Families Say Delaware Inmates Not Getting Adequate Care
DOVER, Del. (AP)- Louis Chance Jr., serving six months behind bars for his fourth drunken driving conviction but hoping to start a new life when he got out, was only a few weeks away from his release date when he began suffering severe headaches.
The headaches grew so agonizing that Chance became disoriented and incoherent, but his family says his pleas for help from prison medical workers went mostly unheeded. Instead, according to a lawsuit the family filed in federal court, Chance was deemed uncooperative and hostile and accused of trying to overdose on pain medication.
At one point, a doctor at Gander Hill prison in Wilmington prescribed "Tylenol and one cup of coffee per day," according to the lawsuit.
More than two weeks after he first reported feeling sick in September 2003, Chance, 37, lapsed into a coma and was sent to a Wilmington hospital. He died of cryptococcal meningitis, an infection and swelling of the membranes surrounding the brain that is one of the opportunistic infections associated with HIV.
Chance's family and other critics say too many inmates with HIV- and AIDS-related illnesses are dying because prison medical providers are more concerned about holding down costs than providing adequate medical care.
Department of Correction Commissioner Stan Taylor declined to comment on individual inmates' cases. Asked whether he was satisfied with First Correctional Medical Inc., the system's medical provider when Chance died, Taylor said noted the company maintained Delaware's National Commission on Correctional Health Care accreditation.
"They were a small regional operation and may not have fully understood all of the factors involved in a statewide contract," he added. Officials with First Correctional Medical did not return repeated telephone calls seeking comment.
The privately held company, based in Arizona, operates in a handful of other states. Its six-year contract with Delaware was worth more than $17 million a year.
In June, First Correctional Medical pulled out of the contract, forcing the department to sign a $25.7 million-a-year, no-bid contract with its previous medical services provider, Correctional Medical Services of St. Louis.
Ken Richmond, a lawyer suing First Correctional Medical and two of its doctors on behalf of the Chance family, said Chance's condition could have been diagnosed and treated had the contractor's doctors scheduled a CT or MRI brain scan.
"It's our belief that the death of Chance resulted from cost-containment polices," Richmond said. In its successful bid proposal to the Department of Correction in 2002, the company said it "fully intends to minimize offsite transports of inmates for any health care services ... not only are offsite visits expensive for the medical provider, but also for the Department of Correction that must incur high security expenses."
The end of First Correctional Medical's contract came after DOC officials requested an inspection earlier this year by the National Commission on Correctional Health Care. Taylor said both the NCCHC and the DOC's medical review committee had identified "some issues," but he declined to provide details.
In winning the contract, First Correctional Medical boasted of its "very low number of lawsuits ... and an overall positive record in carrying out every contract ever awarded."
Since coming to Delaware, a move that more than doubled the number of inmates for whom the company was responsible, First Correctional Medical has been the target of more than 40 lawsuits, the vast majority filed by Delaware inmates. Several have been dismissed for a variety of reasons - including the fact that inmates must go through an internal grievance process before they can seek relief in the courts.
Moreover, inmates claiming a violation of their constitutional rights must demonstrate their medical care was not just substandard or negligent, but the result of "deliberate indifference."
Since January 2000, 87 Delaware prison inmates have died while in custody, many, according to DOC press releases, "after a lengthy illness."
"That's what they put on everybody's," said Charlotte Waite of Milford, who said her 37-year-old son, Ronald Trotman, died in March from respiratory failure associated with AIDS. Trotman's family is trying to learn what happened in the days leading up to his being taken to Kent General Hospital with a collapsed lung.
"He was so skinny that he looked like the people from Ethiopia," said Waite, whose family was told by other inmates that Trotman was emaciated and had to use a wheelchair, but said prison officials assured them just days before he died that he was fine.
According to the medical examiner's office, Trotman weighed about 145 pounds when he died. His mother said that was about 30 pounds less than what he should have weighed. His death certificate states that he had AIDS and bilateral pneumocystis carinii pneumonia. However, prison officials told Trotman's family there was no information about HIV or AIDS in his medical records.
"(T)he physician records indicate that there had not been a diagnosis of HIV or AIDS ... , or any presentation that this illness might be present," Taylor wrote Trotman's sister, Rolanda, late last month. "All intake screenings, physicals and infirmary visits revealed no indication of HIV or AIDS."
Since no autopsy was performed, the cause of death, and the fact that he had AIDS, would have been determined from medical records, either those kept by First Correctional Medical or those made at the hospital, said Dr. Richard Callery, the state's chief medical examiner.
"There's got to be some sort of data out there with HIV," Callery said. Relatives of both Chance and Trotman said they did not know the inmates were HIV-positive, and that the inmates themselves may not have known.
Delaware, unlike some other states, does not require HIV testing for inmates.
"Their parents are not being notified that they're even sick," Waite said.
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