code of silence within the California Department of Corrections. Madrid v. Gomez, Special Master’s Report Re Department of Corrections “Post Powers” Investigations and Employee Discipline (Jan. 15, 2004). The inquiry arose from the decision of the director of the Department of Corrections to terminate the investigation of perjury by several correctional officers in a federal civil rights trial for excessive force against prisoners. The special master concluded, A minority of rogue officers can establish a code of silence, threaten the majority, damage cars, isolate uncooperative co-workers, and create an overall atmosphere of deceit and corruption. And if the minority are supported by a powerful labor organization, and the union as well as management condones the code of silence, the consequences are severe. Id. at 99.

10. See, e.g., U.S. ARMY SPECIAL REPORT, supra note 8.

11. See Madrid, 889 F. Supp. 1146.

12. See Ruiz v. Estelle, 503 F. Supp. 1265, 1302 (S.D. Tex. 1980).

13. See Fisher v. Koehler, 692 F. Supp. 1519 (S.D.N.Y. 1988).

14. U.S. ARMY SPECIAL REPORT, supra note 9, at 5.

15. The army acknowledged this problem in typical bureaucratic and understated fashion: “Demands on the Human Intelligence (HUMINT) capabilities in a counterinsurgency and in the future joint operational environment will continue to tax tactical and strategic assets.” Id. at 6.

16. Madrid, 889 F. Supp. at 1155.

17. In one instance, guards placed an African American mentally ill prisoner in a bathtub so hot that it caused third-degree burns and made his skin peel off parts of his body and hang in large clumps around his legs, which had turned white. Id. at 1166–67. This was in retaliation for the man biting a guard one week earlier. Id. at 1166. A prison nurse overheard a guard remark, “[L]ooks like we’re going to have a white boy before this is through . . . .” Id. at 1167.

18. Id. at 1162–78.

19. Id. at 1200.


21. See S.F. Gate: Multimedia,  (last visited Oct. 15, 2006).

22. A recent survey by the United States Department of Justice found that more than half of the nation’s state prisoners had a mental health problem. DORIS J. JAMES & LAUREN E. GLAZE, BUREAU OF JUSTICE STATISTICS, U.S. DEP’T OF JUSTICE, NCJ 213600, MENTAL HEALTH PROBLEMS OF PRISON AND JAIL INMATES 1 tbl.1 (2006). An older survey found that 16% of prisoners were mentally ill. PAULA M. DITTON, BUREAU OF JUSTICE STATISTICS, U.S. DEP’T OF JUSTICE, NCJ 174463, MENTAL HEALTH AND TREATMENT OF INMATES AND PROBATIONERS (1999).


24. OFFICE OF THE INSPECTOR GEN., SPECIAL REVIEW INTO THE DEATH OF CORRECTIONAL OFFICER MANUEL A. GONZALEZ, JR. ON JANUARY 10, 2005 AT THE CALIFORNIA INSTITUTION FOR MEN 3–4 (2005), available at The California Institution for Men is a large, overcrowded intake center located near Los Angeles. See California Institute for Men (CIM), Visitors/fac_prison_CIM.html (last visited July 8, 2006).

25. Id. at 16–17.

26. Id. at 37.

27. Id. at 5.

28. Id. at 19–24.

29. Id. at 79. The independent panel of experts appointed by the California State Board of Corrections also noted the “deplorable” conditions at the prison and the fact that the reception center was overcrowded and serving more prisoners than it could safely process. CAL. STATE BD. OF CORRS., INDEPENDENT OPERATIONS AND INCIDENT REVIEW PANEL ON THE CALIFORNIA INSTITUTIONS FOR MEN 12 (2005), available at operational_incident_review_cim/final%20report.pdf.


31. Press Release, Thom Mrozek, Pub. Affairs Officer, U.S. Attorney’s Office, Cent. Dist. of Cal., Racketeering Indictment Targets Aryan Brotherhood (Oct. 17, 2002), available at

32. Madrid v. Gomez, 889 F. Supp. 1146, 1229 (N.D. Cal. 1995), rev’d and remanded by 150 F.3d 1030 (9th Cir. 1998).

33. Id.

34. See Connecticut Department of Correction, (follow “Recidivism” hyperlink) (describing Connecticut’s Gang Management Program).

