Rats, bugs and ‘natural’ deaths at Florida women’s prison, the nation’s largest

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http://www.msn.com/en-us/news/us/rats-bugs-and-'natural'-deaths-at-florida-women's-prison-the-nation's-largest/ar-BBnVFU0

OCALA, Fla.—Yvonne McBride was a physically healthy 26-year-old when she entered Lowell Correctional Institution for women on June 20, 2013.

The Florida Department of Corrections noted in its exam of McBride that, other than a bout of constipation and a history of depression, she was in good health. She had no fever, no cough, no chest pain or breathing problems. Her lungs and chest were clear, her heart was normal, her prison medical records show.

But a month and four days later, McBride was dead.

McBride is among untold numbers of Lowell inmates who have suffered serious misdiagnoses, delays in treatment and medical neglect over the past decade. The institution — the largest women's prison in the nation — also has a long history, documented in reports and medical audits, of alarming and even life-threatening deficiencies, like failing to provide routine medications and delaying treatment for inmates with potentially fatal illnesses.

McBride's medical records show that she was seen in the prison infirmary July 23 for a fall. The nurse noted that McBride told her she had been ill for six days, coughing up mucus and feeling weak and short of breath.

"The officers sent her multiple times to the infirmary. She was sick as a dog, but they kept sending her back to her dorm," said her mother, Lydia McBride, a registered nurse for 25 years.

Later that Tuesday, McBride was admitted to the infirmary. The next morning, records show, she awoke about 1 a.m., stood up and fell on the floor. She was vomiting blood, her Corrections Department records show.

By the time she arrived at Ocala Regional Medical Center about 1:30 a.m., McBride was in cardiac arrest and septic shock, emergency room records show. She was revived twice between multiple blood transfusions. But her body was shutting down — she had acute pneumonia and renal failure, according to the hospital record.

"Nothing helped to revive the patient back, and unfortunately with the septic shock by an unknown organism, we lost the patient,'' wrote the emergency room doctor, Sujatharani Thiruman.

She was pronounced dead at 8:44 a.m. July 24. An autopsy concluded she died of bronchopneumonia, brought on by the swine flu virus. Twelve other inmates at Lowell later were suspected to have contracted the H1N1 virus, and two months later, 23 more inmates were sick from what was thought to be flu, prison records show.

"This is a woman that needed to be hospitalized and treated for this very severe pneumonia," said Cyril Wecht, a forensic pathologist who reviewed McBride's medical records and autopsy.

The report of the Corrections Department inspector general's office, in which most of the words are blacked out, absolves the staff and institution of blame. "There is no evidence to suggest that inmate McBride's death could be attributed to anything but natural causes," the report said.

Families who have lost relatives say that while the deaths were attributed to natural causes, many would not have died had they received adequate and timely medical care.

Lowell has two doctors, two advanced nurse practitioners and about two dozen licensed practical nurses for nearly 2,700 inmates, according to the Corrections Department.

Families who have lost loved ones say that while the deaths have been attributed to natural causes, many would not have died had they received adequate and timely medical care.

Prisoners and their relatives can exaggerate illnesses, incompetence or indifferent medical care. But the problems at Lowell and its sister facility, the Florida Women's Reception Center — an intake point for women on their way to Lowell and other prisons — are well-documented by the department and the state's Correctional Medical Authority, which oversees inmate health care.

The Miami Herald looked at nearly five years of medical complaints, audits, surveys and facility inspections at Lowell, which consists of a main compound, an annex and a work camp. Inmates interviewed for this story also supplied medical records, emails and other documents to support their claims of medical neglect. The records reveal that, for years, the prison's infirmaries have been dangerously understaffed and its medical facilities often have failed to provide timely, basic treatment for common ailments such as hypertension.

Until October 2013, prison medical facilities were staffed by Corrections Department personnel. Corizon, a private company with contracts all over the country, was brought in by Gov. Rick Scott to cut medical costs. Corizon handles health care at Lowell and 113 other Florida prisons.

Under Corizon, spending on health care at Lowell has dropped significantly, continuing a trend over the past decade. At the same time, inmates have been denied emergency care, timely treatment for chronic illnesses and routine cancer screenings, according to audits of Lowell and the Women's Reception Center in February and September 2015, respectively. Additionally, audits found colonoscopies for inmates with unresolved bleeding that weren't ordered; vaccinations and immunizations for hepatitis that were never initiated; oncology follow-ups that never happened; tests that were denied and postpartum exams that occurred four weeks late.

The list goes on: no follow-up for an inmate with acute head trauma; ultrasounds that were ordered but not carried out; inmates with HIV who were never treated; inmates with histories of breast cancer deprived of their medication. The September audit found that an inmate at the reception center, next door to Lowell, complained of a golf-ball-size lump in her ear in June and was denied an MRI by Corizon.

