Tag: Prison Medical Services

“Like Being in Jail”

During the Corona virus pandemic many states, including my home state of Michigan, have issued some form of Stay Home order for the general public and specifically request that people with Covid-19 or think they may have been exposed to it, to self-quarantine for some period of time.  When this first started, the news was full of dire warnings and bleak statistics as the virus spread far and wide throughout the world.  Over time as the news started to become more hopeful sounding with signs of flattening the curve and progress toward a vaccine and effective treatments the natives, as they say, are becoming restless. 

The federal and state governments have been working, sometimes together and sometimes at odds to manage the crisis.  Everything from trying to ensure that there is enough PPE for first responders to sufficient hospital beds and ventilators for the critically ill to emergency economic funds to help out individuals and business are being organized, implemented and communicated to the people to ensure the wellbeing of our nation.  Not everything has gone smoothly.  Mistakes have been made.  With this novel coronavirus much is still to be learned about methods of transmission, who is at greatest risk and how best to protect them.  Information, opinion and fake news has come from many sources to cloud the issues, second guess the experts and mislead the public about every aspect of this situation.  People following the verbal ramblings of the president and other charlatans have tried unproven and dangerous treatments, which have resulted in numerous injuries and deaths.

Every day there is more bad news about the economy, job losses, and the effect that the shutdown is having on businesses and individuals.  The difficulties of finding basic supplies like toilet paper, hand sanitizer, and cleaning supplies coupled with social distancing requirements have made shopping a chore.  Add to this the boredom that comes from running out of projects to work on and having caught up on sleep and your favorite television programs.  The insanity of trying to work from home while home schooling the kids and worrying about friends and loved ones.  These difficulties combined with the improving weather of spring and the social tendencies of our species have turned the occasional grumble regarding the inconvenience of the whole situation into a growing chorus of displeasure.  Often the focus of this complaining is the very government which was elected to handle these types of situations if/when they occur.

Protests have been organized across the country by those who think that government has overstepped its authority by temporarily closing businesses, banning public/private gatherings, and limiting freedoms that the protesters hold near and dear.  Social media outlets have been asked to police themselves regarding event notices that might be encouraging activities that are illegal during this period of declared state and national emergency.  Protesters waving flags of various origins, toting assault rifles, and flaunting the social distancing advisories march in the streets exercising their rights of assembly, free-speech, and to bear arms.  As the SNL skit about Michigan governor Gretchen Whitmer’s response to the protests in Lansing said, “It’s live free or die, not live free and die.”  What does open carry of assault rifles have to do with Covid-19?  As one pundit said, “You can’t shoot the virus.”  Any display of force is by its very nature coercive and there is no place for it in a democracy.

Protesters carry rifles near the steps of the Michigan State Capitol building in Lansing, Mich., Wednesday, April 15, 2020. Flag-waving, honking protesters drove past the Michigan Capitol on Wednesday to show their displeasure with Gov. Gretchen Whitmer’s orders to keep people at home and businesses locked during the new coronavirus COVID-19 outbreak. (AP Photo/Paul Sancya)

As with any crisis there are people trying to take advantage of the situation.  While the number of major crimes decreased during the initial weeks of the pandemic those numbers are increasing again, especially as thieves target closed stores.  Police departments like most first responders have been hit hard by the virus and many officers are either sick or in quarantine.  This puts a strain on the police to maintain patrols in areas of high crime and respond to calls for aid by those experiencing the life-threatening symptoms of Covid-19.  Police chiefs from the across the country are seen nightly on the news pleading for people to stay home, obey traffic laws, and behave themselves, sometimes to no avail.

