Confronting deliberate indifference: Parsons v Ryan settlement reached.

 EDITED OCT 14, 2014 3:48pm

This first press release is just in from the ACLU of Arizona. I think the DOC is getting off easy without having a public trial, but it saves money and time to do this instead. They were definitely going to lose...

The second press release is from the head of the AZ DOC, Charles Ryan, the guy who was named in the suit. Sounds like he won the lawsuit or something. These are vastly different accounts of the settlement. My bet is that the AZ DOC put the most spin on their version, but it concerns me that they say the following:


" “This is positive news,” said ADC Director Charles Ryan.  “On the eve of trial, the plaintiffs in this case have essentially agreed that the department’s current policies and practices, along with recent enhancements to programming opportunities, adequately addresses the plaintiffs’ concerns relating to constitutional healthcare and conditions of confinement for maximum custody and mentally ill inmates. "

AND:
 
" ADC will monitor its own compliance, thus avoiding costly court oversight, and the Plaintiffs’ attorneys, through record review and on-site tours will confirm compliance, as well."

Say what??? No way!!!

I'm going to have to read the settlement docs myself and get back to you all with another analysis..

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Arizona Agrees to Major Improvements in Prison Health Care, Crucial Limits on Solitary Confinement in Landmark Settlement

For Immediate Release
October 14, 2014

CONTACT:

Alexandra Ringe, American Civil Liberties Union, media@aclu.org, 212-549-2666
Steve Kilar, ACLU of Arizona, skilar@acluaz.org, 602-773-6007
Don Specter and Corene Kendrick, Prison Law Office, dspecter@prisonlaw.com and ckendrick@prisonlaw.com, 510-280-2621

PHOENIX – The American Civil Liberties Union, the ACLU of Arizona, the Prison Law Office, and co-counsel today filed a settlement agreement in their class-action suit on behalf of more than 33,000 prisoners in Arizona’s state prisons. Under the settlement, the Arizona Department of Corrections must fix a broken health care system plagued by long-term and systemic problems that caused numerous deaths and preventable injuries. The settlement will also allow prisoners in solitary confinement who have serious mental illnesses to have more mental health treatment and time outside their cells, and will make other critical reforms in prison conditions.

“The Arizona Department of Corrections worked with us on a settlement that shows a commitment to protecting prisoners’ physical and mental health,” said David Fathi, the Director of the ACLU’s National Prison Project. “We hope other states will now find ways to provide adequate medical, mental health, and dental care to their prisoners.”

“The Arizona Department of Corrections has agreed to changes that will save lives,” said Don Specter, Director of the Prison Law Office. “This settlement will bring more humane treatment for prisoners with serious health care needs, and the potential for their conditions to improve rather than worsen.”

The settlement in Parsons v. Ryan requires the Arizona Department of Corrections (ADC) to meet more than 100 health care performance measures, covering issues such as monitoring of prisoners with diabetes, hypertension, and other chronic conditions; care for pregnant prisoners; and dental care.

The settlement also requires ADC to overhaul the rules for prisoners with serious mental illnesses in solitary confinement. Instead of spending all but six hours a week in their cells, such prisoners will now have a minimum of 19 hours a week outside the cell, and this time must include mental health treatment and other programming. ADC must also restrict guards’ use of pepper spray on these prisoners, using it only as a last resort when necessary to prevent serious injury or escape.

The settlement provides for ongoing monitoring and oversight by the prisoners’ lawyers to make sure the state is complying with its terms.

The groups filed the federal lawsuit in 2012, challenging years of inattention to the health needs of state prisoners and improper and excessive use of solitary confinement, resulting in serious harm and unnecessary deaths. Judge Neil V. Wake of the U.S. District Court in Phoenix certified the case as a class action in March 2013, and the U.S. Court of Appeals for the Ninth Circuit affirmed that ruling in June 2014. Last month, the groups filed reports by nationally recognized experts in corrections and in medical, mental health, and dental care, showing system-wide problems with the prisons’ health care and excessive use of solitary confinement.

In addition to the ACLU and the Prison Law Office, other attorneys on the case are Perkins Coie, Jones Day, and the Arizona Center for Disability Law, which is also a plaintiff in the case.

Click here for a copy of the SETTLEMENT stipulation filed today with the court. 

Click here for a copy of the EXHIBITS to the stipulation.

For more information about Parsons v. Ryan:

aclu.org/prisoners-rights/parsons-v-ryan

For information about the ACLU’s National Prison Project:
https://www.aclu.org/prisoners-rights

For information about the Prison Law Office:
www.prisonlaw.com

For information about the Arizona Center for Disability Law:
http://www.acdl.com/

---now for the official state version----

ARIZONA DEPARTMENT OF CORRECTIONS

1601 W. JEFFERSON

PHOENIX, ARIZONA 85007

(602) 542-3133

www.azcorrections.gov    

JANICE K. BREWER                                                  CHARLES L. RYAN GOVERNOR                                                                            DIRECTOR

For more information contact: Doug Nick dnick@azcorrections.gov Bill Lamoreaux blamorea@azcorrections.gov

Tuesday, October 14, 2014

Parties reach settlement agreement

and seek to vacate Parsons v. Ryan trial

PHOENIX (Tuesday, October 14, 2014) – The Arizona Department of Corrections (ADC) has reached a settlement agreement in collaboration with the ACLU, Prison Law Office and ACDL prior to the pending trial.

The parties have agreed to approximately 100 performance measures applicable to medical, mental health, dental and conditions of confinement.

“This is positive news,” said ADC Director Charles Ryan.  “On the eve of trial, the plaintiffs in this case have essentially agreed that the department’s current policies and practices, along with recent enhancements to programming opportunities, adequately addresses the plaintiffs’ concerns relating to constitutional healthcare and conditions of confinement for maximum custody and mentally ill inmates.

“In regards to those issues, the settlement notwithstanding, it’s unfortunate that the plaintiffs continue to use rhetoric such as ‘solitary confinement’ to describe housing for some inmates.  No such confinement exists in our institutions.  The Department of Corrections has always followed nationally-accredited standards for housing single-cell inmates that include requirements for natural daylight and contact with others, and out-of-cell time.

“Additionally, it should be noted that Arizona’s inmate mortality rates, including incidents of suicide, are within the national average for corrections departments.  In 2012, the most recent year for which statistics are available, Arizona reported 215 deaths per 100,000 inmates, compared to the national average of 254 per 100,000.  Additionally, Arizona averaged 17 inmate suicides per 100,000, which is in line with the national average of 16 per 100,000.

“By avoiding a costly trial, the Department saves significant resources that can be further directed towards continuing to provide constitutional healthcare and structured programming to support successful community reintegration.  This is especially relevant in light of the fact that despite the state of California spending nearly $18,000 per inmate for health care costs due to two decades of litigation by the same plaintiffs in the Parsons case, California is still under court supervision and the inmate mortality rate there exceeds that of Arizona. 

By contrast, Arizona spends nearly $3,800 per inmate in health care costs.

