Access to healthcare inside South Florida prisons and jails is under renewed scrutiny after a pregnant woman with a mental illness delivered her child alone in a Broward County jail cell last month.
In a letter to Broward Sheriff Gregory Tony, obtained by our news partner the Miami Herald, the Broward County Public Defender Howard Finkelstein wrote, “It is unconscionable that any woman, particularly a mentally ill woman, would be abandoned in her cell to deliver her own baby.” The woman says corrections personnel were aware she was near term when admitted to the jail and that she cried for help as she went into labor, but received none. This case is currently under investigation.
Federal law requires prisons and jails to provide medical care to people who are incarcerated. But recent research shows lack of access to healthcare for inmates held in South Florida prisons and jails is not uncommon. In a medical journal, South Florida researchers make the case that too many inmates die in part because "they lack adequate access to timely (health) care." Dr. Tanya Zakrison, a former trauma surgeon at Jackson Memorial Hospital and one of the researchers, joined Sundial to talk about the team’s findings.
This has been edited lightly for clarity.
ZAKRISON: We have to keep in mind that when we're talking about incarcerated men, women and youth in this country in particular we're talking about millions of people and they're the most vulnerable population that we have in this country. Especially when it comes to patient care, in my opinion.
WLRN: Do we have data? Do we know how many women are expecting who are incarcerated?
I'm not aware of any data because essentially when we capture data about who's incarcerated and what's going on behind bars it's voluntary reporting. What I can comment on is the research we did. It worked backwards using information about inmates that had already died while incarcerated and learning from their deaths and the situations they were facing. There is no trauma emergency, general surgery or any sort of surgical database that captures those data or that information.
Why were you interested in trying to learn more about this particular issue?
I will be completely frank and honest with you. This actually was the brainchild of my public health student Dr. Alex Busko who was at the University of Miami at the time. He came to me after learning about the death of Darren Rainey, a 50-year old gentleman with schizophrenia who was incarcerated for a nonviolent drug crime. He became psychotic because he had no access his medications. He started acting out in his cell and as punishment the guards put him in the shower as it's called and scalded him to death. So he was tortured to death. So my public health student was outraged with this and said, "I wonder how often this is happening." And so we took a look. We went to the medical examiner's office where the information is public there and we said, "Llet's do a review over seven years and just look at all the incarcerated inmates who have died and see why they died."
Anything that surprised you when looking at the data?
We were surprised with the results of our findings, which was essentially that close to one in four incarcerated inmates were dying because of preventable surgical or traumatic illness or injury and only a third of those people were actually accessing surgical or had surgical intervention prior to dying. Like cases of people dying from a groin hernia and that really should not happen anywhere in the United States.
And that's treatable. What would have to happen for someone in that situation to lead them to death?
Gross negligence and a denial of surgical care, period. What was even more concerning is because the date ranges of our study (2008 to 2014) we thought Darren Rainey's chart would be included in this. We looked for it and requested it and we were flat out denied access to his chart. What is concerning is how often is that happing happening to other inmates? What other charts are we missing and not getting access to? And so there's a whole bunch of questions that arise from this research more than answers that are provided.
Has anybody been able to give you any answer on that? Do we have any idea of how many cases we may not know about?
We do not. We do not. Not anything that anyone locally in Miami-Dade was willing to give. If you think about it: on a national level we have the Bureau of Justice Statistics that collects data on incarcerated individuals from 50 states and they look at who's died but all of that reporting is voluntary. We actually have no clear idea as to who is dying while they're incarcerated and what they're dying from or who are dying violent deaths as a result of mistreatment, abuse, neglect, negligence or just not accessing care in a timely fashion. It's very difficult to know. Even though these are extremely basic questions involving human rights.