Pubdate: Sun, 14 Nov 1999
Source: Tulsa World (OK)
Copyright: 1999, World Publishing Co.
Contact:  http://www.tulsaworld.com/
Author: Barbara Hoberock

PRISON FLAWS REPORTED 

A medical expert says poor medical care in Oklahoma prisons may put
inmates and staff in danger.

OKLAHOMA CITY -- Two reports on prison medical care indicate that the
Oklahoma Department of Corrections remains plagued with serious
problems despite a $7.2 million appropriation from lawmakers.

National prison medical expert Robert B. Greifinger in September and
November issued two reports regarding the progress the department had
made in the wake of a settlement agreement in the Battle vs. Anderson
case, a class-action inmate lawsuit that began 27 years ago.

U.S. District Judge Michael Burrage, who is considering the settlement
agreement, issued a stay in the proceedings following the $7.2 million
appropriation that came during the Legislature's last session.
Meanwhile, he issued an interim order requiring the department to take
corrective action.

The department's medical staff is preparing a corrective action plan
in response to Greifinger's reports, said Jerry Massie, department
spokesman.

Greifinger in October toured Mabel Bassett Correctional Center,
Lexington Assessment and Reception Center, Joseph Harp Correctional
Center and Oklahoma State Penitentiary.

At all four facilities, he found that access to specialty care -- one
of the key issues in the settlement agreement -- was extremely lacking.

He blamed the problem on the department's central office.

More than 200 inmates had been waiting more than 45 days for
evaluations. Some wait up to a year, Greifinger wrote.

At Mabel Basset, an Oklahoma City women's institution, there is an
unnecessary delay for cervical biopsies because qualified physicians
at the facility ``have not been able to get biopsy forceps,"
Greifinger wrote.

He also noted several problems at Lexington, where counties send
inmates for processing before they are assigned to a state
correctional facility.

"Although the Legislature passed a law requiring the transfer of
medical information from counties to the DOC, there is little
improvement in the proportion of inmates who arrive with the
information," Greifinger wrote.

Tulsa County was the exception, he noted.

Lexington also had serious deficiencies in handling patients with
tuberculosis, which posed a danger to patients and staff.

At Joseph Harp, a patient who died in July had received deficient
care, Greifinger reported.

The inmate had been in the facility since May 1998 and was seen 14
times for complaints of chest and back pain, but no diagnostic studies
were ordered, Greifinger wrote.

After a year, he was diagnosed with non-Hodgkins lymphoma, which is
treatable in earlier stages, he wrote.

The inmate was sent to a hospital, later discharged and required
infirmary care. But there was apparently no room at the Lexington
infirmary. As a result, he spent the last two months of his life dying
in the general population, Greifinger wrote.

At the state penitentiary, half the nursing positions remain vacant,
Greifinger wrote, adding that the facility has trouble recruiting and
retaining qualified primary-care physicians.

Greifinger found a penitentiary infirmary patient with lung cancer who
reported chest pain in November 1998 and February 1999. In both
instances, he should have had further diagnostic tests. In April 1999,
he was diagnosed but waited three more months for treatment.

"These lags during this three-month period were all bureaucratic or
system problems," he wrote. "An earlier diagnosis may have given him a
chance at survival."

In a Sept. 16 report, Greifinger said his work had been seriously
hampered for more than two months because the department staff was
barred from talking to him and from riding in the same vehicle.

"Even today there is an embargo on documents," Greifinger wrote. "I
need not quote from the settlement agreement to the attorneys.
However, I should emphasize that this interference with access to
documents and personnel inhibits my ability to complete my tasks in a
timely manner."

But that apparently changed during Greifinger's next
visit.

"The DOC has made a clear effort to cooperate and communicate during
the past few weeks," Greifinger wrote in his Nov. 1 report.

In the Sept. 16 report, Greifinger accused the department of
exaggerating its compliance with court orders and in several instances
said the department is out of compliance.

Between Aug. 30 and Sept. 16, Greifinger toured two public and two
private facilities.

One private and one public facility had positive attitudes and
high-quality care, but their efforts are hampered by inadequacies in
centrally controlled systems, Greifinger wrote.

The two other facilities had serious problems, Greifinger reported,
which pose imminent danger.

"The medical care at Great Plains (a private prison in Hinton) is
wholly inadequate," he wrote. "There is immediate danger to inmates."

At Granite's Oklahoma State Reformatory, Greifinger found insufficient
physician staffing, grossly insufficient psychiatry staffing and
inadequate access to specialty care, among other things.

He also took issue with the department's efforts to become paperless,
saying it has apparently forbidden staff from having paper copies of
operating policies. Staff are expected to access policies on the
Internet, he wrote.

"Most health-care units, however, do not have Internet access in their
workspace," he wrote. "This policy makes it extremely difficult for
staff to keep current on expectations. There is no way for them to
know if there is an update."

Greifinger's quarterly report is expected to be completed sometime
next week.
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