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From: Taoss - Sherry Swiney 
To: PATRICK Crusade 
Sent: Sunday, September 07, 2003 1:12 PM
Subject: [patrickcrusade] Report Details Alleged Negligent Health Care at Prison

Report details alleged negligent health care at prison

Human rights group files suit in connection with HIAIDS deaths at Limestone 

Mobile Register
Staff Reporter

A grim report, detailing the deaths of 38 HIAIDS-infected inmates at a Huntsville-area prison, was released Wednesday by an Atlanta human rights group that has filed suit against the Alabama Department of Corrections over the treatment of those inmates. 

The 125-page report, written by infectious disease specialist Dr. Stephen Tabet of Seattle, includes photos of crowded conditions and advanced skin infections at Limestone Correctional Facility in Harvest, Ala. The facility is the only one in the country to house HIAIDS-infected inmates who have been segregated from other inmates. 

David Lipman, Miami-based attorney for the HIV prisoners at Limestone, said, "The medical treatment and living conditions experienced by our clients is completely unacceptable, unconstitutional and appalling." 

In March, a class action suit was filed against the Department of Corrections in federal court in Birmingham. 

In the Limestone report, a detailed case summary of each of the 38 inmates who died between 1999 and 2002 is included, followed by Tabet's specific assessment of why the care was inadequate. 

Tabet's report concludes that, "in almost all instances, the death was preceded by a failure to provide proper medical care or treatment," and almost all of the 38 deaths were caused by "preventable illnesses," including pneumo nia, kidney failure and staph infections. 

While no family members are named as plaintiffs in the lawsuit, one mother said she was angry at the lack of care her son received. 

The woman, a Tuscaloosa resident, agreed to talk to the Mobile Register on the condition that neither she nor her son be identified. 

"He was really neglected," she said. After a previous stint at Limestone, "he came home with some kind of ulcer on his leg." 

"I had to take him to the hospital every day. The odor was so foul, we had to roll the windows down. To send him home like that, it was really, really bad." 

The woman said she asked corrections officials if she could bring medicine for her son, but was told by the group providing care to the inmates -- Birmingham-based NaphCare Inc. -- that she could not. 

According to the report, her son died of cirrhosis of the liver, for which he was not treated. A month before his death, he was diagnosed with pneumonia, and a physician prescribed a strong antibiotic. But the Naphcare nurse who dispensed medicines never gave him any, citing a fear of allergic reaction, according to the report. 

Less than a month later, the man died on Labor Day 2002. He was 38, his mother said. 

"I had called on a Saturday, asking to come see him," she said, after another inmate telephoned to let her know her son was ill. 

"I got there at 10 o'clock on Monday, but he was already dead. They said he died at 9 o'clock that morning," she said. 

Tabet visited the facility Feb. 12 and 13 of this year and conducted prisoner examinations, during which he discovered many were not receiving medical treatment for potentially life threatening illnesses, including cryptococcal meningitis and pneumocystis carinii pneumonia (PCP). In addition, accessibility for handicapped HIV prisoners was "disregarded and neglected," and there was evidence of a "recent widespread outbreak of staphylococcal skin infections." 

In the "overcrowded, open warehouse" where the inmates are housed, the report states, the side-by-side, head-to-toe bunks "place(d) these immune-compromised patients and the staff at an undue risk of acquiring contagious diseases." 

After the report was released, Limestone's Dorm 16 -- where HIAIDS patients are housed -- was painted, and screens were installed in doors and windows, according to Tabet's report. 

NaphCare is still administering care in Alabama prisons, though Prison Commissioner Donal Campbell notified the company in May that he would cancel the contract by Aug. 1. NaphCare sued the Department of Corrections, and in July, Campbell and NaphCare agreed to continue the company's services on a month-to-month basis. 

NaphCare and Campbell also are listed as defendants in the class action lawsuit filed in March. 

A settlement -- in which the plaintiffs would demand that conditions and practices for HIV-positive inmates are improved -- could be negotiated as early as mid-September, Lipman said. If a settlement cannot be reached, Lipman said, trial has been scheduled before a federal district court judge for sometime after Jan. 15. 

Brian Corbett, spokesman for the Alabama Department of Corrections, said Wednesday afternoon that his group had not received a copy of the report by that morning.

"The only thing I can say is, it's important to note that this report was done on behalf of the plaintiffs by their chosen expert," Corbett said. 

He said he could not comment further because of the pending litigation. 

Asked if the department would try to settle rather than go to court, Corbett said, "Anytime two sides can agree on something, I think that's the best alternative." 

Lipman said, "The department's own independent monitor, Jacqueline Moore and Associates, made findings that really parallel what we did." 

Moore's group released an audit report, including the conclusion that health conditions were poor at Limestone, in November 2002. 

"She (Moore) didn't have time to address the individual causes of death that we did," Lipman said. "The state, through it's Medical Advisory Committee, has not done it." 

Experts in HIAIDS survival said that, with proper medications, HIV and AIDS patients can live for many years. 

"If a person does not take the proper medications, then the virus will progress faster, and their immune system will deteriorate faster," said FeAunté Preyear, director of education for Mobile AIDS Support Services.

"Those HIV medications are crucial in improving the quality of life and also extending their life expectancy," she said. Without proper care, she said, a secondary infection, such as pneumonia, can be fatal. 

Michael Mitchell, executive director of Mobile AIDS Support Services, said that since the group conducted its study and Moore's audit was released, "there really have been a lot of good changes going on in the prison projects," and he believes more HIAIDS-infected inmates are getting their needed medications.