by David Reutter

In 2005, at the urging of then-Governor Mitch Daniels, the Indiana Department of Correction (IDOC) awarded a contract to privatize medical care for prisoners. The winning bidder, Prison Health Services, merged in 2011 with Correctional Medical Services to form Corizon Health, which later won renewal of a three-year, $300 million contract to provide medical, dental, vision, mental health and substance abuse treatment services to IDOC’s 28,000 prisoners.

In February 2017, however, state prison officials declined to renew Corizon’s contract, instead awarding it to Wexford Health Sources. Consequently, Corizon announced the following month that it planned to lay off almost 700 employees in 22 IDOC facilities. [See: PLN, Sept. 2017, p.32].

PLN has reported extensively on Corizon and the company’s business model, which appears to consist of delaying or denying medical care and reducing staffing costs to increase profits; in turn, that has resulted in numerous prisoner deaths and injuries. [See, e.g.: PLN, Oct. 2015, p.20; March 2014, p.1].

Yet the IDOC’s watchdog over Corizon’s contractual performance was a former Corizon employee.

Dr. Michael Mitcheff was working as an emergency room physician at two Indiana hospitals when, in 1994, he was investigated for buying illegal drugs. He ultimately admitted that over a three-year period he had bottles of a cough syrup containing hydrocodone illegally delivered to his home. Mitcheff agreed to participate in a treatment program and was ordered not to practice medicine during treatment.

In 1998, Mitcheff’s license was suspended for 90 days after he wrote prescriptions in other people’s names and picked the drugs up from pharmacies. Documents from the state medical board indicated Mitcheff had admitted to a state police officer that he picked up 57 pints of a drug that contained hydrocodone.

When his license was reinstated in October 1999, records show Mitcheff was sober for a year – he passed 100 drug tests. The medical board agreed to let him work again, but “only in the Indiana state prison system” – which allowed Mitcheff to serve as Corizon’s regional medical director in Indiana. He said his personal experiences gave him a unique perspective.

“There’s nobody more empathetic to the patient population we serve,” Mitcheff stated. “Addiction is a disease, and who better to understand that?”

In 2014 he became the IDOC’s chief medical officer, overseeing Corizon’s contract. Responding to complaints, Mitcheff said he did not see medical staff “withholding care.” In fact, he added, “we watch that carefully.” Defending the health care provided to IDOC prisoners, Mitcheff proclaimed, “I am confident that our clinical metrics for chronic conditions are better than [in] the free world.”

Yet the number of prisoner medical complaints to the IDOC’s ombudsman jumped from 153 in 2010 to 509 in 2015. Prisoner deaths, including suicides, increased to 86 in 2015.

Then there were the lawsuits. Indiana prisoners or their families have filed over 300 medical-related suits against Corizon and/or IDOC officials in federal court – 76 in 2016 alone. Corizon has settled nearly three dozen of the cases for more than $1.2 million, in amounts ranging from $300 for a prisoner whose appeal related to his cataracts was denied to over $300,000 in a wrongful death case. The settlements are not admissions of guilt, the state Attorney General’s office emphasized, but “avoid the uncertainties of further litigation where taxpayer dollars would be at stake.”

Indianapolis civil rights attorney Michael Sutherlin called Corizon’s philosophy of providing health care “a profit model” rather than “a medical model.” He said the failure to provide basic care in even obviously dire situations demonstrated serious problems with the company’s provision of medical services.

Dr. Mitcheff disagreed, saying, “The question is, ‘How do you make money in this industry and provide great service?’ There is a way, and we did it in Indiana. That isn’t by withholding care, because typically withholding care down the road is going to cost you more money.... The way to be cost-effective and make money in this industry is by providing great-quality preventive care.”

IDOC prisoner Jerry A. Gore, 33, claimed in a lawsuit that after he played basketball on a 105-degree day in July 2012, a guard insisted he take a shower. The guard locked him in a small, unventilated stall, and Gore passed out shortly after he showered in hot water. When he came to, he called for a guard. He collapsed after the door was opened and was carried to a large fan; guards placed a cold rag on his head and called for medical help.

In his complaint, Gore said the responding Corizon nurse took his vital signs, pronounced him fine and walked away. “I couldn’t move,” Gore claimed. “The officers just looked at her.”

Shortly thereafter, Gore said he began vomiting, could not see or hear and turned pale. Guards put him in a wheelchair and took him to the infirmary, which is when the nurse noted he had low oxygen levels. Three nurses were unsuccessful in starting an IV. Finally, a Corizon doctor approved Gore’s transfer to a hospital, where he was diagnosed with heatstroke.

In another case, the family of prisoner Rachel Wood is seeking to uncover the facts of what happened while she was in Corizon’s care. After her death, they learned other prisoners had been helping her to the bathroom, to eat and to fill out forms seeking medical treatment.

Prior to her incarceration, Wood was successfully treated for lupus, a condition that causes blood clotting and other ailments. Corizon, however, did not consult with or arrange for her to see a similar specialist during the two years she was in prison. A lawsuit filed by her family uncovered a series of errors by Corizon that resulted in missed diagnoses, medications that were stopped and started, and tests that were ordered but never performed.

Claude Wood made relentless phone calls to determine his daughter’s location and condition. IDOC officials, however, prevented medical staff from communicating with the family and prohibited them from seeing Rachel – even though her condition was dire.

