ALABAMA DEPARTMENT OF CORRECTIONS

MEDICAL GRIEVANCE OCTOBER 24, 2004

FORMAL MEDICAL GRIEVANCE

RE: CALLOUS INDIFFERENCE TO HUMAN LIFE

To: Prison Health Services

105 Westpark Drive, Suite 200

Brentwood, TN 37027

Phone: 800-729-0069 - Fax 888-729-0069

The Alabama Department of Corrections has a notorious record of inadequate medical care for its prisoners.

After numerous complaints, deaths and lawsuits, the newly appointed Commissioner of the Alabama Department of Corrections cancelled its $29 million contract with Naphcare, Inc., of Birmingham, Alabama, and teamed with Prison Health Services (PHS) of Brentwood, Tennessee, to correct the major problems experienced with Naphcare, Inc.: (America Service Group Inc. [NASDAQ: ASGR] subsidiary Prison Health Services, Inc., signed a $143 million contract with the Alabama Department of Corrections to provide statewide medical services to its inmates beginning November 3, 2003).[1] According to the contract, PHS will be responsible for providing on-site medical care and pharmacy services as well as off-site specialty and hospital-based services to the Alabama DOC. This service is not being fulfilled.

A medical complaint was filed on many of the issues stated herein on or around August 22, 2004 per Warden Stephen Bullard of Donaldson Correctional Facility in Bessemer, Alabama. Following the complaint, I was called to see Ms. Lawson, Director of Nursing. Ms. Lawson was made aware of my complaint issues, yet these issues have not been corrected. This compels me to file a formal grievance for refusal to provide decent medical care. This blatant refusal of medical care rises above the deliberate indifference standard, as required by federal law. It goes far beyond the deliberate indifference standard and has now become callous indifference to human life.

People at this institution are dying like flies. Many of these deaths can and should be avoided by the minimum of medical care. However, the Alabama Department of Corrections medical care provider, PHS, refuses to provide even the minimum basics of medical care. This clearly demonstrates a callous indifference to human life.

Alabama is last in the nation in funding medical care for prisoners, as well as last in the nation on prison spending. Georgia and North Carolina spend twice as much on medical care per inmate as Alabama, while Tennessee and South Carolina spend 75 percent more. Alabama's prisoner health care costs remain the lowest in the country. The state spends about $5.50 per prisoner per day. The national average is $7.38.[2]

States' per day per inmate
health-care costs

Source: 2000 U.S. Department of Justice study, based on a surveyor 1998 data

LOSS OF VOICE

I have lost most of my voice for months. The attending doctor ordered me to return in two weeks stating that he thought there were definite signs of throat cancer. After one month, I still had not been told to return for the doctor's re-evaluation as he had prescribed. After following up over a course of several weeks as many times as I could without getting into trouble, a nurse finally told me to sign up for sick call. In other words, it was "my" duty, not theirs, to ask the medical staff to follow doctor's orders. Finally, on September 13, 2004, I was sent to an outside ear, nose and throat specialist (E.N.T.), Dr. Neckman. Dr. Neckman stated that he would be preparing written recommendations as to proper treatment. As of this date (October 24, 2004), none of Dr. Neckman's recommendations have been put into practice, nor have I even seen a doctor again.

Dr. Neckman's office refuses to release a copy of his recommendations to our investigators, citing DOC rules for secrecy, so I remain completely in the dark as to what his recommendations for treatment are. As of this date, my voice is still mostly lost. The disease (condition) obviously still exists. Yet the medical staff and PHS are completely unconcerned about this potentially serious medical condition with full knowledge as to just how serious this could be, and what treatment Dr. Neckman has prescribed.

CARDIAC PROBLEMS

I suffered three heart attacks in 1989 with 100% blockage in one artery, 85% in another: in total blockage in four arteries. An angioplasty was performed two days later. I have not had a stress test or angiogram since 1989 - that's 15 years ago. Should either of these test be performed, it would surely show an immediate need to have bypass surgery. Yet, this medical provider waits for a massive-fatal heart attack before anything will be done.

CHRONIC CARE

In over two years, I have been to chronic care screening only once. One time, in two years. That was when Warden Bullard checked with the medical staff as to why. The medical staff advised the warden that I should be seen on a regular basis, but had "fallen through the cracks" as they put it, but that would be corrected. That was two years ago.

Two months ago I filed a medical complaint after speaking with Warden Bullard about the absence of medical care. Warden Bullard displayed concern and ordered a full report by the medical staff. The medical staff displayed little concern whatsoever, even after the Warden ordered a full report.

