On July 16, 2015 Florida inmate Oberist Saunders filed a federal lawsuit against the state’s Department of Correction (FDOC), Corizon Health Services and several staff members the Tomoka Correctional Institute (TCI) in Daytona Beach.

Saunder’s suit comes a few months after FDOC Secretary Julie Jones announced her department’s intention to rebid nearly $1.4 billion in inmate medical contracts, the majority of which are held by Corizon. Florida prisons have been home to some of the most horrific stories of inmate abuse and medical neglect, including the story of Darren Rainey — a mentally ill man who was killed after guards locked him in a scalding hot shower. He was allegedly being punished for defecating in his cell. Other inmates were made to clean his skin off the shower floor the next morning.

Rainey’s story is extreme, but the same basic disregard for inmates’ mental and physical health is pervasive across the state’s prisons. The following story described in Saunders’ complaint covers years of alleged neglect for obvious medical needs that began before the prison privatized its healthcare, and got much worse after it did.

Before Corizon: Filth and negligence

Oberist Saunders arrived at Tomoka in February 2010, already suffering from nerve damage and other severe and chronic health conditions affecting his neck, back, shoulder. He notified medical staff on intake and was eventually given an MRI that confirmed “significant damages” to his right shoulder. Medical records also showed that he had an ongoing digestive disorder aggravated by eating certain foods.

In June of 2011, Saunders was brought to an orthopedic specialist who determined he needed urgent surgery on his shoulder to install a metal plate. In July, he underwent the surgery.

The Jacksonville Memorial Hospital, where Saunders most likely should have spent his recovery, had an entire floor secured for inmates. It is undoubtedly a superior location for him to recuperate than the hot, dirty prison from which he had been driven two hours shackled in the back of a van. It was the surgeon’s decision whether or not he would stay and recover there instead of prison. But barely out of his anesthetic daze, Saunders was taken to the van after surgery and brought back to Tomoka. He was not given antibiotics or any other medication to prevent infection.

Back at the prison, Saunders was not brought to the relatively sterile, air-conditioned infirmary on the premises to recover from surgery. Instead was placed back into his normal housing unit. The following day, he went to the medical unit for an evaluation with one of the prison’s doctors, Dr. Galbadon. He told the doctor of his concerns with the environment in which he was healing: his housing unit was not well ventilated and was extremely dirty. He was worried about contracting an infection and requested antibiotics. The doctor refused.

That night, he began to experience intense pain in his shoulder. He was given a pass to visit medical the next day, but before he could get there, a different doctor name Dr. Torres sent word via a nurse that Saunders was getting “the only medication that will be given” to him.

For the next several days, Saunders tried in vain to get a doctor to examine his shoulder. His wound was routinely dressed by nurses in a high-traffic “triage station” — a 10×12 foot room that served multiple purposes and was not sterilized for dressing.

Nine days after surgery, a doctor finally examined the incision and found it was not completely healed and draining fluid. “It needs another four days to heal,” he told Saunders. A couple days later, re-examining the wound, Torres said, “this thing is infected, he needs to be on antibiotics.” The doctor then removed the sutures, “which left a large hole at one end where fluid was draining.” He did not clean the wound but did prescribe antbiotics, smeared some ointment over the hole as well. Saunders was told he was not given antibiotics sooner because “the surgeon had not ordered it.”

Saunders had developed a staph infection, and it was getting worse. The infection had opened canal under the incision that left his bone exposed. Dr. Torres examined the wound again few days later and said, “What am I supposed to do, the surgeon needs to fix that, he caused it.” This time, without cleaning the wound, he smeared ointment on it and re-bandaged it with the same dirty, fluid-covered bandage Saunders had been wearing. The infection subsided after four weeks on antibiotics.

In November 2011, he visited the surgeon again, who decided the plate he had put into Saunders shoulder was infected and would need to be removed. That surgery took place a month later, and this time he was kept in the hospital to recover properly.

In February 2012, a Tomoka physician named Dr. Mesa believed Saunders’ digestive issues might be Irritable Bowel Syndrome and prescribed him Bentyl. Four months later, a separate doctor, Dr. Monserrate, came to the same conclusion and, in addition to Bentyl, put Saunders on a special low-residue diet.

Saunders was also seen by a neurologist on two separate occasions, and was diagnosed with carpal tunnel in both wrists. He gave Saunders a brace for his right wrist during his first visit, but gave him a medical pass for the brace for his left wrist, which he would have to collect from the prison.

