February 12, 2015

An Informal Look at Florida State Senate Proposed Prison Reform Bill - SPB 7020

I focused on key provisions in the areas of the treatment of the mentally ill and inmate abuse. For a look at SPB 7020 in its entirety, go to: https://www.flsenate.gov/Session/Bill/2015/7020

For a link to the Criminal Justice Committee hearing on Febuary 2nd, go to: http://thefloridachannel.org/videos/2215-senate-criminal-justice-committee/


  • A few thoughts regarding the 2/2 Criminal Justice Committee hearing and recent developments
  • Notes on positive provisions in SPB 7020
  • Concerns regarding implementation and other issues
  • News articles from Miami Herald and Palm Beach Post

A Few Thoughts

I wanted to share my thoughts on SPB 7020 and concerns regarding its potential implementation. It is imperative to have accountability and transparency in the Florida Department of Corrections (DOC) and the Office of the Inspector General (OIG). I found it disturbing that newly appointed DOC Secretary Julie Jones would require investigators to sign what amounts to a gag order after she spoke about implementing strategies "so that our department is both transparent and accountable" in her remarks to the Criminal Justice Committee on February 2nd.

I doubt Julie Jones came up with a confidentiality agreement on her own. One only need look to those who would gain from continued secrecy, less accountability, and lack of transparency for the source behind this blatant attempt to avoid answering charges. I would go so far as to say Jones is being manipulated at the highest levels of the DOC and OIG. Instead of pulling off the festering band-aid one painful hair at a time, why not yank it off completely - sooner rather than later. Open the books and let the wrongdoers suffer the consequences.

Julie Jones's many assurances of improvements in the DOC sounded a bit hollow in contrast to the anecdotal accounts from numerous relatives who have loved ones on the inside. I'm being updated on a weekly basis regarding all manner of abuse, beatings, and possible homicides occurring throughout Florida prisons. Just this week for example, inmate Richard J. Wilson, #705776, was reportedly set up by a guard to be brutally beaten by other inmates. The person who told me this got the account from their loved one in Suwannee CI and requested anonymity out of fear of retaliation. They tried to find out if Wilson was in a Jacksonville hospital, to no avail.

Regarding chemical agents, both Julie Jones and Inspector General Jeff Beasley made assurances detailing a series of checks and balances to prohibit the unauthorized gassing of inmates. Beasley implied there could be little unauthorized use of chemical agents due to all the "internal controls." He mentioned a "conspiracy" of many as a way to undermine these controls. I submit that not only are there "conspiracies," but the widespread falsification of reports regarding the punitive use of chemical agents. In my unit, guards regularly backed up their criminal actions with outright fiction.

I hear about punitive gassing of inmates practically every week. I suspect thorough investigations would reveal startling malfeasance regarding this widespread abuse. Please refer to news articles: After Florida inmate’s lethal gassing, claims of cover-up and Inmate's gassing death detailed in Florida DOC whistle-blower complaint. Beasley on 2/2 said that involved officers were either disciplined or resigned with regard to the gassing that resulted in Jordan-Aparo's death. Why were these officers not charged with a crime? Where was any real accountability? Transparency?

What does it say about the OIG and the DOC that the only people doing any serious investigations are the newspapers? Despite all the heavily redacted documents, we've learned about numerous suspicious deaths. There is no dispute Darren Rainey was put into a scalding hot shower by COs to die - begging for his life. Over two and a half years later, no officer has been charged with a crime. Upper level officers and administrators who covered up Rainey's killing have not been charged either. Accountability? Consequences? Transparency?   


            Florida Senate SPB 7020

Key Positive Proposals affecting FL DOC and Office of the Inspector General:

  1. 60 days gain time credits as educational incentive
  2. Reporting Sexual Abuse and Harassment
  3. Review Inmate Grievance procedures
  4. Crisis Intervention Training for COs who work in psychiatric settings
  5. Monitor 'use of force' episodes, follow up care for involved inmates
  6. Annual 'use of force' statistics
  7. Use of force documentation signed under oath
  8. Prohibiting guards with inappropriate use of force episodes from working with mentally ill inmates
  9. Protections for inmates and employees from retaliation
  10. Establishing officer staffing requirements in mental health treatment facilities
  11. Identification of blind spots or areas where staff or inmates may be isolated and the deployment of video monitoring systems and other monitoring technologies in such areas
  12. Assess safety and security technology, make recommendations to update video systems

Provisions for private healthcare providers:
1.      Felony offenses for medical neglect of an inmate
2.      Anonymous reporting of inmate abuse directly to the Office of the Inspector General
3.      Consequences for not reporting abuse of inmates by COs


  1. My primary concern is that 7020 calls for current DOC and OIG personnel to carry out the new directives. These are the same high level command staff, administrators, and inspectors who bungled investigations and covered up crimes. 7020 depends on the same line officers who abused, tormented, beat, and in some cases tortured and killed inmates. The DOC is failing in a number of critical areas. Might the solution be to enlarge the scope of Senator Bradley's Oversight Committee (BOC) to take over some of these functions? For a look at Senator Bradley's bill proposing an Oversight Committee, go to: https://www.flsenate.gov/Session/Bill/2015/0212  
  2. The OIG, FDLE, and DOC have botched investigations in the past. How would the same personnel be compelled to do first rate investigations that result in prosecutions? Clearly, personnel within the FL DOC have conspired to cover up the killing of inmates by correctional officers. Not to mention unlawful beatings and punitive use of chemical agents (gassings). How deep into the hierarchies of the DOC will investigations be conducted to hold those accountable who have protected guards and covered up their crimes? Who will investigate? Perhaps BOC.
  3. The best indicator of future behavior is past behavior. I don't trust the OIG, the FDLE, or the FL DOC to conduct impartial investigations. The only investigators, so far, that can be trusted are the four whistleblowers who uncovered the truth about Randall Jordan-Aparo. I suggest a meeting with inspectors Aubrey Land, David Clark, Doug Glisson and John Ulm to get their insights into the inner workings of the DOC and OIG. For details into their investigation of Jordan-Aparo, please read below: After Florida inmate’s lethal gassing, claims of cover-up and Inmate's gassing death detailed in Florida DOC whistle-blower complaint.
  4. With regard to sexual abuse and rape investigations, will rape kits be made available along with the timely testing of them? In the civilian world, women are made to wait months and even years in some cases due to the lack of funding to test rape kits. In fact, women who have been raped ended up paying for the testing themselves.
  5. A toll-free anonymous hotline, unmonitored by DOC personnel, to report sexual abuse, harassment, staff neglect, beatings, and a whole host of unlawful conduct could be accessible through inmates' payphones. Guards would be required to stay out of earshot.
  6. Mental health treatment: Requiring officers to have Crisis Intervention Training to work with the mentally ill is a great first step. Prohibiting those with two or more use of force notations from working in a psych setting compliments the CIT. It makes sense to include psychological testing for these specific guards as well. My overall concern is how the mentally ill are tracked and provided for starting in our county jails. One solution is to collaborate with jails to identify and begin treatment at the county level. Continuity must be carried over to prison. Once incarcerated in state prisons, the chronically mentally ill must be separated from the general population. A stand alone reception center for them would seem a logical first step.  By the way, how long would an officer have to be free of use of force notations to work in a psychiatric setting? A year might by appropriate depending on the severity of the use of force in a CO's file.
  7. Treatment of the mentally ill: There should be a provision in 7020 prohibiting the placement of the mentally ill in solitary confinement. A growing number of studies are finding long-term negative affects for relatively healthy inmates. For the mentally ill, the aftereffects of solitary can be catastrophic and permanent. In addition, treating the mentally ill who are locked down for 23 hours a day would be problematic.  http://www.apa.org/monitor/2012/05/solitary.aspx    
  8. Regarding the grievance process review: How will grievances be collected, analyzed, and acted upon? Historically, DOC personnel and guards have minimized, discounted, and destroyed grievances. Aggrieved inmates were taunted and retaliated against. Inmates are the eyes and ears about what happens inside FL prisons. Their formal and informal grievances must be taken seriously. In my experience, inmates in my unit accurately reported the abuse of men in cells adjacent to them. The inmate Harold Hempstead filed 90 grievances regarding the scalding death of Darren Rainey. They were ignored or no action taken. It wasn't until the Miami Herald reported the brutal killing that anything was done. The DOC cannot be trusted. I suggest Bradley's Oversight Committee take over the grievance process until such time the DOC is rid of abusers and the personnel who support them. A similar function the BOC could assume is the handling of legal mail. I received a letter this week from an inmate who suggested his legal mail was unsealed at his prison. Two pages were missing in a court filing.    
  9. Regarding use of force investigations: Most, if not all, of the use of force incidents in my unit were written up in a way to justify guards' unlawful behavior. The system as it stands now is riddled with loopholes whereby creative guards can cover up their crimes in writing. Again, I do not trust the DOC or the OIG to investigate use of force incidents in any meaningful way. Again, perhaps Bradley's Oversight Committee could be tasked with this as well.
  10. With regard to private health providers: The penalties for withholding medical treatment are substantial and will hopefully compel nurses and doctors to treat inmates humanely in the future. However, concerning past maltreatment, how far up the hierarchies of Corizon and Wexford will investigations proceed to hold accountable those who conceived profit driven strategies that end up in de facto torture of inmates with painful, severe medical issues. Throwing a few doctors and nurses to the wolves will not solve the problem. Despite assurances from Corizon and Wexford they offer the finest medical care for inmates, the opposite is true. Many in my unit filed numerous sick calls that were not addressed in a timely manner or at all. One man on my caseload suspected he had an abdominal tumor - his solution - swallow batteries and razor blades so an operation had to be done. Surgeons found the tumor, by the way. Please read the Palm Beach Post articles regarding the horrors and pain inflicted on inmates.
  11. Currently, private providers of medical and mental health services to Florida prisons have no training for employees to recognize and report inmate abuse. Future contracts must have provisions included to address this glaring omission - with updates made immediately to current contracts if possible. In a sense, private employees are the checks and balances in the area of inmate abuse. For years, I overlooked many abuses under the rationale that prison was a bad place to be and bad things happened. The problem was that I didn't know what constituted abuse - both Corizon and the DOC had no trainings. Aside from the obvious beating, torture, and killing of inmates, I was in the dark.
  12. With regard to cameras: Having all blind spots covered and overlapped by multiple cameras is a good start. However, depending on the DOC to monitor, maintain, and preserve footage would be problematic. In my unit, Darren Rainey was shown being put in the shower and then the video tape or CD mysteriously malfunctioned. There was no mystery there - guards or DOC personnel sabotaged surveillance footage. While DOC personnel may monitor cameras in their respective prisons, I would suggest an offsite (Bradley's Oversight Committee) facility independent of the DOC and IG's office to simultaneously monitor and store footage from all prisons in Florida. There should be maintenance teams in all three regions ready to repair cameras on a moments notice to prohibit guards from taking inmates to temporary blind spots for abuse.