On television the trend for talk shows is for the personalities to do their shows from home.  The late-night comedians spend their time lampooning the president, life in quarantine, and the idiots who have earned their 60 seconds of infamy.  The daytime shows continue to pander to celebrity, as if those who can most afford not to work can really relate to those who can’t even file for unemployment due to the overwhelming number of people applying.  The poster child for this may be Ellen DeGeneres.  She made a joke on her first show back after 3 weeks off that those of us who have been there found to be in unbelievably bad taste.  She compared coronavirus self-isolation to being in jail.  “It’s mostly because I’ve been wearing the same clothes for 10 days, and everyone here is gay.”  She has a beautiful, spacious mansion in sunny southern California, with her own green space.  Social distancing is not a problem, she hosts her show from her comfy chair and her guests are all virtual. 

The real situation in jails and prisons across America is slowly being revealed by investigative journalists following up on first and secondhand accounts of what life behinds bars is currently like.  Every day I read at least a half a dozen articles from the Marshall Project, the New York Times, Huffington Post, USA Today, Detroit News and Free Press, The Atlantic, and the LA Times just to name a few, that clearly show that neither Ellen nor any other person not currently incarcerated live under conditions even remotely similar to those found in even the best jail.  The picture that these articles paint is very bleak.  Our correctional institutions were not prepared for coronavirus.  Not only that but the system which they are a part of has failed to respond in a timely manner to things like the implementation of CDC guidelines on the control of infectious disease, governmental and court ordered population reduction strategies, and  conducting sufficient testing to determine the true scope of infection. 

Infection rates in some facilities now exceed 50% of the inmate population.  In some regions, the jail or prison is the hot spot responsible for the spread of Covid-19 throughout the community at large, because of the infection rates among correction officers and staff.  Prisons are typically not located in large metropolitan areas with access to hospitals capable of handling more than a few intensive care patients. The result is that inmates are filling up the ICU so that people from the community must go elsewhere.  The notorious prison medical system has exacerbated the situation through callus and unsympathetic care that has resulted in the deaths of prisoners in their cells, which they claim never reported any symptoms to staff.  Inmates report that medical staff do not change gloves between patients; sick inmates are not segregated from the general population immediately; and inmates with mild to moderate symptoms are told to suck it up and sent back to their cells without medications to ease their discomfort.

Attempts by the MDOC to quarantine sick/recovering inmates by setting up quarantine units in several prisons to isolate them from the general population has resulted in the spreading of Covid-19 from one prison to another which had previously been virus free.  The only staff overlap between the quarantine units and the rest of the compound was the medical staff.  There have also been reports that inmates working as cleaning porters have been forced to clean up after infected inmates without any PPE.  The spokes person for the MDOC has repeatedly denied allegations regarding conditions inside of prisons, the same as they have for every other inmate’s complain.  The response as always is that the inmates are lying and that the MDOC has everything under control.  This time he will have a harder time explaining the body count.

Ohio is the only state so far that claims to be testing all its prisoners at all its facilities.  Michigan to date has completed testing at one facility and is now conducting comprehensive testing at a second facility.  This however does not include the correction officers or staff.  At other facilities only those inmates who meet certain criteria are tested.  Since this virus presents itself with such a wide range of symptoms and levels of severity, including asymptomatic infections; only complete testing of inmates and staff can identify the true number of cases.  Given the scarcity of test kits available, it is not surprising that more testing has not been conducted.  Unfortunately, prisoners comprise one of the most vulnerable populations alongside nursing homes and should be a priority.

Compared to the “real world” prison is a place where reality: including things like common sense, empathy, manners, personal hygiene, health care, personal space, and access to PPE is extremely limited or non-existent.  ICE detainees have gone on hunger strikes for more soap and toilet paper.  The federal Bureau of Prisons failed to follow the Justice Departments mandate to reduce prison populations by sending thousands of eligible prisoners home to serve out the remainder of their sentences under house arrest.  Juvenile detention facilities likewise have been slow to release minors who have been deemed to pose no threat to society.  Advocacy groups have been bailing out people who couldn’t afford bail and have been in jails awaiting trials, which have been postponed because the courts have significantly reduced case loads while conducting hearings remotely.  In some states, even after prisons and jails went into quarantine mode, inmates were sent out on work assignments where they risked either catching the virus or spreading the virus into the community.  For example, until just a few days ago inmates from the Rikers Island jail in New York were used to dig graves in a cemetery for the city’s poor.