ADC will monitor its own compliance, thus avoiding costly court oversight, and the Plaintiffs’ attorneys, through record review and on-site tours will confirm compliance, as well. ADC, through its contracted vendor, must meet specific compliance thresholds at its facilities. Within two years, monitoring of performance measures automatically terminates when those performance measures meet agreed-upon thresholds.  ADC can petition the court to terminate the entire settlement agreement after four years.

Execution by Deliberate Indifference: Killing Robert W. Murray.

UPDATED JULY 1 2014: There's nothing new about this, sadly - the AZ DOC has been executing prisoners all along by way of failing to treat their critical  medical and psychiatric conditions. Three death row prisoners in just over  a year have also committed suicide...

You must be a subscriber to see Gary Grado's newest article at the Capitol Times  about the above notice of Robert Murray's death -  if you can afford it,  check it out. Below is the original piece on Murray's cancer last fall, also by Grado, along with my post at the time. Not sure anything more needs to be said, except condolences to anyone who might have cared about this prisoner, as well as to the loved ones of his victims, for whom this will be an emotional time as well. 

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

SOS from Arizona's living dead: 
Deliberate indifference to life on death row
(originally posted to arizonaprisonwatch.org on September 26, 2013 7am)

 one of many letters received at AZ Prison Watch re: 

prisoner frustration over difficulty accessing medical care.

A big thanks goes out to Gary Grado at the AZ Capitol Times for interviewing this prisoner, and to the publication for making this particular article accessible to non-subscribers. Prisoners don't make sympathetic news subjects - especially not those on death row. A lot of folks would just as soon let Murray die of throat cancer untreated, in favor of putting those health care resources into the community (as if the state would actually re-direct "savings" there, instead of into the private pockets of profiteers). 

All I can say is that withholding medical care from Murray because the state plans to kill him anyway is akin to choosing to execute him by applying acid to his throat in small doses over the course of  9 months or so, letting it eat slowly away at his ability to  swallow, speak, and breathe, knowing this will not only kill him, but will make him suffer horribly as he dies. This has nothing to do with one's feeling about the death penalty - it's a question of whether or not you are for the constitution and against torture. If you believe in the rule of law, and that we should not torture our prisoners, then you have to support the provision of a basic standard of medical and mental health care to them.

The other thing is that prisoner health IS public health, and if we don't treat them inside, they come out with high rates of chronic illness, infectious disease, psychiatric disability, and so on. The imprisoned population is especially high-risk, medically, and many live marginally once back in the community, where they are more likely to lack access to health care than most non-felons. In prison they're frequently exposed to things like Hepatitis C (at least 40% of prisoners are believed to be infected), but as a captive patient population, they would be more likely than not to follow up on treatments and regimens that lower their mortality and long term health risks considerably, if their dietary plans and health care provider will offer them.

But that's not what appears to be happening. Deliberate indifference to human suffering is the absolute worst cancer there is in a society, and it's metasticized from the head of the AZ DOC to the agency's extremities. I hear stories like Murray's all the time, sadly - and it's not just the guys on death row. Remember Benny Joe Roseland? I've written to him a few times, but haven't heard back from him since writing that post. DOC says he's still alive, but that's all I can get from them.

Furthermore, as Dan Pochoda points out below, how we treat our prisoners says a lot about our society. The conditions in Arizona's prisons - from the medical neglect to the prevalence of heroin, the dominance of criminal gangs, and the rampant racialized violence - are among the worst in the country. There was a brief spell of progressive vision a the AZ DOC while Dora Schriro was director, under then-governor Janet Napolitano, but she was often mocked as being a "thug-hugger" for favoring rehabilitative programs over punishments, and her efforts were frequently undermined by the Good Old Boys network of DOC administrators and officers.

According to prisoners and former employees, things at the AZ DOC got dramatically worse as soon as Jan Brewer became governor, bringing Charles Ryan out of retirement to be her chief disciplinarian at the AZ DOC. The culture of contempt for prisoners and human rights that permeates that institution has actually been decades in the making, much of it under the direction of the younger Chuck Ryan, so all the bad stuff began to flourish again once he took over the reins there. 

I don't understand that man at all, I have to say. He's spent his career climbing that ladder, but now there, he appears to have utterly ceded control of his prisons to the gangs and profiteers - either that, or he's knowingly and intelligently aiding and abetting them. In either case,  his directorship  should be an embarassment to the Governor's office - for some reason Jan still stands by her man, though. 

Check out the other work the Capitol Times has been doing on the prison system here. If you're a subscriber, this is a pretty good piece that just came out about the class action lawsuit over health care, also by Gary Grado:

Exhibit in class-action lawsuit details failings of prison health system

-------from the AZ Capitol Times (9/16/13)--------

Prison ordeal

Death row inmate struggles with cancer

By Gary Grado

Published: September 16, 2013 at 8:41 am

A lab discovered death-row inmate Robert Murray had cancer the same day a Scottsdale surgeon removed his tonsils, but his disease went unknown to him and untreated for seven more months.

As Murray, 48, and his lawyers try to figure out what went wrong with his medical treatment, one thing is certain. The breakdown coincided with the turmoil surrounding the Department of Corrections’ transition to a private health care provider for Arizona prisoners, and his situation didn’t improve after the first company parted ways with DOC and a new company came under contract.

Murray endured long, painful delays between doctor’s appointments, a misdiagnosis, and a time in which blood from a burst abscess on his tonsil gushed from his mouth. He came to learn he had cancer when the surgeon he hadn’t seen in months asked him if he was finished with radiation to treat the illness, a treatment he never had.

Despite the delays, the cancer didn’t spread. Murray said an oncologist told him that although the situation could have become grave, he should have a full recovery with proper treatment.

“It was prayer, luck it just didn’t explode like it could have,” Murray said in a 21-minute interview from death row in Arizona State Prison Complex-Florence, where he’s been locked up since October 1992.

Such allegations aren’t unusual. A class-action lawsuit alleging DOC has provided inadequate health care for years offers other medical horror stories. And a suit recently filed by the survivors of an inmate who died in October 2012 alleges employees of Wexford Health Sources Inc. of Pittsburgh refused to treat him while he convulsed on the floor. Wexford is a company that provides prisoner health care in Arizona and elsewhere.

“We get weekly at least one letter that is equivalent, literally, to this fellow on death row,” said Dan Pochoda, the legal director for ACLU-Arizona.

Pochoda is one of more than 20 lawyers involved in the class action suit. He said the medical hardships of prisoners don’t resonate with the public, but they should because the state has a heavy obligation to provide adequate health care once it takes control of someone’s life.

“To paraphrase Dostoevsky, the test of a society is how they treat persons in prison,” Pochoda said.

Pleas for help

Murray and his brother, Roger Murray, are on death row for convictions in the May 14, 1991, robbery and murders of Dean Morrison, 65, and Jacqueline Appelhans, 60, at their store in Grasshopper Junction in Mohave County.

Morrison and Appelhans were found face down in their bathrobes, shot several times each in the head with shotguns and handguns. Appelhans was clutching Morrison’s arm.