News Articles

After Florida inmate’s lethal gassing, claims of cover-up

The 2010 death of an inmate in a prison in the Panhandle is being investigated once again amid questions about the original investigation.

08/30/2014 8:54 PM 
Randall Jordan-Aparo died weeping and gasping for breath on the concrete floor of his prison isolation cell, naked except for his white boxer shorts.
Incensed that he had cursed at a nurse, guards at Franklin Correctional Institution in the Panhandle fired nine blasts of noxious gas into his 13-by-8 cell through a slot in the door and, ultimately, left him there, sobbing.
“I can’t breathe, I can’t take it no more, please help me,’’ he pleaded.
Five hours later, the 27-year-old was found lifeless, face-down on the bare slab. His mouth and nose were pressed to the bottom of the door, as if trying to gulp fresh air through the thin crack. His hair, legs, toes, torso and mouth were dusted with a faint orange residue, a byproduct of the gas.
A paperback Bible was under his shoulder.
The Florida Department of Law Enforcement sent two investigators, Michael Kennedy and Michael DeVaney, to look into what had occurred. Their conclusion, summarized in one paragraph: The “disciplinary actions” taken by guards had no bearing on the death.
“They just said he got sick,’’ Jordan-Aparo’s father, Thomas Aparo, recalled being told by corrections officials.
Four years after the September 2010 incident, Jordan-Aparo’s death, and the Florida Department of Corrections’ and FDLE’s highly questionable account of how and why it occurred have spawned a federal investigation, a new probe by FDLE and an uprising by staff in the prison system’s inspector general’s office. Four inspectors say their boss, Inspector General Jeffery Beasley, threatened them at last year’s Christmas Party, saying he’d “have their asses” if they didn’t quit poking their noses into the case, court papers say.
Meanwhile, at least three Franklin guards involved in the gassing or its aftermath have been suspended with pay, one since March 2012, the others since summer of 2013. According to documents obtained by the Miami Herald, many others who were involved remain gainfully employed, and some have been promoted.
An investigative detour
The Jordan-Aparo case is one of a growing number of deaths being scrutinized by criminal investigators, part of a scandal that has embarrassed the head of the Department of Corrections, Secretary Michael Crews, and begun to tar those closer to Gov. Rick Scott.
The current investigations grew out of a 2013 probe of “garden variety” corruption at Franklin, including allegations that a female corrections officer was brazenly engaging in sex with multiple inmates inside the compound. Inmates who were not part of these alleged romps became jealous and complained. Corrections department inspectors Aubrey Land, David Clark, Doug Glisson and John Ulm went to the prison to investigate.
Inmates at Franklin were incredulous, saying the dalliances were a trifling matter compared to the brutal circumstances surrounding Jordan-Aparo’s death.
Intrigued, the inspectors began digging. They interviewed inmates, studied the use-of-force report, the video captured by surveillance cameras, audio of the incident and photographs of Jordan-Aparo’s body. Among their findings:
•  A claim by prison staffers that Jordan-Aparo was being “disorderly” before his death was false. 
•  Initial reports downplayed the fact that Jordan-Aparo was complaining about experiencing extreme pain and simply wanted medical attention, preferably in a hospital.
•  Contrary to claims that his cell had been decontaminated after the gassing, photos clearly showed residue everywhere — orange smears on the floor, in the sink and in the toilet bowl. There was a dense orange cloud above the bunk where Jordan-Aparo would have sat.
•  Although reports said Jordan-Aparo was issued a fresh set of clothing after the gassing, he was dressed only in dirty, orange-stained boxers.
•  Nobody assigned to investigate the matter administratively from the Department of Corrections watched the “use of force” video showing Jordan-Aparo being gassed.