35. See Missouri Division of Youth Services, (last visited Oct. 15, 2006).

36. See Pelican Bay State Prison, (last visited Oct. 15, 2006).

37. Department of Correction, supra note 34. Recidivism in these states is measured differently. In Connecticut, the test is whether the prisoner is redesignated as a gang member.

Id. Missouri uses the more traditional measure of whether the person reoffends. 38. Telephone interview with Ted Roberts & Chris Hizer, Mgmt. Staff, Transitional Hous. Unit, Pelican Bay State Prison (Apr. 8, 2005).

38. Telephone interview with Mark Steward, former Dir. of Mo. Div. of Youth Servs., Mo. Dept. of Soc. Servs. (2004).

Tuesday, November 6, 2012

ASPC-EYMAN Deaths In Custody: Timothy Ben, Suicide.

If anyone has any information about this suicide, please contact me at . Condolences to Timothy's loved ones. Thoughts also to the survivors of his victim, as such incidents often bring issues up for them as well.

Saturday, October 13, 2012

ASPC-Lewis Deaths in Custody: Anthony Brown

---------the following article comes from KPHO Channel 5 News/CBS Phoenix--------

Woman claims inmate husband died after lack of medical help

Posted: Oct 12, 2012 8:52 PM  
Updated: Oct 12, 2012 9:12 PM

A Phoenix woman claims her husband died after being refused medical treatment at Lewis Prison in Buckeye.

Anthony Brown, 43, died at St. Joseph's Hospital on Monday, Oct. 8. After performing an autopsy, the Maricopa County Medical Examiner's Office initial finding is that Brown died of natural causes.

"Nothing natural about a 42-year-old man that laid there for three or four days and died slowly," said widow Jami Brown. "There's nothing natural about that."

Jami Brown said she last spoke to her husband Thursday morning, Oct. 4.

"He was in a good mood, everything was great, you know," she said.

After that conversation, she had trouble reaching him. She visited the prison in Buckeye on Sunday and was unable to find out details of her husband's condition.

She was informed early Monday morning that he had passed away. Since then, she has been able to piece together what may have happened after talking with prison officials and other inmates who were close to her husband.

On the Friday after her last visit, Anthony Brown came down with a severe migraine headache.

"The pain got worse, the pain got worse," Jami Brown said. "He was vomiting and his balance was off and he fell."

She said her husband and other inmates were begging for medical help, but that corrections officers blew them off.

"There were probably 15 to 20 officers and medical staff that had seen him in that condition and not one person did their job. Not one," she said.

Wexford Health Services operates the medical units inside state prisons.

They provided CBS 5 the following statement:

"Wexford is awaiting word on the autopsy to determine the next steps and the reason for his (Mr. Brown) passing."

Anthony Brown was serving a 10-year sentence for aggravated assault. He was set to be released next September.

"My heart hurts," Jami Brown said. "I mean, he laid there for three days and nobody did anything.
Nobody did anything for him."

The Arizona Department of Corrections is investigating Anthony Brown's death.

Friday, October 5, 2012

Justice for Deborah Braillard: Change the Victim's Bill of Rights.

These jail and health care "professionals" from Correctional Health Services should have been criminally prosecuted for their treatment of Deborah Braillard. This is one more reason we need to change the Victims' Bill of Rights in the AZ Constitution to stop exluding prisoners as victims. "Persons in custody for an offense" (and their survivors, if they are killed in the care of cops or corrections officers) are the only class of humans denied those basic rights and protections. 

State entities and predatory corporations like Wexford Health Sources can claim "victim" status if anyone so much as trespasses against them, but prisoners - including people in custody who are not yet convicted or charged - don't have legal status as victims of their criminal misdeeds. We need to change that, people...

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

Maricopa County agrees to settle suit tied to inmate death

Maricopa County administrators have agreed to pay an undisclosed amount to settle a 6-year-old lawsuit over a woman's death that occurred after she was booked into a county jail.

The county has already spent about $1.8 million to hire attorneys to defend itself in the lawsuit, said Cari Gerchick, a county spokeswoman.