It was at this point that Saunders started dealing with TCI’s Dr. Calderon. After waiting two weeks to give him his anti-inflammatory medication and then denying him his left brace, Dr. Calderon stated, “When you see a specialist, they offer recommendations, it is up to your treating physician to determine if the recommendation meets FDOC policies and procedures. Your chart was reviewed and brace was not ordered.”

This doctor would end up being a match made in heaven for Corizon Health Services, which would soon take control of the prison’s healthcare.

After Corizon: Criteria, quotas, and punishment

By the end of 2013, Corizon Health Services had signed a lucrative deal to provide medical services to Florida inmates. According to Saunders’ suit, Corizon’s first order of business was to downsize the medical workforce in its prisons. TCI went from having 3-4 physicians to only one — and that physician was Dr. Calderon. He became both the site physician and medical director, and had a small number of nurses working for him. He was now an employee of Corizon.

Before Corizon, healthcare at the prison had not exactly been sterling, but Saunders had been able to get at least some care from the various physicians that had worked for TCI, including important medical passes that permitted him to have a lower bunk, restricted his lifting of heavy objects and afforded him a “bed-wedge” — a pillow commonly used for patients who have undergone shoulder surgery.

When his passes expired under Corizon’s watch, these items were confiscated and he was denied further access to them. Saunders met with the jail’s medical administrator, who noted on several occasions his severe pain and recommended treatment and medical passes. Dr. Calderon rejected the requests. The administrator asked him to reconsider the dietary pass at least, but he rejected that, too.

A month later, Saunders and the administrator requested he at least get an increase of his stomach medication if he was going to not be on a special diet. That request was rejected by Dr. Calderon as well. All requests were rejected without subjecting Saunders to another medical screening.

Saunders disputed his treatment by Dr. Calderon by filing several medical grievances — all of which, unfortunately, had to be approved by Dr. Calderon himself. When he tried to schedule an appointment to discuss his lower back pain, a nurse told him it was Corizon’s policy that “inmates are required to come to sick call three times before being scheduled to see a physician.” This criteria is seemingly in direct conflict with contractual agreements between Corizon and the Florida DOC to provide treatment based on “sound medical judgement,” not some bizarre quota system.

In March 2014, without a medical pass for a lower bunk, Saunders injured himself trying to get into bed. His bunk did not have ladders. When he discussed this with Dr. Calderon, he was shown Corizon’s lower-bunk medical pass policy and told he did not meet the criteria. He was denied the pass.

Around this same time, Saunders attempted to get his Bentyl prescription renewed that had been provided by Dr. Monserrate before Corizon took over. Dr. Calderon said a test would have to be done, but never ordered it. When Saunders responded by filing a grievance, Dr. Calderon said that the inmate “did not meet the criteria for a low residue diet or Bentyl.”

Similar obstacles presented themselves as Saunders attempted to get Dr. Calderon to x-ray of his back and shoulder. Dr. Calderon insisted on using a “small portable low-sensitivity scanner” which can be less accurate than and was not revealing the obvious issues that Saunders was experiencing — some of which could be identified without an x-ray machine, through the popping and grinding sounds made by moving his shoulder. Dr. Calderon wouldn’t face him during the exam, standing with his back to Saunders for most of the time.

When Saunders persisted in his demands for adequate care and attention, Dr. Calderon told him “I don’t have time for this, you don’t like it then go write some more grievances or call your attorney, I don’t care.”

When Saunders pushed back and said he would not stop, Dr. Calderon “stormed out of the room, flipping off the light on his way out, leaving [Saunders] sitting there by himself.”

In the hallway, Saunders encountered Dr. Calderon again, who blocked his path, pointed a finger in his face and said “You should get a [disciplinary report]” — a statement which Saunders interpreted as a threat should he continue pursuing treatment.

For months, Saunders continued filing grievances and Dr. Calderon kept denying them. In October 2014, Saunders visited with the health services administrator again, who “acknowledged [his] valid points and responded she would consult with Dr. Calderon on the issues.” When he asked the administrator a few days later how that went, she said “I spoke to him and pointed out your valid points but he did not want to hear it. I cannot make him do anything.”

In January 2015, desperate for some kind of recourse, Saunders wrote a grievance directly to Corizon’s corporate headquarters. The following month, he received a response that no action would be taken and that he would not hear from Corizon again.

Saunders’ story as told through his lawsuit provides a valuable glimpse at how the healthcare environment can change when an inmate’s medical needs are contracted out to a for-profit entity. What was already a situation rife with neglect and disregard for the patient becomes exacerbated by the need to maximize profits by cutting staff and denying treatments based on criteria and policies that fly in the face of basic medical ethics.

Saunders is still in prison and has not received adequate treatment for his many ailments, according to the suit.