Their conclusion: Jordan-Aparo died as a result of medical negligence and the “sadistic, retaliatory” use of chemical agents on a sick and helpless inmate who did nothing wrong. And that staff reports following the death contained inconsistencies, errors, omissions and outright lies.
According to the four inspectors who went to Franklin, these findings received a frosty reception from Beasley, who soon informed them thatthey were now under investigation. The reason had to do with their handling of the probe into the sexual escapades at Franklin. One inmate, challenged to provide proof of his relationship with the guard, described in detail and diagrammed the tattoos on her buttocks. To verify the inmate’s statement, Land obtained a search warrant. A female inspector and lieutenant executed it, located the tattoos and photographed them.
The photos were taken as evidence. A lawyer for the corrections officer later complained.
For that, they were told, they were now being targeted.
Relations between the inspectors and their boss deteriorated further, culminating in the alleged encounter during the 2013 Christmas party. The inspectors went above Beasley’s head, approaching Secretary Crews and, ultimately, the governor’s chief inspector general, Melinda Miguel. They sought whistle-blower status, essentially a guarantee that they would not face retaliation for bucking the chain of command.
In a meeting with Miguel that was tape recorded, with permission, by Land, he detailed what he called the Jordan-Aparo cover-up, other corruption within the department and the retaliation he and others were subjected to by Beasley. Miguel denied whistle-blower status to Land and to the others, who had similarly requested protection.
The four filed suit in federal court in July of this year. In the lawsuit, which names Miguel, her deputy, Beasley and his deputy as defendants, the four say they faced retaliation for trying to investigate alleged departmental wrongdoing, which is their job.
Recently, two more inspector general staffers came forward, claiming that they, too, were subjected to threats and intimidation after telling their bosses and Miguel about possible criminal misconduct by prison staff. One of them, inspector James Padgett, claimed that Beasley and deputy Kenneth Sumpter committed perjury and obstruction of justice while trying to squelch other investigations.
In a written statement Friday, Miguel said she and corrections staff are cooperating with the investigation into Jordan-Aparo’s death, adding she has “zero tolerance for unethical or abusive behavior’’ in the department.
Crews, in a written statement, said that he is cooperating as well, and working hard to make it clear that “fabrication, lies, deception, retaliation or other unethical behavior’’ will not be tolerated in the system.
Neither Miguel nor Crews would talk about the case with a Miami Herald reporter.
Culture of ‘impunity’
In May, the Herald began a series of articles about prison deaths with the story of Darren Rainey, a 50-year-old mentally-ill inmate at Dade Correctional Institution south of Homestead.
After he defecated in his cell and refused to clean up the mess, Rainey was herded by corrections officers into a locked, closet-like shower and left there, subjected to a stream of unbearably hot water for as long as two hours until he collapsed and died. His pleas for mercy went unheeded, according to inmate witnesses.
Unlike the Jordan-Aparo case, where the recent allegations have been made by highly regarded staffers, the complaints about Rainey’s treatment came from fellow inmates, who witnessed what went on or heard his screams and sent a string of letters and grievances to prison department leaders. They were ignored. The June 2012 death went uninvestigated for nearly two years, until the Herald began interviewing inmates in May.
In the wake of the Herald’s reporting, Crews fired Dade Correctional Warden Jerry Cummings and his deputy, Royce Dyke. The guard suspected of being primarily responsible for forcing Rainey into the shower, a beefy former college lineman, resigned in July. To date, no one has been criminally charged. At a pair of news conferences, Crews vowed reforms, not only at Dade Correctional, but across the prison system.
When they filed suit, the prison system inspectors attached copies of the Herald stories on the questionable deaths of Rainey and other inmates to support their claim that the department isn’t exercising due diligence in investigating suspicious inmate deaths.
Howard Simon, executive director of the ACLU of Florida, said despite Crews’ promises of reform, the state’s prison system isn’t likely to change until people are held accountable and prosecuted.
The problem, he said, is not one incident but “a culture within the [Department of Corrections] in which guards feel they can kill inmates with impunity.’’
Two brothers
Life was not easy for Jordan-Aparo even before he landed in the bleak confines of Franklin Correctional. Shawn Jordan-Aparo, his younger brother, said their birth father was a drug dealer who sexually abused him and his older brother from the time they were little. Their mother, he said, was a drug addict who was in and out of prison and was never able to take care of them.
At the ages of 5 and 7, the boys began a nomadic life that Shawn says took them to 28 different foster homes over the next five years,
“We got to the point that we didn’t even unpack our stuff. We just skipped from home to home,’’ he said.
Both boys suffered from a genetic blood disorder, Osler-Weber-Rendu (HHT) syndrome, a treatable but little-known disease that causes abnormal blood vessel formation in the lungs, liver, skin and brain that often leads to chronic nose-bleeding and lesions on the skin and around the mouth.
Shawn said he and Randall ended up in an orphanage in Tampa, where they were mentored by the recreation director, who though single, eventually decided to adopt them.
“I just knew it would be hard for them to be adopted at their age,” Thomas Aparo said. “I wanted to give them a second chance.”
But by then, the boys were teenagers, and after spending most of their young lives tethered to foster care, the lure of new-found freedom was too tempting. They struck out on their own and began getting into trouble.
“Neither one of us knew anything about drugs, sex, school, friends that get you trouble, having a work ethic. No one really taught us all those things.
“We were always kind of on our own. We weren’t bad people. We did what we had to do to survive. We stole food from Walmart — no gang-banging or violent things,’’ Shawn said.
He said Randall was like a father figure, taking care of him and sometimes taking the fall when they got into trouble.
While both served time in prison on and off, they remained in touch.
In 2010, with Randall doing a stretch at Franklin and Shawn on the outside, the brothers started planning a new life. They spoke on the phone three months before Randall’s death.
“He was talking like he was happy. He was saying ‘I’m almost out and maybe we can get together and change.’ And three months after that — bam — he is dead.’’
At first, Shawn said, the family was told that Randall had suffocated in his cell. Then they were told he died of internal bleeding. But nothing seemed to make sense because, Shawn said, Randall was in good health the last time he spoke to him.
After the memorial service, Shawn heard from an inmate’s mother. She said her son had written her from Franklin that Randall’s death didn’t happen the way the department was claiming.
Anguish and anger
A week before Jordan-Aparo’s death on Sept. 19, 2010, he began experiencing bleeding problems, Department of Corrections records indicate. On Sept. 15, senior registered nurse Pamela Housholder noted that Jordan-Aparo had complained of back pain after falling while playing basketball on the prison grounds.
Over subsequent days, Jordan-Aparo collapsed several times and was taken at least three times to the infirmary, where nurses did little to help him, records show. He had a fever of 102, told the medical staff his lungs and his heart were hurting and that he was having trouble breathing.
At one point, nurse Martha Greene performed an electrocardiogram, but admitted she wasn’t good at reading the results. She said his heart was working fine.
Greene contacted the prison doctor, who instructed her to start an intravenous application and keep the inmate in the infirmary. After several unsuccessful attempts at inserting the IV, they gave up and left Jordan-Aparo in the infirmary overnight, records said.
The next morning, at 4 a.m. Sept. 18, Greene and LPN Lucy Franklin examined Jordan-Aparo, who complained he was in pain and needed to go to the hospital.
Jordan-Aparo, becoming agitated, at one point blurted: “I am going to sue your f------ ass. I need to go to the hospital!’’
Greene summoned Capt. Mitchell Brown, who without consulting a doctor, decided to remove Jordan-Aparo from the infirmary and place him in an isolation cell — No. 1104 — for causing a “disturbance,” prison records said.
“Ain’t nobody comin’ to help you,’’ a guard known as Big Jit told Jordan-Aparo, according to witnesses. He then ordered the inmate to “man up’’ and shut up.
Jordan-Aparo’s file was then reviewed. Although his disease could cause respiratory difficulties and the department was aware of his affliction, the file indicated that he “had no known medical condition that would be exacerbated by the use of chemical agents.”
At 11:25 a.m., after receiving approval of Col. Timothy Copeland, the duty warden, Lt. Roland Austin gave the order to gas Jordan-Aparo.
First he was given a “final statement,” telling him why he was being gassed. Then, with video surveillance cameras rolling, Officer James Hamm sprayed three one-second bursts of OC, a concentrated form of pepper spray, striking Jordan-Aparo in the upper torso, Hamm’s report said. Three bursts equaled one application.
At 11:59, Hamm sprayed another three bursts. Approximately six minutes later, after contacting Copeland, Austin gave the order for a third application, this time using tear gas, an agent that causes severe burning in the lungs, particularly in confined spaces.
In all, Jordan-Aparo was subjected to 600 grams of chemical agents in a confined space.
Sven-Eric Jordt, a professor of pharmacology at Duke University who studies the effects of pepper spray and tear gas, said that after just 10 minutes of exposure to the tear gas alone in such a confined space, the concentrations would have been near lethal.
“Obviously, the agent was sprayed directly onto the inmate and may have deposited on his skin, clothing, eyes and mouth at much higher concentrations, with less of it airborne, making the concentrations that much higher,’’ he said.
The guards said they “escorted’’ Jordan-Aparo to a decontamination cell, although inmates would later say that Jordan-Aparo was dragged. Photographs and other evidence raise questions about whether he was decontaminated at all.
“He was orange,’’ one inmate told investigators two years later.
“I can’t take it, I can’t take the gas, I can’t breathe’’ Jordan-Aparo said, according to another inmate interviewed by prison system inspectors in 2013.
Jordan-Aparo was so weak after a shower that guards had to put him in a wheelchair to take him back to his cell. Photographs of his body reviewed by the four inspectors in 2013 show that, despite visiting the shower, he was clearly still coated with residue.
If he and his cell were not properly decontaminated, Jordt and other experts said, Jordan-Aparo would have continued to be exposed to the chemicals, breathing in the toxins — until breathing would become almost impossible.
At about 12:30 p.m. he was taken to the infirmary and examined. Nurse Ola Riley couldn’t get a blood pressure reading because the inmate was uncooperative, prison records said. But she did record wheezing in the lower right lobe of his lung. She and nurse Franklin then contacted the on-call physician, Dr. Mohammad Choudhary, who instructed them to try again to take his blood pressure. Instead, they allowed the guards to take Jordan-Aparo back to his isolation cell.
Nearly two hours later, reports say, Riley and Franklin went to the inmate’s cell in a repeat attempt to take his blood pressure. Jordan-Aparo was unable to move, refused to cooperate and wouldn’t sign a release form, so the nurses left, records said.
At 4:30 p.m. Sgt. Kevin Hampton tried to give Jordan-Aparo his dinner tray and found him sprawled on the floor. He refused to eat. Asked if he was OK, Jordan-Aparo purportedly gave a thumbs-up sign.
Even healthy inmates are supposed to be checked every 30 minutes, but it’s not clear whether anyone looked in on Jordan-Aparo from 4:30 until the time his body was found at 6:08 p.m.
The Herald also reviewed hundreds of documents, including letters and emails, showing that the prison’s then-warden, Diana Andrews, and Miguel had been told from at least 2011 that there were lingering questions about the way Jordan-Aparo had died.
On the night of his death and the following day, another Franklin inmate, Joseph Avram, called his sisters, Kimberly Donovan, and Christina Bullins, who is a probation supervisor with the Department of Corrections. He told them he had witnessed what the guards did to Jordan-Aparo and was worried about his own safety.
Bullins and Donovan began contacting prison officials, repeatedly writing letters. Bullins, who was also a member of the corrections officers’ labor union, said she began receiving threats from her bosses that her job was in jeopardy.
In April 2011, two years before the four inspectors approached Miguel, she contacted the chief inspector general to request whistle-blower protection. The request was denied, the inspectors’ lawsuit says. She was subsequently fired in a dispute over medical leave.
Dueling doctors
Dr. Lisa Flanagan, the medical examiner who did the autopsy on Jordan-Aparo, didn’t attribute his death to the application of gas. She wrote that the cause was “complications of multiple cardiac and pulmonary abscesses’’ and mentioned the gas only as an explanation for the staining of Jordan-Aparo’s skin.
But in a post-autopsy meeting with FDLE investigators, Flanagan noted that had Jordan-Aparo received timely and proper medical care from the onset of his sickness, he may not have died.
Dr. John Balmes, an inhalation injury expert with the University of California’s Berkeley School of Public Health, said the gassing almost certainly contributed to Jordan-Aparo’s death.
“He had a fever. He passed out. He had a serious blood-born infection and they gave him an irritant gas that can cause fluid in his lungs,” said Balmes, who reviewed records at the request of the Herald. “They gave him something that made him sicker and that gas contributed to his death.’’
Cyril Wecht, a nationally known forensic pathologist who also reviewed the records at the Herald’s request, called the case one of the worst he has ever seen in terms of how many people were involved .
“This prisoner’s abscesses didn’t develop overnight, and for him to have been in the [infirmary] and then to be gassed ... the people who have ignored this in some ways are even more ignorant than the horrible guards and nurses,’’ said Wecht, who has been involved in various high-profile cases, including reviewing the deaths of John F. Kennedy, Robert Kennedy, Elvis Presley and Anna Nicole Smith.
Despite evidence of medical neglect and excessive force, no one was charged with a crime. The state attorney’s office for Franklin County reviewed the findings and declined to prosecute.
The FDLE report said: “Though inmate Jordan-Aparo did complain numerous times of medical problems commencing four (4) days prior to this death, it is not the scope of this criminal investigation to address those issues.”
That was based on the information available at that time, said FDLE spokeswoman Gretl Plessinger. When new information became available, the case was reopened and it remains active, she said Saturday.
Suspended with pay are Sgt. Hampton (aka, “Big Jit’’) Lt. Austin and Randall Johnson. A fourth guard, Terry Whitlock, was fired in 2012, though it’s not clear if that was connected to the Jordan-Aparo case, and prison system officials declined to explain.
The on-call doctor, Choudhary, held a temporary certificate to practice medicine in an area of critical need — in this case, the prisons. Five months after Jordan-Aparo’s death, while on call at the Alachua County Jail in Gainesville, he was seen driving erratically, running over curbs, state records show.
He was later found passed out drunk behind the wheel of his car, according to state Department of Health records. A review by the state medical board resulted in a reprimand and a fine, but he kept his license. There is no criminal arrest on his record.
One of the nurses who examined Jordan-Aparo, Patricia Lemon, had her license put on probation for three years prior to coming to Franklin. According to the Florida state nursing board, she was found in 2003 to be forging prescriptions for painkillers. After she served her probation, her license was reinstated, state records show. There is no criminal charge in her name.
3 months too late
Jordan-Aparo, who was serving a 19-month stretch for credit card fraud and drug possession when the guards gassed him, would have been released three months later had he lived.
Instead he was cremated, with the remains sent home to Thomas Aparo in Palm Harbor.
Aparo, who had drifted apart from Shawn and Randall, declined to discuss Randall’s death.
Randall Jordan-Aparo’s brother, Shawn, had plenty to say. He is angry.
“There is no reason he should have passed away, no reason he shouldn’t have been to the hospital,” Shawn said. “I never got a chance to say goodbye.’’

Inmate’s gassing death detailed in Florida DOC whistle-blower complaint

Joining a chorus of criticism of Florida’s prison system, four investigators filed a whistle-blower complaint against their employer.