"What our folks are told at Corizon is to do the right thing. To practice good medicine," said Corizon spokeswoman Martha Harbin. "Preventive care is getting this stuff on the front end. That's how you save costs. You don't save costs when the conditions rise to the level of complications."

Separately, state and county health inspections of Lowell have found problems there with sanitation, food safety and contagious diseases that have, at times, led to quarantines –– which the department calls "movement restrictions." Parasites have been found in the water, and meat served to inmates was deemed rancid in 2012 by the U.S. Department of Agriculture, records show.

Lowell Warden Angela Gordon said that more than half of the complaints she receives are about medical care, and that "through the grievance process, from what I can see, very few of them are found to be legitimate."

She said the health care workers "are doing their jobs."

"It may not be exactly what the inmates think they should be getting, but the inmates are receiving care for the most part," Gordon said.

However, inmates said they are not only getting sick, they also are cursed at for complaining and punished for pleading with nurses and doctors for help. Even those with serious, visible health problems are sometimes put in disciplinary confinement for "disrespect" if they question their medical diagnoses, inmates said.

Former inmate Tanya Yelvington, 55, said she was disciplined for asking a nurse to change her bloody gloves before examining her.

In 2008, Yelvington, then at Gadsden Correctional Institution in Quincy, discovered several lumps in her breasts. She was alarmed because her family had a history of breast cancer. Her sister and mother had had it.

Shortly thereafter, she was transferred to Lowell and, for the next year, Yelvington, her husband and her sister fought the Corrections Department to get a biopsy. She underwent several mammograms, she said, but they were either inconclusive or turned up nothing.

That's because the technician who performed them — on a mobile mammogram unit — failed to capture the portion of her breast where one of the masses had formed, Yelvington said. She said she argued with the technician to the point where she was threatened with confinement — a highly restrictive form of incarceration away from the general prison population.

"I have large breasts and I told her 'the lump was in my nipple and unless you have the nipple inside the machine you are not going to see what I'm talking about,'" Yelvington said.

At one point, her sister, Teresa Tellez, offered to pay for a private biopsy, but the Corrections Department, Yelvington said.

In October 2008 — 10 months after his wife said she detected lumps — Yelvington's husband, Larry Jones, wrote a letter to the Ocala Star-Banner and the state, demanding to know why she had not been treated.

"Another week has passed and my wife has still not received any medical help but she did go to medical 10/16. My wife was found to have 3 masses 10 months ago at (Gadsden) and is now at LCI. When she got to medical she waited for an hour and a half and finally was told (after she asked) that they had no record of why she was there in medical. This is a sick woman who stayed there for nothing because a [corrections officer] sent her. This is the SECOND time this has happened,'' Jones wrote on Oct. 17.

It took 14 months for Yelvington to get a biopsy, records show. By then, the malignant tumor in her right breast had more than doubled in size, her medical records show. The cancer had spread to her lymph nodes. She agreed to have a double mastectomy.

She had surgery in November 2009 at Memorial Hospital in Jacksonville. The hospital provides services to inmates, although the doctors who perform surgery are contracted by the Corrections Department separately, a hospital spokeswoman said.

When she returned to the prison, Yelvington said she contracted an infection that nearly killed her. Photographs show that after her surgery, her chest was so mutilated that portions of her breasts were still attached.

She said the doctor in charge of the surgery offered to repair the damage to her chest, but Corrections Department would not approve the procedure, considering it cosmetic.

"They do as little as possible and will go to the lengths of letting you die or misdiagnose you to save money. The inmates are animals to them. ... If you have bone cancer, they will tell you you have arthritis and give you Tylenol," Yelvington said last month at her sister's home in Hollywood, where she spent her first Thanksgiving with family in a decade and a half.

She said that when she left the prison, the Corrections Department made sure she left without a shred of dignity. The prosthetic breasts that her sister had bought for her to wear home were thrown out by a prison sergeant. The department said her possessions were discarded because she did not to make proper arrangements to collect them within the required time.

Yelvington, who served 16 years in prison, doesn't minimize the debt she owed for her crime, a DUI manslaughter that killed a motorcyclist in 1998. But she said inmates are human beings.

"When these medical doctors and nurses take an oath, they don't take an oath to say, 'I'm going to help these people in the hospital because they are worthy. [But] because you made a mistake and you're in prison, we're going to treat you like a dog ... you don't deserve to live,'" she said.

Seven deaths were recorded at Lowell and its annex last year. But that number could be misleading because seriously or chronically ill inmates who are transferred to a prison hospital, such as the Reception and Medical Center in Lake Butler — and then die — don't count in Lowell's tally, even if they left Lowell only a few days earlier.