Any other details on the terms of the settlement will remain under seal until the county Board of Supervisors meets on Oct. 17 to authorize the agreement, she said.

The Sheriff's Office is also not authorized to comment on the agreement until it is approved, a spokesman said.

In addition to Maricopa County and the Sheriff's Office, the lawsuit targeted Correctional Health Services, the taxpayer-funded agency that provides constitutionally mandated health care in the county jails.

The lawsuit was filed in 2006 by the surviving family members of Deborah Braillard, a 46-year-old woman who had been booked in jail several times before her entry into the Fourth Avenue Jail on Jan. 1, 2005, on suspicion of drug possession.

During her prior jail bookings, Braillard's diabetes had been noted during the health-care screening that every county inmate undergoes when admitted into jail.

But employees of Correctional Health Services failed to note Braillard's medical condition in early 2005.
Instead, because Braillard was barely coherent and slurring her words, jail health-care workers thought they were dealing with a woman in the throes of a drug addiction.

Braillard was coming off drugs and showing signs of a blood-sugar crash, according to court documents, her family and testimony from jail employees. She was disoriented, vomiting, soiling herself, sweating profusely and complaining of pain, according to court documents. Employees attributed her symptoms to drug withdrawal.

Four days after she was booked into jail, Braillard was taken to Maricopa Medical Center, where she would remain unconscious until she died 18 days later of complications from diabetes.

The form used to assess the medical condition of an incoming inmate lists 27 questions. A health-care worker completed Braillard's assessment in less than a minute, according to court documents.

No one noticed that Braillard was diabetic. An electronic medical-records system, had it been in place, could have immediately alerted employees about Braillard's condition. She had been administered insulin at the jails many times before, and an electronic system would have included her medical history.

County administrators signed a $4.5 million contract for an electronic medical-record system in March, though the network is still in the design phase, Gerchick said.

Wexford Arizona: Deliberate Indifference Kills (UPDATED).

(UPDATED below....)

Wexford Health Sources
1850 N. Central Ave. Phoenix
October 3, 2012

Families: this is evidence for your loved one's civil rights suits if they've been suffering as a result of medical neglect at the AZ DOC and still can't get relief. Print and mail it to them. They MUST follow the grievance process, and not just file more HNR's on the same issues. Take this to an attorney if you can afford one, and get the following material/resources to loved ones inside so they know how to protect themselves from this predatory corporation:
ACLU: Know your rights: The PLRA (READ FIRST!!!)
Columbia University: Jailhouse Lawyer's Manual (read chapter 1 to familiarize yourself, then download and print what chapters they need)

National Lawyer's Guild Jailhouse Lawyer's Handbook (more compact than the one above: download here or send the NLG  $2 and the prisoner's contact info, and they'll send them a bound copy) - every prisoner needs one of these for the rest of their incarceration.
AZ Department of Corrections Policies: Inmate Grievance Procedures

AZ DOC Policies: Inmate Mental Health Care
AZ DOC Policies: Inmate Health Records

"Parsons v Ryan" Class action suit over medical neglect and abuse of the mentally ill before Wexford  even came - they aren't the only culprits here. Anyone potentially suing the DOC for medical issues needs to have a copy.

Instructions for Prisoners filing civil rights suits in AZ - they need to know this is what their grievances lead to -mwhet they need to prepare for - if they don't get adminstrative relief from the DOC or Wexford- but they can get hurt if they don't file it right. Contact Middle Ground Prison Reform early in the grievance process for info about options for legal representation or professional criminal justice consultation services.

Report medical and conditions of confinement complaints to the ACLU-AZ
Contact Mary Lou Brncik at David's Hope to organize around mental illness in the criminal justice system.

Contact me (Peggy Plews: 480-580-6807/ to organize with other families and former prisoners who want to make a difference for all. 

And have prisoners write to me directly at AZ Prison Watch PO Box 20494 Phoenix, AZ 85036, for packets of info about their rights...I will send them out as long as I am able to. They must be persistent if they don't hear back from me in a week, and keep me posted about changes in their status if we're working on something.