Murray wrote a book titled “Life on Death Row” in which he denied committing the murders.

He has contended with an assortment of health problems during his 21 years in prison, and it was during an examination in February 2012 that he first complained of a lump in his throat.

Murray’s tonsils were becoming swollen and sore by April 2012, which was one of the final months that DOC provided medical care. Murray saw a DOC doctor in May and was diagnosed with an infected tonsil and given antibiotics.

Just days before his appointment, DOC and Wexford Health Solutions announced the company had been awarded a five-year contract to provide onsite medical, dental, pharmacy and mental health care, as well as the administration of third-party services.

Murray claims in a nine-page affidavit that the antibiotics had no effect and his many requests over the next month to see a doctor went unfulfilled as the swelling worsened and swallowing became difficult.

“His neck and face were visibly deformed,” said Murray’s attorney, Jennifer Garcia, a deputy federal public defender.

Wexford took over on July 1, 2012, and the company informed Murray he was on a waiting list to see a doctor, even as he continued to submit medical requests pleading for help.

“At least once during this period I overheard RX delivery nurses state that ‘Wexford has no available doctors for (the infirmary),’” Murray wrote.

In a Cure Notification, a letter to Wexford to outline how it wasn’t complying with the contract, DOC said the company’s staffing shortage created “inappropriate scheduling gaps in on-site medical coverage.”

In his requests to see a doctor, Murray writes about shooting pains in his ear, choking and coughing and difficulty breathing. He saw a nurse practitioner on July 20, 2012, who became alarmed by his condition and prescribed “magic mouthwash,” a formula of various medicines used to treat ulcers in the mouth.
Four days later the abscess burst.

“A warm fluid gushed into my mouth, I thought I may be vomiting and hurried to my sink,” he wrote.

He was rushed to the hospital, but he didn’t see a surgeon until September and wasn’t on the operating table until Nov. 19, 2012.

DOC, meanwhile, was already unhappy with Wexford’s performance, stating in the Cure Notification that the company was inadequately staffed, administered medication incorrectly, inconsistently and incompletely, and lacked a sense of urgency in addressing crisis situations.

DOC referred to several incidents in which it said Wexford did not comply with the terms of the contract, including not giving medication to a mentally ill inmate who hanged himself and a nurse who contaminated diabetes insulin with syringe tainted with Hepatitis C and continued to inject inmates with it.

Wexford responded with a letter of its own explaining that “the majority of the problems Wexford now faces are long-standing issues, embedded into (DOC) health care policy and philosophy, and which existed well before Wexford Health Sources assumed responsibility of the program.”

Wexford also alleged that DOC kept key information hidden during the procurement process.

An aggressive form of cancer

Dr. Joel Cohen of the Allergy Ear Nose and Throat Center in Scottsdale removed Murray’s tonsils on Nov. 19 and sent them to a nearby lab. The lab confirmed he had cancer and phoned the results to Cohen the next day, according to the pathology report.

Dr. Sun Yi, a University of Arizona professor who specializes in cancers of the head and neck, said that after diagnosis, blood work and scans would be done to determine the severity, or stage, of the cancer, a process that generally takes a few months.

From there, the patient would be referred to various oncologists.

“With malignancy, the more time you wait the more time the tumor has to continue to populate and grow,” said Yi, who is not involved in the case. “The worst case scenario is the cat’s out of the bag situation where it metastasizes and becomes phase four and for most cancers incurable at that point.”

Yi said cancer in the throat is extremely aggressive.

There are no records of any of the steps Yi described in Murray’s medical file.

Murray said Cohen wanted to see him 14 to 21 days after the surgery, but “ADOC-Wexford failed to take action.”

Cohen said he reported the cancer by telephone to a doctor at DOC on Nov. 20, 2012, and recommended treatment.

The doctor said he regularly treats prisoners and he understands there are all sorts of prison protocol that must be followed for each visit. He typically wants to see a patient for post-operative visit in 10 to 14 days.

“The prisoners can’t always come back when they’re told to come back,” Cohen said.

He said it is not his responsibility to prescribe the cancer treatment.

A spokesman for DOC and spokeswoman for Wexford declined to comment for this story. The agency and company agreed Jan. 30 to end the contract and DOC signed a new one with St. Louis-based Corizon Health Inc., which took over services on March 4.

Murray’s throat was still irritated and swollen in the meantime, and he got an appointment with Cohen on May 14.

“He’s talking to Corizon all the time about this problem and no one seems to be addressing them for months either,” Garcia said. “It doesn’t seem to me things have been measurably better under Corizon.”

Murray said Cohen asked him about his radiation treatment, which he never had, but the doctor still didn’t tell him about the cancer.

Records indicate Murray was prescribed radiation and a CT scan that day, but there is nothing in the record explaining why. When Murray returned to the doctor’s office on June 7 he saw Lee, Cohen’s associate.

“He said, ‘You have cancer, you didn’t know,’” Murray said. “It was kind of an astounding moment, surreal.

I kind of expected something was not right.”

Ray Norris, a medical malpractice attorney with the firm Gallagher and Kennedy, said medical negligence is determined by whether a doctor fell below the standard of care.

Norris, who is not involved in Murray’s case, said standard of care is measured by what an ordinary, prudent, and reasonable health care provider would do under the same circumstance.

“If there was a breach of the standard of care, the question then becomes causation, or in other words, what difference did it make,” Norris said.

Murray’s theory is he thinks Cohen expected him to return for a follow up visit within a few weeks and was going to inform him then about the cancer, but when Wexford failed to schedule the appointment Cohen never followed up. “I think it was probably just an accident, but an accident can be easily overlooked,” Murray said.

Murray is still undergoing treatment, and while it isn’t going at the pace he would prefer, he said he’s been assured it is normal pace for treating such a cancer. He said he is still considering his options on filing a lawsuit and looking for a civil lawyer.

Health Decline

May 2012: Inmate Robert Murray diagnosed with possible infected tonsils and given antibiotics. Wexford Health Solutions is awarded $349 million contract to provide health services to Arizona prisoners.

June 2012: Swelling in neck worsens.

July 1, 2012: Wexford takes over medical services.

July 24, 2012: Abscess in neck bursts and Murray rushed to hospital.

Aug. 17, 2012:  In an incident not related to Murray, Wexford nurses are accused of improperly administer medication by making inmates lick powdered medication from hands.

Aug. 23, 2012: Mentally ill inmate who didn’t receive psychiatric medication for weeks found hanged in cell.

Aug. 27, 2012: Wexford nurse allegedly contaminates diabetes insulin with syringe tainted with Hepatitis C.

Sept. 21, 2012: Arizona Department of Corrections informs Wexford of assorted contract breaches.

Nov. 19, 2012: Murray, whose face is deformed from swelling, undergoes tonsillectomy and lab results show he has cancer.

January 2013: Murray’s requests for follow up with surgeon unfulfilled, problems and pain with neck persist. Wexford and DOC agree to cancel contract. Corizon becomes new contractor.

June 7, 2013: Murray informed he has cancer that went untreated for seven months.

