Medical Snafu, Ongoing Prison Problem

MEDICAL SNAFU
Ongoing Prison Problem
By: Boston Woodard

The good folks of Ringling Brothers and Barnum & Bailey Circus could not put on a zanier presentation of pseudo—organized confusion that defines the medical system within the California Department of Corrections & Rehabilitation (CDCR), What a joke, what a burn, what
a mockery and rip-off of billions in taxpayer's tender.

Another punch in the gut further impeding the reclamation of California's severely crippled prison “health care” system, was thrown by Judge Thelton Henderson. Henderson, a senior judge in the Ninth Circuit Court in San Francisco and member of the ‘three-judge-panel’ assembled in late 2007 was seated to fix the deep wounds of the CDCR; in particular, horrific medical care for prisoners and severe overcrowding (housing more than 170,000 prisoners in a system designed for half that number) . Henderson was thought to be the savior of a health care system responsible for the “unnecessary” and “preventable” deaths of as many as one prisoner per week for years; and who has the power (as a federal judge) to deflate the severe overcrowding throughout the prison system by ordering a cap on the prison population.

In the latest installment of stupidity connected with the woebegone medical services provided to prisoners, judge Henderson fired federal receiver Robert Sillen. Sillen was hired in 2006 by judge Henderson to “repair” the “crumbling” health care system at California's 33 state prisons. Sillen was let go January 23, 2008 by Henderson who said it was time for a more joint effort approach to the problem.

Sillen was a former Santa Clara County health care director, who is said to have become "brash" and "impetuous" according to state (prison) officials and legislators while rapidly pushing forward his vigorous plan to breath sanity and purpose back into the medical sideshow managed by the CDCR.

Pernicious ultra-right-winger Todd Spitzer, (R) Orange, Chairman of the Assembly Select Committee on Prison Construction and Operations on Sillen's dismissal snorted, "(Sillen) is a one-man show who had utter disdain for the legislature. He would constantly threaten us that if we didn't do it his way.... He would back his truck up to the Treasury and would take whatever amount of money he needed."

Spitzer's incongruous assertions on Sillen are intended to malign the first person to confront and take on the surfeit of incompetence and arrogance that define prison officials in decades. Toddy-boy is of an extreme minority group of whining right-wing demagogues (in Sacramento) hell-bent on depriving prisoners of quality medical care and will stop at nothing to block anyone who attempts to bring humanity back into the prison system or who attempts to eliminate draconian practices behind prison walls.

With the social skills of a pissed-off wharf rat and the compassion of an over-paid executioner, Spitzer can only blow smoke up the asses of those dumb enough to listen to his diatribe on Mr. Sillen.

In a scathing report by Mr. Sillen late last year, he wrote that "66 (confirmed) inmates succumbed to preventable or possibly preventable deaths in the California correctional system" in 2006. Sillen attributed the fatalities to a "systematic failure in the prison medical care system." Mr. Sillen also expressed “My goodness, these are human beings and they ought to be treated as human beings.”

There were changes for the better (albeit a little slower than hoped for) beginning to happen with the prison's medical system. Prisoners got to "triage" a little quicker; nurses seemed more attentive (rumor has it many were admonisned and/or retrained) and prisoners were finally seeing “specialists” after many years of waiting in many cases. Some prisoners were, finally, after waiting years (in many cases) receiving long over-due surgeries. Most prisoners ascribed the changes to Mr. Sillen's unwillingness to be intimidated by prison and medical officials when it was time for them to answer the real questions.

“Why were potentially serious signs and symptoms missed or misdiagnosed?" Why did you fail to “tailor the pace of evaluation to the clinical situation?" And “Why didn't you follow well established guidelines for care?” These were some of the questions posed by Sillen in his attempt to fix the problems.

About the same time Judge Henderson was having his lapse of good judgement (eliminating Sillen), an interesting development was brewing behind the walls of Solano State Prison.

Solano State Prison in Vacaville had aryuably one of the ugliest medical situations in the California prison system. (See "They Don't Tripple—Bunk Dogs!" at: http://www.indybay.org/newsitems/2006/08/13/18297041.php

On or about January 9, 2008, Solano's Chief Medical Officer, A.C. Traquina, received information that a prisoner, who after weeks of complaining of respiratory problems, was suspected of having Tuberculosis (TB). Subsequently, the suspect case was removed from the prison and transferred to an outside hospital for further medical evaluation. If the prison's medical department had paid attention to screening protocol, this prisoner would not have made into the general population to potentially infect thousands of other prisoners and prison staff.