COVID-19 quotes set to prevent the spread of coronavirus. Quarantine and self-isolation. Stay Home Stay Safe. Limit contact to others. Prevention the spread of Coronavirus. Stock vector illustration.

Directions to inmates from the MDOC regarding how to protect themselves from the coronavirus have been described as confusing, contradictory, inadequate and/or misleading.  The MDOC instructed MSI, its prison factory service to begin producing cloth face masks for staff and inmates.  It then began to issue 3 masks each to inmates with directions to wear them whenever they leave their cells, but only at facilities which have had a positive case diagnosed.  Even after the pandemic was known to be circulating in prisons, inmates are still being released on parole or probation without being tested to see if they are infected or being instructed to self-isolate for 14 days.  Inmates being paroled can’t find access to critical services that are usually provided by governmental or non-profit agencies to get started in their community placement.

In March when the first signs of community spread of the virus were reported, the MDOC like most other jails and prison systems closed their visiting rooms and banned outside volunteers and program instructors from entering the facility.  Internal programs like GED or mandatory programing continue with fewer inmates allowed to attend each class.  Fewer inmates where allowed to go to chow at one time to promote social distancing.  In the level 1 facility where I was housed, in the chow hall we had 4-man tables which barely had enough room for 4 trays.  Even cutting the seating in half leaves you eating face to face with another person.  In some places where the infection rates are highest the chow halls have now been closed and the food is delivered to the inmates in their cells.

To allow inmates to communicate with their family and friends prison phone companies like Global Tel Link are providing weekly free 5-minute calls to inmates.  Email services like JPay have given inmates free electronic stamps to allow them to write home using the kiosk located in the housing units.  This sounds like a nice gesture from companies who have made millions of dollars from selling overpriced services to inmates for years.  The reality is that phones and kiosks are used by dozens of inmates daily and the limitation on the types of cleaning/disinfectant products allowed means that inmates who uses these devices put themselves at risk.  Sanitizers and cleaning products containing 60% ethanol, or 70% isopropyl alcohol have been shown to be the most effective against the coronavirus however, only dilute bleach is allowed.  The old technique of putting a sock over the phone may not protect you from contracting the coronavirus when you put the handset to your face. 

Approximately 95% of all inmates in the US will be released back into society when they complete their sentence.  Unfortunately, Covid-19 does not discriminate in who it infects.  There have been numerous tragic stories reported in the news of inmates within days, weeks or months of being released who have contracted the virus and died.  One of the saddest was the case of a women in jail who gave birth while on a ventilator and later died without ever getting to know her child.  Another involved a man who had been incarcerated 44 years.  He was convicted of murder at age 16.  He had turned down parole earlier in the year, intending to ‘max out’ his sentence and leave prison a free man.  Having reconsidered that decision after the pandemic started, he was scheduled to be paroled in a matter of weeks when he passed away from the virus.  Technical parole violators who have been sent to jail or returned to prison have gotten sick and died. 

Jails and prisons are like petri dishes which culture microorganisms.  Even in the best of times they are unsanitary places full of unhygienic people.  When I was in jail awaiting my court hearings there was no warm/hot water available in my cell, only cold water from the sink and shower.  The soap provided was so poor that it did not foam or suds making it difficult to wash after using the bathroom or before meals.  Very few people are incarcerated in single-man cells, most are crowded into dormitories with a hundred other people.  Social distancing is just not an option so when one gets sick, many get sick.  Getting a cold or the flu in prison is miserable, getting Covid-19 for many could be a death sentence.  Knowing this, the level of fear among inmates is running extremely high. 