On Tue, Oct 2, 2012 at 10:13 AM, DONNA LEONE HAMM <> wrote:
Mr. Charles Ryan, Director
Arizona Department of Corrections
1601 West Jefferson
Phoenix, Arizona  85007

Dear Mr. Ryan:

Yesterday, Oct. 1, I received a telephone call from Dr. Lawrence D'Antonio, who works for a contractor who provides professional healthcare workers to Wexford.  As you know, Wexford, in turn, provides all medical care for prisoners within the Arizona Department of Corrections.  D'Antonio currently works at the Eyman Complex/Rynning.  He was originally supposed to work at Meadows, but now only works at Rynning. He says the Meadows Unit is a "lost cause."   If I understood him correctly, he believes there is no doctor currently assigned to Meadows Unit and that the Clinical Center there is essentially inoperative.  He has been a doctor (D.O.) for 27 years.  He has worked for the contractor who provides doctors to Wexford since about July 2012.

D'Antionio says that Dr. Tom Bell is the Statewide Medical Director employed by Wexford.  The Regional M.D. for Wexford is Dr. Hector F. Garcia.  He is Dr. Bell's boss.  Karen Grant is the Director of Nursing for Wexford.  D'Antonio refuses to converse with or take orders from Grant.  Grant was abusive, used obscenities with him, and was unprofessional during their initial conversation.  He believes that it is ironic that only current physican at the Eyman/Rynning Unit (D'Antonio) has no communication  with the Director of Nursing.  He has advised his own employer that either Wexford needs to obtain someone other than Grant for him to communicate with or he will not work there at all.

He says "personnel (medical) are leaving in droves."  Grant was ordering him to do things outside his training and outside of his expertise.  She was ordering him to see patients who needed specialists; he is not a specialist.  He says that Dr Bell ordered  that certain medications are to be stopped for some inmates.  When asked why the medications were to be stopped, Bell stated, "Because they are prisoners."  He asked Bell, "Is this your own medical decison-making?"  Bell replied, "This comes from Wexford."

Karen Grant has ordered D'Antonio to write prescriptions en masse for patients whom he has not seen.  He refused to do so, stating that in most cases he needs to see each patient individually before he can prescribe a medication.  He says Wexford is sabotaging everything by doing such things as excessive questioning of the doctor ("for more information") when he prescribes a medication.  When he makes a referral for a patient to have a procedure, obtain a specialist's opinion, have additional testing, etc., Wexford has a procedure which they call a "collegial" conference call.  Their staff get on a conference call and the vast majority of the time, they delay the additional procedure by requesting "additional information" from the referring doctor.  This goes on and on, back and forth, so that the procedure itself never gets done or is so delayed as to be meaningless (or dangerous) for the patient.

He says that he was told that all prior referrals (for specialists, tests, etc.) made by DOC healthcare workers prior to July 1, when Wexford took over, are cancelled, and will not be honored.  Instead, the inmate is required to go through the referral process all over again, thus further delaying what might be life-saving diagnostic testing.  D'Antonio says that many of the referrals are "shelved" and continuously cycled through the "get more information" process over and over.

D'Antionio refers to the mistakes and unethical conduct going on by Wexford employees as "staggering" and "criminal."  He says that while he does not consider himself to be soft on crime or criminals, "they are human beings and deserving of basic medical care."  He has restricted his exposure to liability for the type of care being provided to inmates by limiting the days he will work, the hours he works, and the units at which he will work.  He says what is happening at the Meadows Unit and throughout the Florence prisons is a "disgrace."

The doctor says that there are such people as what doctors refer to as "hatchet" doctors or "administrative" doctors -- they work for a corporation and have given up their ethics (and oath) to 'do no harm' by accepting a huge paycheck just to go along with corporate policies and directions.  D'Antonio says there are doctors (or nurses) such as this that work for Wexford.

He says that each time he sees a patient, he must fill out a progress note.  This is a form.  When he orders lab work, an x-ray or a prescription, each requires a separate form.  At the Meadows Unit, it was nearly impossible to find the forms needed, thus delaying and complicating the already dysfunctional process.  He says chart work is ignored and there is no review process.  He was originally hired just to do induction physical exams for incoming (new) prisoners, but that he has ended up doing everything from emergency care, chronic care, diagnostics, etc. and that they are so back-logged in reviewing charts that there is no reasonable way that each patient's chart can be reviewed in a timely manner.

