By Carrie Wilkinson
Although Prison Legal News and its parent organization, the Human Rights Defense Center (HRDC), are best known for litigation involving censorship by prison and jail officials, HRDC also co-counsels select other cases, mainly involving wrongful deaths on behalf of prisoners’ surviving family members.
As detailed in this issue’s cover story, one of those cases involved Washington state prisoner Ricardo Cruz Mejia, who died after an untreated infection turned deadly. The medical examiner listed his cause of death as necrotizing fasciitis/Fournier’s gangrene, sepsis and septic shock.
Mejia’s preventable death was a case of history repeating itself. In 2004, Washington prisoner Charles Manning was initially diagnosed as having a reaction to Robitussin. Hospital staff subsequently found he had Fournier’s gangrene, and his genitals were amputated to save his life. Manning survived and filed suit, settling with the state for $300,000 in 2008. [See: PLN, June 2008, p.20].
Ricardo Mejia was diagnosed with ulcerative colitis in October 2010 while incarcerated at the Washington State Penitentiary in Walla Walla, and prison medical staff prescribed medication to treat his condition. His symptoms included gastrointestinal problems and blood in his stool. He was seen by medical staff 14 times in the 48 days before he died, and not only reported the treatments were not working but that his symptoms were becoming progressively worse – including headaches, a sore throat, skin rashes, pain and vomiting.
As with Manning, the initial treatment prescribed for Mejia did not remedy his symptoms and DOC medical staff failed to take further action until it was too late and his condition escalated into Fournier’s gangrene. Mejia died of the same infection under the care of the same prison medical system that had almost killed Manning seven years earlier.
A DOC incident report prepared by Dr. David Kenney seven months after Mejia’s death noted that “the drugs he received to control his symptoms (steroid enemas, aminosalicylates and oral steroids) may not have completely controlled his disease,” and that “an ongoing evaluation of his response to these medications was not recorded.”
Following an initial tort claim, a complaint was filed in Thurston County Superior Court on December 20, 2013 on behalf of Mejia’s estate and his two minor children, alleging that DOC medical staff had “ignored obvious signs of infection and serious illness and he literally rotted to death under their care through negligence and deliberate indifference.”
According to the complaint, Mejia’s symptoms worsened in January 2011, and on January 14 he sought medical care for mouth and rectal ulcers; a nurse noted he had not had a bowel movement in four days, and his rectum “showed a large, excoriated, blistered area.” Physician assistant Kenneth Moore refused to see Mejia or admit him to the prison’s inpatient unit, but only ordered Lidocaine for pain over the phone. Moore later agreed to admit Mejia for inpatient care after a nurse voiced concerns.
Following worsening symptoms, Mejia was finally transported to an outside hospital on January 15, 2011, where surgeons “cut away large portions of his buttock and rectum” in a last-ditch effort to save his life. They were unsuccessful and he “died a horrible, grotesque, and painful death, at age 26.”
The lawsuit claimed that Washington DOC medical staff had violated standards of patient care by failing to provide adequate treatment to Mejia in spite of his obvious, serious symptoms. The complaint noted that recognizing those symptoms “required only basic health care skills and knowledge; it is ‘Medicine 101.’”
The Washington Department of Health conducted an investigation into Mejia’s death and found that prison medical staff “did not provide a formalized process for continuity of care and supervision of care,” which “may result in inappropriate and unsafe care.” Further, the investigation determined that “the facility did not have a formalized process for midlevel providers to discuss complex medical cases with the medical director and did not have [a] formalized process to refer complex cases from the midlevel provider to the medical director.”
Dr. Kenney’s review recommended ten improvements for DOC medical staff, including a review and assessment of the primary care system “to optimize comprehensive assessment and management of medical conditions, [to] ensure that continuity of that care is maintained and [staff] be accountable for oversight of all care delivered.”
Four months after the lawsuit was filed, which named the Washington DOC and six DOC medical practitioners – including Moore – as defendants, the case settled in March 2014 for $750,000. Mejia’s estate was represented by the Human Rights Defense Center and Seattle attorney Jesse Wing with MacDonald Hoague & Bayless. See: Soria v. Washington DOC, Thurston County Superior Court (WA), Case No. 13-2-02598-9.
(Published by Prison Legal News; used by permission)