BY JULIE K. BROWN  07/07/2014

Four investigators with the Department of Corrections have accused the state of Florida of running a prison system rife with corruption, brutality and officially sanctioned gang violence — and of retaliating against them when they tried to expose what was going on.
The four filed a federal whistle-blower complaint on Monday alleging that state prisoners were beaten and tortured, that guards smuggled in drugs and other contraband in exchange for money and sexual favors, and that guards used gang enforcers to control the prison population. They claim those actions were either tacitly approved or covered up.
For weeks, the Miami Herald has reported on claims of abusive treatment by corrections officers, as related by inmates, nurses and a psychotherapist, primarily at Dade Correctional Institution, where an inmate was herded into a scorching hot shower and left until he collapsed and died. Now claims of abuse are coming from DOC investigators, the persons charged with rooting out such abuses.
“We have zero tolerance for unethical behavior, and take any allegations of abuse seriously,” said Melinda Miguel, Gov. Rick Scott’s chief inspector general. “An investigation into these allegations is currently active, and upon the conclusion of the investigation information will be made publicly available.”
In the complaint and accompanying documents, veteran investigator Aubrey P. Land described the death of a 27-year-old inmate, Randall Jordan-Aparo, who was found lifeless — a Bible next to his head, his body coated with yellow chemical gas — at Franklin Correctional Institution in September 2010.
According to Land, Jordan-Aparo, serving an 18-month term for credit card fraud and drug charges, was placed in solitary confinement and gassed multiple times by guards after he had begged to be taken to the hospital for a worsening medical condition. Land, who said he stumbled on the death of Jordan-Aparo while investigating other “garden-variety” corruption and abuses at Franklin, said the prison’s medical staff, corrections officers and supervisors later conspired to fabricate reports and lie to law enforcement about the events leading to the inmate’s death.
Jessica Cary, a spokeswoman for the DOC, said the agency had not yet seen the lawsuit so it could not comment.
To date, no one has been criminally charged or held administratively responsible in the death of Jordan-Aparo.
“I’ve done this for 30 years. My skin don’t crawl very often,’’ Land told Miguel in a taped interview in March.
“They killed that damn kid [Jordan-Aparo]. He laid there for five days begging for help.’’
In their lawsuit, Land and fellow investigators John Ulm and Doug Glisson concluded that the DOC’s 2010 Jordan-Aparo death investigation “was either intentionally misleading or the Department of Corrections’ investigators at the scene in 2010 had been grossly negligent.’’
The case is one of several DOC inmate deaths that remain under investigation. The fourth plaintiff, David Clark, was not involved in the Jordan-Aparo case, but investigated others.
In May, the Miami Herald reported on the death of Darren Rainey, a mentally ill inmate at Dade Correctional placed in an excruciatingly hot shower, allegedly as punishment for defecating in his cell. As with Jordan-Aparo, Rainey, 50, is said to have begged for help before he died. A fellow inmate said guards who placed him in the closet-like chamber taunted him by asking: “Is the shower hot enough?’’
After two years, Miami-Dade police have yet to complete their probe, and Miami-Dade Medical Examiner Bruce Hyma has not released the cause of death. The Department of Corrections suspended its investigation but says it has reopened the matter, at least to look at how showers are used in the prison system.
The American Civil Liberties Union of Florida, as well as church and human rights groups, have asked for a U.S. Justice Department probe into the Rainey case.
Dade Correctional inmate Harold Hempstead, a burglar serving more than 100 years, repeatedly wrote letters to the office of DOC Inspector General Jeffery Beasley providing details about the death of Rainey, who was serving a two-year term for drug possession, and the alleged scalding of other inmates. Convicted killer Mark Joiner also wrote a letter, saying he helped clean up the “crime scene’’ and was ordered to discard evidence.
In an interview with the Herald, Joiner said he placed pieces of Rainey’s skin that had peeled off his body into a shoe. A guard told him to throw the shoe away, he said. Neither Hempstead nor Joiner was interviewed by police or the DOC until the Herald began writing about Rainey’s death.
Land told Miguel he learned about Jordan-Aparo’s death when he was sent to Franklin in early 2013 as part of a state law enforcement task force probing an assortment of problems.
“We got inmates down there that are getting their throats slashed on a regular basis,’’ Land said, according to a transcript of the Miguel interview filed with the lawsuit. “Their faces slashed, beat down with locks and socks; tremendous amount of contraband allegations that staff is ordering this and bringing in contraband and being paid and everybody we’re talking to is saying, ‘You know they killed that kid.’ ”
“So finally, I had heard enough. And I said, go back and start looking at all the deaths. Nobody would give me a name. And I find Randall Jordan-Aparo and immediately bells and whistles start going off. This thing ain’t pretty.’’
In an interview with the Herald, Jordan-Aparo’s father, Thomas Aparo, said prison officials and the Franklin County medical examiner told him that his son had died of an “infection’’ that, he said, they likened to a cold.
In reality, the 27-year-old suffered from a rare blood disorder that was noted in his prison medical file, according to records obtained by the Herald. He had been ill for weeks prior to his death, begging for medical attention as he increasingly grew weaker.
When he could barely breathe, walk or talk, he demanded that the prison’s nurses take him to the hospital. They allegedly refused, even after consulting by phone with doctors and other medical staff.
Jordan-Aparo became angry, and cursed the nurses, threatening “to sue their asses’’ if they didn’t get him to the hospital, records show.
The nurses called the guards, claiming Jordan-Aparo was being “rude.” The guards placed him in a steel-walled solitary-confinement cell.
“The next day, the captain comes down there and gasses him, and gasses him and gasses him,’’ Land told Miguel.
He was sprayed so much that photographs show the outline of his body surrounded by mustard-colored gas all over the cell walls.
The prison’s supervisors and guards fabricated reports saying that their use of chemical agents was justified because Jordan-Aparo was “causing a disturbance.’’ Land, who said he viewed video footage of the inmate’s last hours, said the inmate was too sick to cause a disturbance and that all he wanted was to go to the hospital.
Land said Beasley had interfered with an earlier probe of his involving a corrections officer whose brother worked under the DOC inspector general. Land told Miguel that Beasley had cited “professional courtesy’’ as cause not to pursue a case against the officer, who was accused of accepting bribes and sexual favors in exchange for giving a woman access to a prisoner with whom she was having a romantic relationship.
Land said he refused to go along.
“I’m not going to be bullied over this,’’ Land told Miguel. “And I’m going to tell the Jordan-Aparo story.’’
He further told Miguel that by October 2013, with the Jordan-Aparo probe complete, he and fellow investigators Ulm and Glisson found themselves the subject of internal affairs complaints, which they believe were filed in retaliation for pursuing the Jordan-Aparo case.
The investigators say DOC Secretary Michael Crews told them that if they wanted whistle-blower status — a form of protection from administrative sanctions — they should take their concerns to Miguel.
Land said he was referred by Miguel to the Florida Commission on Human Relations, which investigates discrimination and sexual harassment as well as whistle-blower-type complaints.
The FDLE confirmed that the FBI and the U.S. Attorney General are investigating Jordan-Aparo’s death

Palm Beach Post


Privatizing prison health care leaves inmates in pain, sometimes dying

Updated: 6:05 p.m. Friday, Sept. 26, 2014 

By Pat Beall - Palm Beach Post Staff Writer

Inmates called her Red, for the thick auburn hair her beloved older sister once painstakingly curled.
Smart as a whip at 9, Donna Pickelsimer was troubled in her teens, struggling with alcohol in her 20s and, at 52 a convict, sentenced to 15 years behind bars.
Under the care of Florida’s newly privatized prison health system, she didn’t last four.
Handing off prison inmate medical care to for-profit companies was designed to deliver tens of millions of dollars in taxpayer savings beginning in 2012.
But for inmates, it has come with cold-blooded consequences, a Palm Beach Post investigation found.
Post investigation: Prisoners dying for care
Just months after all medical care in state prisons was privatized, the count of inmate deaths spiked to a 10-year high in January and continued at a record pace through July.
Doctors have expressed alarm. The number of seriously ill prisoners sent for outside hospital care is on track to drop by 47 percent from 2012, the last year for which the state handled medical care. Inmates say prescription painkillers are abruptly replaced with over-the-counter drugs such as ibuprofen.
Pickelsimer’s undiagnosed lung cancer was treated with Tylenol and warm compresses.
·                     PRIVATE PRISONS: Profit, Politics & Pain
Serving time for manslaughter, “Donna did something wrong, and she went to prison to pay for what she did,” said Pickelsimer’s sister, Beverly Clancy. “But she was not sentenced to death.”
Following weeks of questions from The Post about inmate deaths, Florida’s Department of Corrections took action late Friday, warning prison health provider Corizon Inc. that its $1 billion contract was at risk if things didn’t improve.
“The level of care continues to fall below the contractually required standard,” wrote DOC Secretary Michael Crews. Problems, noted Crews, had begun almost as soon as Corizon took over inmate care for the vast majority of state prisoners.
“We are currently in the process of evaluating Secretary Crews’ concerns, and will work in a spirit of collaboration to address them,” said Corizon spokeswoman Susan Morgenstern. “Corizon works hard every day to deliver quality care to our patients,” she added. “We take that responsibility very seriously.”
Only dollars and cents
Forking over millions of dollars to pay for inmate health care never has been politically popular. And when Gov. Rick Scott, a former hospital conglomerate executive, campaigned in 2010 on saving tax dollars by turning over prison medical care to for-profit companies, lawmakers embraced the idea.
In 2012, the state inked inmate health care contracts totaling $1.3 billion with two companies: Wexford Health Sources for care at nine major prisons and Corizon Inc. for approximately 44. In addition, the companies care for inmates at prison annexes, work release centers and two centers for new inmates — roughly 100,000 prisoners in all.
Brenda V. Smith, a law professor at American University who has studied women’s health in prisons, doesn’t oppose privatization. But, she says: “There’s a sort of ignorance oftentimes at the policy level about what these changes mean. All they are looking at is dollars and cents.
“You have to be concerned about how you are getting these cheap rates.”
No state is under a legal obligation to provide inmates with excellent medical care.
They are, however, legally bound to provide adequate care by the U.S. Constitution’s ban on cruel and unusual punishment.
“I admit I was one of those saying, ‘Hey, they’re in prison, they can’t expect a lot,’ ” said Sandra Bustin, whose nephew was given over-the-counter painkillers such as Aleve for bone cancer. “But even basic care was missing.”
Bad numbers
In fact, inmate deaths are sharply up, according to state-supplied mortality data.
Data analyzed by The Post excluded deaths from homicides and accidents. Included are deaths from natural causes, such as disease and infection, as well as suicides and deaths in which the cause is listed by the state Department of Corrections as “pending.”
Suicide, a tiny portion of the deaths in all years, is considered a medical issue, as psychiatric care is part of the private companies’ health care contracts. The “pending” category, which occurs most frequently in 2014, is almost always determined to be a death from natural causes, 15 years of prisoner death records show.
Among the The Post’s findings:
·                     In January, roughly 100 days after medical privatization was fully phased in, the monthly inmate death count shot to a 10-year high of 36.
·                     Inmate deaths for the first seven months of this year totaled 206, also a 10-year high when compared with the first seven months of any other year and an 18.4 percent increase from the first seven months of 2012, when the state handled medical care.
·                     When the state was in charge of all or most medical care, the monthly count of inmate deaths reached or topped 30 a total of 15 times in 10 years. That includes one year where the monthly death count hit 30 twice and topped 30 twice. This year, deaths topped 30 a total of four times in just seven months.
·                     At the current rate of deaths, 2014 will have about 5 percent more deaths than the 313 recorded in 2012, the previous high.