He states that he has been told by Wexford employees that, "We are forbidden from talking about what happens here. . ." and that he has been advised, "Prisoners have died at the Meadows Unit due to lack of care since Wexford took over . . . ." (He was unable to provide me any names or DOC #'s of inmates who have allegedly died at Meadows Unit due to lack of medical care since Wexford took over on July 1, 2012).

He says that the Wexford formulary for approved medication is "archaic." He gave an example of the medication that Wexford has approved for hay fever.  (I can't spell it).  He says this was a medication that was being phased out in the 1980's (it was a medication that he would have taken as a child)  -- and that the standard of care in today's world for allergies is an antihistamine and/or a nasal steroid spray.  He says Wexford approves a salt water/ocean spray which is so outdated, it is laughable.  So, when he writes a prescription for a timely/updated drug (a "non-formulary" drug), Wexford can't fill it (won't fill it) because it isn't in their formulary.  So, there is a huge delay for the patient in obtaining non-formulary medication, and the formulary list itself is actually responsible for delay after delay after delay for patients to obtain a prescribed medication, including for serious medical problems.  He states that Wexford would likely claim that their formulary medications are "great" and "adequate," but many of their medications are simply not used anymore in today's real world of medicine in the USA.

He says he works a 12-hour day with no breaks and he even eats lunch while charting.  He works the hours by choice in order to get in his weekly hours in as short a time as possible to get out of there as quickly as possible.  But the workload is so far behind, it would require a full team of doctors to get caught up and would take a year.
He is concerned because many of the inmates are complaining they are not getting enough food and the doctor is concerned about the weight loss he has actually observed.  His says he has heard comments from many people that the real reason for the recent riots/disturbances at Tucson and Rynning is because of an underlying tension or stress among the inmate population due to (1) not enough food; (2) being denied medical care.  The DOC explained the reason for the riots to the media as "racial disturbances."

Dr. D'Antonio has openly discussed with Dr. Bell his concern that Dr. Bell could have a work-related breakdown over his job.  He is deeply concerned about Dr. Bell's mental well-being and feels it is possible that Dr. Bell may become "overwhelmed" by his job duties as Medical Director.  D'Antonio believes the various relevant Arizona professional medical boards and nursing board should immediately become deeply involved and investigate what is happening.  The Hippocratic Oath:  Do no harm -- is being violated directly.   He says he is witnessing "outrageous" medical neglect and actions contributing to such neglect by staff.

When a patient is referred for an outside professional test, procedure or consultation, the referral goes to the Wexford "collegial board."  He has asked, "What happens if it (the referral) is denied?"  Dr. Bell told him, "Well, it goes back to the referring doctor."  D'Antonio said, "Well, what happens if I refer the same patient a second time for the same procedure because I obviously believe he needs it?"  Bell replied, "Well, then we fire you because you keep making referrals."

He says many doctors and nurses have quit.  About 9-10 doctors have quit between the Florence and Eyman Complexes.  Describing the situation as "under-manned" or "under-staffed" is a diversionary term by Wexford.  The doctors who quit need to come forward to explain the reasons why they quit.  The under-manned situation is a result of the very problematic things that are happening.

D'Antonio says that what is happening in the Department of Corrections with respect to inmate medical care is "nothing short of outrageous."

He will agree to an interview with the media or with the ADC Director, but will only do face-to-face.  He lives in Tucson.

Mr. Ryan, on September 5, 2012, I wrote you an email expressing my concerns about the care being afforded to inmates by Wexford, and wondered why the company did not seem to be attempting to especially impress the Department during the early stages of their multi-million dollar, multi-year state contract.  You did not respond to this email.  It now appears as though Wexford sees the ADC as a cash cow for corporate profits at the expense of the very care they supposedly are contractually, legally, morally, and medically committed to providing.  This cannot be permitted to continue, and corporate assurances of corrective action are fundamentally insufficient as a response to the level, nature, and depth of the issues that now are emerging as a result of the outsourcing of inmate medical care to Wexford.

