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Did Private Prison Medics Let A Woman Die To Save Cash? Judge Rules Pa. Lawsuit Will Go Forward

Matt Stroud

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Earlier this year, Holly Otterbein at Newsworks reported about a disturbing lawsuit related to a woman’s death at the Montgomery County Correctional Facility (MCCF) in Eagleville, Pa., about 45 minutes northwest of Philadelphia. The facility is a jail, not a state prison; the woman in custody, Patricia Pollock, had been picked up on an arrest warrant and had not gone to trial on charges. The lawsuit’s plaintiffs alleged that a private prison medical contractor at the jail “‘faced powerful financial disincentive’ to conduct diagnostic testing on inmates or send them to an outside medical provider.” This disinsentive, the lawsuit claims, caused the medical contractor to put off testing Pollock until it was too late. Lawyers representing the jail and the medical contractor asked a judge to throw the case out of court. A judge recently denied that request. The case will go forward. The circumstances of the allegations are outlined here in PDF form, and below:

On the morning of September 22, 2011 … Patricia Ann Pollock, ate breakfast with her mother, the late Anna Pollock. Ms. Pollock told her mother that she was feeling ill and complained of severe nausea; her mother urged Ms. Pollock to seek medical attention. In the afternoon of September 22, 2011, before Ms. Pollock could seek medical attention at a hospital, she was taken into custody by the Upper Moreland Township Police Department on an arrest warrant. Because Ms. Pollock’s family could not pay the bail that had been set, she was transferred to MCCF in the early morning hours of September 232011.

At some point on September 23, 2011, Ms. Pollock was seen by defendant Nurse Doe 1 who reported that Ms. Pollock complained of pain and the inability to move her left arm and noted that Ms. Pollock had reported taking clonazepam, an anti-anxiety-medication, for approximately two years; defendant Nurse Doe 1 recommended that Ms. Pollock be placed on a treatment protocol for withdrawal from benzodiazepines.

Later that same day, Ms. Pollock was seen by defendant Nurse Doe 2; at that time, Ms. Pollock was reported to be yelling in her cell that she could not breathe, that she was experiencing severe chest pain, and that her chest felt like something [was] pressing all the way down to [her] back.”

An echocardiogram was conducted and produced an abnormal result showing an elevated heart rate. The result of the echocardiogram was shared with defendant Carrillo. Defendant Carrillo took no further action upon receipt of the abnormal echocardiogram result other than to order that Ms. Pollock be placed in a cell for medical observation and that she receive a benzodiazepine withdrawal protocol.

From personal observation of Ms. Pollock, defendants Nurse Doe 1 and Nurse Doe 2 knew or should have known from track markings appearing on Ms. Pollock’s arms that Ms. Pollock was a past user of intravenous drugs.

As of the afternoon of September 23, 2011, defendants Carrillo, Doe 1 and Doe 2 were aware that Ms. Pollock was an intravenous drug user who presented with essential symptoms of bacterial endocarditis: pain in her chest, rapid heart rate, and difficulty breathing.

Despite these symptoms, no CMC medical staff conducted any physical examination of Ms. Pollock, nor did any CMC medical staff conduct diagnostic testing, such as a chest X-ray or laboratory testing, to determine the nature of Ms. Pollock’s condition.

Despite the knowledge that Ms. Pollock presented with these serious symptoms as of the afternoon of September 23, 2011, and despite the fact that Ms. Pollock had been placed in a cell for purposes of medical observation, no CMC medical staff conducted any examination or evaluation of Ms. Pollock’s condition for approximately thirty-six hours

Shortly before midnight on September 24, 2011, defendant Nurse Doe 3 assessed Ms. Pollock’s vital signs and noted several factors showing that Ms. Pollock’s condition had deteriorated, including the fact that her pulse was very rapid, she had rapid breathing, and she appeared to be weak, restless, sweating and anxious.

When defendant Carillo was made aware of Ms. Pollock’s condition, she did not conduct any physical examination of Ms. Pollock, order any diagnostic testing, nor order that any other CMC medical staff conduct a physical examination or diagnostic testing.

Ms. Pollock’s condition and her worsening symptoms were not consistent with benzodiazepine withdrawal.

Despite the fact that Ms. Pollock’s condition was not indicative of benzodiazepine withdrawal, at midnight on September 25, 2011, defendant Carrillo ordered that Ms. Pollock receive an increased dosage of medications ordered as part of the benzodiazepine withdrawal protocol started nearly two days earlier.

After the increased dosage was ordered, Ms. Pollock was not evaluated or seen by CMC medical staff for at least thirty-six hours. Accordingly, during that time period, no CMC medical staff saw Ms. Pollock to assess her vital signs or to monitor in any way the serious medical conditions that she had presented with on September 23, 2011: chest pain, rapid heart rate, and difficulty breathing.

On the morning of September 26, 2011, defendant Nurse Doe 4 saw Ms. Pollock who complained that she had been vomiting blood, that she was suffering from rib pain and weakness, and that she could not breathe.

Later that morning, defendant Carrillo saw Ms. Pollock for the first time since she had entered the facility three-and-a-half days earlier.

Defendant Carrillo noted that Ms. Pollock complained of feeling weak and experiencing dry heaves.

Defendant Carrillo also noted that Ms. Pollock had extensive scarring on her arms that appeared to be from needle tracks, although Ms. Pollock told her that she had not used heroin in eight months.

As of the morning of September 26, 2011, defendant Carrillo knew that Ms. Pollock had a history of intravenous drug use and that she had for more than three days been exhibiting symptoms of bacterial endocarditis, including pain in her chest, rapid heart rate, and difficulty breathing.