Incarceration is a stressful situation in the best of times, now it is nearly at panic levels.  Around the world and even in the US there have been prison riots over fears about Covid-19 and what it could do inside the walls.  Video from a cell phone that had been smuggled into the Wayne County jail in Detroit showed inmates with their tee-shirts pulled up like masks over their faces pleading for help.  Pictures of the Cook County jail showed a window with a message spelled out in toilet paper calling for help.  In addition to the non-profit organizations that were bailing people out of jail, others have begun to supply soap free of charge to inmates that were not getting it otherwise.  While gestures like this are appreciated, they do not address the underlying issues that are putting so many people at risk.

Prisoners hung signs pleading for help in a window of the Cook County jail on Tuesday.
Credit…Jim Vondruska/Reuters

Since the early 2000s prison populations in many, but not all states, have been slowly but steadily decreasing.  Violent crime rates with a few exceptions have also been decreasing during this time according to FBI statistics.  According to a recent report from the MDOC the prisoner population in 2019 was at 96.9% of capacity.  There was also a reduction of 445 beds due to prison closings that resulted from the decrease in population.  What they are not telling you is that the current prison capacity is double of what they were originally designed for.  I was in two different prisons with level 1 pole barns that had originally been equipped for 80 men.  There were 4 men assigned to each cubical.  Now there are 160 men in the housing unit and 8 men to a cube.  When I was in level 2 and level 4 the cells were two-man rooms.  While level 2 was designed that way, level 4 was not, they were supposed to be one-man cells with their own toilet and sink.  Instead of addressing the overcrowding issue by keeping prisons open with fewer inmates the MDOC decided to maintain few prisons in order to offset cost increases while keeping its $2 Billion budget flat. 

It is not a case of Monday morning quarterbacking to say that this was a fatal mistake.  Many people have been speaking out about this problem for years, yet the MDOC ignored the warning signs such as outbreaks of norovirus that have resulted in prisons being quarantined on a regular basis.  The sad thing is that unlike the Flint water crisis there will be no Attorney General investigation, no one will lose their jobs, and no one will be held responsible for the criminal negligence that has led to the unnecessary loss of life that has resulted from the coronavirus pandemic of 2020.

Having said all of this, I hope I have made my point that self-isolation at home is not like being in jail.

Anti-Social Distancing

It has been widely reported in the news recently about the fears of what could happen with the COVID-19 pandemic spreading inside of jails and prisons.  There has been much talk but little action nation wide to reduce the population density by releasing non-violent offenders and those with high risk factors such as the elderly or those with sever chronic health issues.  Defense attorneys and prisoner advocates along with some District Attorneys have petitioned the courts and the various state correction agencies to act on humanitarian grounds to little effect so far.

In Michigan, the MDOC itself can do little to reduce prison population due to Truth in Sentencing.  This policy was enacted by a vote of the people and would require a super-majority in both houses of the legislature to overturn.  Michigan is about the only state in the country which enacted this draconian punishment back in the 1980s that still persists in this failed deterrence strategy.  It was part of the Tough on Crime policing laws, where inmates would not be considered for parole until they had reached their Earliest Release Date (ERD).  Combined with harsh sentencing guidelines Truth in Sentencing caused an explosion in the incarceration rate which lead to the current over crowing situation. 

Now Michigan prisons are full of inmates serving long indeterminate sentences.  While your Earliest Release Date (ERD) might be 7 years, your maximum release date could be 15 years.  The result is that there is no guarantee that you will qualify for parole after serving 7 years.  There is no good time or disciplinary credit unless you were sentenced before Truth in Sentencing.  Longer sentences and harsher policies like the 3-Strike law mean that the number of older prisoners has increased significantly as a percentage of the total inmate population.  This runs counter to the evidence that people typically age out of crime and the fact that the number of older convicts going to prison for the first time is significantly lower than for those in their teens, twenties or thirties. 

Inmates in general tend to be in poorer health than the general population.  This is due in part to the large number of older inmates, but also to the number of inmates with underlying medical conditions, mental conditions, and/or addictions.  Combine this with poor health care which has been the subject of oversight by a federal judge, the result is that even in good times there are needless deaths due to inadequate treatment, medication and therapy. 