Building #14 (one of 24 throughout the prison) was placed on a "Medical Modification Program" (quarantine) pending completion of TB testing. Before that protocol was completed (after only 5 days). Building #14 prisoners (about 340) were allowed back into the general population to work, play sports and mingle with other prisoners for two full days.

When the mistake of releasing possibly infected prisoners was realized (2-days later), Building #14 prisoners were once again placed on quarantine status. Two more buildings (approx. 350 prisoners per building) were also placed on quarantine. Medical staff had to now administer hundreds of new TB tests (including X-rays) to prisoners in those buildings.

After medical staff’s irresponsible attempts to read the TB tests (check for abnormalities on forearm where needle was given) 2 days later, all prisoners were once again back into their dormitories to have a re-read of the botched TB protocol. You had to have been there to witness the Keystone Cop-ish-like way this all went down. Unbelievable!

During the second attempt to read the TB tests, Solano's Warden D.K. Sisto and Chief Medical Officer Alvaro C. Traquina made a perfunctory appearance in at least one of the quarantined buildings. This time, the lines and procedures overseen by medical and custody staff were more orderly and an attempt to seem attentive by medical staff was apparent.

Warden Sisto sat (talking with an unidentified staff member) at one of the prisoner's dayroom tables in Building #13 for a few minutes then left. Warden Sisto did not speak with the prisoners during his brusque visit.

Chief Medical Officer Traquina was asked if he would answer a few questions prisoners had pertaining to the TB scare. The prisoners wanted to know how much danger they were in and what preventative measures they could take to avoid becoming infected.

Unexpectedly, Chief Medical Officer Traquina snapped, “No! You can not ask any questions! I don't answer questions!”

As of this writing, Solano State Prison has not issued one word of information pertaining to the prevention of Tuberculosis to it's general population. No handouts, no flyers. no bulletins, no speeches, nada, zilch, nothing.

Explosive attitudes such as Chief Medical Officer Alvaro C. Traquina's, demonstrate the very behavior that most likely contributed to a federal receiver taking over the entire medical department within the CDCR. When top officials, in this case medical, display abhorrent outbursts and will not answer pertinent questions regarding the health and welfare of his charges, the entire system has failed.

Approximately a week before the building that was initially quarantined for Tuberculosis, more than 100 prisoners were transferred to a private prison in Mississippi; some from the same building with the infected prisoner. Hopefully, the CDCR notified that prisoner and those potential carriers were tested.

Mr. Silien was replaced with “long time California government troubleshooter,” McGeorge School of Law professor J. Clark Kelso. Judge Henderson is now calling Sillen's 20 month reign the "primarily investigative and evaluative phase" and Kelso's enlistment the “implementation phase” with “more cooperation and less confrontation.” The math on this one is easy; the CDCR (masters at pressuring yes, even federal judges) now have a man (representation) on the inside to curtail and head off at the pass, hundreds of medical lawsuits filed on behalf of mishandled and neglected prisoner patients.

Among Sillen's accomplishments were; reducing the gaping vacancy rates in the ranks of the California prison doctors and nurses and raising their pay, ordering a new acute care center at San Quentin State Prison and kicking off other medical construction projects throughout the state, improving specialty care, making sure medical contractors get paid on time and a litany of other solutions and recommendations for overall improvement in the prison's medical system.

So now, Robert Sillen, an experienced administrative medical expert is gone and is replaced by a lawyer who has been a government ringer for decades, to handle phase II" of a medical disaster he knows nothing about? MMmmmmm. Go figure.

In the meantime, while Judge Thelton Henderson, Governor Arnold Scwarzenegger and Assemblyman Todd Spitzer are recklessly dealing with the lives of sick and dying prisoners, the rest of us may as well save our band-aids as there will be nothing for prisoners in the last phase of this three ring circus.

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Boston Woodard is a prisoner/journalist who has written for the San Quentin News and the Soledad Star, and edited The Communicator. The Department of Corrections has pulled the plug on all three publications.