AZ DOC denies any outbreak of scabies at ASPC-Tucson/Rincon.

So, this came into my box on Friday. Given how I raked Mr Pratt over the coals on the issue last week, I owe it to him to post this response he gave to some questions Donna Hamm raised about my previous post on Corizon. Her questions to him are in bold, his answers are in italics.

 My source still stands by her account of what has transpired at ASPC-Tucson/Rincon, however, and will be sharing it with mainstream media. They have the resources to do the fact-checking; I just amplify the voices of those who are otherwise effectively silenced by the system. If anyone out there has additional information about how ASPC-Tucson/ Rincon has been run the past year, please let me know.  My contact info is at the top of the page.

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Arizona Prisonwatch

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FOLLOWUP FROM Middle Ground: parasitic infestation of the elderly, sick and dying at Tucson/Rincon ICU...

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Arizona Prisonwatch
To: Peggy Plews
From: PRATT, RICHARD <RPRATT@azcorrections.gov> Date: Fri, May 2, 2014 at 6:54 PM Subject: RE: CORIZON's deliberate indifference: parasitic infestation of the elderly, sick and dying at Tucson/Rincon ICU.. To: Middle Ground Prison Reform <middlegroundprisonreform@msn.com> Cc: "chcampbell@azleg.gov" "atovar@azleg.gov", Governor Brewer <azgov@az.gov>, "abiggs@azleg.gov" <abiggs@azleg.gov>, "dgowan@azleg.gov" <dgowan@azleg.gov>, Daniel Pochoda , Caroline Isaacs, Peri Jude Radecic  "NICK, DOUG" , "RYAN, CHARLES"  "NORTHUP, DAWN" , Ms. Hamm: In response to your follow up: 1.      What was done to stop the spread of scabies once it was initially discovered?  Did the seven alleged cases result from staff ignoring the first case and letting it spread, or was it not discovered until several people already had it at approximately the same time?  If the first case was ignored and then it spread from that case into several cases, what is being done specifically to insure that serious attention will, in the future, be given to even a single outbreak of such a serious condition?  What safeguards are in place to insure that it is readily diagnosed and treated for an inmate who reports symptoms prior to spreading it to others? To be clear, let me reiterate, there has been no parasitic outbreak of scabies. On 03/24/14 a CNA working night shift in the IPC reported that she had a rash for approximately one week that was not resolving.  She was immediately sent to occupational health and treated for scabies.  Her diagnosis was made without confirmation by any skin scrapings.  No inmates or other staff were diagnosed with scabies at that time. The employee subsequently quit her job without notice citing personal reasons. On 04/23/14 seven IPC staff members reported a rash of varying degrees, after they were comparing symptoms with each other.  They were sent to occupational health and five of them were given a cream to treat scabies.  Again, this diagnosis for those five employees was made solely based on presentation and statements from staff regarding scabies.  The other two staff were diagnosed with contact dermatitis and a napkin rash. All seven have been cleared and have returned to full duty. One staff member also reported having a child with scabies approximately one month prior. 2.     Without violating their HIPPA privacy rights, are there in fact seven Corizon employees who've contracted scabies but were not permitted to take sick leave due to staff shortages, as is implied in Plew's original email? No. The information implied in Ms. Plew’s original e-mail is not correct. One staff was restricted from coming back to work for six days, four staff returned to work within 24 hours (full duty), and the other two staff (not diagnosed with scabies) returned without any restrictions. All of the Corizon staff were permitted to leave work upon reporting, and the only restrictions were based upon doctor’s orders. Paid time off was granted for anyone undergoing treatment or with work restrictions. No one was denied sick leave for any reason. An alternative staffing plan was put into place in the event all of the employees would have been taken off work for an extended period of time. 3.     