Medical neglect at its worst
By Mark Harrison, TNC contributing writer
Andres Romero agrees that people who disobey the law should be punished appropriately for their crimes. The sixty-seven-year-old prisoner does not believe that he should be punished with post-operative brutality and reckless disregard for his expiring life. Medical abuse and neglect cannot be tolerated anywhere in the civilized or uncivilized world; not in developing countries where doctors and medical supplies are scarce, and not in Coleman, Florida, USA.
In August 1999 Andres Romero began experiencing frightening symptoms that had him seriously worried about his health. He requested medical attention at FCC Coleman, and received what he believed to be inadequate examinations by unqualified physician's assistants who were indifferent, at best, towards his suffering. His ill health persisted, and so did he; after three months he was finally transported to Leesburg Medical Center on October 21 for an examination. The stress test and cardiac catheterization produced an ominous and conclusive diagnosis. Romero had triple coronary artery disease, an unstable angina, and faulty heart valves. To correct his life-threatening condition, the recommended procedures were a triple bypass heart surgery and valvuplasty to repair his restricted heart valves-immediately!
Romero was stunned and confused. Why, for an agonizing three months, had he suffered and wondered about his condition with not even an educated guess as to what might be the cause of his pain. And why had none of the "examinations" revealed his foreseeable and conceivably fatal condition? Why no mention of cardiac disease, no differential diagnosis, and no precautionary measures? Considering that common indicators of heart disease are established among medical practitioners throughout the world, it seems that health care personnel would have recognized his lethal symptoms at Coleman.
In his letter to the November Coalition in June, Mr. Romero wrote, "previous examinations made no mention of this." He was unprepared for this daunting news. It seems that the prison medical staff might have previously identified, or at least cautioned of, heart disease prior to the day before surgery. As it was, he had little choice but to consent to the recommended procedure.
Five hours of surgery were required on October 22, 1999 to correct his struggling and bloodstarved heart. Doctor Richardson reported in his discharge summary that his patient was "making good progress" and had an "uneventful post-op period." This was good news, but Mr. Romero would have no more good news for a while. He was transported back to FCC Coleman, five days after surgery, in his frailty, on October 27.
The doctor ordered his patient not to engage in any activity that required exertion and, specifically, not to walk up or down stairs. It was additionally ordered that proper hygienic facilities be provided to prevent infections from the wound on his leg where the "saphenous vein was harvested," and on his abdomen where his "sternum was divided in the midline" to access his heart.
After his return to the prison, Mr. Romero was staggered again upon learning of his assignment to "segregated housing," more commonly referred to as the "hole" by prisoners, and by anyone familiar with these solitary conditions. Special housing unit officer, Lieutenant K. Pike, made the decision to issue this "administrative detention order," citing "pending bed space." The "hole" is normally reserved for unruly prisoners, not for an aging patient convalescing from triple bypass heart surgery.
Mr. Romero took this news sitting down in a wheelchair. The guards then determined it was necessary to handcuff their prisoner, but not with his hands forward-behind his back, stretching around the back of the wheelchair in an excruciating position for a man who had his abdomen split open just five days prior. It was clear that the ailing Romero posed no threat to the guards. He was not going to escape or start a scuffle, and handcuffing the old man served no sound correctional purpose.
Romero pleaded, asking that he be spared from maneuvering his body in that position because of the stress placed upon his recently divided sternum and the stitches running the length of his abdomen. Unmoved, the guards proceeded to place handcuffs on Romero, hands behind his back, disregarding the prisoner's pain and any possible injury that might be inflicted in this agonizing position. To Mr. Romero this was a blatant act of cruelty and brutality at the whim of guards who had no reason for this action other than, possibly, to serve their own demented pleasures. Maybe they were having a bad day, but certainly not as bad as the geriatric in their care who was still meant to suffer even more indignities.
Romero writes, "The prison guards ... demonstrated an inhumane attitude towards me by then ordering me to get out of my wheelchair while I still had my hands pulled behind my back and handcuffed." The guards ordered him to walk down a flight of stairs to his cell, heedless of his doctor's orders and the fresh wound running from his ankle to his thigh.
Appealing for concession, he insisted that his pain is too great and repeated that he was ordered by his surgeon specifically not to ascend or descend stairs. The guards capitulated, determining that Romero was physically incapable to negotiate the flight of stairs. Then, in Romero's words, "they manhandled me in the wheelchair." Still seated with hands stretched behind his back, straining at his reattached sternum, abdominal skin pulling at the recent stitches that zippered from neck to navel, he bounced and jerked down the stairs and into an inadequate cell for a pain-racked old man.
Adding insult to injury could be considered an insensitive disregard for a fellow human being. Adding injury to injury is brutal and sadistic and should never occur anywhere in a country that calls for basic standards of human dignity and pledges support for essential human rights.
The "hole" was not equipped for Romero to care for himself. "The ability to bathe properly was hindered because one must raise himself up onto an elevated shower stall," writes Romero. The slick aluminum floor and walls "created a very dangerous situation because it was so slippery, especially for someone in my condition." Yet, determined to keep his wounds properly cleaned and free from infection, he maneuvered in acute agony, unassisted, in and out of the slick and elevated shower stall for the next five days.
Romero petitioned the guards daily for adequate arrangements that would allow him to properly care of himself while recovering. His requests were either ignored, or simply never forwarded to the person who could authorize appropriate conditions.
On his second day in segregation Romero was visited by Nurse Brown who administered medications for high blood pressure, post-operative pain medication, and medication for high cholesterol. Mr. Romero requested that the nurse also administer Flumatide 125, the drug prescribed for the remainder of his life for treatment of prostate cancer, diagnosed by Dr. Guillermo Vasquez in November of 1993. The cancer is considered terminal if it were to advance. Six daily doses of the medication had been prescribed to hold the cancer in remission.
Nurse Brown informed him there was no record of this medication being required for his treatment. Yet, Dr. Guillermo states in his letter dated November 26, 1996, "The patient has aggressive cancer of the prostate and has a poor prognosis with a life expectancy of anywhere from three to five years from the time of diagnosis. He will need to continue his medications." Medical records are often reported missing from prisoners' medical files.
The majority of prisoners are unable to afford legal help, or are unprepared to legally challenge medical negligence encountered behind prison walls. Mr. Romero, however, is fortunate in this regard. His attorney, Marisa Mendez, wrote to Warden Gregory Parks at FCC Coleman. "We are concerned about Mr. Romero's continued health and welfare while he remains incarcerated at Coleman. We were advised, in fact, that when he was returned to Coleman, he spent five days in the "hole' apparently because there was no available bed space. While in the "hole" he did not receive appropriate or adequate follow-up medical care, treatment, or attention. We know that he has been returned to the general population but is still not receiving the appropriate medical care."
Indeed, Mr. Romero did not receive adequate follow-up medical care. "I have received a bad infection in my leg, and for the past two months, I have had pain and suffering from it." His prostate cancer medication was resumed on Nov. 1.
Andres Romero's case of brutality and medical neglect is reprehensible, though not isolated, judging from numerous reports and letters from medically challenged, geriatric, and infirm prisoners across the nation. Mr. Romero knows that he will never return to his unlawful ways if he were allowed to live his few remaining years with friends and family where adequate medical treatment could also be provided. Those who hold Mr. Romero's fate in their hands also must know that this man, nearly seventy years old, is not a threat to society. Romero was given a life expectancy of three to five years in 1993 by Dr. Guillermo
No one is benefiting from Romero's continued incarceration
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