The most recent audit of Lowell's health care highlighted alarming deficiencies, including inmates being denied antibiotics, blood-pressure medication and insulin.

Although inmates tell horror stories, it is difficult for outsiders to verify them. When it fulfills public records requests, the Corrections Department redacts anything related to medical care. For example, it might black out facts like the attending individual was a nurse or that an inmate was bleeding after a cell extraction. The prison system does this under the federal law known as the Health Insurance Portability and Accountability Act, or HIPAA. Because of the same law, it also will not comment on the treatment given individual inmates.

While the law protects the privacy of prisoners' health records, it also limits public oversight. Even family members can have difficulty getting a prisoner's medical records.

Several inmates interviewed said they found it difficult to obtain their own records. The Correctional Medical Authority noted that one of the most problematic issues was sloppy record keeping. "Notable disorganization," the auditors found at the reception center. The disorganization often made it impossible to follow through with treatment for an inmate. Prisoners at Lowell reported the same issues to auditors a few months earlier.

At the conclusion of a recent audit, the CMA declared a state of emergency at Florida Women's Reception Center and said immediate action was required by Julie Jones, secretary of the department.

Corizon, based in Tennessee, has been the source of so much trouble that Jones decided earlier this year to renegotiate its contract. Then. last month, the company said it would not to renew its $1.1 billion contract and plans to pull out in six months, leaving care for 74,000 of the state's 100,000 inmates in limbo.

Corizon also is facing a federal class-action lawsuit by inmates over the quality of care they received, and the state has fined the company almost $70,000 for failing to meet standards set by the Correctional Medical Authority.

Corrections Department spokesman McKinley Lewis said the department has issued a corrective plan for the Women's Reception Center. The major issues, he said, have been resolved there.

"We took that very seriously," Harbin, of Corizon, said. She said 75 doctors and nurses were brought into the reception center and every patient was seen and evaluated.

But officers who work at Lowell say the medical staff is stretched so thin that officers are being forced to pick up the slack.

An officer said the prison asks guards to distribute routine over-the-counter medication, such as ibuprofen, to inmates, something the officer isn't comfortable doing.

"Now we have to hand out pills to inmates, which means we have to fill out the forms and make sure they aren't taking too much. I can stand there for three hours handing out pills just because Corizon doesn't want to give inmates their pain medication. I turn from a corrections officer to a pill line nurse," said the officer, who spoke on the condition of anonymity for fear of reprisals from the department.

Yvonne McBride's mother, Lydia, said she last saw her daughter when she was transferred from the Marion County Jail to the prison system in June 2013. The family later found out that shortly after arriving at Lowell, Yvonne had fallen ill, and that the medical staff kept telling her there was nothing they could do and kept sending her back to her dorm.

"A healthy 26-year-old doesn't die of pneumonia," said Lydia McBride, who once worked as a nurse for the Marion County Jail but says she quit because she didn't approve of how the other nurses treated prisoners.

Court records show that her daughter was arrested in January 2013, charged as an accomplice in an armed robbery. She and Charles Studer were convicted of robbing an acquaintance of $900. The Ocala police report said Studer likely brandished a BB gun, and that McBride went along for the ride.

Her Corrections Department medical file said McBride suffered from panic disorder, anxiety and depression. She told doctors that she had been raped multiple times and battered by an ex-boyfriend. She tried to commit suicide and was once admitted at a hospital for mental health treatment, records show.

McBride said that she tried for years to find the right combination of medication to help control her daughter's biopolar disorder. She said her daughter used alcohol to try to control her panic, and her erratic behavior led her to get into trouble. She would lose jobs and hang out with the wrong people.

"It was difficult to watch her pain," her mother said.

"Prisoners are human beings and the people who are their guardians, no matter what their personal thoughts may be, they should treat these inmates. There is no excuse for this, this was a preventable death if she had been properly diagnosed and treated," said Wecht, a former president of the American Academy of Forensic Sciences who has reviewed a number of high-profile autopsies, including those of John F. Kennedy and JonBenet Ramsey.

Records show that McBride was among seven women who died at Lowell in 2013. Three of those medical-related deaths — two from pneumonia and one from a failed shunt — occurred within two days of each other in April.

"I can't tell you how many times I was threatened with confinement for arguing with a nurse," former inmate Kat Jones said. "How are they upholding their oath when they deny you medical care?"

Liane Lastra, who left Lowell recently, said she was told by prison staff that a pregnancy test she received when she arrived at Lowell in February showed she was eight to 12 weeks along.

A month later, she started bleeding and went to the infirmary. Her medical records show that she was seen on March 7, with the nurse noting that Lastra was "at 12 weeks of pregnancy." She reported abnormal vaginal bleeding and clotting. The nurse noted that Lastra was told to come back two days later and see a doctor, records show.