Some deaths are expected: Age 50 is considered elderly among inmates, the result of little or no health care prior to prison.
“Many of our patients have not had access to health care before they see us and are already suffering from addiction, mental issues and chronic conditions such as diabetes and hypertension,” said Susan Morgenstern, a spokeswoman for Corizon. “We are not always able to restore them to full health again.”
Any number of factors can push mortality rates higher, such as an influx of older inmates, pointed out DOC spokeswoman Jessica Cary. And, said Cary, when DOC handled medical care in 2012, more inmates died than in 2013, when private companies gradually assumed care for all inmates.
“This is a snapshot in time,” she said of the 2014 numbers. “While we are continuing to monitor the number of deaths and their causes very closely, another year or more of information is needed to identify a trend.”
However, Crews’ Sept. 26 letter to Corizon makes clear the agency expressed concerns about shortcomings in medical care, nursing, mental health and administration fewer than 90 days into the company’s contract.
Repeated meetings have yet to fix the problems, Crews wrote, and now, the state is considering financial penalties. Payment will be withheld for each prison where Corizon fails to meet 80 percent of auditing standards. If a prison fails multiple audits, Corizon may have that facility cut from its contract.
Different suits, same complaints
Even as the state was quietly meeting with Corizon last year, inmates and doctors were voicing concerns.
Three private-practice doctors outside the Florida prison system agreed to speak with The Post anonymously. All expressed worry — and anger — with changes.
It wasn’t a perfect system when the state was in charge, said one, but now: “We order surgery and they don’t come in. They are dying before they get to surgery.”
At Memorial Hospital in Jacksonville, a once-busy ward designed to house more than two dozen prison inmates now holds as few as three or four a day, doctors say.
State numbers confirm the sharp dropoff: In the first eight months of this year, Corizon and Wexford sent just 1,009 inmates to outside hospitals. At that pace, the number of inmates referred to hospitals this year will plunge 47 percent from 2012, when DOC handled health care.
George Horn is among those waiting for surgery. The Columbia Correctional inmate was left with space where his right hip joint should be, according to his federal lawsuit. Horn’s artificial hip joint was surgically removed in early 2013, one of three surgeries needed to treat an infection. Wexford first approved, but later denied an operation to replace the bone, leaving Horn, who has six years left on an 11-year burglary sentence, without a hip joint.
Horn said he recently was told he would get another surgical consult, eleven months after the surgery was originally planned.
Tylenol for nerve pain
The Post reviewed more than 350 federal lawsuits brought by a Florida jail or prison inmate between 2004 and 2014 against Wexford or Corizon, as well as those filed against Corizon’s predecessors, Correctional Medical Services and Prison Health Services. Prison Health Services provided care at the Palm Beach County Jail from 2002 to 2004, but lost a bid for a new contract following reports of withheld psychiatric medicine, an outbreak of an infectious disease and inmate deaths which triggered lawsuits.
“In our litigious society, people file lawsuits for many reasons of their own,” said Corizon’s Morgenstern. “I can tell you that the majority of lawsuits filed against us are dismissed or resolved before they ever go to court.”
However, lawsuits alleging serious medical complaints tended to describe the same types of problems: fewer consults or treatment by outside specialists, Tylenol and ibuprofen prescribed for overwhelming pain and medication abruptly changed or withdrawn.
For instance, several Florida inmates previously prescribed Neurontin for pain say in court suits that they have been switched abruptly to over-the-counter painkillers such as Tylenol. Neurontin is a non-narcotic anti-seizure medication used to treat nerve pain.
A 60-year-old Florida inmate diagnosed with rheumatoid and osteoarthritis, bursitis, fibromyalgia, tendinitis, a dislocated shoulder and ruptured disks said he took Neurontin and another painkiller, Tramadol, for 10 years. Corizon’s prison medical director stopped the Tramadol and cut the Neurontin dosage in half, the inmate said. Acting as his own lawyer, he sued — not for money, but to get his medicine.
Separately, an inmate with a narrowing of spaces in the spine said state doctors prescribed Neurontin for three years to treat related nerve pain. “All that changed in November 2013,” he said, after Corizon began providing care. “I was told that the Aleve they gave me to replace the Neurontin I was on was the only thing I was going to get.”
When the inmate asked why, the doctor wrote first that the drug was no longer approved; when the inmate persisted, the physician changed the explanation, writing that the inmate no longer met criteria for getting the drug.
Crutches, shoes
One blind prisoner who has trouble walking was prescribed orthopedic shoes in 2008, legal documents show. Such shoes can retail for as little as $99. DOC regularly filled his prescription beginning in 2009. This year, when it was time to replace the shoes, Corizon’s doctor refused, the inmate said in written grievances filed at the prison.
In another case, an inmate’s leg prosthesis was taken from him by state guards. The amputee was given crutches. Corizon authorized a new prosthesis— the inmate’s $10,000 device was lost — but in a federal suit, the inmate says five months lapsed before it was delivered. All the while, the muscle in what remained of his leg was withering.
When the inmate did get the device, it wasn’t fitted, said Randall Berg, executive director of the Florida Justice Institute, a legal advocacy group. As a result, “The stump became raw and infected and finally after some pressure from us they gave him antibiotics,” he said.
Federal law bars the state, Corizon and Wexford from discussing an inmate’s health.
However, DOC’s Cary point out that the state employs 17 monitors to watchdog medical care. “When there is a charge of inadequate care, each is personally reviewed and if care is found inappropriate we direct the provider to take corrective action,” she said.
In incidents involving Wexford, said spokeswoman Wendelyn Pekich, “We are confident we and our employees acted appropriately. For those instances still pending, we believe further investigation will demonstrate and prove the lack of any wrongdoing or negligence.”
Dramatic cuts
Determining whether medical care is appropriate and necessary is a key component of containing medical costs. And Corizon’s bid for Florida business emphasized the successes of its own cost containment strategies with a series of dramatic cuts: In Maine in 2011, Corizon said, “We have developed a new working definition of ‘medically necessary care,’” which cut visits to health care providers outside the prison by 30 percent.
In New Mexico, a new system of monitoring psychiatric drug prescriptions slashed monthly costs from $180,000 in 2007 to less than $30,000 in 2011, an estimated taxpayer savings of $2.1 million a year.
University of California Professor of Economics Kelly Bedard, who has researched inmate mortality, said that drops in prescriptions and hospital visits aren’t necessarily a sign companies are skimping.
“You can overtreat,” she said. For instance, the state may have over-prescribed psychiatric drugs. Fewer ER visits may mean a company is improving preventive care.
Fewer outside consults might mean that mobile X-ray and ultrasound services are being brought to the prison. “Making quality specialty and diagnostic services available within the prison facilities reduces the need for inmate patients to travel to community hospitals,” points out Wexford’s Pekich. That’s what Corizon did in Arkansas.
Seizing control
But Bedard’s research on 1990s-era mortality rates also found deaths rose slightly in prisons where care is provided by private companies, “and that leads to a whole host of questions.”
The same year Maine and Corizon redefined “medically necessary care,” a state-ordered review of the contract with Corizon found that about half of prescription records reviewed were missing information. State prison officials were concerned that prisoners were getting thewrong medications. Staff training was lacking.
In Idaho, where psychiatric drug use dropped by 13 percent in 2011 and prisons had one of the lowest rates of inmate hospitalization in the country, a 2012 report by a court-ordered monitor was so critical of Corizon’s care at one prison that the state sought to keep it sealed.
The cost of not getting health care right can wipe out taxpayer savings: States are usually sued right along with the health care companies, and inmate lawsuits rack up a state’s legal defense bills.
Equally problematic is that federal judges overseeing class-action cases can seize oversight from the state and dictate details of care. That’s what happened in Florida in 1972, when a prisoner’s handwritten lawsuit prompted federal judges to oversee Florida inmate health care for the next two decades.
The substandard health care at the heart of that case was provided by the state, not private companies. However, William Sheppard, a Jacksonville attorney who represented the inmates, said that about eight of every 10 inmate letters to his law firm allege substandard medical services under the privatized system.
Sheppard doesn’t doubt the companies are saving the state money. But, he says, cases like Pickelsimer’s exact another price: “How much does it cost your soul to watch these people die?”
Staff writer Kavya Sukumar contributed to this story.

2 private health care firms
Two companies won contracts in 2012 to provide medical care to the state’s prison inmates; privatization was complete by the end of 2013.
Corizon Inc./Valitas Health Services
HQ: Brentwood, Tenn.
Incorporated: 2011, following a merger between the corporate parents of PHS Correctional Healthcare and Correctional Medical Services. Corizon Inc. and Corizon Health are the subsidiaries of Valitas Health Services, which is majority-owned by a Chicago private equity firm.
Annual revenue: $1.4 billion
Provides health care for 362,000 offenders in 27 states
Florida contract: $1.08 billion over five years
Florida prisons: Regions I and II; Central Florida Reception Center; Avon Park, Hernando, Lake, Polk, Sumter and Zephyrhills prisons and their annexes, work camps, road prisons and work release centers.
Wexford Health Sources Inc.
HQ: Pittsburgh
Incorporated: 1991
Provides health care and other services for about 165,000 offenders/ residents in 13 states
Annual revenue: Not publicly available
Florida contract: $245 million over five years
Florida prisons: South Florida Reception Center; DeSoto Annex, Hardee, Arcadia, Charlotte, Okeechobee, Martin, Everglades, Dade and Homestead prisons and their annexes, work camps, road prisons and work release centers.
Source: Florida Department of Management Services, company reports, Moody’s Investor Services
Award-winning prison reporting
Palm Beach Post investigative reporter Pat Beall won the 2014 Hillman Foundation award, a national investigative journalism award. Her eight-month multipart series, “Private Prisons: Profits, Politics, Pain,”linked a nationwide pattern of human rights abuses to corporate cost-cutting.
DOC warns Corizon
Following weeks of questions from The Post about inmate deaths, Florida’s Secretary of Corrections Michael Crews took action late Friday, warning prison health provider Corizon Inc. that its $1 billion contract was at risk if it didn’t take immediate action to improve “patient care issues,” among others.
Award-winning prison reporting
Palm Beach Post investigative reporter Pat Beall won the 2014 Hillman Foundation award, a national investigative journalism award. Her eight-month multipart series, “Private Prisons: Profits, Politics, Pain,” linked a nationwide pattern of human rights abuses to corporate cost-cutting.
DOC warns Corizon
Following weeks of questions from The Post about inmate deaths, Florida’s Secretary of Corrections Michael Crews took action late Friday, warning prison health provider Corizon Inc. that its $1 billion contract was at risk if it didn’t take immediate action to improve “patient care issues,” among others.

