One Dead in Ohio

An Inmate's Death Casts Doubt on the Company Picked to Run the City's Prison Health System

In early July, Rodney "Rocky" Eickstadt checked into a Columbus, Ohio, jail for what he thought would be a 175-day stretch on a drunk-driving rap. The 35-year-old electrician, who had never committed any other crime, had no idea it would turn out to be a death sentence.

Eickstadt, unbeknownst to himself or his family, had developed a severe case of diabetes, a disease that can kill—if left untreated. And untreated it was.

"I believe they killed my son," said Eickstadt's 71-year-old mother, Dorothy.

For two and a half weeks, PHS medical staffers apparently failed to diagnose, treat, or even acknowledge Eickstadt's life-threatening diabetic symptoms: vomiting, constant urination, shortness of breath, fatigue, and bleeding gums, according to records obtained by the Voice.

The main target of her anger is Prison Health Systems, the huge for-profit corporation that runs the medical ward at Franklin County Correctional Center II. On January 1, Tennessee-based PHS, which takes care of 175,000 inmates in 27 states, is due to take over management of New York City's jail medical system. The new contract, worth an estimated $300 million over the next three years, is supposed to represent a new day in the long and troubled history of the city's correctional health system. But if Rocky Eickstadt's experience is any guide, the city should proceed with extreme caution.

For two and a half weeks, PHS medical staffers apparently failed to diagnose, treat, or even acknowledge Eickstadt's life-threatening diabetic symptoms. And he had a medical encyclopedia's worth: vomiting, constant urination, shortness of breath, fatigue, and bleeding gums, according to records obtained by the Voice.

The pattern of apparent neglect lasted right until the bitter end. Even after Eickstadt was found writhing on the floor of a holding cell with barely detectable blood pressure, the company's nurse waited 15 minutes to call a PHS physician. Finally, on the morning of September 11, Eickstadt was shipped to the county hospital, where he died two days later.

The county, which signed a $2.5 million a year contract with PHS in 1998, wasted no time in letting the company know who was liable for any lawsuits. "Despite clear indications . . . of a diabetic condition, [PHS] personnel did nothing to address or diagnose his diabetes," wrote Jeffrey Glasgow of the Franklin County attorney's office.

"We plan to sue them all," says Michael Rourke, who is representing Eickstadt's family in the case.

A PHS spokesperson says it is company policy to withhold comment on deaths at its facilities until staffers conduct a "mortality review" of prison and medical records. In a September 18 letter, Vincent Spagna, the company's medical director at the jail, admitted that he too had "concerns about the performance of the nursing staff," though he had not yet drawn any conclusions.

PHS, which is currently in final contract negotiations with New York's Health and Hospitals Corporation, was supposed to be a godsend. For the past three years, the city's 13,000 inmates, most of them housed on Rikers Island, have been under the care of St. Barnabas Medical Center. The St. Barnabas contract, inked in January 1998, was hailed as a money-saving innovation, imposing a managed-care model on a system with out of control costs. Yet, almost immediately, the scheme collapsed. Within the first six months, two city inmates died amid allegations that serious injuries and illnesses were improperly treated, and Manhattan DA Robert Morgenthau opened an investigation into the hospital's patient-care practices.

The PHS contract, which is due to be approved by HHC's board by early December, is basically a back-to-the-future plan, replacing the lump-sum payment system that caused so many problems under St. Barnabas. From now on, the city will pay its medical contractors for each service performed on-site. The idea is to create incentives for more aggressive treatment of inmate illnesses; St. Barnabas was often criticized for skimping on care in order to cut costs under the HMO model. Under the new plan, EMS will transport the most severely ill inmates for care in city hospitals, which will pick up the cost.

In September—at almost exactly the time Rocky Eickstadt was wasting away in Ohio—the city was selecting PHS over St. Vincent's Hospital and Capital Health Management of Queens for the contract. Sources close to the process say PHS was the lowest bidder.

Recently, corrections officials around the country have begun to raise serious questions about PHS's performance in their jails. The company has come under fire for failing to maintain adequate staffing levels or acceptable patient care in Maine, Georgia, Pennsylvania, Florida, and Washington.

In Philadelphia, PHS was forced to make improvements after an independent monitor released a scathing 1998 report that found serious deficiencies in the company's treatment of acute illnesses and in its propensity for hiring subpar doctors. In one case cited in The New York Times, PHS staffers were alleged to have waited five months to treat a man who was suffering from a life-threatening aneurysm.

There were other allegations. In 1994, officials in Pinellas County, Florida, accused the company of contributing to the death of a 46-year-old female inmate, who pleaded for, but never received, her prescribed heart medication. In addition, a small county jail in Maine recently fired the company for inadequate staffing—the same problem that led the Georgia state corrections department to fine the company $250,000 in 1995.

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