"There's nothing I can do for you, go back to your dorm,'' Lastra recalled the nurse saying. She said that at first, she felt no discomfort, but was nevertheless alarmed by the bleeding. She asked for permission to stay on bed rest, but she said the nurse refused. The nurse's log doesn't include anything that the nurse advised her to do.

Two days later, on Monday, March 9, the doctor performed a Pap test, records show. He noted that he removed several clots during the examination and that the patient "probably miscarried."

"He put something inside me and I could feel him scraping. He told me there was nothing he could do, I was probably having a miscarriage," she said. The doctor told her to return to her dorm and come back the next day for a sonogram. She spent the night in excruciating pain, she said.

When she arrived the next morning, she was told to wait in the hallway. She said the nurses had difficulty finding her medical file.

"I started feeling urges to push and leaned down and I was praying." Something popped out of her and fell into her pants as she was standing there being ignored, she said. Once she got the staff's attention, they had her drop her pants so they could remove what had dropped, Lastra said. She was not sent to a hospital.

Lastra was no longer pregnant.

Corizon said it could not comment on specific cases.

In June 2014, the Corrections Department received several reports that there were worms crawling out of the bathroom sinks and toilets in Lowell's annex in two dorms, P and Q. According to departmen's inspection report, black larvae were found in the sinks, and the drains were "filthy'' and filled with bugs and other parasites. On June 16, the prison inspector took photographs of the bug-infested conditions and told prison authorities that the water should be tested in all the dorms.

A day later, Eric Lane, the regional director who oversees Lowell, wrote a note to a Jason Melnick, who had written the prison about alleged corruption and other issues, including unsanitary facilities at the prison. Contrary to what the department's own inspector had found a day earlier, Lane said there was no record of any worms or insects in Lowell's annex.

"I want to stress to you that the idea that any staff member associated with this agency would knowingly and willingly make continued, concerted efforts to 'cover-up' a clear cleanliness issue/health hazard ... is alarming at the least," Lane wrote, adding that he had the dorms inspected the day before and all areas were "clean and orderly."

County health inspection records show that over the past two years, the prison kitchens have at times been plagued by rats, roaches and flies. Mechanical dishwashers didn't operate properly. More than once, the prison has been ordered to use "single serve" plastic utensils because of cleanliness issues. The food the prison serves inmates has been so bad at times that the U.S. Department of Agriculture did a surprise inspection and found that the meat— which smelled like fish — was rancid. Kitchen workers reported they were told to use garlic or sauce to mask the smell.

Former inmate Crystal Pascual, who worked in the Lowell annex kitchen, said the inmates used to tie the bottom of their pants legs or tuck them secure in their boots to keep mice from crawling up their legs. She said she fed them so they would stop jumping on her.

"The dishpit and oven had families living in there," said Pascual, who was released in 2013.

Corrections Department records show that in addition to flu problems in 2013, Lowell had an outbreak of chickenpox in February 2014, head lice in April of that same year and, between Sept. 23 and the first of October, 65 inmates were kept in dorm isolation because they complained of gastrointestinal problems.

Records show the 19 other inmates fell ill this past August from a stomach ailment.

Cynthia Goodman, who was serving a three-year prison term, was among those who died in 2013. Her death predated Corizon getting the health care contract by a few months. Kat Jones, who said she was with Goodman before she died, said Goodman bled to death in a prison bathroom.

Goodman was a kidney dialysis patient, Jones said.

"She kept complaining that she was bleeding from her port. She complained for more than a month. We gave her clothes because she would bleed all over them. She would tell them but they would just send her back to the dorm," Jones said.

"One morning she got up early with me. We were both in wheelchairs. She got into the shower and started screaming for help. I got in there and blood was spurting from her port, all over the walls on the ceiling, on the floor, people were screaming. Everyone was frozen and didn't know what to do," she recalls.

"The sergeant came and kept calling medical, but no one answered. He took her out the door, but she died," said Jones, who was later interviewed by prison inspectors about the death.

"They tried to say she was picking at her skin, that she was picking at the port. I know that isn't true. She complained for over a month."

Goodman's autopsy, by the Marion County Medical Examiner, said Goodman died because of a "rupture of infected hemodialysis shunt."

The manner of death was listed as "natural."

Of the 57 deaths at Lowell over the past decade, only one — a disputed suicide in 2008 in which the inmate allegedly hanged herself while handcuffed — has been categorized as anything other than "natural." Ten recent deaths remain under review.

Kat Jones said that when she went to prison she thought it was the other inmates, especially the killers and other violent offenders, she was going to have to worry about.

"You don't have to worry about the inmates; you have to be worried about the people who are supposed to be there to protect you and take care of you.''