Medical care is so poor at an Idaho state prison that it amounts to neglect and cruel and unusual punishment, according to a report that was unsealed Monday.
Correctional health care expert Dr. Marc Stern said there have been some improvements at the Idaho State Correctional Institution south of Boise. But terminal and long-term inmates sometimes went unfed, nursing mistakes or failure likely resulted in some deaths, and one inmate wasn't told for seven months that he likely had cancer, he said.
The Idaho Department of Correction and the prison health care provider, Brentwood, Tenn.-based Corizon, said they're disappointed and are preparing a response that will show the care delivered to inmates meets constitutional and health care standards.
Stern was appointed to study the care prison near Boise as part of a long-running lawsuit brought by inmates. A federal judge is expected to consider the report as he decides whether to allow the lawsuit to continue or bring it to a close.
Some of the medical problems described in the report are disturbing, including Stern's findings that inmates who were terminal or required long-term care and who were unable to move on their own were sometimes left in soiled linens, given inadequate pain medication and went periods without food and water. Stern said those conditions were "inhumane."
Emergency care was also found deficient in the report, with medical staffers routinely failing to bring parts of a basic resuscitation device _ a ventilator mask for rescue breathing _ to inmates experiencing medical emergencies. Prison guards reported to Stern that they sometimes had to call the health staffers multiple times to get them to respond to inmate emergencies, and sometimes the nurses only responded by phone, telling the guards to have the inmates request care the following day.
In another case described by Stern, a nurse who found an inmate unconscious and having serious breathing problems didn't take any other vital signs and failed to give the man oxygen.
"Such evaluation was critically important at this point because it was highly likely the patient was not getting enough blood to his brain and required resuscitation," Stern wrote.
Instead, he contends, the nurse moved the patient to the health unit and only assessed him a few minutes later, when he was having a heart attack. The patient died.
"It is impossible to know if immediate application of life saving measures in the living unit would have saved this patient," Stern wrote. "However, failure to provide these measures greatly reduced any chance for survival."
The report focuses only on the Idaho State Correctional Institution, though Corizon provides medical care for all inmates in Idaho's state-run prisons.
Inmates at the Idaho State Correctional Institution, called ISCI, sued more than 30 years ago, alleging that they were subject to violence and rape by fellow inmates, denied adequate medical care, subjected to poor diets and forced to deal with extreme overcrowding.
Over the next three decades, they won several rulings designed to improve conditions at the prison, and the federal court continued to oversee operations to make sure that the state was complying with all of its orders.
But U.S. District Judge B. Lynn Winmill is eager to end the court's babysitting role, and the Idaho Department of Correction hopes the lawsuit will be closed for good. The inmates, however, said some of the rulings still aren't being complied with _ particularly the orders to improve access to medical and mental health care.
Complicating matters is that the prison has grown and changed over the years, and the state now says it's difficult to apply the old rulings to the facility as it now stands.
Attorneys for the state argued against releasing the report, saying the public could confuse Stern's findings with the court's opinion. The state said the report should be sealed until both sides had responded to the findings in court.
Corizon is not named as a defendant in the case. But in a joint statement released moments after the report was unsealed Monday, officials from the company and the state acknowledged a few of the allegations in the report "may be well-founded but unfortunate anomalies" but most of them have been or are being addressed.
"We are particularly puzzled by the Special Master's report because it contradicts a recent (June, 2010) accreditation study of the Idaho Department of Correction by the highly respected National Commission on Correctional Health Care (NCCHC). Their very thorough study found our care to exceed compliance with national healthcare guidelines," the organizations said in the statement.
Officials with Corizon released a statement taking issue with Stern's findings. The company said Stern inappropriately used legal language and made conclusions that were totally unsupported by the facts.
"The recent Special Master's report regarding healthcare at the Idaho State Correctional Institution (ISCI) is an incomplete, misleading and erroneous representation of the current healthcare delivery system. The flawed report totally undermines the hard work and trust developed between the Idaho Department of Correction, Corizon and our inmate patients," the company said.
Stern's review process was biased, incomplete and based on anecdotes related to a few, isolated incidents, the company maintained.
Corizon said it's so confident of the quality of care that it has contracted with an auditor to review Stern's methodology and asked the National Commission on Correctional Health Care to return to Idaho and perform a "thorough review in compliance with the court's instructions, at Corizon's expense."
That audit will occur on April 2 and 3, the company said.