Unhealthy Diagnosis

Another employee leaves prison alleging poor care for inmates.

The medical director of a state prison in Hobbs has stepped down from his post less than a month after a legislative committee requested an audit of the corrections health care in the state.

Dr. Don Apodaca, medical director of Lea County Correctional Facility (LCCF), turned in his resignation on Nov. 6 due to concerns that inmates there are not receiving sufficient access to health care. According to Apodaca, sick inmates are routinely denied off-site visits to medical specialists and sometimes have to wait months to receive critical prescription drugs. Apodaca blames the policies of Wexford Health Sources, the private company that contracts with the state to provide medicine in New Mexico’s prisons, for these alleged problems.

Wexford has been the subject of a four-month SFR investigation, during which a growing number of former and current employees have contended that Wexford is more concerned with saving money than providing adequate health care, and that inmates suffer as a result. On Oct. 24, the Legislative Finance Committee (LFC) tentatively approved an audit that will assess Wexford’s contract with the New Mexico Corrections Department (NMCD) and also evaluate the quality of health care rendered to inmates [Outtakes, Nov. 8: “Prison Audit Ahead”].

LCCF’s medical director since January 2006, Apodaca is one of the highest-ranking ex-Wexford employees to come forward thus far. His allegations of Wexford’s denials of off-site care and the delays in obtaining prescription drugs echo those raised by other former and current employees during the course of reporting for this series [Cover story, Aug. 9: " Hard Cell?”].

Specifically, Apodaca says he personally evaluated inmates who needed off-site, specialty care, but that Wexford consistently denied his referrals. Apodaca cites the cases of an inmate who needed an MRI, another inmate who suffered from a hernia and a third inmate who had a cartilage tear in his knee as instances in which inmates were denied off-site care for significant periods of time against his recommendations.

When inmates are actually cleared for off-site care in Albuquerque, they are transported in full shackles without access to a bathroom for the six- to seven-hour trip, Apodaca says.

"Inmates told me they aren't allowed to go to the bathroom and ended up soiling themselves," he says. "The trip is so bad they end up refusing to go even when we get the off-site visits approved."

When it comes to prescription drugs, there also are significant delays, Apodaca says. Inmates sometimes wait weeks or even months for medicine used for heart and blood pressure conditions, even though Apodaca says he would write orders for those medicines repeatedly.

"Wexford was not providing timely treatment and diagnoses of inmates," he says. "There were tragic cases where patients slipped through the cracks, were not seen for inordinately long times and suffered serious or fatal consequences."

Apodaca says he began documenting the medical problems at the facility in March. After detailing in writing the cases of 40 to 50 patients whom he felt had not received proper clinical care, Apodaca says he alerted Dr. Phillip Breen, Wexford's regional medical director, and Cliff Phillips, Wexford's regional health services administrator, through memos, e-mails and phone calls. In addition, Apodaca says he alerted Wexford's corporate office in Pittsburgh. Neither Breen nor Phillips returned phone messages left by SFR.

Apodaca says he also informed Devendra Singh, NMCD's quality assurance manager for health services. According to Apodaca, Singh assured him that he would require Wexford to look into the matter, but Apodaca says he never heard a final response.

"Wexford was simply not receptive to any of the information I was sending them, and I became exasperated," he says. "It came to the point where I felt uncomfortable with the medical and legal position I was in. There were individuals who needed health care who weren't getting it."

Singh referred all questions to NMCD spokeswoman Tia Bland; Bland responded to SFR in a Nov. 20 e-mail: "If Don Apodaca has information involving specific incidents, we will be happy to look into the situation. Otherwise, we will wait for the LFC's audit results, review them and take it from there."

Wexford Vice President Elaine Gedman would not comment specifically on Apodaca's allegations. In a Nov. 20 e-mail to SFR, she wrote that Wexford will cooperate with the Legislature's audit and is confident the outcome will be similar to the 14 independent audits performed since May 2005 by national correctional organizations.

"Wexford is proud of the service we have provided to the Corrections Department as documented in these independent audits and looks forward to continuing to provide high quality health care services in New Mexico," Gedman writes.

Members of the Legislature’s Courts, Corrections and Justice Committee, which requested the forthcoming audit, toured LCCF on Oct. 19 and were told by both Wexford and NMCD officials that there were no health care problems at the facility. On the same tour, however, committee members heard firsthand accounts from inmates who complained they couldn’t get treatment when they became sick [Outtakes, Oct. 25: “Medical Test”].

That visit, along with Apodaca's accounts, calls into question Wexford's and NMCD's accounts, State Sen. Cisco McSorley, D-Bernalillo, says.

“We were told on our tour that nothing was wrong. And now to hear that there is a claim that Wexford and the Corrections Department might have known about this makes it seem like this information was knowingly covered up,” McSorley, co-chairman of the committee, says. “We can’t trust what’s being told to us. The situation may require independent oversight far beyond what we have. This should be the biggest story in the state right now.”

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