Has someone investigated the physician assigned to that unit (Rincon) who is accused of ignoring patients presenting with symptoms of scabies?  As Plews noted, some of the individual prisoners may not have the ability (physical or mental) to file grievances or complain in any effective manner, but that does not relieve the DOC and/or Corizon of the responsibility to investigate. The doctor overseeing the infirmary has advised that with regard to the inmate population there were no confirmed cases of scabies within the IPC at any time during this period. Please note that these inmates are also seen daily by numerous nursing staff where any complaints can be voiced. 4.         With respect to the allegation that insufficient amounts of food are given or that bedsheets are not being changed in a timely manner, is there any procedure in place for you to make unannounced inspections?  If not, why not?  What can or is being done to insure that this issue, allegedly reported by a former Corizon employee, is not actually happening? I have received no reports with respect to these allegations. The medical monitoring team has full access to the infirmary 24/7 (without announcement) and inspects all aspects of patient care. Most of the inspections are unannounced, and take place many times each and every month, to include different shifts. 5.     Plews didn't identify the prisoner who allegedly died of "natural causes," but whom the Corizon ex-employee reports as having died due to neglect, so I am not sure how you can check into this, especially since no time frame was given to define "recently."  Can you somehow investigate this allegation to insure that no prisoner has died due to neglect or indifference?  Again, what active "hands on" inspections by you or someone in your office takes place at each health/medical unit -- in particular at the Tucson complex -- and how many of those inspections are unannounced?  How often do you visit the units to see things with your own eyes? There is a mortality review process for any deaths within the department which involves the monitoring bureau. I attempt to get out to the field personally whenever time permits. I also have administrators who travel regularly in the field supervising the complex monitors. 6.     The allegations regarding tampering/altering records at Tucson/Rincon ICU are especially troubling, and they originate from an ex-employee at Corizon.  What does the DOC intend to do regarding these extremely serious allegations regarding withdrawal/changing of medications,  at "other yards" (which Plews doesn't identify). Even if the ex-Corizon employee chooses not to come forward to contact you with her allegations or with more specific information, I urge you to investigate these claims on your own.  If all of her allegations are false, it will simply confirm that Corizon is doing the job they are contracted to perform and that your contract monitors are doing their jobs, too.  If any of the allegations are true, then immediate remedial measures need to be taken.  I hope I need not remind you that the bulk of the tragedy at the Kingman Prison a few years ago was a result of the DOC contract monitors not doing their job; I would hope that the Department will not allow such tragedy to repeat itself with the multi-million dollar inmate health care contract. Record reviews are just one part of the monitoring taking place in the field. It is not uncommon for a monitor to copy certain records at one point in time, and go back to the record at a later date to determine if any improper alterations have been made to the original records. We do our best to ensure that the inmates are receiving the constitutionally mandated care they deserve. Of course, specific allegations are able to be investigated more appropriately than general claims painted with a broad brush. As I have indicated in the past, I appreciate issues that are brought to my attention relating to the health care of the inmate population. Respectfully, Richard Pratt ________________________________ Interim Assistant Director Arizona Department of Corrections Health Services Contract Monitoring Bureau Office:  (602) 771-2100