Privatizing prison care: Warm compresses, day of rest for cancer lumps

Posted: 12:00 a.m. Saturday, Sept. 27, 2014

By Pat Beall - Palm Beach Post Staff Writer

Even as lumps bulged from Donna Pickelsimer’s upper arm and back, Hernando prison’s medical staff prescribed Tylenol and hot compresses to treat her undiagnosed lung cancer.
Unable to bear the pain, Pickelsimer at one point wept that she wanted to cut her arm off.
+Donna Pickelsimer  photoWWW.PALMBEACHPOST.COM
Donna Pickelsimer after her arrest by Ocala Police where she was charged with second degree manslaughter.
That prompted solitary confinement.
Six weeks later, she was dead.
It’s likely Pickelsimer never knew she was dying.
Post investigation: Prisoners dying for care
·                     No hip joint or painkiller, inmate lives in a wheelchair
·                     Privatized prison care: How The Post got the story
Neither did the Corizon nurses and Haiti-educated doctor treating her, according to more than 800 pages of medical records provided by her family to The Palm Beach Post.
Some records omit information, or provide conflicting information. On s, dates are changed.
But available records show that Pickelsimer was weeks from death before malignancy was first mentioned and the cluster of lumps beneath her skin fully documented.
·                     PRIVATE PRISONS: Profit, Politics & Pain
For four months, Pickelsimer begged for relief. Unable to dress herself or bathe, her arm hanging at her side, Pickelsimer’s unrelenting pain and worsening symptoms were variously treated as a rotator cuff injury, a cold and pockets of fluid which could be massaged away.
“I don’t know if medical could have prevented her death,” wrote Lisa Key, another inmate. “But they definitely could have prolonged her life and kept her out of so much pain.”
Cough, then pain
Serving 15 years on a manslaughter charge, Pickelsimer could have a tough exterior. So when she admitted feeling sick, Key was concerned.
“It started with a cough about a year ago,” Key wrote to Pickelsimer’s sister. “All medical would do was listen to her lungs and tell her they were clear. “
In February, a nurse noted that Pickelsimer, for 35 years a two-pack-a-day smoker, reported a chronic cough which had already lasted three to four months.
Less than four weeks later, when the cough got so bad other inmates complained, Pickelsimer was back in the clinic.
She had lost weight. She had pain in her back. She was given cough syrup.
When she began having trouble getting out of bed, she was allowed to take either Tylenol or ibuprofen.
The pain grew. “She couldn’t move her arm at all without screaming,” Key said. “She kept calling medical emergencies, but the nurses kept saying she was lying and that it was all in her head.”
Lumps began pushing their way to the surface of her skin. Nurses said they didn’t want to look at them, Key said.
Warm compresses
In mid-April, Pickelsimer was prescribed warm compresses. Her blood pressure shot to 162/104, above the threshold considered dangerous by Corizon. She was given two shots of painkillers plus a steroid, ibuprofen and aspirin.
On April 17, she was prescribed warm compresses.
On April 18, a doctor authorized one day of bed rest.
On April 21, she was prescribed ibuprofen and compresses.
She lost 12 pounds. Other inmates started doing her chores. She needed help dressing and bathing. She struggled to walk.
About this time, Pickelsimer was undergoing a battery of IQ tests. “I don’t know what is happening to my body,” she told the tester. “Extensive complaining,” wrote the tester afterwards. “Speech monotonous.”
On April 25, she returned to the clinic in tears, her eyes bloodshot, unable to raise or bend her red and swollen arm. She received a shot for pain relief, a warm compress and permission to stay in bed for a day.
On May 2, she said that she was in so much pain that she wanted to cut her arm off. “I want to die,” she told nurses. She was locked in an isolation cell.
However, alarmed at the lumps on Pickelsimer’s arms, a nurse called the doctor. He recommended that Pickelsimer massage the lumps and keep her arm elevated.
Delayed MRI
On May 5, an ultrasound technician found a mass in her arm. An MRI was recommended.
It was a week before the test was approved.
Pain spread to her back and hip. And Key noticed a new symptom. Her friend had become almost childlike, she said. Her vision was blurred.
On May 23, an MRI scan found a suspicious mass and recommended more testing.
Testing time, though, had run out.
On May 28, Pickelsimer was admitted on a stretcher to Lake Butler, site of a state prison hospital.
“I walked in, and it was horrible. I couldn’t believe it,” said her sister, Beverly Clancy. “Her left arm was full of lumps. They were all over her side.”
Eight days after being admitted, she got a chest scan.
Pickelsimer drifted in and out, but not because she was on powerful pain medication. Initially, she was given a form of Tylenol, said her sister. Morphine was not authorized for a week, records show.
A doctor’s nighttime note on June 7 showed that Pickelsimer’s blood pressure was falling. She no longer responded to painful stimuli.
Shortly before dawn, she died.
The following day, results of her chest scan were stamped received.
“Animals are treated better,” her sister said.

Privatized care: Ibuprofen as bone cancer destroys inmate’s spine

Posted: 3:00 p.m. Saturday, Sept. 27, 2014

By Pat Beall - Palm Beach Post Staff Writer

At first, Anthony Carvajal thought it was just a simple slip and fall. Serving five years on theft and firearm charges, the 44-year-old was in the kitchen of a prison work-release center when his legs buckled.
After a large lump emerged on his spine, he was told by Corizon medical staff that it was a pulled muscle. He was given ibuprofen.
+Privatized care: Ibuprofen as bone cancer destroys inmate’s spine photoCHIP WEINER / CREATIVE LOAFING T
Anthony Carvajal, treated in prison with ibuprofen for his bone cancer, with his father Henry in his living room in Tampa. ... Read More
When a nurse got a reflex after tapping his knee, Carvajal said, he was told to come back after he was paralyzed, “because there’s nothing wrong with you.”
Months passed. Carvajal began losing weight.
And the pain was unrelenting. As one doctor later described it, the pain would have been the equivalent of someone twisting Carvajal’s spinal vertebrae until they broke, then wrenching them out of his back.
Post investigation: Prisoners dying for care
·                     No hip joint or painkiller, inmate lives in a wheelchair
·                     Privatized prison care: How The Post got the story
Carvajal lay in his bunk and prayed to die.
Frantic, Carvajal’s father deluged the prison with phone calls and letters seeking help. The elderly Carvajal was told nothing was seriously wrong.
Six months after Corizon medical staff began treating Anthony Carvajal’s crippling back and leg pain with over-the-counter painkillers, a social worker called Henry Carvajal. His son had multiple myeloma. The bone cancer was slowly destroying his spine.
·                     PRIVATE PRISONS: Profit, Politics & Pain
By one estimate, early treatment might have given Carvajal as much as another 10 years. When he was released from a Tampa hospital in May, doctors gave him weeks.
So far, he is beating those odds. Authorized for compassionate release by the state Parole Board, Carvajal is living with his father outside of Tampa.
Corizon recently settled with Carvajal for undisclosed terms. No suit was filed. Details are confidential. But, said Carvajal attorney Jack Gordon, it was a “cooperative resolution. Corizon did the right thing.”

No hip joint or painkiller, inmate lives in a wheelchair

Posted: 3:00 p.m. Saturday, Sept. 27, 2014

By Pat Beall - Palm Beach Post Staff Writer

When the lights go out at Columbia Correctional prison, George Horn hunkers down in his wheelchair and tries for a few hours of rest.
Sleeping in his bunk is unthinkable.
+No hip joint or painkiller, inmate lives in a wheelchair photo
George Horn’s infected hip joint was removed, but surgery to replace it was not authorized.
The 53-year-old says he can lie only on his left side and only for about 30 minutes before the pain kicks in.
Horn has no hip joint.
Relief isn’t available. Prescribed morphine for two years as the joint rotted, Horn was forced off the painkiller cold-turkey.
Post investigation: Prisoners dying for care
·                     No hip joint or painkiller, inmate lives in a wheelchair
·                     Privatized prison care: How The Post got the story
Horn’s troubles started well before Wexford Health Sources took charge of his medical care, but it is Wexford that left him without a hip joint.
Serving time on an 11-year burglary sentence, Horn’s defective artificial hip joint became infected. Two private-practice specialists hired by the Department of Corrections prescribed surgery to replace the joint. That didn’t happen.
Instead, over the next several months, a state prison doctor drained pus from the hip, said Horn. Antibiotics failed to stem the infection. He was placed in a prison unit providing relief to terminally ill inmates.
·                     PRIVATE PRISONS: Profit, Politics & Pain
In February 2013, he was sent to Kendall Hospital for a heart procedure.
The same two doctors who had recommended hip surgery 19 months earlier saw Horn on a stretcher. They asked how the surgery went, said Horn. “When I told them I hadn’t had it, they thought I was joking,” he said.
Seven days later, a specialist operated. But the delay was costly for Horn and taxpayers alike: Instead of a joint replacement, complex surgery was required to save Horn’s badly infected leg from amputation. And instead of one surgery, another three surgeries would be needed.
The last surgery would replace Horn’s hip joint, as the defective one had been removed.
Wexford, which by then was providing medical treatment at the prison housing Horn, authorized the procedure.
Then it unexpectedly required another opinion.
The new doctor said he would not operate on Horn.
Wexford subsequently denied Horn’s surgery, leaving him without a hip joint.
For two years, Horn said he had been given liquid morphine to deal with the pain.
However, a Wexford doctor abruptly stopped the painkiller. “She said she would not be a drug dealer,” Horn recalled. Morphine had been found as contraband at the prison, and, according to Horn’s suit, the doctor said she would not be giving it out any longer.
In addition to significant and prolonged flu-like symptoms, rapid withdrawal from morphine can be dangerous, triggering everything from increased heart rate to decreased blood sugar levels. Symptoms can linger for weeks. The longer the use, the more severe the symptoms.
They can be reduced with medical assistance. Horn said he got none.
Horn has been transferred to a prison where Corizon handles medical care. Recently, he said another consultation with a surgeon had been approved.
“Being in prison is my punishment to pay my debt to society.” said Horn. “I messed up.” But, he said, “I’m a prisoner, not a monster.
“It’s a terrible thing to say, but I wish God would take me.”