It’s been known for many years that jails and prisons are a breeding ground for disease.  Tuberculosis, Hepatitis, HIV, MERSA, Norovirus, and Influenza, just to name a few, have been of significant concern.  In the MDOC, Hepatitis and Influenza vaccinations are available.  TB skin tests are performed routinely.  Prior to release all parolees are tested for HIV.  Every year there are individual prisons quarantined due to an epidemic of one sort or another.

It’s been well documented that prisons are severely overcrowded.  Even with falling rates of incarceration in Michigan, the MDOC closes prisons rather than reduce population density because of the cost savings.  Housing units that were originally designed to hold 80 men now contain 160.  Single beds were replaced with bunk beds.  Desks were removed to make room for additional lockers.  This effectively reduced the square footage allotted per inmate by 50%.  Infrastructure could not be updated so toilets, sinks and showers have double the utilization.  This happened all across the MDOC.

In prison, access to cleaning chemicals is limited.  The cleaning chemicals available are highly diluted because concentrated chemicals can be weaponized.  Heavy bathroom utilization combined with unsanitary conditions due to inadequate custodial maintenance and poor personal hygiene by many inmates, leads to a breeding ground for germs, bacteria and mold.  Add in outdated, inoperative ventilation and old plumbing subject to frequent backups, you have a recipe for disaster. 

While I was incarcerated, I experienced a norovirus quarantine.  It was the only time when dilute bleach was made available for the inmates to clean their areas of control.  5-gallon buckets of bleach water were put out with a few rags and was moved from cube to cube down the hall.  The problem was that not everyone participated in the housekeeping and I’m not sure how well the common areas of the units were cleaned.

Like most of the epidemics in prison, personal hygiene plays a big part in transmission.  Hand washing isn’t widely practiced and there are lots of places where there is no access to soap.  Places like the school building bathroom frequently did not have soap, let alone toilet paper.  Hand sanitizer is not available because it contains alcohol.  The mouthwash doesn’t contain alcohol either.  Alcohol pads from medical used by the insulin dependent diabetics are contraband.  The basic tools used to combat the spread of infectious disease are either not practiced adequately by inmates, poorly implemented and executed by staff,  or prevented by policy as security risks.

Policy says that soap made by MSI will be supplied to inmates as needed.  That didn’t mean that soap was always available.  Housing units generally only order a certain amount based on their budget as determined by the unit counselor.   State soap didn’t have the best reputation, so if you had the funds in your trust account, you would order soap from the commissary. 

Recent news from the MDOC website reports that Michigan State Industries (MSI) is making masks and other PPE for officers and inmates.  Like the recommendation from the CDC that the general population should be wearing cloth masks when going out in public, the MDOC has begun distributing masks to inmates in prisons with confirmed cases of COVID-19.  This fails to take the rest of the CDC guidelines into account.  Inmates can’t separate themselves from others who might be showing the initial symptoms of the virus.  Instead staff must make the determination to quarantine the inmate pending the result of a confirmation test.

Masks without the proper way to clean your hands before and after handling them or being able to properly clean and sanitize them, can lead to contamination.  If anything, they will provide a sense of false security.  When doctors, nurses and first responders who have been trained in proper PPE handling techniques are getting sick with the virus, what chance do inmates have?  In an article I read recently the author concluded that wearing a cloth mask was better than wearing nothing.  Hardly a strong recommendation, but still better than simply pulling up your tee-shirt over your nose which has been shown to provide almost no protection.

At the time of writing this article the number of inmates in the MDOC with confirmed COVID-19 cases was 338 with 2 deaths.  Thirteen of 29 prisons had confirmed cases.  Thirteen other prisons in the MDOC had tested at least one inmate with negative results.  These numbers have doubled in a week and appear to be following the same trends experienced in the general population.  Changes such as suspending visits, stopping outside volunteers or tours from entering the prisons did not prevent the virus from entering prison.  One prisoner in the upper peninsula contracted the virus while he was in the local hospital where COVID-19 positive patients were being treated.  Inmates arriving from county jail may have also brought in the virus.  However, the most likely avenue for the virus to get into prison was through the staff. 