An email dated April 11, 2012 from Rockville Correctional Facility superintendent Julie Stout discussed a phone call from guards watching Rachel that morning, “indicating that the offender has a short time to live. She is receiving blood but it isn’t staying with her. Her kidneys are failing and her feet are changing color. She is also starting to swell. She has not been officially placed in imminent death status.... Information from [a Corizon employee] this morning doesn’t match the information we received. The information the [ ] officers received came from nursing staff.”

Two days later, Janet Robertson, a Corizon nurse who coordinated care with outside hospitals, wrote an email to the IDOC and her Corizon supervisor, stating, “This is to inform everybody that at the last minute, 2 of the MD’s [at the hospital] would not approve the discharge of Rachel Wood to Rockville. They would only approve a discharge to Kindred [Hospital].”

That hospital did not have an ER, nor was it equipped to provide the type of chronic care Rachel required. During the transfer, Rachel coded in the ambulance and died as she reached Kindred, still shackled and handcuffed.

“The dispute there is who made the decision [to discharge Rachel from Terre Haute Regional Hospital] and what was the decision based on,” noted Michael Sutherlin, the family’s attorney. “It appears Corizon wasn’t going to pay anymore.” Terre Haute’s contract with Corizon did not include long term care, he added.

“I just wish someone would have had a heart,” said Sue Williams, Rachel’s mother. “We tried so hard to get to her.”

Before he went to prison, Nicholas Glisson told his mother, “Mom, I won’t see you again.” Glisson, 50, survived laryngeal cancer in 2003. The surgeries, however, left him without a larynx, part of his pharynx and part of his left jaw bone. A tracheotomy tube was inserted in his throat and he required a voice prosthesis to speak. He also wore a brace to support his neck, which was weak from surgery and radiation.

At home he was able to keep the tube and hole in his throat clean, but knew he would be unable to do so while serving a 10-year sentence for selling one of his OxyContin pills to a police informant.

Once in prison, Glisson’s behavior became erratic. A nurse concluded he had psychiatric issues, but she failed to look for physical causes or seek a psychiatrist’s input. An expert witness in a lawsuit filed by his family testified that Glisson was suffering OxyContin withdrawal.

His mental health medication was also changed from its previous prescription, causing further problems. There was evidence that lab reports were ordered but no indication the results had been reviewed. A doctor found one report in his inbox which noted Glisson’s kidneys were failing. He was sent to a hospital for a week, then died four days after his return to prison; that was just 37 days after he began serving his sentence. A coroner noted Glisson’s “extreme emaciation,” while a forensic pathologist found acute respiratory insufficiency/pneumonia, renal failure and dehydration.

The wrongful death suit filed by Glisson’s family remains pending, after the district court’s grant of summary judgment to the defendants was reversed by the Seventh Circuit in March 2017. See: Glisson v. IDOC, U.S.D.C. (S.D. Ind.), Case No. 1:12-cv-01418-SEB-MJD.

“Money is not the issue whatsoever,” stated Nicholas’ mother, Alma Glisson. “The issue is justice.”

Another prisoner said one of Corizon’s shortcomings was its refusal to listen. Luis Silveria warned prison officials that he would kill someone in 2006. In May 2009, he hoarded enough pills to nearly kill himself; he also said he would kill any other prisoner placed in his cell.

During a “medication management” visit with a Corizon psychiatrist in June 2009, Silveria was quoted as saying he would kill other people. “I warned them ahead of time, so it’s not my fault,” he said. Yet the psychiatrist declined to prescribe medication to Silveria, writing, “The patient does not express homicidal ideation.”

In July 2009, IDOC team members noted Silveria was “adjusting well with a cellmate.” A month later, prisoner Patrick Whetstone, 25, was found dead in Silveria’s cell. Just two months before his release, Silveria had tied Whetstone’s hands behind his back, put a plastic bag over his head and strangled him.

In an affidavit, Silveria said he had warned the psychiatrist a week before Whetstone’s murder, stating: “‘Listen, I need to be back on my medication.’ Well, we went back and forth like this for a month. No medication. Well, I unfortunately killed Mr. Whetstone. Two days later, they show up at my door. Guess what? ‘We think you need to be back on your medication.’”

Whetstone’s family received settlements totaling $1.1 million for his death in 2014, including $330,000 from Corizon. See: Eutsey v. Corizon, U.S.D.C. (N.D. Ind.), Case No. 3:11-cv-00327-JTM-CAN.

The family had hoped to achieve policy changes with their lawsuit, and Silveria agreed reforms are needed. He added the only positive thing that could happen with Corizon is not a monetary settlement or punishing him for killing Whetstone. Rather, “It’s they gotta listen. That’s it.”

The Indiana legislature passed a measure that helped boost Corizon’s profits with a 2012 law that placed limits on what hospitals can charge for providing medical care to prisoners.

“This arrangement isn’t working,” said attorney Kent Hull, who represented Jerry Gore in a lawsuit against Corizon and several of the company’s employees. “Indiana has a legal responsibility to provide adequate medical care, but it cannot simply walk away and say, ‘we’ve delegated that to Corizon.’”

However, a federal district court entered summary judgment in favor of the defendants in February 2017, dismissing Gore’s claims related to Corizon’s deficient medical care. See: Gore v. Corizon, U.S.D.C. (S.D. Ind.), Case No. 1:13-cv-00241-JMS-DML. 

Sources: South Bend Tribune, Washington Times, Inside Indiana Business