In a lawsuit filed on February 24th, the mother of Brandon Clint Hacker claims that a “continuing policy, pattern, custom and/or practice of … willfully and deliberately ignoring the medical needs of inmates of the Jail” contributed to the death of her 35-year-old son at Kentucky’s Madison County Detention Center (MCDC).
Charlotte Diana Winkler is suing private inmate medical contractor Advanced Correctional Healthcare, Inc. (ACH) and their employees: Dr. Nadir H. Al-Shami, Advanced Registered Nurse Practitioner Layla Troutman and Licensed Practical Nurse Arlene Johnson. She is also suing Madison County, Jailer Doug Thomas, Capt. Tom Jones, Capt. Cory Dunning, Deputy J. J. LaGrange, Capt. Keith Trickler, and Deputy Whitney Bratcher.
ACH is in the midst of a $222,000 contract to provide healthcare at MCDC. According to their website, the Illinois-based contractor oversees inmate medical care in 17 states and works with “adults, juveniles, and Immigration & Customs Enforcement (ICE) detainees on behalf of jails, juvenile detention centers, work release centers, methadone clinics, and more.”
Hacker started to feel sick at MCDC a few days after he was arrested for failing to appear at child support hearings, the complaint states. He filled out a medical request form, writing “Very sick, stomach, meds.” Records indicate that one of ACH’s nurses who visited Hacker, LPN Johnson, described him as “sick, shaky, chills, upset stomach.” He had high blood pressure and “active tremors, body aches, sweating.” Johnson noted that day that his symptoms were consistent with “Possible W/D [withdrawal] from heroin.”
For the next two days, the lawsuit says, Hacker went without medical attention because no healthcare workers were stationed at the facility over the weekend. “Mr. Hacker and his cellmates repeatedly requested that he be seen by a doctor or taken to a hospital, to no avail,” it states. By Sunday, Hacker’s pain had become unbearable. He filled out another medical request form, writing: “Blood Pressure. Need to see A.S.A.P. Having trouble breathing. Stomach problems.”
A series of incident reports show that guards began to take notice of Hacker’s deteriorating condition. Deputy JJ LaGrange filed a report that read:
ON 5-4-2014 I DEPUTY LAGRANGE WAS ORDERED BY CAPTAIN [TOM] JONES TO CONTACT DR. AL-SHAMI IN REF[ERENCE] TO INMATE HACKER FEELING SICK TO HIS STOMACH, INMATE HACKER ADVISED THAT HE COULD NOT KEEP ANYTHING DOWN, HE ALSO STATED THAT HE WAS GONNA (SIC) BE DOPE SICK, DR. AL-SHAMI ADVISED ME TO GIVE HIM VISTIEL (SIC), AND BENTNOL FOR HIS DOPE SICKNESS AND PHENAGRAN (SIC) FOR HIS STOMACH SICKNESS, ALL THREE MEDS WHERE (SIC) ADMINISTERED TO HIM, HIS BLOOD PRESSURE WAS 110/70 BEFORE MEDS WHERE (SIC) ADMINISTERED SO KONOLAPAN (SIC) WAS GIVEN.
A follow-up note by Deputy LaGrange stated that “no “KONOLOPAN” was administered to Mr. Hacker.” According to the suit, Dr. Al-Shami was providing this guidance from over 100 miles away from MCDC.
That same day, Captain Jones filed a separate report:
INMATE HACKER ADVISED ME THAT HIS STOMACH HURT AND THAT HE THOUGHT THAT HE WAS BLEEDING INTERNALLY DUE TO THE PAIN. I CALLED DR. AL-SHAMI AND ADVISED HIM OF THE SITUATION. HE ADVISED ME THAT INTERNAL BLEEDING WOULD NOT CAUSE PAIN. HER FURTHER ADVISED TO MONITOR HIM. I ADVISED CAPTAIN DUNNING AT SHIFT CHANGE OF INMATE HACKER AND SEVERAL OTHER MEDICAL COMPLAINTS THAT HAD OCCURRED THROUGH THE SHIFT.
Before dawn the next morning, Captain Trickler filed another:
ON THE DATE OF 5-5-14 AND (SIC) OR ABOUT THE TIME OF 0300 [3 am] TO 0320 [3:20 am]. I CPT KEITH TRICKLER WAS PASSING OUT LOWER LEVEL MEDS. WHEN I CPT TRICKLER GOT TO CELL 023 I CPT TRICKLER NOTICED INMATE BRANDON HACKER SITTING AT THE TABLE. I ASKED INMATE HACKER WHAT WAS WRONG, INMATE HACKER STATED TO ME THAT HE WAS REALLY GOING THROUGH IT. INMATE HACKER STATED THAT HE WAS DOPE SICK. I CPT TRICKLER GAVE INMATE HACKER HIS MEDS AND WENT TO THE NEXT CELL FOR MEDS.