Staff entering prisons must undergo a daily temperature check and answer a series of questions about possible exposure as they enter for work.  If this is anything as thorough as their inspections for drugs, cellphones or other contraband, then it won’t be long before the virus is in every prison.  This is serious and in addition to 142 staff members testing positive there have been two staff deaths reported.  COVID-19 is a silent killer that is often contagious before any symptoms become apparent.

There have been a number of unusual facts about this Corona virus that are particularly troubling.  First there the observation that the virus kills more men than women.  Then there is the issue around how the virus is affecting brown and black communities and individuals at alarmingly higher rates than in the general population.  Also, the elderly and those with underlying health issues are specifically vulnerable.  Finally, there is the issue of access to health care.  The percentage of men significantly out numbers the number of female prisoners.  There are a much higher percentage of brown and black ethnicities incarcerated than in the general population.  There are a large number of inmates who are either elderly or in very poor health.  Finally is the problem of prison health care even in the best of times. This will combine into a perfect storm that the MDOC and all other jails and prisons, either state or federal are not capable of handling.

When this pandemic is brought under control and life resumes its new normal, my concern is that the successful measures taken to combat the spread of this disease will be eased or rescinded altogether.  That the more onerous measures such as restricting visits and access by volunteers, lock downs and restricted movement by inmates will continue.  And that the lessons learned will be quickly forgotten or ignored by administrators and legislators.  When it comes to corrections there is more than a tendency to cling to the failed, outdated, outmoded policies and procedures of the past.  There is a conscious effort to maintain the status quo, resist change even in the face of significant pressure, and a lack of real accountability in a critical branch of government.

If you have loved ones or friends currently incarcerated- pray about them; reach out to them; speak out for them. 

For information regarding the COVID-19 pandemic and how it is affecting those in jail or prison I recommend the coverage being provided by the Marshall Project website.  It is the best source on the internet for daily updates of news being reported across the country the affects our loved ones and friends serving time behind bars.

For specific updates regarding the COVID-19 pandemic in the MDOC, information can be found on their website at: https://medium.com/@MichiganDOC/mdoc-takes-steps-to-prevent-spread-of-coronavirus-covid-19-250f43144337

DWH

Duane Waters Hospital Google Earth

Duane Waters Health Center (DHW) is a 112 inpatient bed medical facility operated by the MDOC.  It provides acute medical, outpatient, and long-term care.  It is adjacent to the Charles Egeler Reception and Guidance Center and is located at the site of the old walled prison in Jackson.  Opened in 1986 DWH was named after Dr. Duane Leonard Waters who worked with the Michigan Corrections Commission for 25 years to modernize health care for Michigan prisoners. This information comes from the MDOC website and sounds well and good but like so much else doesn’t tell the whole story.

In the 1980’s a number of inmate lawsuits filed in federal court regarding prison conditions and medical care were combined into a class action.  The state negotiated a settlement known as the Hadix consent decree which outlined specific goals for improvement of prisoner care.  Despite repeated attempts by the MDOC to convince the court to end the consent decree it is still in force, providing oversight and monitoring progress made to improve conditions.

Over the course of the first 5 years I was in prison I made annual trips to DWH for eye exams, so I have some firsthand experience.  There were a lot of stories about DWH circulating and from talking with the old timers it was clear that you didn’t want to end up there.  I don’t know the statistics but a lot of inmates have died there over the years. One time when I was being processed into the facility and was standing across from the elevators waiting to have my leg irons removed I watched them wheel out a body bag on a stretcher.  When that happened the dozen or so inmates I was with grew very quiet and still in respect for the dead.

