Malingering is basically faking an illness in order to achieve some non-medical goal. Reading inmate files and medical records, it is apparent that inmates are routinely presumed to be malingering even when there are clear signs of serious illness. There are legitimate concerns about prison security related to malingering such as the security risks of transporting malingering inmates for outside medical care. However, in most cases the presumption of malingering is purely pretextual and has nothing at all to do with prison security. The presumption of malingering by prison officials typically in coordination with the prison medical provider often leads to horrific harm to inmates. A lot of folks/taxpayers might say “So what?”. To that I would respond, “you’re paying for it and it is very expensive”.
Numerous Cases of Osteomyelitis Illustrate the Presumption of Malingering
Collins & Collins, P.C. has numerous medical malpractice claims in litigation against New Mexico Corrections Department (NMCD) and its former medical provider for the gross, reckless, inhumane medical neglect of NMCD inmates who have suffered spinal osteomyelitis often accompanied by sepsis.
Osteomyelitis is slow developing infection. It is easily preventable with basic antibiotic treatment. Due to the extraordinarily high rate of MRSA in prison environments, a simple scratch, pimple or other skin abrasion can become infected. Many inmates are immune compromised due to drug use, hepatitis C, diabetes and other chronic illness. This makes them highly susceptible to the progression of minor infections to major infections if not treated properly.
Osteomyelitis is a slow process. Along the way, the inmate will show numerous signs of worsening infection such as fever, fatigue, irritability, nausea, redness, swelling, severe pain and lost range of motion. As osteomyelitis begins to develop and progress, the signs are not subtle though the disease continues to progress slowly. In the cases filed by Collins & Collins, P.C., the inmates go through all of these symptoms and signs with inmates repeatedly requesting medical attention which is routinely denied. Generously, one might attribute the refusal to provide critical, sometimes life saving care to the presumption of malingering. I say this is a generous assumption because it is just as likely that the care was and is denied out of simple cruelty. In the alternative, the motive may be strictly the maximization of profits to the medical provider.
Whatever motivates the denial of medical care, the result is the same, infections go untreated even once the inmates is in agonizing pain and unable to walk. This can go on for weeks or months with the inmate finally being transferred to outside medical facilities, often to the New Mexico taxpayer funded University of New Mexico Hospital. They will remain at in the hospitals for weeks or months before transfer to rehab facilities. Assuming the inmates survive, they will eventually be transferred back to NMCD. And even then, the inmates may not be provided with the minimal specialist ordered follow up care resulting in recurrence of osteomyelitis. Without belaboring the point, this is not just cruel and inhumane, it is extremely expensive to taxpayers.
NMCD Not Alone in Presumption of Malingering
A recent case in the Santa Fe County jail shows that NMCD and its medical providers are not alone in their cruelty, inhumane treatment and the reckless disregard of inmate health. In that case, a female inmate was suffering from meningitis. Her repeated pleas for medical help were not just ignored but met with laughter and mockery from the guards. The guards told her to just shoot up some heroin that she was just going through withdrawal, a textbook case of false assumptions of malingering and/or cruelty.
According to other inmates, she begged for help filing repeated requests for medical attention. The other inmates pleaded with guards on her behalf as the woman begged them also to get her help saying that the guards were just going to let her die which they in fact did do.
As a result of the refusal to provide medical care, the meningitis led to infection and sepsis in her spinal cord and brain stem. By the time she was sent to the local hospital, she was paralyzed from the neck down and unable to breathe on her own yet in its wisdom the Santa Fe County jail saw fit to shackle her feet.
Unfortunately, this is a scenario Collins & Collins, P.C. has seen before. Just like our cases at Collins & Collins, P.C. the ultimate result was the death of the inmate and like our own cases, an inevitable lawsuit against the jail. And yes, you guessed it, all of this will be paid by Santa Fe and New Mexico taxpayers including the hospitalization and the lawsuit to come.
Training Essential for Prison Guards
There is no excuse for the negligence of the medical providers in these cases. The fact is they are either grossly incompetent or simply sadistic and cruel. Perhaps it is a little of both.
On the other hand, the guards are not medically trained. They should not be making decisions of whether an inmate gets medical care. They should be trained to immediately respond to sick calls by referrals to medical. This will accomplish a couple of things. First, the inmate will presumably get appropriate medical care (the fact is they probably will not in a prison or jail setting due to medical incompetence and disinterest). Second, and perhaps most compelling for the State of New Mexico and/or the counties at issue and their respective taxpayers, this will avoid the enormous medical costs of fixing what could have been easily prevented. Finally, the taxpayers will avoid the costs of expensive litigation, attorneys fees and judgments or settlements stemming from the refusal to appropriately respond to serious inmate illnesses.