AL JAZEERA's America Tonight: Another whistle blown on Corizon.

Blessings to former Corizon employee and whistleblower Teresa Short. What she did here took both courage and compassion. How sad that it has become an extraordinary thing these days to simply do the right thing and tell the truth.


Thanks to Abby Leonard and Adam May at Al Jazeera America Tonight for this coverage last week, too. They've been super.


Families, if you're advocating for an imprisoned loved one needing medical or mental health care, check out these posts below, and feel free to contact me: peggy plews 480-580-6807 / arizonaprisonwatch@gmail.com.

Corizon and the AZ DOC: Prisoners & Families, Know Your Rights. http://www.arizonaprisonwatch.org/2013/03/corizon-and-az-doc-prisoners-families.html

 Corizon's deliberate indifference: fighting back.

 http://www.arizonaprisonwatch.org/2013/05/corizons-deliberate-indifference.html

A word of advice - if you need help and cant hire an attorney, you'll need to drag your AZ state legislators into it to get anywhere - start filling them in  now, and make sure the DOC knows that you're cc'ing them on everything you have to write to Director Ryan in order to get your loved one taken care of. They can be found here: http://www.azleg.gov/alisStaticPages/HowToContactMember.asp

Please make sure your loved one in prison is doing the grievance process properly so they can sue these bastards if they still don't treat them right. Keep an eye on the DOC policy page, too, so you can see when things change and send copies inside.

 ---------------------------------

Whistleblower: Arizona inmates are dying from inadequate health care

An “America Tonight” investigation found dozens of cases of neglect in Arizona'€™s privatized prison health care system

 Watch parts one and two of Adam May's report.

May 28, 2014 3:45PM ET

 

by Abigail Leonard  & Adam May @adammaytv

 

SAFFORD, Ariz. — Regan Clarine found out she was pregnant just two days before she was sentenced to two and a half years behind bars for possessing a narcotic for sale. Giving birth to her baby daughter while she was incarcerated at the state prison complex near (Phoenix) was an experience she says nearly killed them both.

Clarine says her first indication things were not right with her health care was when she asked prison officials for an ultrasound. She was worried she wasn't gaining enough weight, but they never gave her one. Instead, Clarine said that after about nine months, prison doctors sent her to the hospital to induce labor, but when the baby still didn’t come, they performed a cesarean section against her wishes.

When Clarine went back to her cell, her C-section wound re-opened.

“It was big enough for me to put my fist in there,” she said. “It was the worst pain I’d ever been through in my life.”

Clarine said she alerted guards, but they refused to let her see a doctor, leaving her on the prison yard with a gaping wound for two weeks. When she finally saw medical staff, she said they told her that she was lucky to be alive. They treated her with a wound vacuum. Then, she said, they employed an antiquated medical treatment.

“They decided to use sugar … like McDonald’s sugar,” she said. “They would open it and pour it inside [the wound] and put gauze over and tape it up. And I had to do that for like three weeks.”

Clarine’s story is one of dozens. Like many other states, Arizona privatized its prison health care system two years ago. In a six-month investigation, “America Tonight” found disturbing cases of inadequate treatment, and evidence that Wexford Health Sources, the first private company Arizona contracted to provide prison health care, was aware that it was violating prisoners’ constitutional rights.

Arizona’s system is currently run by Corizon Health, the largest private prison health care provider in the country. Now, for the first time ever, one of its former employees is blowing the whistle about its failures.

Going unfed

Teresa Short was a patient care technician for Corizon, but lost her job in late March for refusing to go to work while suffering from a case of scabies she caught from a prisoner. Short said she thought it would be unethical to treat patients while she was still contagious. She had already infected a family member, she said, and feared her son could contract it and bring it to his high school. According to Short, Corizon and Arizona prison officials have been trying to cover up the outbreak, which now includes the original prisoner and seven staff members. (Read Corizon's response.)

But the most persistent problem at Corizon, Short said, was staffing.

“We have a lot of dementia patients that take time in feeding,” she said, “and because of the short staff we'd have to stand there for hours to try to feed them and it was just not permitted.”

Sometimes, those patients would go unfed, she said. Others who were incontinent would sit for hours in their own feces, she said. And still others died.

Short described one dementia patient who had a vascular catheter in his arm for dialysis treatments. He didn’t understand what it was and kept playing with it, she said, so she repeatedly told senior staff he needed additional supervision. Instead, they sent him back to his cell, alone. At 5 a.m., she went in to check on him.

Former Corizon patient care technician Teresa Short said some Arizona prisoners have died because there weren't enough medical staff on duty.

 

“[I] could smell blood before I even went into the room,” she said. “And when I turned on his light, it looked like somebody had been murdered. There was blood all over the room. I screamed for help.”

Short said the man had unplugged the catheter and quickly bled out. If Corizon had employed more staff to monitor patients, she said, he might still be alive.

There are some numbers to back up Short’s claims. Since the state privatized its prison health care, medical spending in prisons dropped by $30 million and staffing levels plummeted, according to an October report from the American Friends Services Committee, a Quaker social justice organization. It also found a sharp spike in the number of inmate deaths. In the first eight months of 2013, 50 people died in Arizona Department of Corrections custody, compared with 37 deaths in the previous two years combined.

According to a 2012 lawsuit filed by the American Civil Liberties Union, the health care in Arizona’s prisons now amounts to cruel and unusual punishment, with prisoners at serious risk of "pain, amputation, disfigurement and death.” The suit cites examples of Arizona health officials telling prisoners to pray to be cured and drink energy shakes to alleviate cancer symptoms.

“People are often sent to prison for two-year, three-year sentences that have turned into death sentences because of the absence of the basic minimal care,” said Dan Pochoda, legal director for the ACLU in Arizona. He said in his 40-year career, he’s never seen a worse prison health care system.

In an emailed statement, Corizon spokeswoman Susan Morgenstern said that the company could not discuss individual cases because of privacy laws, but that “the vast majority of our current staff levels exceed contract requirements,” and that their care follows the guidelines of the National Commission on Correctional Health Care and the American Correctional Association.

“Our goal is always to provide quality care while being good stewards and making the best use of public funds,” she wrote.

“As for lawsuits, we treat hundreds of thousands of patients in millions of healthcare encounters each year,” she added. “… The majority of lawsuits are brought by inmates without an attorney representing them and are dismissed or resolved prior to trial.” (Read the company’s full statement.)

'He had plans'

After his cancer, inmate Tony Brown's pain medication was switched from morphine to less-powerful Lortab.

America Tonight

Tony Brown is another inmate who died since Arizona privatized its prison health care. He was serving a 10-year sentence for aggravated assault and was due to be released last September.

“They were supposed to come down for Thanksgiving this year,” his daughter Jenna Jumper said. “He never got to meet my husband and he wasn't there when I got married, so they were going to come visit.”

Brown was in remission from esophageal cancer, according to his medical records, and had been prescribed morphine for the pain. But in October 2012, the prison ran out of the drug. Medical staff switched him to Lortab, a weaker painkiller.