While prison is a dangerous place and several inmates are killed by other inmates on an annual basis, for the 95% of inmates which will likely receive parole, the fear of dying in prison is more likely related to a medical issue such as a heart attack or cancer.

DWH lost its certification to perform surgery years ago.  I heard horror stories of wrong limbs being amputated, post-operative infections, patient neglect, misdiagnosis, and excessive pain and suffering.  The doctors and nurses no longer work for the MDOC but for a subcontracted medical service provider, a for profit company.  But that hasn’t done anything to improve medical care. doctors that work in prisons have a reputation for being poor physicians that can no longer work with the general public.  Not long after I arrived at my first prison the state police showed up to arrest the doctor.  They found that he had been stealing prescription medications that were supposed to be distributed to inmates.

Decisions regarding treatment are made by case managers working for the medical service provider and will routinely deny requests for testing and treatments recommended by the physicians.  The medical service provider has a national reputation for providing substandard care and has faced numerous lawsuits both by innates and the states that it contracts for.

Their philosophy seems to be to delay and if possible avoid making a diagnosis and when that doesn’t work delay treatment or seek to least costly treatment option regardless of success rate.  Major medical procedures required by inmates including surgery and cancer treatments are now performed at public hospitals.  In Jackson and Lansing there are enough inmates in the hospital that the MDOC maintains a prison ward.  In addition, inmates are transported off site for doctor’s appointments and outpatient treatments. Inmate medical expenses are one of the highest cost centers due to the aging prison population.  Yet getting medical treatment can be a major ordeal with delay, denial, and a very one-sided grievance process that puts the inmate at a significant disadvantage to fight the decisions made.  Inmates pay a $5 copay for medical service appointments and are charged this even when no services are provided.  For those without financial resources this is just another debt added to their bill that will follow them after they get out.

My level II bunkie was a lifer that had been down since the 1970’s.  He had COPD due to emphysema from smoking his whole life.  It was well managed using a national brand inhaler.  The health care company decided to change his medication to a cheaper alternative over the objections of his doctor.  The result was an almost immediate deterioration of his condition from fit enough to work in the chow hall wiping tables for $90 per month to wheel chair bound, oxygen dependent, and indigent.  Quality of life is a major concern in prison since it doesn’t take much to destroy what little you have when a major change in health status occurs.  The result of going cheap on his medication is that the overall cost of his health care increased significantly.

From talking with an inmate who was suing the doctors and nurses for pain and suffering in regards to a misdiagnosis for cancer, I learned that the ability to successfully prove malpractice is not easy.  The lawyers provided for the doctor were so used to dealing with prison malpractice claims that when they asked the judge to dismiss the claim during a pretrial hearing they were caught off guard when the judge informed them that the doctor was being sued under different statutes and the case was going forward.  Every now and then an inmate will win, but the cost to the doctors, the medical service provider and the state aren’t great enough to cause them to change their ways and improve inmate medica1 services.

I myself had personal experience with prison medical services.  Due to a preexisting medical condition I was at a high risk for heart attack or stroke and classified as chronic care for additional monitoring.  This meant I got a medica1 exam every six months instead of the annual checkup that was part of routine medical care.  But when I developed an unrelated non-life-threatening condition, I did not receive the same level of care.

Due to poor food quality I developed hemorrhoids as a result of hard stool and difficult bowel movements.  The hemorrhoid ointment for sale in the commissary wasn’t Preparation H and did nothing to treat the painful condition I was suffering from.  I was literally reduced to tears from the fiery pain I experienced from bloody swollen hemorrhoids.  My first trip to medical I received a small supply of Tuck’s pads that actually worked to provide temporary relief in treating my condition, but no further supplies were provided when those were used up.  Medical wouldn’t address the underlying cause and I ended up having to purchase fiber laxative powder for $5 every two weeks for the next 7 years, along with hydrocortisone cream to reduce the swelling. If I hadn’t had the financial resources available to afford this I have been in a world of hurt.