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Wednesday, 23 September 2015

At Louisiana’s Angola Prison, Lawsuit Claims, the Sick Face Neglect, Isolation, and Death

Men incarcerated at the Louisiana State Penitentiary, commonly known as Angola, are suing prison officials and the Louisiana Department of Corrections for failing to provide adequate healthcare to the more than 6,000 people currently held there.
In a scathing, 63-page complaint, lawyers representing Angola’s prison population allege that men are routinely denied appropriate medical care, resulting in “unnecessary pain and suffering, exacerbation of existing conditions, permanent disability, disfigurement, and even death.” The class-action suit, Lewis v. Cain, was filed in the United States District Court in the Middle District of Louisiana and alleges violations of the Eighth Amendment protection against cruel and unusual punishment as well as violations of the Americans with Disabilities Act, which requires that disabled prisoners receive reasonable access to programs, services, and activities.
The complaint was filed in May by the Promise of Justice Initiative, the Advocacy Center, the ACLU of Louisiana, and the law firm Cohen Milstein. It details dozens of examples of inadequate care culled from the experiences of over 200 poeple, painting a picture of callousness, neglect, and even cruelty. According to the complaint:
  • Lead plaintiff Joseph Lewis, who is 81 years old, was experiencing chronic throat problems for over two years, including coughing, spitting up mucus, and burning sensations. The only remedy prescribed by the prison doctors was Q-Tussin, an over-the-counter spray. After a visit from his attorneys, Lewis finally received a biopsy and was diagnosed with throat cancer.
  • Plaintiff Kentrell Parker, who is quadriplegic and cannot move any body part below his neck, was placed in solitary confinement in 2014 for complaining about his lack of care – despite the fact that he is totally incapable of notifying prison staff from his isolation cell should an emergency arise. Mr. Parker also alleges that he has often missed meals because, while food is delivered to his cell, medical staff is frequently unavailable to feed it to him. He claims he is regularly left to sit in his own feces for hours at a time due to chronic understaffing, and as a result he was recently diagnosed with a blood infection from bacteria entering his blood from his stool.
  • A 75-year-old man believed he was having a stroke due to numbness in his body, but was only examined after his fourth request to prison officials. Early intervention is critical during a stroke, and as a result of the delay in treatment, the man is now blind, unable to walk, and has difficulty chewing.
  • Plaintiff Otto Barrera, who is missing his lower jaw as the result of a gunshot wound and is unable to eat or take medication without an enteral tube, was referred for reconstructive surgery in 2014. Prison officials denied the request, deeming the surgery “cosmetic.” Mr. Berrera has been prescribed a “soft diet” but is given the same food as the other prisoners, forcing him to tear the food up into small pieces and place it in the back of his mouth to attempt to swallow.
  • James Johnson received treatment for multiple myeloma until 2012, when it was determined that the cost of treatment was prohibitive. His chemotherapy was replaced with steroids, which caused his legs to swell and his blood sugar to remain elevated. Mr. Johnson died last year, shortly after noting that doctors were only making the rounds once every month or two.
The complaint goes on to describe, in its words, “horror story after horror story” – a paralysis that could have been prevented, a torn knee ligament that was identified then ignored, a softball-sized hernia that required but did not receive surgery, a degenerative joint condition that has awaited surgery for a decade, endlessly delayed biopsies, and even a 16-year wait for a cane for a blind man.
This is not the first time that Angola has been accused of having inadequate health care. In the early 1990s, the Department of Justice intervened as a plaintiff in a class action lawsuit called Lynn v. Williams that accused prison officials of many of the same deficiencies that are currently at issue. The DOJ summarized its findings as follows: “The medical care at LSP is grossly deficient. The medical care delivery system at LSP fails to recognize, diagnose, treat, or monitor the serious medical needs of LSP inmates, including serious chronic illnesses and dangerous infectious and contagious diseases… As a result of inadequate medical care at LSP, inmates have suffered and continue to suffer serious harm and even death.”
One of the areas of particular concern to the DOJ was the use of solitary confinement to house sick prisoners. As they noted at the time, “Defendants’ use of isolation rooms in the infirmary is improper and dangerous. Defendants place seriously ill patients in locked rooms that may adversely affect their medical conditions. Nurses in the nursing station are unable to see or hear inmates in the locked isolation rooms and infrequently check on the inmates in these rooms.”
Michael Puissis, who served as the plaintiffs’ medical expert in that lawsuit, observed that sick prisoners were often kept in locked cells unnecessarily. “These rooms have heavy gauge steel doors with a small (approximately 6 inch) viewing panel. Patients must gain the attention of nursing staff by screaming and banging on the door. Nurses sit behind an enclosed viewing area, which muffles sound from the ward. There is no nursing call button in these rooms. On the day of my visit, an infirm AIDS patient, who had difficulty walking, was locked up in one of these rooms because he was described as an escape risk.”
Fast-forward 23 years later, and it would appear that little has changed. The current warden, Burl Cain, is the same warden who ran the prison in 1998, when a consent decree was temporarily issued to resolve some of the problems enumerated by the DOJ. According to the Lewis plaintiffs, medical assistance is constantly delayed or denied, or offered only after individuals bring in attorneys and threaten litigation. Prescriptions go unfilled. Medical devices are virtually nonexistent. Record-keeping is inadequate. Men are threatened with disciplinary action for seeking medical care if they are deemed to be “malingering.” Untrained staff and prisoners are doing the work of doctors. And the list goes on.
The lawsuit even points out that one of the Defendants, Stephanie Lamartiniere, who is responsible for oversight and supervision of the entire medical staff at Angola, has no medical background. Her previous job? Warden Cain’s secretary.
What the complaint does not mention is the fact that many doctors working in state prisons have had histories of disciplinary actions that preclude them from practicing medicine in non-institutional settings. The problem is particularly prevalent in Louisiana, according to a 2012 investigative journalism piece by the Times-Picayune.  The newspaper uncovered that 60 percent of the doctors practicing in Louisiana state prisons had been disciplined by the state medical board for violations ranging from possession of child pornography to dealing methamphetamine to sexually abusing patients. This compares to 2 percent of the state’s non-prison physicians. Four of the doctors named in the article were working at Angola at the time of publication.
The plaintiffs in Lewis are seeking to force Angola to beef up their medical staff, provide patients access to needed surgeries, offer timely and competent responses to emergencies, improve sanitary conditions, and better accommodate the disabled, among other objectives. If successful, the suit could catalyze improvements at other correctional facilities seeking to avoid similar litigation.




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