In a video taken by prison guards and obtained by “America Tonight,” Brown is seen just after he was put on the new medication, writhing in pain while handcuffed to a gurney. His medical records show that guards told nurses his condition was worsening and that he "needed to be checked out." But there is no record of medical staff visiting his cell.

In another video taken two days later, a prison chaplain checks on Brown at his wife’s request.

“Inmate Brown, I spoke with your wife earlier today,” the chaplain is heard saying. “Can you communicate with me please? I’d like to speak with your wife later on. Is there something I can tell her?”

Brown, face down on a bunk, barely moves and doesn’t respond. A guard can be heard saying, “Is it me or does this just not feel right to anybody else?”

The guards started CPR and nurses came to assist, but 40 minutes passed before they realized no one had called an ambulance.

He died in a hospital the next day. Two days later, his widow Jami Brown said she finally received a call back from Wexford, the private prison health care company in charge at the time.

“My biggest thing is that if people would stop to realize that he did have family,” his daughter said, “and that he did have a child and he did have a wife and he had plans.”

The official cause of death was listed as complications from cancer. But Brown's family is suing Wexford, claiming he died from lack of adequate medical care.

In a statement, Wexford attorney Ed Hochuli said he couldn’t discuss details of the case because of the lawsuit and health care privacy laws, but wrote: "Based on the limited information we have at this time, though, I am very confident Wexford Health and its employees acted appropriately, and further investigation of this claim will demonstrate and prove the lack of any wrongdoing or negligence by Wexford Health.”

But there are signs that Wexford was aware of problems.

“America Tonight” obtained a copy of a PowerPoint presentation written by top Wexford executives for a meeting with the Arizona governor's office in November 2012 – four months after the company started providing care in the state. It warned that the care it and the Department of Corrections were providing was "not compliant with … requirements" and that "the current class action lawsuits are accurate." It recommended an overall operational cleanup, staffing reassessment and the appointment of a governor’s office liaison.

The PowerPoint presentation also says that the department's "transparency" policy with the media could "encourage negative press."

'A grain of sugar'

State Rep. John Kavanagh said Clarine’s story about being treated with sugar didn’t seem like a “true allegation,” adding that it “sounds ridiculous.”

 

 

Prison officials deny any problems with privatized care. Richard Pratt, the interim director of the health services division of Arizona’s Department of Corrections, told “America Tonight” that staffing levels since privatization were “basically the same.”

“Corizon staffing levels have been coming up on a monthly basis to the point even last month the hours that they were working with their existing staff exceeded the contract requirements,” he said.

He also denied there was a scabies outbreak, as Teresa Short had charged.

But Pratt emphasized that privatizing health care wasn’t a decision made by the Department of Corrections.
“It was legislated and mandated and it was the law,” he said. “So we were forced to do this.”

Legislators who supported the privatization promised that it would save taxpayers money, while maintaining adequate levels of care for inmates. The majority of states have privatized prison health care, rewarding private companies for keeping costs down.

“I mean, people die in prisons,” said state Rep. John Kavanagh, who wrote the legislation that privatized the state’s prison health care. “I receive a lot of handwritten notes from prisoners. I receive emails from prison families with all sorts of allegations of crazy behavior. And then, you call the prison people up and they usually have a reasonable explanation for it.”

Kavanagh said Clarine’s story about being treated with sugar didn’t seem like a “true allegation,” adding that it “sounds ridiculous.”

“You know prisoners have 24/7 to think up allegations and write letters,” he said. “I'm not saying that some of them can't have a basis in fact. But you got to take them with a grain of salt or in the case of the hospital, with maybe a grain of sugar.”

Kavanagh was also dismissive of the ACLU lawsuit. “I think most people who get into [class-action lawsuits] wind up with nothing and the lawyers walk away in limousines with their trunks full of cash,” he said.

No bid, nothing

Richard Pratt, interim health services director for Arizona’s Department of Corrections, denies that there’s a scabies outbreak in prison and says that Corizon’s staffing levels have exceeded the requirements of the contract.

 

 

Before Tony Brown’s death, Wexford was already coming under fire after a contract nurse exposed more than 100 inmates to hepatitis C by using dirty needles to deliver medication, according to the Department of Corrections. Four months later, Arizona severed ties with Wexford and awarded the three-year, $369 million contract to Corizon, which has similar contracts in 28 states, according to its website. But it has faced problems in many of them; in the last five years, Corizon has been sued for malpractice 660 times.

Arizona Democratic House Minority Leader Chad Campbell said the Legislature didn't properly vet Corizon before signing the contract.

“No bid. Nothing,” he said. “It was deemed an emergency situation by Department of Corrections so they didn't have to go through the normal process.”

Campbell also noted that Corizon had just hired the former head of the Department of Corrections, who was the mentor of the current head of the department.

That’s not the only tie that members of the state government have to private prisons. Charles Coughlin, the former campaign strategist for Gov. Jan Brewer, runs a lobbying firm called HighGround Public Affairs Consultants, which represented one of the country’s largest private prison companies. HighGround donated $5,000 to Jan PAC, Brewer's super PAC.

Then in late March, Kavanagh allocated $900,000 in state funding to the private prison company GEO Group Inc., even though the Department of Corrections said it wasn’t needed, according to the Arizona Republic.

“They're profiting on taxpayer dollars and to me, if I'm going to hand out money to a private entity, I want to make sure it's being spent wisely,” said Campbell, who is now calling for an investigation.

The governor's office declined a request from “America Tonight” for an interview and referred us back to Kavanagh, who said the allegations that Brewer accepted bids because of personal relationships were “baseless.”

“I think they're propaganda,” he said. “I mean, people say to me I've gotten campaign contributions from private-prison people. Well, yeah. I got from a lobbyist who represents them but that lobbyist also represents 40 other clients in different industries. It's smoke and mirrors. It's a façade.”

In the meantime, allegations of wrongdoing continue to mount. According to the American Friends Service Committee report, an inmate at the Whetstone Unit of the Arizona State Prison Complex tested positive for tuberculosis in August. But Corizon did not test other prisoners, even those who were doing community service outside the complex.

A healthy baby

Clarine walks out of prison, escorted by her father

 

 

Earlier this month, Regan Clarine completed her sentence. “America Tonight” met her as she was released into the waiting arms of her father, Paul.

“It’s one of the happiest days of our life,” he said. “Hopefully we’ll never have to do this again.”

They drove to a nearby hotel to reunite with the rest of the family, including her 11-month-old daughter, Rylan.

They’d met a handful of times on brief prison visits, but Rylan didn’t recognize her mother. Still, Clarine was happy to see her so healthy.

She responded to Kavanagh’s allegation that she was probably making up her story with a laugh, saying, “That’s crazy. I don’t think I could even come up with something like that … Sugar?”

To add insult to injury, her mother, Lori, said the prison has billed her $2,000 for Rylan’s birth. She is disputing the charges but fears it could hurt her credit if she doesn’t pay them. She says privatized prison health care simply isn’t working.

“You know, she got her just punishment,” Lori said. “But, oh my goodness, they're still human beings. Take care of them.”