State hired prison health firm despite record of horrific deaths

Posted: 3:00 p.m. Saturday, Oct. 25, 2014

By Pat Beall - Palm Beach Post Staff Writer

Long before Florida hired Corizon Inc. to handle prison health care, the Tennessee-based company racked up impressive revenues, securing a string of government contracts and dominating the inmate care industry.
But as Florida inked its $1.09 billion deal with the company in 2012, Corizon also quietly was signing off on lawsuit settlements linked to dangerously deficient care. It faced withering criticism in an Idaho class-action suit and was faulted in a federal report on an immigrant detainee’s death. Maine auditors criticized Corizon care.
·                     Death at the Palm Beach County Jail: A timeline
·                     Dying for care: Documents
None of that made its way into Corizon’s 2,300 page bid for the Florida contract, despite a requirement to disclose investigations and legal settlements.
In fact, none of the criticisms and incidents should have come as a surprise to state officials. High-profile deaths and lawsuits linked to Corizon and the two companies that merged in 2011 to create it — Prison Health Services and Correctional Medical Services — span more than a decade. Many were in Florida.
Booked into the Volusia County Jail on a misdemeanor charge, Tracy Veira died in 2009 from forced, and untreated, opiate withdrawal; she had been left alone in a cell for the last four days of her life. The same year, Collier County Jail inmate Joan Graeber lost her baby after staffersdelayed treatment for a blood condition lethal to the fetus.
+State hired prison health firm despite record of horrific deaths photo
Convicted killer Michael Costello’s 1972 handwritten Florida lawsuit alleging poor medical care triggered a landmark class action suit- and 20 years ... Read More
Between 2002-2004, when Corizon handled medical care at the Palm Beach County Jail, two inmates died when medicines were withheld, including one HIV-positive prisoner treated with Tums. Judges released two others so they could get medical care. The health department threatened legal action if a potentially deadly infection racing through the jail wasn’t brought under control.
Two cancer-stricken Florida state prison inmates were treated with Tylenol and ibuprofen by Corizon staffers this year as their undiagnosed disease spread, The Palm Beach Post reported last month. One inmate died in June. A second is dying.
This, too, was not a first for Corizon: In 2010, Manatee County inmateJovon Frazier’s arm pain was treated with Tylenol and muscle exercises for four months before an MRI indicated he had bone cancer, a suit brought by his mother charges. His arm was amputated. However, cancer already had spread to his lungs. Frazier, serving less than a year for theft and drug charges, died.
+State hired prison health firm despite record of horrific deaths photo
Timothy Souders, 21, died of heat and thirst in 2006 after spending much of the last four days of his life ... Read More
State: Corizon fully disclosed
Corizon believes details of those and other cases did not have to be divulged, and that it stayed well within the terms of what the state wanted to know. “Corizon Health is confident that its bid was responsive,” company spokeswoman Courtney Eller said.
Florida corrections officials agree. Even if information on lawsuit settlements, the Maine audit and federal investigation had been provided, the company’s bid response met the definition of full disclosure, Florida Department of Corrections spokeswoman Jessica Cary said.
+State hired prison health firm despite record of horrific deaths photo
Timothy Souder
Late last month, after The Post identified a spike in inmate mortality rates, Corrections Secretary Michael Crews formally warned Corizon its contract could be pared back or payments withheld unless medical treatment improved.
The warning was based on “serious concerns” about inmate health care, Cary said, and Crews has directed the company to take “immediate, specific measures.”
While not specifically addressing the written warning, Corizon’s Eller said that “we have implemented a number of improvements over the past year. We look forward to continuing that progress in the future.”
But attorney Randall Berg, who sued both DOC and Corizon on behalf of an amputee inmate who could not get a prosthetic leg, remains skeptical of both the company and DOC.
“When one has to sue DOC and Corizon to get inmates’ hernia surgeries, prosthetic legs, artificial knees; finally the secretary does something,” said Berg, executive director of Florida’s Justice Institute, an inmate advocacy group.
“Corizon has been a disaster and in breach of contract since assuming the contract.”
Post investigation: Prisoners dying for care
·                     No hip joint or painkiller, inmate lives in a wheelchair
·                     Privatized prison care: How The Post got the story
Other states’ criticisms
Citing the need to slash costs, the Legislature voted to hand off state prisoners’ medical, psychiatric and dental care to private companies in 2011. By late 2013, privatization was complete.
Today, Corizon and Wexford Health Sources share responsibility for roughly 100,000 Florida inmates under five-year contracts worth more than a combined $1.3 billion. Corizon snared $1.09 billion of that.
It’s not surprising that Corizon and the two companies that merged in 2011 to form it — Prison Health Services and Correctional Medical Services — would come under fire. Prison care is difficult and prisoners are litigious. Inmates can, and do, fake illness. They don’t necessarily need to fake, though: Prisoners frequently suffer complex and chronic diseases, as well as mental illness and serious dental problems. It’s why even a 50-year-old Florida inmate is considered elderly.
Even so, bidders for the Florida contracts were required to disclose settled lawsuits and federal reports involving inmate care within the previous five years. Corizon provided a list of financial penaltiesassessed by governments for unspecified contract lapses and aparagraph confirming “certain oversight or regulatory agencies have on occasion reviewed issues at facilities contracted to Corizon.”
However, nowhere in Corizon’s bid documents are details of five five court settlements, a critical federal report on the death of an immigrant detainee, a Maine report detailing shortcomings in that state and in 2010, renewed federal oversight of an Idaho prison where Corizon provided medical care. All occurred within the five-year time frame.
·                     Between 2007 and 2009, Corizon spent more than $6.6 million to settle suits brought by three pregnant women who lost their unborn babies and a fourth whose baby sustained permanent brain damage.
·                     In 2011, U.S. immigration officials commissioned a formal inquiryinto the fatal heart attack of an immigrant detainee who was held in two jails, including a jail in Albany, N.Y. jail. The woman died in Albany, where Corizon provided treatment. The federal report found that the woman’s previously prescribed heart medicines were given in the wrong dosages and at the wrong time.
·                     In 2010, a doctor hired by Corizon quit after six months at an Idaho prison. Unqualified staffers handled medical care and pharmacyoperations ran afoul of state law, he said, a practice he reported to state medical boards. A federal judge subsequently appointed a monitor to report on medical care at the prison. The monitor’s assessment was so scathing state lawyers sought to keep it sealed.
A 2011 Maine audit found that Corizon was slow to respond to inmates reporting illness, failed to conduct regular physicals and could not always prove medicine was administered at the right time or in the right amount. State prison officials challenged the review’s findings, in part because of the small sample size.

ER trip: Money for ‘foolishness’
In two other back-to-back legal settlements not found in Corizon’s bid documents, the company’s nurses faulted company practices.
In 2007, 25-year-old Brett Fields was serving time in the Lee County Jail on two misdemeanor charges when he came to the infirmary with a red, pull-filled lump on his arm. Corizon’s medical staff prescribed antibiotics.
It didn’t help. Fields’ arm remained swollen. Back pain followed, then uncontrollable twitching in his legs. Four weeks into his confinement, Fields couldn’t walk or uinate. He had no knee reflex. He was given Tylenol.
Crawling to a toilet, Fields’ lower intestines fell out of his bowels. A nurse appeared, accused him of faking, had him placed on a sheet and dragged to a medical observation cell.
The same nurse later testified that Corizon supervisors “yelled a lot” about nurses sending inmates to hospitals. Staff was told to make sure doctors decided whether inmates needed an ambulance, she said, “because it cost … so much money every time we take somebody to the ER.”
If a doctor makes the call, she said, “that way, there’s not any unnecessary money spent for foolishness.”
Reluctance to use emergency transport was repeated in Minnesota in 2010, a court case alleges, where inmate Xavius Scullark-Johnson’s anti-seizure drug had been cut in half, triggering multiple convulsions. A nurse turned away an ambulance, the suit said.. Scullark-Johnson was left brain dead.
In Fields’ case, the delayed call for emergency treatment came as an untreated, antibiotic-resistant infection spread to his spine. There, it created an abscess, damaging his spinal nerves. When finally sent to a hospital, he was rushed into surgery, but as doctors, a jury and an appeals court later agreed, help came too late to avert permanent damage. He remains partly paralyzed.
A jury awarded Fields $1.2 million in damages.
Protocols not followed
In the fall of 2013, as Corizon’s billion-dollar state contract was being implemented, the company was settling another lawsuit brought by the family of a county jail inmate, one which also involved disturbing statemrnts by acompany nurse.
Tracy Veira told medical staff she was taking prescribed opiates when she was booked into the Volusia County jail on drug charges. Corizon staffers halted the medication without explanation.
Opiate withdrawal can be managed. Untreated, it can be deadly. Almost immediately, Veira no longer could eat or keep down liquids. In the space of a week, she dropped 20 pounds, according to court documents.
Confined to an isolation cell, Veira spent much of four days alone, throwing up volumes of noxious green fluid.
She died of dehydration. The cell was so fouled that even an hour after her death, workers had trouble remaining in it.
One of three nurses on duty the night before Veira died, Inga Jones, described seeing Veira lying across clinic chairs, pale, slurring her words and twitching while the supervisory nurse read a book.
Jones believed Veira needed to get to a hospital. So did another nurse. Neither was in charge, though.
Jones also believed Veira had not been seen by a doctor and was not checked after she was locked into her cell.
But that was the norm, Jones said in court papers. “Drug and alcohol withdrawal protocols were routinely not followed,” wrote Jones. “Many times I recalled returning to duty and finding a patient in full-blown detox.”
Cruel and unusual
Inmates are not legally entitled to excellent care. They are, however, legally entitled by the U.S. Constitution’s ban on cruel and unusual punishment to adequate care.
“A prisoner who receives a sentence of 2-10 years, deserves to do 2-10 years,” wrote a Michigan federal judge in 2006. “What he does not deserve is a de facto and unauthorized death penalty at the hands of a callous and dysfunctional health care system.”
The judge was overseeing a Michigan class-action suit alleging substandard medical and psychiatric care. That care was being handled by Correctional Medical Services, or CMS, the Corizon predecessor.
Among the cases cited: A psychotic 21-year-old strapped to a concrete slab for four days when the heat index hovered at 100. He died of heat and thirst.
A doctor saw him once, according to court documents, but did not take his vital signs. On the fourth day, a nurse detected a “faint” pulse — but prison video shows he then left the cell. The inmate died an hour later.
After hearing details of the death, the judge ordered multiple changes,writing that, “The days of deadwood in the Department of Corrections are over, as are the days of CMS intentionally delaying referrals and care for craven profit motives.”
Killer forces change
Florida has had its own taste of federal judges controlling prison care. In 1972, convicted Florida murderer Michael Costello’s handwritten lawsuit alleging poor medical care by the state — not private companies — triggered a landmark class-action suit lasting two decades.
Because a federal judge in the Costello case was persuaded that overcrowding was linked to poor health care, state prisoners had to be released and expensive new prisons built. The state’s bond rating was threatened by the ongoing litigation.
The court relinquished control only after Florida created theCorrectional Medical Authority, a state-financed, independent panel that surveyed prison health care.
In 2011, the same year state lawmakers voted to put health care in the hands of for-profit companies, they eliminated money for CMA, effectively abolishing it.
Some money was restored in 2012. CMA began inspecting prisons again in 2013.
Several got good marks. For instance, treatment at Hernando Correctional prison was equivalent to community standards, the team wrote, and medical staff deserved to be commended. Inmates, they wrote, “were generally satisfied with health care.”
Two months after the CMA review, Hernando inmate Donna Pickelsimer was taken to a state prison hospital to live out her last days. For months, medical records show, Pickelsimer’s painful, spreading lung cancer was treated with Tylenol and warm compresses by Corizon staff, even as bulges appeared on her chest, back and arm.
When Pickelsimer complained of pain, she was placed in an isolation cell.
CMA’s report did not reference any inmate with lung cancer. However, sandwiched between praise for the medical staff were observations that cancer treatment for two women wasn’t carried out. Months after a cancer specialist prescribed a round of testing, one inmate was still waiting on the screenings.
The other woman’s prescribed follow-up treatment related to ovarian cancer had been denied by Corizon. There was no record that the prison doctors offered any alternate plan of treatment.
‘It makes anybody cry’
Despite the criticisms and high-profile cases, privatizing to manage burgeoning inmate medical care costs remains popular. In the past 12 months, Corizon has inked contracts valued at more than $1 billion with jails or prisons in California, Kansas, Georgia and Minnesota.
In Indiana, prison officials last year signed Corizon to a three-year contract, despite the highly publicized death of Rachel Wood the previous year.
Inmates said Wood, 26, was bleeding from her eyes and nose when prison medical staff directed an ambulance to take her, not to a hospital, but to a long term care facility.
Dead on arrival, Wood had more than 3,600 nanograms of the antidepressant Citalopram in her system, said her father, Claude Wood. The recommended dosage is no more than 120 nanograms. A medical examiner ruled her death was a result of “therapeutic misadventure” — medical error.
“Why did state officials blow this off?” asked Wood of Indiana’s decision to hire Corizon. “It makes anybody cry, what they’ve done.”

