Death and Detention

More questions arise after a Wilmot prison inmate dies

When we chatted with Bart Graves earlier this month, the Arizona Department of Corrections spokesman estimated Tucson's state prison population at 3,900.

As of Nov. 19, that number is down by one.

On a sunny Saturday before Thanksgiving, Charles Hacker died. According to KGUN Channel 9, he'd visited the Wilmot prison nurse, complaining of difficulty breathing. But Channel 9 says he was sent back to his cell.

Pima County's medical examiner says the cause of death won't be determined for three or four weeks. But a source with contacts inside the prison tells the Tucson Weekly that Hacker apparently died of pneumonia. His family has reportedly hired a lawyer.

Greg Fizer, warden of the Arizona State Prison Complex-Tucson, didn't return a phone call seeking comment. And DOC spokesman Bob Huhn in Phoenix won't discuss the death, except to say that an investigation is ongoing, and the cause appears to be natural.

But natural in what sense?

Either way, Hacker's death occurs amid growing questions about medical care at the Tucson prison, which currently suffers a 34 percent shortage of full-time nurses. Concerns about the facility were raised by Pam Fields, a veteran registered nurse with experience in correctional institutions ranging from Oregon to New Mexico ("House of Pain," Currents, Nov. 24). Fields spent a mere two months at the Tucson prison, before resigning in October because of the abysmal healthcare.

"There were several instances where I felt that patient care was not delivered correctly," she says, "people not getting medications, no follow-ups without outside appointments in a timely manner, someone in quite a bit of pain after a surgery--where there was obviously something wrong--and not being allowed to get back to the surgeon."

Conditions were so bad, says Fields, that she often couldn't fulfill her professional obligations. "I left there because of the conditions, and because I didn't want my nursing license to be in jeopardy."

Similar situations were echoed in letters from prisoners, sent to the Criminal Justice Program of the Arizona Friends Service Committee, a Quaker organization. Inmates complained that chronic diseases went untreated, and injuries largely ignored.

The Weekly's source also confirms those conditions, as described by an inmate currently in the prison. Hacker was being treated with antibiotics for a staphylococcus aureu infection, says the source, when it got into his lungs and killed him. And "the staph infection is running rampant through the prison," the source says.

Prison officials deny that medical care is substandard at the Tucson prison. But unlike other medical facilities, correctional health care is exempted from licensing under state law. Instead, the Tucson prison is reviewed by the National Commission on Correctional Health Care. Based in Chicago, the agency accredits more than 450 jails and prisons across the country. The NCCHC reviews nine areas in correctional health care, from administration, health promotion and medical services to the proper maintenance and availability of medical records.

According to NCCHC President Edward Harrison, the reviews consider all aspects of prison medicine, from availability of prescriptions to sanitary conditions. Overall, he says, health care in America's prisons has "tremendously improved" since the 1970s, when a U.S. Supreme Court ruling reinforced the right of inmates to receive basic health care. "We're not talking about Cadillac health care, but necessary health care."

Harrison won't provide results from the Tucson prison's 2003 evaluation, instead referring a reporter to state officials. But at the state level, oversight seems to be lacking. While accreditation reports are to be reviewed by the Arizona Department of Health Services, the DHS still lacks a copy of that assessment--two years after it was issued. "We have not received an accreditation report from (the DOC)," says Assistant DHS Director Mary Wiley. "But we can call them and see if they will send it to us."

Either way, those taxpayer-funded reports won't be available to the public, due to what one DOC official calls "inmate confidentiality" issues.

Still, the need for improved corrections accountability seems a no-brainer. Case in point: During interviews with this newspaper, DOC officials claimed that Fields never raised her concerns with prison supervisors. But in a series of written reports obtained by the Weekly, Fields directly criticized administration of the prison's health care. And in at least two of those reports, she specifically criticized the prompt availability of medical records for inmates she was treating--a criteria evaluated by the NCCHC.

The Tucson Weekly contacted DOC spokesman Bart Graves, to find out what happened to those critical missing reports. Nearly two weeks later, we're still waiting for an answer.

Meanwhile, many blame the ongoing DOC crisis on funding shortfalls, which likely exacerbate the Tucson prison's nursing shortage. But if funds are one problem, basic conditions are another. Which raises this question: Are those conditions so shabby that Fields could have actually endangered her license? In particular, she felt her inability to administer necessary medications at the prison--because often, there weren't any--could be considered negligence.

We put this question to Joey Ridenour, executive director of the Arizona State Board of Nursing. "It's really a systems issue," says Ridenour, "and (a nurse) really needs to do everything she can do to let individuals who are accountable in that system know that meds are not available, so it becomes their responsibility.

"As long as (Fields) can demonstrate that she did everything that she could to make the ultimate person (aware) that the meds were not available, she is an advocate," Ridenour says. "But if this happens time after time, then it becomes a systems issue."

It was certainly a systems issue for Charles Hacker. At age 31, he was serving time for car theft. And he was slated for release next fall.

Instead, he received a death sentence.

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