CORIZON at ASPC-Perryville: Deliberate indifference to our elders.

I received the following letter from a woman at ASPC-Perryville who is deeply concerned for a friend’s welfare, and hopes that publishing her story will help improve the quality of care she gets from Corizon staff and the AZ DOC. She’s one of few women I’m in touch with who really knows how to fight back through the grievance process and civil rights suits. Thank you, Laura Medley. You rock!

 prisoner Dominique Keys

ASPC-Perryville

“In 2006, Dominique Keys developed osteomyleitis. This is an infection of bone marrow and/or bone structures usually caused by a bacteria. For months she had a fever up to 104 degrees, and AZ Department of Corrections (DOC) medical told her nothing was wrong with her.


Without her knowledge, this infection ate through the spinal vertebrae causing two cervical fractures. For months medical left Dominique in her cell partially paralyzed in her own urine and feces telling staff that there was nothing wrong with her.


By January 2007, (medical) sent Dominique to the hospital where the fractures were discovered. After which Dr. Naftaly Attias performed a corpeltomy fusion at C 5-6, C4-7 with a steel cage. The doctor did not bother to tell Dominique that he had accidentally drilled a hole through her spinal cord. In fact, she didn’t find this out until 2012.


By 2013, after Corizon assumed the control I wrote a letter to Corizon’s legal department. Dominique was examined by a physician at St. Luke’s Hospital who stated that the damage to her cervical spine was irrepairable and re-affirmed that she still required a second surgery(A spinal rod). The surgical consult was approved in December 2013, however, nothing has been done.


I filed a medical malpractice case against Dr. Attias in Maricopa County Superior Court (CV 2012-017403) I waived all of the motions and oral arguments for Dominique. Even with a court order, it has taken months just to get a copy of her medical records. Just short of a contempt ruling.


ADOC did not want the release of these medical records not only because of the spinal issues, but because of several issues. In 2011, Dominique fell transferring from the toilet to her wheelchair. You could clearly see a dislocation of her left shoulder and medical refused to address the issue.


So, once again I wrote a letter to Corizon’s legal department. Last November, St. Luke’s hospital performed an MRI. All of the muscles tore, arthritis, and healed improperly, rotator cuff blown out and she requires complete joint replacement. Even with surgery, Dominique will never have full use of her left arm and shoulder. 3 months later, medical claims that they’re trying to find a doctor to perform the procedure.


Dominique had cardiac issues. Specifically aneurysm on the carotid artery with high blood pressure and several blocked arteries. After DOC was notified that Dominique required cardiac surgery, it’s been several YEARS since she has been seen by a cardiologist.


Dominique is a 70-year old woman. With respect to her spine, intermittent paralysis and extreme pain. These assholes wouldn’t even approve her with a wheelchair. Her daughter bought her a wheelchair. She’s in agony with her shoulder. With the cardiac, the pain has her blood pressure at stroke levels.


Nothing is being done and essentially ADOC wants her to remain in a cell, shut up and die! At this point, in considering adding Arizona as a party to the Attias lawsuit just to obtain orders for medical treatments…”                                         ------------------------

Dominique apparently just returned to Perryville from the hospital on 5/11/14 - I dont know what procedure she may have had there, but expect to hear back from her friend soon.

Please, readers, contact Governor Brewer’s office and urge her to appoint an executive team to investigate the privatization of the DOC’s health services - the performance of these private companies has been criminal, for which they are making a profit off of the tax dollars stolen from our schools to care for prisoners - in fact, Corizon is being paid over $300,000 a day to deny prisoners the essential care they need.

Governor's Office
Executive Tower
1700 West Washington Street
Phoenix, AZ 85007

(602) 542-4331
 

 You can also complain directly to Corizon about Dominique’s care at 1-855-276-5416
 or by E-MAIL: InmateHealthInquiry@corizonhealth.com

For those of you who are also fighting for a loved one’s medical care at the AZ DOC, please refer to these posts below, and call or email me if you need help. Your loved ones MUST be filing grievances, not just more HNRs, if they aren’t getting the care they need. Reach me, Peggy Plews at 480-580-6807 or arizonaprisonwatch@gmail.com.

http://www.arizonaprisonwatch.org/2013/03/corizon-and-az-doc-prisoners-families.html

http://www.arizonaprisonwatch.org/2013/05/corizons-deliberate-indifference.html

http://www.arizonaprisonwatch.org/2014/05/death-sentence-kpnxs-halloran-and.html

photo by PJ Starr / Chalk art by Margaret J Plews

Phoenix, AZ (Thanksgiving 2011)

"DEATH SENTENCE": KPNX's Halloran and whistleblower expose depth of negligence at Corizon/AZ DOC.

SOS to the AZ STATE Legislature (PHX 2013 )

What follows is an interview with a Corizon whistleblower/former employee, Teresa Short, and the results of extensive research by KPNX investigative journalist, Wendy Halloran. Wendy has even posted critical evidence for us from her research below. Teresa worked in the infirmary at ASPC-Tucson/Rincon, and was deeply troubled by much of what she saw while there. If you or a loved one of yours has been mistreated at ASPC-Tucson/Rincon in the past year, please get in touch with me. And to anyone out there who is or will be litigating Corizon: you need to send this article to your attorney. These people are preying on the sick and dying.

AZ DOC prisoners and their families owe both Teresa and Wendy a debt of gratitude for their willingness to risk retaliation by the powerful to bring the truth to light. Even our state's legislators are afraid to call DOC and Corizon out for what they've been up to.  This experiment has not only been a colossal waste of taxpayer dollars that could be used to prevent crime and incarceration, but will be sucking resources out of the state budget long after Corizon has run away with its profits. At great cost to Arizonans - with the blessing of our Republican legislature and governor - Wexford and Corizon have perpetrated additional harm on the very people the DOC is supposed to be "rehabilitating", costing the lives and livelihoods of far too many individuals who do not deserve to be thrown away. 

Rather than whitewashing things like this poor man bleeding out due to negligent care, DOC Director Ryan should be pounding down the Governor's door saying "THIS ISN'T WORKING!!!!", and begging the legislature to reverse their order to privatize state correctional health care. He owes them the truth - he owes that to all of us. 

To all the rest of you at the DOC and Corizon who are trying to do the right thing by the patients you serve: thank you for all your acts of kindness and professionalism, but your silence still makes you complicit with the real bad guys. Please talk to SOMEONE about what you have seen and been ordered to do as well, if it goes against yours or your profession's ethics. Otherwise, they will most surely get away with this fraud, waste and abuse. You might want to start with contacting Wendy Halloran at KPNX. If anyone can put the info you may have to good use, it's her.


Wendy Halloran, KPNX/12News
200 East Van Buren
Phoenix, AZ 85004
602-444-1212


Or drop me a line: Peggy Plews 480-580-6807 arizonaprisonwatch@gmail.com

--------------from AZCENTRAL.COM / KPNX News12----------

Death Sentence: Prison healthcare costly, ineffective

Wendy Halloran, 12 News | azcentral.com 5:53 a.m. MST May 22, 2014

Arizona taxpayers are footing a $10.2 million per month bill for healthcare a 12 News investigation has found leaves some patients untreated.

