There are some 5000 lawsuits a year filed, most of them lose.

This is what my big summit meeting with state officials as about, horrible medical neglect.

Now Dr. Videen is doing an analysis one by one and I am sending them to the top brass that attended the meeting.  They claim not to know these practices exist.  Now, they jump on our complaints right away whereas in the past it took months and months.

This is due to all the media coverage.

This is what his evaluation looks like:

In response to our meeting last month at CMF, I have been asked by Cayenne Bird of the UNION to review a case for your quality assurance program.  To this end, I have reviewed personal statements, appeal forms and copies of medical records provided by Mr. Wesley at the California Institute for Men in Chino. I find his care to be quite disturbing on the following grounds:

1. He was denied appropriate analgesics, i.e. narcotics.
2. Medical records were altered.
3. Documentation of examinations are insufficient.
4. A delay in surgery lead to permanent neurologic injury.
5. While his reasons for appeal were valid, no administrative action was taken.

Briefly, Mr. Wesley is a 37 year old man who presented to medical attention on April 6, 1999 for acute low back pain and sciatica.  There was a previous history of a laminectomy for a herniated nucleus pulposus in 1995 and a work-related back injury (while incarcerated) in 1997.  He was prescribed acetaminaphen and baclofen.  Failure to obtain relief lead to a trial of ibuprofen and radigraphs of the spine were taken.  Continued pain lead to an Orthopedics consultation and a trial of cyclobenzaprine. The Orthopedist suspected a herniated disc, ordered an MRI and a trial of prednisone on May 6, 1999.   The MRI was delayed secondary to concern over retained surgical clips from a previous gastric fundoplication, but revealed a "severe" disc extrusion with displacement and compression of the S1 nerve root on May 26.

Follow up evaluation by the orthopedist on June 10 lead to recommendation for laminectomy and nerve root dissection.  On this date, there appears to be a prescription!  Written for Percodan (a narcotic) on a Department of Corrections Pharmacy form.  This was overwritten without appropriate initials and clarification.

In an impassioned plea for pain relief, Mr. Wesley wrote a letter to the Doctor, noting that he received phenylgesic instead.  No response was given.  Between that date and his eventual surgery on November 16, 1999 there were 16 documented encounters with the medical staff (at least).  Despite complaints of severe and disabling pain he was not provided narcotics, but instead was given a variety of non-steroidal anti-inflammatory agents, steroids, muscle relaxants and acetaminaphen.  Given a history of gastroesophageal reflux severe enough to require surgery, this combination of drugs should have warranted more aggressive prophylaxis against gastrointestinal irritation, he received only a trivial dose of Maalox.  Predictably, he developed gastrointestinal bleeding.  On October 8, 1999 an evaluation at ortho/spine clinic noted diminished strength in the right gastrocnemius muscle and no achilles reflex, an apparent change from the previous examination.  Surgery was scheduled for November 2, but delayed for unclear reasons.  The procedure lead to immediate relief of pain, but had no effect on his nerve injury which was attributed to the herniated disc by the surgeon.  The only documented adequate neurologic examination during this entire time is that on admission to the hospital.

Mr. Wesley has further allegations that I find troubling.  He states that he was not given a pass from work during this period of time.  In my review of the records, I can find only "lay in" status given for a few days at most, implying that this is indeed true.  Mr. Wesley states that his 602 appeal process was confounded by errors and delays.  In my review of these documents, I must support his claim that the whole process is unduly difficult, capricious and seemingly designed to fail.  Despite his cogent
argument, he was not given a valid response.  Instead, he was literally invited to litigate his claim.  More troubling were encounters with the Medical Technical Assistants after filing the 602, that seemed confrontational and allegations that his surgery was delayed because of his refusal to cooperate and rescind his complaint.

It was my impression from Dr. Khoury, that care such as this is not the goal of the Department of Corrections and I hope that some semblance of quality can be injected into the system in a prospective manner.

Sincerely,

John Videen, M.D.