After filing the medical complaint, I spoke with the Director of Nursing, Ms. Lawson, about several complaints including chronic care. I advised the director that Chronic Care Screening had seen me only once in two years and due to that, my prescribed medication had expired.

Ms. Lawson asked what medical problems I had that would qualify me for chronic care. I advised her that I had suffered three (3) heart attacks, suffered from inflammatory spinal arthritis and also suffered from emphysema. Then she stated, "That's triple chronic care!" Yet still, I have not seen chronic care screening.

PHYSICAL

I have not had a physical in well over four (4) years. Not that I'd care to have a flu vaccination, but the guy that sleep's beside me was already given a flue vaccination. Yet I have not even been offered one. He's 39 years old and in good health. I am 60 years old and in very poor health (triple chronic care). This is the "perfect" example of the state of mind of the medical provider's (PHS') deliberate indifference to a known serious medical need and a "callous" disregard for human life. Callous indifference describes this perfectly!

DRUG REACTION

On or about September 18, 2004, I was given Niacin without being told why. I had a reaction to this prescribed medication. Side affects and medical reactions to any prescribed medication can be extremely serious especially to anyone with chronic diseases. When I attempted to seek help, the medical staff gave me the run-around. On nurse sent me to another nurse, and that nurse tried to end me back to the first nurse. I am speaking of a "drug reaction" - a drug reaction can be fatal, yet all I got was a run-around. Once again: a complete and callous indifference to human life.

DENTURES

I have attempted to get dentures for several years. As soon as PHS secured the medical contract in November of 2003, I immediately signed up for sick call requesting dentures. My request was returned advising that I was on the dental list. I have yet to see a dentist.

CORRECTIVE LENSES

I also immediately signed up for an eye examination and corrective lenses. Since 16 years in prison, I have yet to have a properly prescribed pair of glasses. Every single pair of glasses was improperly prescribed. Always the left lens was blurred. Zero response from PHS. I have yet to see an eye doctor, or even a PHS representative with his little electronic device.

CONCLUSION

Considering all of the above, plus much more, PHS continually displays callous indifference to human life. Sadly, this indifference appears to be the "norm" rather than the exception. In my 16 years in Alabama Prison, I do believe PHS is the very worst medical provider - or so-called provider - I have ever witnessed. PHS flatly does not care at all! PHS shall live forever in the Medical Hall of Shame.

For every medical procedure withheld this means massive amounts of profit for PHS and its stockholders, while Alabama taxpayers foot the bill. And yet, PHS was hired by the taxpayers to "provide comprehensive medical coverage to inmates in Alabama (see footnote above)." Just how shamelessly misleading can a publicly own company get?[3] These are compelling reasons and all the more reason for the US Federal Government to take control over Alabama State Prisons.

Signed:

Patrick Swiney - DOB October 24, 1944

154406 G79

100 Warrior Lane

Bessemer, AL 35023

Copies to:

Alabama Department of Corrections, Legal Division (certified return receipt) US Department of Justice, D.C.

Federal Bureau of Investigation (for file) United States Attorney, Birmingham (for file)

United States Attorney, Montgomery (for file) Southern Poverty Law Center, Alabama

Governor Bob Riley, Alabama Human Rights Organizations on the Internet (by email)

Southern Center for Human Rights, Atlanta, GA Warden Stephen Bullard, Donald Correctional Facility

US District Judge Myron Thompson, Alabama Montgomery Circuit Judge William Shashy

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[1] October 21, 2003 Nashville City Paper

Brentwood-based America Service Group Inc., the only publicly traded health-care service provider for prisons in the U.S., confirmed that it is in final negotiations to provide comprehensive medical coverage to inmates in Alabama. The company's subsidiary, Prison Health Services Inc. is in talks with the Alabama Department of Corrections for a contract worth $142.7 million over its three-year life. The contract does not include mental health services. Company officials anticipate the contract could go into effect as early as Nov. 3. It will contain two additional one-year renewal options. The company's stock closed at $23.19 on Monday. The share price has more than doubled in the last year. Found on the Internet at

www.nashvillecitypaper.com/index.cfm

[2] "Prison's Medical Care Blasted" Birmingham News March 12, 2004 found on the Internet at www.schr.org/prisonsjails/newspaper%20articles/Limestone/news_limestone13bham.htm

[3] Mission: "[PHS] specializes in setting the benchmark for quality managed healthcare services to correctional services throughout the United States." Vision: "PHS will lead the correctional health care field in reputation and results, differentiated from competitors by the highest standards of operational excellence, clinical quality and client service." Found on the Internet at www.prisonhealth.com/overview.html