 

Arizona taxpayers pay $125 million a year to Corizon, a company contracted to provide healthcare to Arizona's inmate population. A 12 News investigation revealed there are questions about whether the company is driving up its profits at the expense of taxpayers.

What's more, billing records show the Department of Corrections is spending millions more to defend itself from a 2012 class-action lawsuit filed by the American Civil Liberties Union of Arizona and the Prison Law Office out of Berkeley, Calif.

That filing accuses the department of not providing adequate medical care, mental health care and dental care to prisoners.

The state hired Struck, Wieneke & Love PLC, a private law firm in Chandler, to handle its defense. Legal billing records show taxpayers have already paid the firm $2,988,910.68 as of April, 2014.

In an interview, Dan Pochoda, the legal director for the ACLU of Arizona, says the defense of the lawsuit was given to a private firm too quickly. He questions why the Attorney General's Office is not defending the case.

"The Attorney General's Office, they have a section that does the defense for this specific agency, in this case the prison systems, as they do for other agencies and presumptively it should start off obviously with the AG," he said. "You know it's going to be a significant expense once we go outside. These are profit-making firms just like the health-care provider is a profit-making provider. Their bottom line is making more money."

That's nearly $3 million in public money to a private firm defending the Department of Corrections against allegations its private healthcare provider is doing an inadequate job.

Related documents
• Struck Wieneke %26 Love, PLC invoice - March 2014. (PDF, 266 KB)
• Struck Wieneke %26 Love, PLC invoices - May 2012 to March 2014. (Zip, 1.16 MB)
• Corizon invoices - March through October, 2013. (PDF, 493 KB)

Questions about inmate care
We reviewed records from March through October 2013 and found at least 16,000 medical delays, ranging from not treating an HIV-positive prisoner to inmates not getting antipsychotic medication.


Why should taxpayers care? Every day Corizon is on the job, we pay on average $339,000, whether it does its job or not.
Teresa Short worked as a patient care technician for Corizon at the state prison in Tucson. She resigned in March and has since had trouble dealing with the death of an inmate she cared for.


That inmate was James Copeland. Copeland was serving time for failing to register as a sex offender.
Copeland was diagnosed with dementia and kidney disease. He was a dialysis patient housed in the medical unit where Short worked at the prison. Copeland had a vascular catheter inserted in his chest, which is a port for dialysis.

That device prompted Short to warn her colleagues on several occasions after she caught Copeland disturbing its cap. Short was nervous and believed due to his dementia he needed constant supervision or he might compromise the catheter. She was very skeptical about Corizon's decision to house Copeland there rather than in a hospital.

A Corizon nurse's progress notes on Copeland on November 19, 2013 reveal signs of dementia. The nurse wrote that Copeland became agitated and stated "he wants to go that way, pointing to the other end of the unit," and pulling on the lines attached to medical equipment such as his vascular catheter and blood-pressure monitor.

On November 23, the nurse writes of Copeland's state, "confused and needs frequent directions and orientation."

Related document
• Nurses' notes on James Copeland - November, 2013. (PDF, 744 KB)

Red flags ignored

Short says Copeland would pull on oxygen lines during dialysis treatment, would pull on his vascular catheter lines and would stand up all the time when he was supposed to be sitting down receiving treatment.


Reports show Short checked on Copeland at 4 a.m. on November 28, 2013. That was Thanksgiving Day. He was hungry and asked for food.

The security check log shows a corrections officer accounted for all inmates being alive and well in that wing of the prison at 4:46 a.m.. Copeland displayed no unusual behavior.

At 5:25 a.m., Short went to Copeland's cell to give him some food and discovered him lying on his bed in a pool of blood.

"When I walked into the room, I was stepping on blood clots that were the size of livers, I mean they were huge," said Short.

Copeland had done what Short predicted, ripping off the cap which covers the catheter opening.
Short says she could see blood on the walls and even Copeland's shoe print in blood near the door.
"I felt like I failed him," she said.

 

Teresa Short(Photo: 12 News)

 

The Department of Corrections Inmate Death Notification says medical responders performed life-saving techniques on Copeland. Pictures taken by DOC's investigation team show patches from a heart defibrillator on the inmate's chest.

The report shows an AED (automated external defibrillator) was utilized, but did not recommend shock. Medical staff determined not to perform CPR due to the fact that Copeland had bled out and there was not a sufficient amount of blood left to try to resuscitate.

Short says all of his options were gone.

Related documents
• Criminal investigative report (PDF, 712 KB)
• Administrative investigation report (PDF, 4.23 MB)

Delays after death

According to the DOC's criminal investigative report, Nurse Brenda Hinton and Nurse Robin Sheppard pronounced Copeland deceased at 5:45 a.m. Nurse Hinton was directed by the on-call doctor, a Dr. Barciaga, to call 911.

The report states there was a disagreement among Hinton, Sheppard, and Barciaga. The Tucson Fire Department, which has a station across the highway from the prison, did not arrive on scene until 6:58 a.m. and pronounced Copeland deceased.

The report does not detail what the disagreement was about, but makes it sound like the two nurses were arguing about whether to call 911 or disobey the instructions of the on-call doctor.

On December 30, 2013 the Pima County medical examiner listed the cause of death as exsanguination - fatal blood loss - due to an uncapped vascular dialysis catheter. The manner of death was ruled accidental.

In a statement to 12 News, DOC Director Charles Ryan says, "All inmate deaths are investigated criminally and administratively. This process involves a review conducted by Corizon, a review by ADC, as well as an independent report by the county medical examiner. This investigative process determined conclusively that the death of inmate Copeland was accidental; a fact independently corroborated by the Pima County medical examiner.

"At the time of the incident, the unit was appropriately staffed and inmate Copeland's welfare was documented on a regular basis. He was discovered unresponsive by a certified medical technician who immediately alerted an ADC correctional officer and the on-duty RN and LPN. Each of these investigations determined that the death of inmate Copeland was accidental and none raised any concerns about the medical protocols for inmate Copeland either prior to or following his death."

According to DOC monitor reports, prepared monthly by staff in the Department of Corrections' Department Health Services Contract Monitoring Bureau, a problem with infirmary staffing was identified on October 30. Just weeks later, Copeland died at a time when staffing levels at the infirmary were still inadequate, according to Short.

Related documents
• DOC monitor report - Tucson, see page 71 for staffing comments (PDF, 9.91 MB)
• DOC monitor reports - All prisons, April-October, 2013 (Zip, 319 MB)

"We're the ones who have to carry the burden when something is preventable and we cannot prevent it because we don't have enough people to supervise the ones that need supervision the most," she said.

Teresa Short says she was compelled to blow the whistle. If not for Copeland, for the people footing the bill.

"The taxpayers need to really see what's happening to people," she said. "I think most people would be disgusted. They care about the bottom line, they care about the dollar."

