Dying to Get Out

Some inmates tell horror stories about healthcare at the women's prison in Vandalia. Some didn't live to tell their tales.

Reminding those present that state law requires that corrections officials "shall arrange for necessary healthcare services" for inmates, she said, "I submit to you that surely this did not happen and [Summers] did not receive the proper medical care."

When she was finished, it seemed to Gilpin that she'd gotten through to at least some of the committee members.

"I think it is legitimate that people have concerns about whether they can trust the system," said Senator Larry Rohrbach, a California Republican.

Representative O.L. Shelton, a Democrat from North St. Louis, was more blunt. "What we need, we need a new team in this facility, in this state," Shelton proclaimed. "That's what we need. I think we need a new medical service for this state because I don't think that this is adequate for anybody."

But when the joint committee issued its annual report six months later, there was no call for a new medical service. Instead the committee made seven recommendations, many of which the MDOC agreed to implement. Among them: Regular meetings would be held between Correctional Medical Services, Representative Kelly and the Jefferson City Archdiocese; conflicting medical recommendations were to be referred to consulting physicians not employed by CMS; and family members would be allowed more access to inmates at off-site hospitals. At Vandalia, CMS would provide inmates with customer-service surveys and CMS staffers would attend every-other-week inmate council meetings where inmates could air medical concerns.

Buschell points to a few other changes that came out of the 1999 hearings: "We achieved a streamlined medical parole process, because it became clear with Stephanie Summers that other people had made decisions along the way so that it never made it to the parole board. And the infirmary was changed somewhat."

But when all was said and done, Buschell and others were disappointed. A prison medical system that they felt required major surgery had been treated with a Band-Aid. "I think it's gotten worse, rather than better," Buschell says today.

Peter DeSimone wasn't surprised with the outcome. "Most of the members of that joint committee have prisons in their district," says DeSimone, who has since retired from his post at the Missouri Association for Social Welfare. "For them, prison was not something to watchdog; it was something for jobs and patronage in their own districts, and economic activity."


One elected official who was attempting to watchdog prison healthcare was Representative Charles Quincy Troupe. For several years the north St. Louis Democrat had sponsored a bill to create an independent ombudsman position to give inmates access to an agency outside the MDOC and CMS that had the power to investigate, inspect and subpoena.

"It's not like it is so radical," DeSimone comments, noting that similar programs exist in 25 or 26 other states, including Kansas and Minnesota. But Troupe's bill never made it to the state house floor.

Troupe also tried to delve into inmate complaints himself. In January 2002 he wrote a letter to MDOC director Gary Kempker, requesting an investigation into the death of Vandalia inmate Lavenia Populus.

"Someone who cleans the infirmary witnessed Inmate Populus' death, and reported that the room looked like a slaughter house, that Ms. Populus has been crying and pleading for help all day, telling them she was in severe pain," Troupe wrote. "It is also reported that a doctor's answer was to prescribe Maalox. Apparently, Inmate Populus died in a pool of blood, hemorrhaging from every orifice, and there was blood on the walls and what was believed to be human tissue matter mixed with blood on the floor."

Troupe went on to say he'd been told Populus had been diagnosed with hepatitis C: "Is this a natural end to people who are infected with hepatitis C disease, and if this is the case, explain the blood on the walls and the lack of assistance for an obviously pleading and dying woman. Further, not being a medical person, I would like a medical explanation from the doctor as to how Maalox would help the pain from an obviously hemorrhaging person, and if death were imminent, then the humane thing to do would have been to make death as painless as possible.

"Was inmate Populus sentenced to death by the state? I await the results of your investigation," Troupe concluded.

The answer he received was hardly satisfying. "They explained to me that that's normal with hepatitis C," Troupe recounts. "My response to that is: That is total insanity."

Though it is by no means the only ailment they encounter, CMS doctors are undoubtedly well acquainted with the ravages of hepatitis C. According to the federal Centers for Disease Control and Prevention's recent report on hepatitis viruses in correctional settings, 15 percent of all inmates nationwide are infected with hepatitis C, while the infection rate in the general population is less than one-tenth of that: 1.3 percent.

Although people who contract hepatitis B usually fight off the disease and develop immunity to the virus, hepatitis C is far more insidious. Stubbornly resistant to attack by the body's immune system, the virus typically takes up lodging in the liver and lies dormant, sometimes for years. By the time symptoms surface, they've already progressed to advanced liver disease, with patients typically dying from cirrhosis of the liver and/or cancer. Death is painful, preceded by jaundice, fatigue, swelling, internal bleeding, vomiting blood or bleeding from the rectum.

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