Vegetative State Blamed on Poor Corizon Care

     (CN) - The nation's largest provider of correctional medical care ignored a North Carolina inmate's agonized pleas for help as he suffered excruciating pain and vomited blood for 10 days, causing a heart attack that left him in a permanent vegetative state, his family says in a federal lawsuit.
     Glenda and Calvin Simmons, the parents of Bryan O'Neil Simmons charge in a lawsuit filed in the Federal Court in Greensboro, N.C., that Corizon Health Inc., a firm based in Brentwood, Tenn., and no stranger to lawsuits accusing it of providing inadequate care to prisoners, violated both national and state standards of care established for inmates.
     And they assert these lapses were aided and abetted by co-defendants, Guilford County, N.C., its Sheriff, B.J. Barnes, and the Guilford County Sheriff's Department.
     Bryan Simmons, 36, a newlywed with no history of health problems, was serving 90 days at the Guilford County Jail for a parole violation when he became ill shortly before Thanksgiving Day 2012.
     In a phone call to home that day, Simmons told his parent that he was unable to go to the bathroom for several days and that he had been throwing up blood. Two days later, Simmons was found on the floor of his cell, apparently unconscious, the Simmons say.
     Despite the presence of blood on his clothing and floor, Simmons "was not examined by a physician and his request to be seen at a hospital was denied by the Corizon staff," his parents say.
     Nurses on duty at the jail did draw Simmons' blood, but the lab work was not reviewed until after he suffered his heart attack.
     Simmons' parents say that on Dec. 1, 2012, they received a call from a cellmate that told them their son had collapsed on the floor, was unable to move and had urinated on himself.
     The Simmons say they immediately drove to the jail but their request to see their son was denied. Despite assurances that their son was fine, the Simmons say they pleaded for him to be taken to the hospital, explaining that he must be seriously ill because he was going to be released in two days.
     In the meantime, unbeknownst to his parents, Simmons was moved from a general cell to a medical cell where he was placed on video surveillance because it was believed he was "Suicidal."
     According to the lawsuit, this action was taken "[a]round 4:55 P.M. on December 1, the jailers and nurse reported that Bryan had a bloody rag in his mouth and wanted to kill himself due to the pain he was experiencing."
     The videotape from the jail purportedly shows Simmons unable to walk, begging for help and writing "HELP" in the air with his finger. The complaint says nurses told Simmons he couldn't go to the hospital until he saw a doctor. However, no physician was scheduled to visit until after Simmons was released from the jail.
     Fred DeVore, attorney for Simmons' family, said Corizon was contracted to provide emergency care 24 hours a day, 7 days a week.
     "It's just a practical matter that if there is an emergency, you go to the hospital," DeVore said. "Just because a doctor isn't on call doesn't mean you don't fulfill your obligations."
     Corizon's attorney did not return calls to comment on the case.
     Despite his worsening condition, Simmons jailers allegedly continued to prepare for his release. At 1 p.m. on Dec. 2, 2012, the complaint says, Simmons was removed from his cell and escorted to an elevator. According to Simmons' parents, a video camera in the elevator showed their son collapsing in the elevator and being pull to his feet by his handcuffs by a guard accompanying him.
     On the way to a cell on the medical ward, Bryan collapsed again from the elevator, and again was pulled to his feet by the jailer ... approximately eight minutes later, Simmons went into cardiac arrest caused by excessive internal bleeding from a perforated ulcer," his parents say.
     At that point, an emergency 911 call was made, but, Simmons' parents say, "According to EMS notes, the responding medics asked for any complaints from Simmons before he collapsed. Recorded in their notes they were told, 'According to staff, patient was reported to have vomited once last night however has not had any complaint today.' There is no mention of the previous days or the preceding night wherein Simmons had complained of pain, distention, his concern about internal bleeding or his constant vomiting of blood for at lest four days ..."
     The Simmons say that after their son's heart attack jail and Corizon staff were slow to provide emergency care and failed to give him oxygen for 34 minutes.
     "Due to the lack of oxygen after his collapse, Simmons is profoundly disabled and is in a permanent vegetative state," his parents say.
     William Hill, who is representing the Guilford County Sheriff's Department, said the detention officers could do nothing to help Simmons because they had to follow the directives of the Corizon staff.
     "We relied completely on their judgment," Hill said. "They were contracted to provide medical care. This allowed the detention staff to do their job of running the jail."
     Under Corizon's $6.9 million contract with Guilford County, which ended on June 30, if a prisoner was transferred to a hospital from the jail for medical treatment, Corizon had to pay the expense.
     DeVore said believes this requirement was a critical role in the staff's decision-making: If their son had been sent to the hospital from the jail, Corizon was contractually responsible for paying for it.
     A Florida jury came to that same conclusion in March 2011 when it found that Corizon, then doing business as Prison Health Services, was deliberately indifferent to a Lee County inmate's medical needs and awarded him $1.2 million in damages.
     In his complaint, Brett Fields, said he had an infection on his arm that refused to heal, despite treatment with antibiotics. He complained to jail personnel over several weeks, insisting that the medications weren't helping the open wound. He was sent to a medical block that dealt with MRSA infections, but, the "lax" treatment didn't work.
     Despite Fields' worsening symptoms, including his legs twitching uncontrollably, back pain, and partial paralysis in his lower body, PHS did not send him to the hospital. An MRI later showed that an abscess was pressing on his spine and had damaged his spinal cord. Fields is now partially paralyzed.
     In 2012, the 11th Circuit affirmed the jury's verdict and held that it was reasonable for the jury to conclude that the company had delayed medical care to save money.
     More recently the 9th Circuit ruled that a class of inmates may advance claims Arizona's prison health care system is dangerously understaffed and negligently managed.
     According to a report from Al Jazeera America, a former Corizon employee turned whistleblower claims that staff shortages resulted in mentally ill prisoners going unfed or sitting for hours at a time in their own excrement; and that in some cases prisoners died from lack of proper treatment.
     Corizon responded to these allegations with a lengthy statement from Susan Morgenstern, a company spokesperson, that said in part, "As for lawsuits, we treat hundreds of thousands of patients in millions of healthcare encounters each year. Unfortunately, some of those patients are prone to filing lawsuits, which are simply allegations and not proven. The majority of lawsuits are brought by inmates without an attorney representing them and are dismissed or resolved prior to trial."
     The company has also run into trouble for not protecting employees from workplace violence and assault. The company was fined $71,000 last month by the Occupational Safety and Health Administration for its plain indifference to worker safety and health at Rikers Island prison in New York.
     "Corizon failed to address the serious problem of assaults against its employees until OSHA began its inspection," said Robert Kulick, OSHA's regional administrator in New York. "Corizon needs to develop and implement an effective, targeted workplace violence prevention program that includes administrative and engineering control, as well as personal protective equipment and training, to reduce the risk of violence against its employees."