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Carolyn Liberto approached the medical staff at Fluvanna Correctional Center for Women (FCCW) complaining of chest pains on July 21. The 70 year old had a history of hypertension and congestive heart failure, but the medical staff allegedly told her that her vitals were normal and to return to her cell. During the night, she began to have trouble breathing. She died hours later.

Four days later, 38-year-old Deanna Niece complained of chest pain and shortness of breath so severe she fell to the ground. As with Liberto, she was not referred for evaluation. That night, she went into convulsions and began to vomit blood. An inmate said she “died on the floor” just three weeks shy of release. The coroner ruled cause of death as pulmonary embolism.

Details of the July deaths were among multiple allegations of medical mismanagement included in a 48-page contempt motion filed in U.S. District Court in Charlottesville on Wednesday (Sept. 6).

Lawyers for a group of prisoners say the Virginia Department of Corrections (VDOC) has failed to meet the requirements laid out in a 2016 settlement agreement to improve care at FCCW. That settlement came after years of complaints and a class-action suit arguing that the prison’s medical services were so substandard that they potentially violated prisoners’ Eighth Amendment protection from cruel and unusual punishment.

FCCW “was built with an eye towards having the best medical care, and if this is the best medical care, I’d hate to see what it’s like in all the other prisons,” said Brenda Casteñada, an attorney with the Legal Aid Justice Center in Charlottesville.

Instead, the medical facility has become mired in what the contempt filing calls “an institutional culture of indifference,” with inadequate staffing and a lack of leadership at the top translating into substandard care for the prison’s 1,200 inmates.

Since 2014 medical care at FCCW and more than a dozen other Virginia prisons has been contracted out to Armor Correctional Health Care at an annual cost of $82 million.

As part of the settlement, VDOC agreed to regular evaluations by a compliance monitor. Dr. Nicholas Scharff, a Pennsylvania-based consultant, has made at least five multi-day visits to the facility since March 2016, and according to the filing, has found that not only has FCCW failed to make significant progress toward compliance, in some areas they’ve actually “regressed to non-compliant.”

Among one major area of concern for Scharff is the prison’s sick call procedure. Inmates have to place a request for care, often waiting days for a response. The program is run by licensed practical nurses (LPNs), who do not have the necessary skills to diagnose cases. In his review of charts during a visit in April 2017, he found only 44 percent of cases were adequately addressed. With LPNs acting as a filter between patients and providers, the inmates often see their conditions go unaddressed until they have become seriously ill.

Scharff’s reports paint a portrait of a medical department that is simply too slow to provide care: slow to refer patients to outside providers, slow to act on those providers’ recommendations, slow to distribute medications, slow to fill prescriptions. The turnover rate for medical staff is high, and the facility had yet to hire a full-time, permanent medical director.

The end result is inmates suffering pain that can last long after their sentences have ended.

“Not only was I punished for my crime, I was punished a second time when FCCW denied me critical medical care,” said Sherry Richburg in an affidavit.

Richburg, 63, alleged that FCCW’s failure to properly treat a fungal infection stemming from an operation to her leg while in custody led to amputation of the leg after her release earlier this year.
The contempt motion, filed on behalf of the prisoners by lawyers at the Legal Aid Justice Center, the Washington Lawyers Committee, and the D.C. law firm Wiley Rein, asks that VDOC be subject to daily fines until the problems have been fixed, or the appointment of a special master to take control of operations.

VDOC attorneys have not yet responded to the plaintiffs’ filing, and any ruling from Judge Norman K. Moon could be months away.

In an email, VDOC spokesperson Gregory Carter said the department does not comment on pending litigation. Repeated requests for comment from FCCW went unanswered.

“It’s frustrating because people are hurting now, they aren’t getting care now, and it’s been ongoing for years and the DOC hasn’t made the changes that they agreed they should make,” said Casteñada. “There’s a real human cost to not making these changes.”