Two hours later, when Hacker didn’t respond when his name was called for breakfast, Deputy Bratcher wrote:
ON 5/5/2014 AT THE TIME OF 05:30 A.M. I (DEP. W. BRATCHER) SERVING LOWER LEVEL FOOD SERVICE. WHEN I GOT TO CELL 023, I CALLED EVERYONE BY ALPHABETICAL ORDER TO COME UP AND GET THEIR FOOD. WHEN GOT TO INMATE HACKER’S NAME, CELL 023 POINTED WHERE INMATE HACKER WAS LAYNG (SIC) AT, AND ASKED IF THEY COULD GET HIS FOOD.
The lawsuit states that it was not until Deputy Jailer Matt Dees encountered Hacker that he was finally escorted to a clinic for an actual medical evaluation — several days after he had begun complaining about pain and sickness. Dees wrote:
Walked by cell inmate pecked on glass I entered cell and inmate hacker (sic) was sitting in chair. Inmate hager (sic) stated he was having withdraws (sic) from heroin and felt very sick. left (sic) cell and Captain Tom Jones told me to take him to medical. I helped inmate hacker (sic) put on t-shirt and walked him to medical.
But it was too little, too late. The final report included in the complaint reads:
5/5/15 (sic) 9:25 am I/M [inmate] brought up to Med Room. D/T [detoxing?] C/O [complaining of] being sick. I/M pale sweaty. States he was trying to get through withdrawals on his own. Very [illegible]. Reaching out grabbing this writer. Inquiring from inmate what type of drugs he has ingested. I/M states heroin. Track marks notice to arms. States he’s unable to keep any food down. 120/78. Call to MD. Order received. Inmate took Vistaril 25 mg Bentyl 20 mg. Attempted to give inmate gatorade to drink. Several sips taken. Spilled some in the floor and clothing. Stated he hasn’t had a bowel movement in a while. 120/78. Hands cold skin moist. While this writer was encouraging inmate to drink more of the gatorade I/M layed back on bed eyes rolled to back of head.
Hacker was rushed to the hospital shortly thereafter, where he was pronounced dead at 10:47 am. The lawsuit states that the coroner “attributed Mr. Hacker’s death to acute peritonitis due to peptic ulcer disease with perforation of duodenal ulcers.”
Withdrawing safely from opioid drugs like heroin requires attentive and experienced medical care, without which an individual can face serious health risks. Research has found that ulcers can form and perforate in the stomach during withdrawal, which can be fatal. That same study stressed the importance of “supervised medical detoxification with special attention to gastroprotective agents such as antacid drugs.”
According to the suit, medical workers and corrections officers acknowledged for nearly a week that Hacker was suffering from withdrawal, but “violated numerous written policies and procedures of Defendant ACH, including but not limited to those concerning monitoring of inmates believed to be experiencing withdrawal and/or stomach/abdominal pain.”
The suit also alleges that Hacker never saw a medical professional other than Nurse Johnson since his admission to MCDC, and that Johnson “cannot diagnose or treat illnesses.” The complaint claims he was never actually seen in-person by Dr. Al-Shami or ARNP Troutman.
Contracted inmate medical care has come under increased scrutiny in recent years as states and municipalities face exploding prison populations with higher proportions of inmates suffering from mental health, substance abuse and chronic health issues. In an effort to reduce spending on medical care, some have chosen to sign lucrative contracts with “specialized” for-profit prison medicine companies, like ACH. Perhaps the most infamous of such companies is Corizon Health Services — the nation’s largest for-profit inmate medical provider — which has been sued over 600 times in connection to inmate deaths and injuries and was fined $71,000 by OSHA for failing to protect its workers from violence. Corizon is currently under fire in New York City and Florida in particular.
Much of this dysfunction may be attributed to cost-cutting measures employed by these contractors to meet their unrealistic contractual obligation to provide care to such a high-need population at a fraction of what it costs governments. Such measures include under-staffing and hiring under-qualified medical personnel, and changing or cancelling inmate prescriptions. In places like New York City, where Corizon is indemnified, taxpayers end up paying in lawsuits and fines a significant portion of what they would have “saved” by privatizing their inmate healthcare — not to mention the unquantifiable cost in human life.
In 2014, it was reported that ACH was named as a defendant in three separate lawsuits concerning deceased inmates. The company was accused of “[withholding] the most basic medical care in order to save money, banking on the insurance of the medical contractor to cover any resulting lawsuits” — including the case of a 19-year-old who died of gangrene while in jail for stealing Star Wars DVD’s and attempting to pass a fake $100 bill.
On Thursday, a former ACH nurse for the Anderson County Jail in South Carolina was charged with filing a false report concerning the death of an inmate last year.
Jailer Doug Thomas also said last year that he wanted to switch medical providers at MCDC, telling the Richmond Register that “the most important reason to switch the detention center’s health provider [away from ACH] is legal liability. Under the new contract, a nurse would oversee the distribution of medication in the jail. Currently, detention center employees distribute medication, for which they have to undergo two hours of training.”
Jailer Doug Thomas, Advanced Correctional Healthcare, Inc., and attorneys for Ms. Winkler did not respond to requests for comment on this story.