Copeland's death just the tip of the iceberg 

According to the Department of Correction's own monitors, Corizon failed to deliver timely medical care at least 16,000 times during an eight-month period in 2013.

In fact, some of the documentation shows the provider was not providing any healthcare. These cases include:

• At the prison in Tucson, an HIV-positive inmate received no treatment.
• Chemotherapy for two other inmates was delayed.
• An inmate had to have a craniotomy after falling 33 times because he wasn't supervised in the infirmary.
• At the Eyman facility, Corizon failed to reorder chronic-care medication for dozens of prisoners.
• No timely treatment for an inmate with prostate cancer.
• In Yuma, mentally ill prisoners had not been seen by doctors since December, 2012.
• Psychotropic medications were not renewed.
• At Perryville, the women's prison, long delays to see the doctor once prisoners were referred by nurses.

"They're examples of what you see month after month after month," said Corene Kendrick, an attorney for the Prison Law Office in Berkeley, Calif.

"If I were a taxpayer, someone who feels very tough on crime, I would be outraged by this because it's taxpayer money that's going into the pockets of a corporation," she said.

Kendrick is one of the attorneys behind the class-action lawsuit filed by the ACLU and the Prison Law Office against the Arizona Department of Corrections. The suit alleges inadequate medical, mental health, and dental care.

Kendrick contends no effort is being made by the Arizona Department of Corrections to hold Corizon accountable for the violations when the evidence, she says, is overwhelming in the reports being made by DOC's own monitors.

Which brings us to four inmates who've been granted medical parole in the last six months by the Arizona Board of Executive Clemency.

Name	Medical parole date
Dean Vocke	10/31/13
Glen Huggins	12/11/13
Nishma Kanabar	2/28/14
Margaret Van Wormer	4/18/14

Huggins and Kanabar have already died.

Dean Vocke was given six months to a year to live. Before he was medically paroled, Vocke had ten months left on his sentence for vehicle theft when he complained about back pain in October, 2012.

Vocke gave 12 News permission to review his medical records for our reporting; we are not publishing them due to the amount of personally identifying information they contain.

His first appointment was cancelled because no provider was available. X-rays taken at the end of February showed bone abnormalities consistent with cancer. The nurse requested an MRI.

"They wouldn't do an MRI, they kept denying an MRI, denying an MRI," Vocke said. "They didn't want to spend the money."

 

Laurie and Dean Vocke(Photo: 12 News)

 

At the end of May, 2013, medical staff ordered CT scans, but Corizon denied it. Finally, at end of July, 2013 a CT scan was performed.

It confirmed Vocke had cancer which now had spread to his hips and his spine.

"And finally [the cancer] ate my pelvis and my hip away," said Vocke.

In September a second CT scan showed the cancer spread to his abdomen and one of his kidneys.

Medical records show there was an eight-month delay in treating Vocke, because of Corizon's actions.

"It was kidney cancer that could have been 95 percent survivable and now they're saying I can't survive it whatsoever," Vocke told us.

Vocke's physician sent a request to the Arizona Board of Executive Clemency for early release due to imminent death.

From that request, the clinical summary and prognosis read:

"Inmate Vocke has been diagnosed with renal cell carcinoma with metastasis to the bone. He underwent a right nephrectomy and will start chemotherapy in a few weeks. This is a very aggressive form of cancer and his oncologist and onsite Medical Director for ASPC-Tucson have both recommended clemency. Since inmate Vocke is wheelchair bound and in the advanced stage of the disease, he is not considered a threat to society.

"Because of the aggressive and advanced nature of his cancer, he is not expected to survive this illness. The oncologist has indicated that for this type of cancer, about 50% of patients may survive up to six (6) months while about 35% may live up to one year."

The physician indicated Vocke has a life expectancy of six months or less.

On October 31, 2013 the Board of Executive Clemency commuted Vocke's sentence. He was granted medical parole, so he can die surrounded by family. His wife Laurie says it's torn them apart.

We tried to seek comment from Corizon on the many issues outlined in our reporting.

Susan Morgenstern, a spokeswoman for Corizon asked us to supply her with the documentation we obtained under Arizona's Public Records Law. We requested the quarterly and monthly monitoring memos and reports referred to above, known as MGAR (short for Monitoring-Green-Amber-Red) reports.

In response to our questions, Corizon provided these answers via email:

• Mr. Copeland. You asked about the investigation into the tragic death of Mr. Copeland. As I believe you know, it has been investigated and officially determined to be an accident. It's been thoroughly reviewed by several agencies; and the care provided and protocols followed were all appropriate.
• As you know, HIPPA [sic] prevent health care providers such as Corizon from providing any medical details about specific individuals to you or anyone else. But I can assure you that we are always willing to review individual care plans to be sure appropriate care is provided.
• As for your very general allegations, we would be happy to check into them and provide information if you could give us enough detail to do so. You referenced delays in care and prescriptions; can you give us the specific instances you are talking about (date/time/location/documentation)?
• You've also talked about four unnamed inmates who were medically paroled and alleged they did not receive proper care. If you will give us the names of these individuals, we will review their medical records to ensure they received proper care.
• Finally, you've alleged there are staffing shortages, but that is simply not accurate. When the transition to Corizon occurred in March 2013, we immediately assessed the staffing and began an aggressive recruiting and training program. Today all current staff levels exceed the contract requirements.
• We believe that Corizon is providing quality care to the patients we treat every day, and we stand behind our medical professionals who work inside the correctional facilities.

Corizon responded with a second statement after we provided more specific information.

Teresa Short: A former Corizon employee alleges lack of care, staffing shortages, and that she was "set up to fail."

• Corizon is first and foremost a health care provider, whose top priority is the health and safety of patients. To that end, we practice evidence-based medicine as prescribed by licensed medical professionals and focus on providing quality health care.
• The vast majority of our current staff levels exceed the contract requirements. For example, since the time of the MGARs provided you, the staffing for mental health care at the Yuma facility has increased substantially.
• We not only empower our employees to succeed in fulfilling our mission, we also require them to meet the highest standards of conduct and professionalism.

MGAR Reports: Various allegations

• As you know, MGAR reports are monitoring tools meant to raise issues that are then addressed and resolved. By design, they capture issues requiring attention at a specific moment in time, some of which are immediately resolved. The MGARs provided you are now 8-9 months old.
• In addition, Corizon is prohibited by HIPAA from discussing individual patient cases, just as any other health care provider or hospital is restricted.
• But it's important to note that Corizon care follows the guidelines of the NCCHC and the ACA, which are the correctional industry standard.

Complaints from patients who were medically paroled

• Again, HIPAA prevents Corizon from discussing details of individual patient care.
• As a health care provider focused on quality, we stand behind our dedicated medical professionals and the treatment plans they provide to patients.
• The process for inmate compassionate discharge is initiated by the inmate or the family and is considered by the Board of Executive Clemency, not Corizon nor the ADC.

Expired Licenses

• Our staff has all necessary and appropriate licenses, so this allegation is simply not true.

Thanks,
Susan Morgenstern
senior vice president