Corizon at ASPC-Tucson/Rincon ICU: patients, staff infested with parasites

I find the institutional neglect of the elderly, non-verbal, and dying especially heinous. It's no wonder that Corizon and the DOC decided to cut corners with the prisoners who are least likely to be able to fight back. My deepest gratitude to the health care professional who had the courage to report all this to the public that is paying for it - and to all the folks still  working for Corizon who are delivering the best care they can under the worst of conditions. At least the prisoners know who the good guys among you are.

I'll post Director Ryan's answer when it comes.

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Arizona Prisonwatch

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CORIZON's deliberate indifference: parasitic infestation of the elderly, sick and dying at Tucson/Rincon ICU.. 1 message

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Arizona Prisonwatch                Tue, Apr 29, 2014  7:43 PM
To: CHARLES RYAN   Cc: "chcampbell@azleg.gov" , atovar@azleg.gov, Governor Brewer , "abiggs@azleg.gov" , "dgowan@azleg.gov" , Daniel Pochoda , Caroline Isaacs , Peri Jude Radecic , Richard Pratt , Donna Leone Hamm
Charles Ryan, Director Arizona Department of Corrections 1601 W. Jefferson St Phoenix, AZ 85007 April 29, 2014 Director Ryan: I'm writing with grave concern about the welfare of both the patients and medical staff of ASPC-Tucson/Rincon's Intensive Care Unit. I've heard complaints from a former Corizon employee that there's a serious, ongoing outbreak of blood sucking parasites (scabies) among both the patients and employees there needing immediate intervention. The public health department wont take any action, but I do expect you to. Apparently the physician in charge is in deep denial about this infestation, and is thus refusing to properly treat the sick and dying people who have been infected with scabies. At least 7 Corizon employees have been infected by scabies as well, but have been denied time off to treat their own conditions because there are no other staff to cover their shifts. Thus, they risk spreading the parasites to other patients, many of whom are elderly or have compromised immune systems already - which is why this outbreak is an urgent matter to attend to, whether or not there are any prisoner grievances. Patients who are too far gone may not even know that they've been infested with these parasites to file a complaint - they just lie there and suffer. That's not all that's going in in that unit, though. The DOC is complicit in the neglect by ignoring staffing needs in the ICU - my source tells me she worries that some of the sick and dying may not even be getting fed regularly or having their soiled sheets changed enough because the place is so drastically understaffed. Many of those patients who need help eating and toileting don't have the voice to complain or the coherence to know they missed lunch or wet the bed. You have a special duty to look out for them when you hear that the people you hired to do so are not. The former employee I spoke to also alleges that at least one prisoner has died recently due to negligence on Corizon's part, a death which was reported as being from "natural causes". Thus, each one of those ICU patients should have a through medical evaluation done by someone not affiliated with Corizon to prevent another wrongful death. And really, all the health units with seriously disabled and non-verbal patients should have extra oversight from the DOC. The worst abuses always happen to those who can be expected to remain silent. On other yards I know that Corizon abruptly stopped pain medication regardless of how severe the patients condition was, and only transitioned those prisoners to alternative meds for relief if they fought for it, which few prisoners know how to even do. Unfortunately, the demented and brain-injured patients you imprison who will never be able to advocate for themselves effectively or "exhaust administrative remedies" so they can sue you all, making them easy prey for profiteers like Corizon. Those people just  look for the most vulnerable and ignored population to cut their corners with. That's where you need to be looking, too. From what my source has told me about the overall situation in Rincon's ICU, patient records and staff logs should be immediately seized and inspected so they can't be tampered with, while interviews are conducted with staff about evidence of criminal wrongdoing in regards to those patients by Corizon. I frankly think what Corizon is doing amounts to stealing resources from both the patients and the state, and defrauding us all by not delivering what they have been paid for and have promised.  The consequences of such a violation of that contract has no doubt been deadly to more than one of their imprisoned patients. Please assure me that you will send a health care team into Rincon ICU immediately to deal with this situation and evaluate those patients and their records, and make sure that all receive the necessary treatment for their ailments, be it scabies, Alzheimers, or cancer. If your DOC employee monitoring Corizon at Rincon was doing their job thus far, you wouldn't be getting this letter from me, so I wouldn't count on them to do the job right now - they would just have incentive to downplay everything so they don't look like a fool. Please evaluate whether your Corizon contract monitoring staff are just oblivious, deliberately indifferent, or actually complicit in hiding Corizon's crimes against the people of this state. I'll have public records requests pertinent to this email in to your legal department by the morning. I'll also pass your contact information on to the former Corizon employee I spoke to, who may be willing to speak to DOC investigators if you plan to take this seriously. Just let me know who she should contact. Sincerely, Margaret Plews -- Margaret J. Plews, Editor Arizona Prison Watch P.O. Box 20494 Phoenix, AZ 85036 480-580-6807 "Our strategy should be not only to confront empire, but to lay siege to it. To deprive it of oxygen. To shame it. To mock it. With our art, our music, our literature, our stubbornness, our joy, our brilliance, our sheer relentlessness, and our ability to tell our own stories..."  - Arundhati Roy Arizona Prison Watch arizonaprisonwatch.org Survivors of Prison Violence - AZ azprisonsurvivors.blogspot.com Jailhouse Lawyers' Auxiliary Guild - AZ jailhouselawauxiliaryaz.blogspot.com