Despite the prolonged presence of these symptoms, defendant Carrillo did not order any diagnostic testing, such as a chest X-ray, or laboratory testing, such as a complete blood count or a urinalysis, which would have allowed for the diagnosis of Ms. Pollock’s condition.

Further, as of the morning of September 26, 2011, defendant Carrillo knew that Ms. Pollock’s condition had not improved due to use of the benzodiazepine withdrawal protocol and, therefore, knew that Ms. Pollock’s symptoms were not the result of benzodiazepine withdrawal.

Notwithstanding that knowledge, defendant Carrillo noted that Ms. Pollock was experiencing benzodiazepine withdrawal with dehydration and ordered only that she receive intravenous fluids.

Four hours later, Ms. Pollock was given intravenous fluids.

However, less than 90 minutes after the administration of intravenous fluids, defendant Nurse Irvine noted that the intravenous access had been removed and that, accordingly, Ms. Pollock was no longer receiving fluids.

Defendant Nurse Irvine took no further actions to ensure that Ms. Pollock received fluids, nor did she evaluate Ms. Pollock’s vital signs.

At 9:50 p.m. on September 26, 2011, defendant Nurse Rhinehart noted that Ms. Pollock was naked and wrapped in a sheet for most of the evening shift on the medical unit.

Defendant Nurse Rhinehart noted, further, that Ms. Pollock was requesting to drink fluids but could not drink on her own without the assistance of her cellmate.

Defendant Nurse Rhinehart took no actions to monitor Ms. Pollock’s intake of fluids, nor did she evaluate Ms. Pollock’s vital signs.

At 7:30 a.m. on September 27, 2011, correctional officers in the medical unit where Ms. Pollock was housed observed that Ms. Pollock was in great distress and requested that CMC medical staff evaluate her.

At that point, Ms. Pollock had been in the MCCF medical unit for four-and-a-half days exhibiting the symptoms of bacterial endocarditis.

At no time, had any CMC medical staff ordered or conducted necessary diagnostic testing.

Instead, Ms. Pollock had received only medications as part of a benzodiazepine withdrawal protocol and less than 90 minutes of intravenous fluids.

Defendant Carrillo examined Ms. Pollock at 7:40 a.m. on September 27, 2011 and noted that she complained of leg pain, was sweating heavily, and was clammy and pale with cool extremities.

Ms. Pollock’s pulse was elevated to more than twice that of a normal rate, her respiratory rate was elevated, and her blood pressure was extremely low.

Defendant Carrillo ordered that Ms. Pollock be transferred to the emergency department of the Mercy Suburban Hospital.

When Ms. Pollock arrived at Mercy Suburban Hospital, she was noted to be confused and disoriented, but she stated to medical staff that she was in great pain and that nothing had been done to alleviate that pain while she was at MCCF.

Physicians at Mercy Suburban Hospital ordered immediate diagnostic testing and determined that she had a large abscess of her tricuspid valve consistent with bacterial endocarditis.

Physicians at Mercy Suburban Hospital determined, further, based on laboratory testing that, as a result of the infection in her heart, she was experiencing massive organ failure.

Physicians determined that surgery was required to address the infection in her heart.

Air transport to the Hospital of the University of Pennsylvania was arranged, and Ms. Pollock was taken from Mercy Suburban Hospital at 6:15 p.m. on September 272011.

While en route to the Hospital of the University of Pennsylvania, Ms. Pollock’s heart stopped. Efforts to resuscitate her while en route and upon arrival at the hospital proved unsuccessful.

Ms. Pollock was pronounced dead at 6:49 p.m. on September 272011.

An autopsy report concluded that the cause of Ms. Pollock’s death was acute fulminant verrucous endocarditis.

No need to belabor my belief that prisons and prison contractors should be responsibilities of state and federal governments rather than corporations. Instead, I’ll let the lawsuit speak to the conflict inherent in this particular case:

On July 13, 2006, defendant CMC entered into a contract with defendant Montgomery County that granted CMC the exclusive right to provide medical services to inmates at MCCF from 2007 through 2010. On January 14, 2010, defendants CMC and Montgomery County agreed to extend the term of contract through January 72012.

For the years 2009 through 2011, the contract and the contract extension provided that Montgomery County would pay to CMC more than $4 million in each calendar year in return for medical services provided to inmates.

As part of the contract, CMC agreed to cover all costs, up to a limit for catastrophic cases, for inmates who required outside medical services, including hospitalization for serious illnesses.

As part of the contract, CMC agreed to cover all costs for diagnostic testing.

Under the contract, defendant Carrillo, as Medical Director for CMC, held exclusive authority to determine whether MCCF inmates should receive diagnostic testing or be sent for outside medical services, including hospitalization for serious illnesses.

Under the contract, any expenditure of funds for diagnostic testing or for an inmate requiring outside medical services would reduce CMC’s annual profits.

Throughout the period of the contract between defendants Montgomery County and CMC, upon information and belief, the defendants in this matter have been the subject of lawsuits in this Court alleging that the defendants and their employees had, with deliberate indifference, failed to provide medical care for serious medical needs.

Upon information and belief, defendants CMC and Montgomery County took no actions to in any way remedy or address the inappropriate care alleged to have occurred in previous lawsuits and in other instances of inappropriate care that have not been the subject of litigation.

Here’s a judge’s order forcing the lawsuit to go forward. And here’s even more info.

Hattip, Courthouse News.

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Follow me on Twitter @ssttrroouudd where I frequently post stories like this one that will educate you daily about the state of criminal justice in the United States.

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Matt Stroud is a former Innocence Network investigator who now covers the U.S. legal system, in all its glory and ugliness, as a freelance journalist. Follow him on Twitter @ssttrroouudd. Email him at stroudjournalism<at>
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