Inmate With Cauda Equina Syndrome Allegedly Receives Inadequate Treatment


Correctional Medicine Expert

This case involves an incarcerated woman with a past medical history of spinal arthritis who was admitted to the hospital for several days with an acute gastrointestinal bleed. While being treated for the gastrointestinal bleed, the patient complained of lower back pain and was found to have an epidural abscess. The patient underwent various surgical procedures to remove portions of the vertebral bone and relieve the pressure from compressed nerves. She was eventually diagnosed with cauda equina syndrome. In spite of immediate surgical intervention, the patient subsequently passed away from hospital-acquired pneumonia. It was alleged that if the patient had been allowed an early parole, she would have received better surgical treatment and would not have suffered the medical complications she did.

Question(s) For Expert Witness

  • 1. Please describe your experience in correctional medicine.

Expert Witness Response E-037152

Expert-ID: E-037152

I am currently the chief medical officer for a sheriff’s department overseeing the medical, mental health, and dental care to over 84,000 annually booked inmates and an average daily population of 5,800 inmates. The level of care and follow up treatment plans would have to be discerned from the medical records to make a recommendation of early parole due to medical issues. Based on limited information about the nature of the infection, consequent surgery and complications, and his functional status, it appears the patient has a condition that may warrant it. I have recommended compassionate release and alternative custody in our system based on inmates who have significant medical issues and have even written reports and made available to testify on similar matters.

Expert Witness Response E-005992

The responsibility of the medical staff is to accurately summarize the history, condition, treatments, diagnoses, and prognoses for the patient. The legal authority then uses that information to decide if early parole is granted. Some jurisdictions, like Massachusetts, have a “compassionate release” statute where early parole may be granted by the legal authority after a determination by the medical authority that the patient has a prognosis of a life expectancy of fewer than six months. I was involved in preparing medical summaries for at least three patients looking for early release or transfer because of medical issues. I have similar experience providing medical summaries for pre-trial detainees seeking legal reconsideration regarding their need for confinement.

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