PENDLETON – As Michael E. Akens tried to climb out of the top bunk in his cell at the Pendleton Correctional Facility shortly after midnight on March 6, 2014, he began to feel ill and dizzy, falling to a table below.
His cellmate summoned a correctional officer and asked for him to send for the nurse on duty to check Akens’ injuries of the ribs, stomach and midsection and to confirm whether he had punctured a lung.
According to a federal lawsuit filed on May 22, 2015, on behalf of Akens’ estate, he was given a “cursory examination” by the nurse employed by Corizon Health and returned to his cell.
At 4 a.m., Akens, who had entered a plea agreement on a child molest charge in 2009 in Johnson County, complained of “significant rib and abdominal pain,” dizziness, breathing problems and a possible panic attack. He was given some Tylenol and sent back to his cell.
“I can’t imagine how scared he would be to be in that much pain to be sent back,” said his sister Diane Turner. As a representative of Akens' estate, she has initiated a lawsuit against Corizon.
At 6 a.m., the nurse again was summoned after Akens lost consciousness and fell to the floor, surrounded by other inmates. The nurse, according to the complaint, balked at assisting Akens until a guard said he was not breathing.
At that point CPR was initiated, but it was too late. Akens, 51, was declared dead at 7:02 a.m.
Akens’ lawsuit is one of more than 30 initiated by inmates or estates of offenders in Indiana against Corizon.
The St. Louis, Mo.-based company also faces scores of additional lawsuits in other states where it has contracts to provide similar health-related services.
“Corizon is not well-liked," said Indianapolis-based lawyer Michael K. Sutherlin, who is representing Akens’ estate in the lawsuit. “You’ve got this incredibly unfair system that’s not just designed by Corizon. Corizon just takes advantage of legal loopholes.”
Sutherlin is ushering through the courts four active cases involving inmates who he said have suffered under the health care provided by Corizon.
"It is not a service that has been beneficial to inmates at all. It’s been beneficial to DOC because they have been able to cut costs, but it’s been at the expense of the inmates,” he said.
The Herald Bulletin requested an interview with Corizon chief executive officer, Dr. Woodrow A. Myers Jr., who served as commissioner for the Indiana State Department of Health from 1985 to 1990. Though Myers was not made available for an interview, Corizon officials provided responses to key questions asked by The Herald Bulletin.
However, DOC and Corizon officials declined to comment on pending litigation.
“It’s important to emphasize that the existence of a lawsuit is not necessarily indicative of quality of care or any wrongdoing,” Corizon officials said in a prepared statement. “Malpractice suits are a fact of life for most doctors in America today, and that is particularly true in the correctional healthcare industry, where our patient population is highly litigious.”
Suspicious deaths
Complaints filed by offenders allege Corizon’s callous treatment of the prisoners over the past two years also has led to the death of PCF inmate David Howard. In addition, they allege Corizon’s practices, policies and inadequate training have led to the near deaths of PCF prisoners Raymond Parkhurst and Gary Scallissi and delayed medical care for Tranell Nash, Paul Roberson and Thomas Keeker.
DOC officials report there have been five deaths so far this year at Pendleton, but no indication was given how many of those were from natural causes.
Corizon is under a nearly $300 million contract with the Indiana Department of Correction to provide medical, mental health, substance abuse, dental and vision services for the Indiana’s correctional facilities.
Face-to-face interviews with some of the 1,761 offenders at PCF reveal their concern that Corizon is more interested in the health of its balance sheet than of the patients it serves; that Corizon staff dismisses the humanity of the patient population it serves; and that high staff turnover and improper training results in inconsistent care.
In addition, Sutherlin said, the contract between DOC and Corizon contains provisions for monitoring the contractor’s work.
“I don’t think they monitor, honestly,” he said. “DOC doesn’t really take an active role in doing anything.”
According to Corizon’s statement, the company averages more than 5.5 million onsite patient care encounters annually. During the one-year period ending April 30, 2015, the company averaged 1.36 lawsuits per 1,000 inmates under its care.
“In fact, 99 percent of cases do not result in a judgment or admission of wrongdoing on Corizon’s part,” the statement said. In Indiana, however, that figure over the five-year period ending April 30, 2015, was 93 percent, the statement said.
Profits over patients
Turner, Sutherlin and PCF inmates Jerry A. Gore, Robert Holleman and Donald A. Lock agree the emphasis on privatization of services shifts the focus from the health of the offenders to profits for privately held Corizon.
“It is a profit-motivated enterprise,” Sutherlin said.
“You can’t beat a system that gets billions and billions of dollars … The privatization of things is destroying everything, and it’s the taxpayer who is being ripped off,” Lock said in a face-to-face interview with The Herald Bulletin at PCF.
“(The Indiana Department of Correction) farms out the health care and food service as a way to wash their hands of it,” Holleman said, also in a face-to-face interview at PCF. “A private contractor will never do as good a job as you would do yourself because they are in it to make money.”
In fact, Gore and Holleman allege in their court complaints some offenders actually may have died because of untimely or substandard treatment at the hands of Corizon and its employees. And though he has yet to receive a response, Holleman recently filed a complaint with the U.S. Department of Justice, requesting the investigation of two deaths and the medical issues at PCF.
“That’s just the tip of the iceberg,” he said. “Medical-wise, Corizon does not live up to its bargain.”
