----- Original Message ----- 
From: Pam Starr 
To: ; ; 
Sent: Friday, September 12, 2003 10:12 AM
Subject: [patrickcrusade] Medical Malpractice And Negligence - Missouri.

        In 1992 the State of Missouri contracted with Correctional Medical Services (CMS), the nation's largest prison HMO to provide 'quality healthcare' in Missouri's 21 prison facilities. However, since 1992 prison inmate deaths have risen and continue to rise due to medical malpractice, negligence, and deliberate indifference by the statewide healthcare provider contracted by the State of Missouri. 

            As reflected in past articles, doctors affiliated with CMS in some cases, are currently or have been in the past, disciplined by specific State Boards of Healing Arts. As such disciplined doctors who aren't allowed to practice medicine on the general public are permitted to do so behind bars---even if they've lost their Drug Enforcement Administration license, which means that they "can't prescribe something as simple as Tylenol 3 or a toothache."

            Any disciplinary action by any Board in the Medical Arts is a serious matter. It is a patient's (offender's) right not only to know the background and credentials of those forcing specific narcotics, pharmaceuticals, treatments and surgeries, but to be provided with accurate diagnoses and prognoses. 
            The current medical director over CMS statewide in Missouri is a D.O. In 1996 disciplinary action was taken against her by the Missouri Board of Healing Arts. She was disciplined in violation of Section 334.100.2 (5) RSMo. 1994 and was permanently restricted from practicing obstetrics unless she got prior written permission from the Board. At that time she was still affiliated with the Missouri Department of Corrections and CMS. As such medical records, treatment protocols, prescriptions bear her name. The restriction against her went into effect 8.23.96. In 2001 she requested that her license be returned to her after presenting evidence that she completed additional training in obstetrics. This license was reinstated 3.16.01.

            In reading the 1998 article entitled "Death, Neglect & The Bottom Line," by Bill Allen and Kim Bell of the St. Louis Dispatch, all one has to do to reflect the current status of prison healthcare, is change the date of that article to reflect the current date, and 'up' the numbers of deaths and permanent disability. In so doing, one will have the accurate up-to-date picture of healthcare; not only in Missouri's prison system but in prison systems across the nation.

            Medical care by prison HMO's is provided by "contract" physicians hired and assigned to local (primarily) State prison facilities. Comparatively low cost, inexperienced and system intimidated physicians. Incarcerated patients incur either permanent medical disabilities or die. Counter to diagnosis and treatment recommendations of CMS unaffiliated 'outside' physician specialists. Medical records compromised and misrepresented in pursuit of cost-reduction. Documented? Yes. Pervasive? Yes. A function of policy and procedures nationwide? Yes. Are they motivated to impose change? No. To date, a corporate mentality of stonewalling, even though they know that the families of offenders (which number in the millions), and various organizations are determined to shine a "bright light in dark corners". And relatedly for the collective "they", reflective of budget considerations, adhere to a "see no evil, hear no evil, speak no evil" mentality. Inappropriately treated diabetes, Stage IV wounds untreated, broken bones inappropriately treated, if treated at all, unnecessary amputations due to diabetes, spider bites and gangrene, untreated Hepatitis C, TB out of control, TB medication regimens stopped before treatment is completed, Cancer treated as heartburn, seizures ignored, hearing aids not provided, nurses acting as doctors, doctors that can't speak English, withheld medications, crash carts not on site, heart attacks ignored, dead offenders left in their cell for 'the next shift' of correctional officers. All easily documented.

            Prisoners that are dying are shuffled back and forth from institution to institution so as not to increase the number of deaths at a specific facility that has a high mortality rate. Deaths reported by the prison facility to the area newspapers, state that the inmate died of natural causes---or after a lengthy illness; whether 21 or 81 years old.

            Wheelchairs have been taken away from crippled inmates and crutches have been denied those same inmates. After limb amputation, prostheses are denied.

            Offenders are told by doctors that "they wish they would die rather than have to treat them any further." Gel cap medications are given to offenders that have premeditatedly been emptied. Offenders have been injected with unknown substances by doctors and nurses.

            The Hippocratic Oath is turned upside down by the very doctors that took the oath. A comment made by one CMS medical director sums up the corporate mentality nicely: "I don't have to treat you, you can't touch me." Individuals suffering from diabetes, having Blood/Sugar readings between 200-500 is considered normal by CMS standards. Complications from inappropriately treated diabetes are dismissed and treated as something contrary. The Department of Corrections states they don't interfere with prisoner healthcare when in fact, all documentation points to the contrary. The 
grievance process is designed and orchestrated to punish those that ask for treatment of any kind and is used to punish those that refuse questionable treatment. Requests for grievance forms are met with threats of punishment. Grievance forms are denied prisoners. 

            The politicians of the State of Missouri are well aware of the prison healthcare problem, as is the Missouri Department of Corrections. They have refused to acknowledge the problem. Rather, they continue to make a living off of the back of offenders and their families; a constituency, numbering in the millions that grows increasingly angry.

             **For over two decades, Correctional Medical Services (CMS) and other managed care companies throughout the United States have been taking over prison and jail health care from government agencies coast to coast. For a fee, their workers provide everything from Band-Aids and Tylenol to heart-bypass surgery and psychiatric counseling. Taxpayers are paying billions of dollars to these firms. Missouri taxpayers alone have already paid CMS in excess of $170 million dollars over the last eight years. There is good reason to question the quality and motives behind today's correctional health care. It is an industry that takes advantage of the public's ill will toward inmates to give poor care (or no care) while aking a profit. A big profit. At the public's expense. CMS and other managed health care companies are very creative at avoiding treatment costs while appearing to provide a façade of care. The cost avoidance techniques of CMS go too far when they are utilized to hasten the death of inmates. They are experts at delaying medical care to pad profits

The above article comes from The Wrongful Death Institute