Prison System, Contractor Accused Of Denying Inmate Surgeries

Lawyers for Florida inmates have filed a class-action lawsuit against the Department of Corrections and prison health-care provider Corizon, alleging that the state agency and the company are denying hernia operations to save money.

The complaint was filed Wednesday in federal court in Tallahassee on behalf of three inmates. Two of the inmates, Amado Parra and Archie Green, suffer from hernias but have been denied the opportunity to consult with a surgeon, the lawsuit says. A third inmate, Tracy Copeland, was seen by a surgeon who twice recommended a hernia operation, but state corrections officials denied the procedure both times.

The lawsuit, filed by Florida Justice Institute Executive Director Randall Berg, details numerous inmates' years-long struggles to get hernia operations. It says they were repeatedly denied consultation with surgeons or were not allowed to have surgery once doctors decided it was necessary.

"It's a pattern and practice of denial of medical care on the basis of saving money and maximizing profits," Berg said in a telephone interview. "This is surgery that the taxpayers of the state of Florida have already paid for. Corizon is under contract with the state of Florida to provide medical care to inmates that need medical care, and they're simply not providing it."

But Corizon issued a statement Wednesday saying it does not have policies limiting or preventing hernia surgeries or other medically necessary procedures. Corizon had not been served with the lawsuit, but company spokeswoman Martha Harbin said "what makes good business sense and good medical sense is excellent preventive care."

"We are first and foremost health-care providers. Our mission is to deliver safe, effective and efficient health-care services using best practices and evidence-based medicine,'' Harbin said in the statement.

The treatment of inmates with hernias is the latest in a litany of complaints about privatization of the prison system's health-care services.

Tennessee-based Corizon and Wexford Health Services took over prison health care about two years ago after a drawn-out battle over outsourcing ordered by the Legislature in 2011.

The state awarded Corizon a $1.1 billion, five-year contract to provide health care for about three-quarters of the state's 100,000 inmates. Wexford Health Services is responsible for the rest of the prisoners.

Less than four months before Gov. Rick Scott, who pushed for the privatization, was re-elected in 2014, former Corrections Secretary Michael Crews quietly agreed to pay Wexford and Corizon an additional $3.2 million to stay on the job for another year.

Two months after he inked the contract amendments, Crews threatened to stop payments to Corizon, saying the company failed to follow through after audits revealed shortcomings in multiple areas, including medical care, nursing and staffing.

So far this year, the corrections department has fined Corizon $67,500 in liquidated damages, according to agency spokesman McKinley Lewis.

The lawsuit filed Wednesday accuses the agency and Corizon of violating the Eighth Amendment prohibition against cruel and unusual punishments.

Inguinal hernias cause severe pain, which typically worsens with activity or exertion, and can cause serious complications, including death, if left untreated, Berg wrote in the 45-page complaint. The medical standard of care for hernia patients is surgery --- one of the most common surgeries in the country --- as soon as it is detected, he wrote.

But since Corizon took over in October 2013, physicians have refused to submit consult requests or such requests for surgery are is denied, the lawsuit alleges.

"Defendants have enforced this policy, practice and custom despite knowing that failing to provide these surgeries will lead to prisoners being left in excruciating pain, limited in their activities, and at risk for serious complications or death," Berg wrote.

Copeland, who has suffered from a hernia for more than two years and was twice denied surgery despite the recommendations of a surgeon, "feels like his insides are falling out of his body" and "has been reduced to lying in his bunk most of the day," Berg wrote.

Seeking class-action status, Berg said at least 62 prisoners have experienced the same problems and as many as 10,000 inmates --- or 10 percent of the prison population --- could be affected, based on the rate of hernias in the general population.

Corizon receives a fixed, per-inmate fee for health services and must also pay the corrections department $250 each time it transports an inmate over 50 miles roundtrip for medical services, with some exceptions, Berg wrote.

"Thus, Corizon has a financial incentive to avoid providing medical care and treatment, especially when that care involves sending prisoners to outside specialists," he wrote.

Berg also represented Daniel Plotnick, an inmate who sued the state and Corizon last year after being repeatedly denied a hernia consultation. At a hearing last September before U.S. District Judge Robert Hinkle, who is also presiding over the lawsuit filed Wednesday, Corizon officials agreed to allow Plotnick to see a surgeon. Shortly afterward, the inmate received two hernia surgeries. Plotnick settled his case against the state, Corizon and a doctor for $90,000 in damages and attorneys' fees.

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