What The Post found
In a Sept. 28 story, reporter Pat Beall documented horrors and a downward spiral in care since private companies took over prison health care in Florida.
·                     Two inmates with fatal cancers were treated with Tylenol and ibuprofen as their disease spread. One died in June. The other is not expected to live beyond this year.
·                     The number of inmates being sent to outside hospitals is sharply down. At the current rate, admissions will drop by 47 percent compared with the last year state corrections officials oversaw medical care.
·                     In January, inmate deaths from causes other than murder or accidents hit 36, a 10-year high. Deaths for the first seven months of this year totaled 206, a 10-year high when compared with the first seven months of other years.

More at mypalmbeachpost.com
Death at the Palm Beach County Jail - An interactive timeline
As part of its continuing series on prison health care, The Post has published more than 3,200 pages of source documents, including lawsuits and the companies’ response to them; court depositions and transcripts; bid proposals; contracts and audits.
They can be read at: mypalmbeachpost.com/dying-for-care-documents/
Pleaded to murder
to avoid jail care
Writhing in abdominal pain but given only antacids, Kevin Coleman sat for three weeks in the Palm Beach County Jail, awaiting his second trial in a murder. New evidence likely would exonerate him. But he pleaded no contest to the charge, leaving him a felony record but releasing him for time served, to make sure he didn’t go back. 

Prison medical suits show patterns: Meds stopped, treatment delayed

Posted: 3:00 p.m. Saturday, Oct. 25, 2014

By Pat Beall - Palm Beach Post Staff Writer
Prisoners are notoriously litigious, one reason why Corizon and the companies that merged in 2011 to form it — Prison Health Services and Correctional Medical Services — are named in several hundred lawsuits and reports examined by The Palm Beach Post.
Some suits are clearly frivolous — an injured thumb, for instance.
+Prison medical suits show patterns: Meds stopped, treatment delayed photo
Ashley Ellis
However, cases involving serious injury or death typically allege the same type of problems: key medications stopped or changed, fatal delays in diagnosis or treatment, and failures to react promptly to clear-cut crises.
Some occurred before Florida inked a five-year, $1.09 billion contract with the company. Others have emerged since.
The repeated lapses in care, say critics, represent a pattern.
+Prison medical suits show patterns: Meds stopped, treatment delayed photo
Andy Henriquez
Federal privacy laws bar Corizon from discussing health issues of individuals. But in court documents, the company has argued that it acted appropriately.
In suits involving legal settlements, Corizon has not acknowledged fault.
Among the cases:
+Prison medical suits show patterns: Meds stopped, treatment delayed photo
Rachel Wood
Permissions to die
According to a pending class-action lawsuit filed on behalf of Alabama prisoners by the Southern Poverty Law Center, five ill inmates were persuaded to sign Do Not Resuscitate forms without understanding what they were signing. One inmate was blind. In another instance, the suit alleges, life-saving care was withheld from an inmate because he had signed a DNR. He survived.
Fetus denied care
+Prison medical suits show patterns: Meds stopped, treatment delayed photo
Savannah Sparks
When 15-weeks-pregnant Joan Graeber entered the Collier County jail on a misdemeanor charge in 2008, she knew she needed a specific shot: Her blood type was incompatible with her baby’s. The World Health organization considers the shot one of the most important medications needed in a basic health system. Without it, a fetus can die. Graeber did not get the medicine. The baby died. Two days passed before the dead baby was delivered, and then only after an emergency court order. A suit was settled in 2011.
Ruptured aorta
According to other inmates, his mother and his girlfriend, Andy Henriquez, 19, had reported difficulty speaking, breathing and walking for several days when he was placed in solitary confinement at New York’s Rikers Island. Inmates said they refused to eat in order to get him aid. He was prescribed a muscle relaxant. Henriquez bled to death after his aorta, the largest vein in the body, slowly tore and then ruptured. Corizon said its medical staff treated Henriquez’s symptoms, such as back pain, but could not have known of Henriquez’s pending crisis based on those symptoms.
·                     State hired prison health firm despite record of horrific deaths
·                     Death at the Palm Beach County Jail: A timeline
·                     Dying for care: Documents
This month, the Associated Press reported a 36-year-old man died screaming for help in solitary confinement at Rikers after being denied anti-seizure medication by Corizon staff. It was one of 15 deaths in five years, including Henriquez’s, the AP said were linked to medical care.
Skin sloughs away
In Minnesota, inmate Teddy Korf was taken off his antidepressants and given a drug prescribed for bipolar disorder and nerve pain. Korf had not been diagnosed with either. He quickly developed a life-threatening side effect, including a massive rash, sloughing of skin and a temperature topping 105 degrees. Eventually sent to a hospital, Korf spent 30 days in a burn unit as the entire top layer of his skin fell away. He is now blind. A suit was settled.
Untreated paralysis
A paranoid schizophrenic, Kelly Green rushed headfirst into a cement wall while in court. According to a pending lawsuit, for the next several hours Green lay in his own feces, unable to move and having lost control of his bowels. Nurses called by guards stated that as long as he was breathing there was no emergency. Green had a fractured neck and spinal cord injury. He died from complications of the resulting paralysis. Corizon maintains it provided appropriate treatment and has denied the lawsuit’s description of key symptoms.
Heart meds delayed
Irene Bamenga, a French citizen who overstayed her tourist visa and was attempting to return to France, was arrested by immigration officials and jailed until they could send her to France. Bamenga died of heart failure in the Albany, N.Y., county jail one day before she was to board the plane. It was the second of two jails where she was detained. Corizon handled medical care there. In 2011, U.S. immigration officials commissioned a formal inquiry . The federal report found that Bamenga’s previously prescribed heart medicines were given in the wrong dosages and at the wrong time. A lawsuit is pending.
Unfilled prescription
Ashley Ellis died within 48 hours of being admitted to a Vermont prison on a misdemeanor traffic charge in 2009. The 90-pound, 23-year-old begged Corizon staffers to give her the doctor-ordered potassium needed to stabilize her heart. Although typically available at drugstores, none of the over-the-counter supplement was in stock at the prison. A settlement was reached before a suit was filed.
Hands, feet amputated
Louisville, Ky., jail inmate Melissa Quiggins saw a jail dentist who suggested she could save her severely abscessed tooth if she waited to have it treated until after she left jail. Quiggins, whose tooth was visibly draining pus, was not provided antibiotics until shortly before her release in 2009, when she was given a two-day supply. By then, the infection had spread to her lungs, triggering sepsis. Her hands and feet were amputated. A lawsuit was settled in 2013.
In a separate case, Michigan inmate Martinque Stoudemire’s lupus predisposed her to blood clots. Corizon withdrew her prescribed blood thinner, then provided it in smaller doses. Clots subsequently formed in her legs. Both were amputated. Corizon has countered that problems with Stoudemire’s veins, not clots, necessitated the amputations.
Fatal heroin withdrawal
In a Louisville, Ky,. jail, slow responses to drug crises claimed the lives of three inmates in five months. Among them was 27-year-old Savannah Sparks, who was booked into the city jail on a shoplifting charge. A heroin addict, Sparks died after four days in withdrawal, covered in her own sweat, urine, feces and vomit. “She had a bad detox,” a nurse told Kentucky TV station WDRB. “I mean we have those all the time.”
Reports of withheld food, water
In early 2012, a court-appointed monitor’s report on medical care at an Idaho prison was so scathing state lawyers argued it should not be made public. Among the findings: Ongoing complaints that a dialysis nurse failed to provide food or water during the hours-long treatments; stopped treatments before they were completed; didn’t deliver medicine; and, sometimes, denied treatment.
“It is more likely than not that authorities were aware of the potential danger to the safety of patients for several months but unduly delayed taking action to protect them,” wrote the monitor. A state investigation, he said, “strongly suggests that the delay was based on financial rather than patient safety or labor relations considerations.”
Corizon and the state vehemently disagreed with the findings. Corizon commissioned its own study, which found conditions met constitutional muster, and Corizon last year won an Idaho contract to provide inmate care.
Details of these lawsuits and others, with Corizon’s responses, can be read at mypalmbeachpost.com/dying-for-care-documents.