“One of the most common misperceptions about our company – and indeed our industry – is that we somehow benefit from providing lower quality care,” Corizon officials said in the prepared statement. “To the contrary, what makes good medical sense and good business sense is excellent and proactive preventive care – intervening early to treat conditions before they become serious and more costly to treat.
“In short, we have nothing to gain from providing less care, and we do not unreasonably withhold medically-necessary treatments to cut costs. We are committed to treating our patients as we would our own family – with integrity and respect.”
Less than deserving
Another issue, Sutherlin and the offenders said, is they believe the DOC and vendors staffs assigned to the prisons see their wards as less than human.
“They probably don’t look at us the same way they would a relative or friend,” Holleman said.
But, again, Corizon officials disagreed.
“As a physician-led company, we at Corizon Health pride ourselves on using evidence-based medicine that meets the highest standards of care as outlined by the American Correctional Association, National Commission on Correctional Health Care and the Bureau of Prisons – and we are proud to be at the forefront of our industry in many areas,” the company’s statement said.
“Our physicians, nurses and staff face unique challenges every day working in an often dangerous environment; we operate in facilities that are built for security, not the provision of care.”
In fact, the statement said, Corizon relies on innovative and specialized services that include the use of Interferon gamma release assays to detect tuberculosis infection, an automated medication reconciliation process at intake with InterMedHx and a proprietary suicide prevention screening tool.
“As a result of these innovations and our practitioners’ commitment to providing best-in-class care, in many cases, our patients’ healthcare outcomes are significantly better than those of the general public – and that’s despite the fact that they enter incarceration on average, far sicker,” the statement said.
Revolving door
Sutherlin and some of the offenders have doubts about the professionalism of the medical staff who treat inmates.
In fact, Sutherlin said he deposed a former Corizon nurse who was present at the Akens incident. That nurse, he said, testified she did not pass the licensing test the first time and admitted under oath she was unable to secure a job in a traditional hospital or nursing home.
“This is the kind of people they usually hire,” he said.
Holleman said he also wonders whether the doctors hired by Corizon are those who can’t get jobs in more respectable medical facilities because they can barely hold on to their medical licenses.
“It’s important to understand that, even while the environment is uniquely challenging, the level of care behind bars is no different (and in some areas is much better) than outside of the facilities,” Corizon’s statement countered.
In fact, company officials argue they hire highly educated, trained and experienced medical professionals who follow accepted treatment protocols and are subject to peer review.
“We actively recruit and hire professional healthcare staff from the finest medical schools and nursing programs in the country, with the same ethical standards as those who treat us in the community at a hospital or clinic,” the statement said.
But Sutherlin said Corizon does not have the staff, equipment or facilities to provide care for offenders who need advanced medical treatment for chronic conditions such as diabetes or dialysis for kidney disease.
“They can’t deliver that, and they don’t want to. That costs too much money,” he said. “They don’t know how to handle medical problems that are serious or chronic … They can’t do an IV inside the prison walls.”
The offenders said the high turnover rate of the medical staff also may influence the quality of care they receive.
“It seems like they go through doctors every other month,” Gore said. “Some doctors don’t want to help, and the doctors who do try to help, they fire them.”
Corizon officials acknowledged that the company’s staff turnover is relatively high but added they do not consider it high for their industry.
“Working in a correctional setting is extremely challenging – but we have many employees who have dedicated their lives to their work,” the statement said. “Corizon Health’s skilled and compassionate nurses, physicians and other healthcare providers are motivated every day to work hard, in a demanding environment, to ensure quality care for all of our patients.”
Sutherlin, Gore, Holleman and Lock also assert that Corizon staff are inadequately trained to distinguish between minor medical events and true emergencies, which prevents the offenders from receiving timely treatment.
Though a roster of topics covered in Corizon's training list includes topics, such as infirmary care, intake health screening and transfers, and nursing assessment protocols, Sutherlin said he believes medical staff are trained almost solely in tactical defense.
“New hires begin with an onboarding program – one that we continue to refine and enhance – and mandatory training as required by the Department of Corrections,” Corizon officials countered. “Employees go through a period of shadowing existing staff to ensure they are comfortable with their work duties and are up to our quality of care standards.”
Corizon Health's most recent chief executive officer has been Dr. Woodrow A. Myers Jr., former commissioner for the Indiana State Board of Health.
The Indianapolis native was not made available for an interview on the issues related to Corizon's medical services at the Pendleton Correctional Facility.
However, Corizon officials have announced he will be replaced as CEO effective Nov. 2 by Karey Witty.
Witty has been a member of Corizon’s board of directors since 2011 and served as chief financial officer of Correctional Medical Services prior to the merger that formed Corizon Health.
Myers, who joined Corizon in 2013, will assume a newly created role of vice chair of the board of directors and serve as a consultant to the company.
The 1977 graduate of Harvard Medical School became a controversial figure while serving as Indiana’s top health professional for his support of a law that required the recording of the names of people with AIDS.
The law also provided that those with AIDS who engaged in unprotected sexual activity, could be quarantined.
According to his bio on Corizon’s website, Myers previously served as managing director for Myers Ventures, LLC, devoted to his personal interests in domestic and international healthcare management.
Prior to that, he was executive vice president and chief medical officer of WellPoint, Inc. where he established the Health Quality Assurance Division.
After leaving Indiana where he was health commissioner for five years, Myers became health commissioner for the New York City Department of Health and Mental Hygiene.