Just prior to the Sept. 5th email, I had notified you of a Wexford nurse who had ordered a female inmate to lick a powdered prescription medication from her own hand after the nurse had poured it into the hand.  The inmate protested because of the unprofessional and unorthodox method of medication administration and ended up with a disciplinary sanction and movement to another yard.  It is unknown if the nurse was sanctioned or terminated, but you did advise me that Wexford had "retrained" their nurses in the proper method of distribution of medication.

Now, with the above serious information as provided to me, I have no choice but to contact the relevant Medical and Nursing Boards of the State of Arizona.  Human lives are at stake.
While we appreciate the recent well-written noncompliance letter from Joseph Profiri, that letter does not go far enough.  For example, there is no mention that families can't get in touch with or recieve call back response from Wexford about their loved one's medical care.  Families repeatedly complain to me that Wexford's "hot line" is completely non-responsive.

Donna Leone Hamm, Judge (Ret.)
Executive Director
Middle Ground Prison Reform
(480) 966-8116
----EMAIL #2: October 5, 2012------ 

Mr. Charles Ryan, Director
Arizona Department of Corrections
1601 West Jefferson
Phoenix, Arizona  85007
                                                 Re:  EMERGENCY ACTION NECESSARY
Dear Mr. Ryan:

It is my understanding, based on information coming directly from Dr. Lawrence D'Antonio, that Dr. D'Antonio was escorted off the Rynning Unit by the Deputy Warden of the Unit and a security officer, after my recent email to you had been (apparently) forwarded to Wexford.  This is apparently the procedure applied toward whistle-blowers by Wexford.
It is also my understanding that Karen (or Caryn) Grant, Director of Nursing, resigned very recently (since my email to you).  I don't know if her resignation is connected to the fact that when I filed a complaint against her with the Arizona Nursing Board, they advised me that there is no "Karen Grant" who is licensed to practice nursing in the State of Arizona at this time, but that a "Karen Grant" was licensed up until 1991.  I believe that impersonating a nurse is a felony in Arizona.
Meanwhile, I have learned some additional very disturbing information from Dr. D'Antionio which, if verified as correct, amounts to an EMERGENCY situation.  The following information cannot simply be passed along to the "appropriate personnel" as you advised about my previous email.  Each and every prisoner who is incarcerated in the state Department of Corrections is entrusted to your department's care and custody, and you and your Department are ultimately responsible for their care, welfare and safety, which -- of course -- includes providing the community standard of care for serious medical needs.

During the time he worked at the Rynning Unit, Dr. D'Antonio personally observed that some inmates are given incorrect medications.  He also observed that some inmates are receiving medications which are contraindicated for other conditions that they have (for example; no inmate who is a diabetic should take a beta-blocker, etc.).  Some combinations are drugs which have the potential for being lethal.   He also observed that some inmates are being given double doses of prescribed medication, each dosage from a different manufacturer with a different name.  Once again, in some cases, the double dose could be fatal or seriously debilitating.  He reported to me that he advised Dr. Tom Bell of his observations, and Bell essentially shrugged him off and did not seem to grasp the import of D'Antonio's concerns.  As Dr. Bell had previously stated, "They are just prisoners."

Because you now are in possession of the above information as related to me by a licensed doctor in the state of Arizona and based upon his own personal observation, I believe that you are obligated to order an immediate audit/investigation of ALL inmate medical files for inmates housed at the Rynning Unit.  The investigation must be conducted by an independent qualified doctor or doctors who are not connected to Wexford or to the Department of Corrections in any manner.  Wexford should pay for the audit/investigation.  Other units should be audited as well because there is no reason to believe that these egregious mistakes are isolated to the Rynning Unit only.
Again, it is insufficient to simply pass this message along to Wexford. This potentially dangerous and/or lethal information must be addressed at once and I expect to receive a report of the findings in a timely manner.  A report that addresses these issues would not have to reveal HIPPA protected information because a code number could be assigned to each case.  It is imperative, however, that any incorrect medications, double-dose medications or contraindicated medications must be identified at once; hopefully, prior to an emergency situation induced by deliberate indifference or by gross negligence.

Please advise.

Donna Leone Hamm, Judge (Ret.)
Criminal Justice Consultant
Executive Director
Middle Ground Prison Reform
(480) 966-8116 (or contact James Hamm at (602) 339-0176