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WDI's Blog covers a boundless spectrum of health care and death topics that affect us all at one time… or another and in one way or another. Topics are to the point and in understandable no-nonsense language to maximize clear understanding.      Subscribe to Blog Newsletter

29 July 2017 - The Power of a Witness
19 January 2017 - LifeCare InterlockSM - What You Don’t Know Matters
16 Dec 2016 - Ensuring Adequate Health Care for Inmates is Family's Responsibility
09 Dec 2016 - State Departments of Correction Looking for Cheaper Ways to Bury Deceased Inmates
                        — Don't Fall Into the Trap

10 Nov 2016 - The Perfect Storm—Prison Health Care & Death
06 Nov 2016 - Jail & Prison Deaths—Stop the Madness—Another 'Suspicious' Michigan Prison Death
01 Nov 2016 - Prison Health Care & In-Custody Deaths—Families Need to Step Up
20 Oct 2016 - Prison Medical Paroles aka Compassionate Release
                        — Not About Compassion At All

19 Oct 2016 - What's it Gonna Take?
14 Oct 2016 - The Gerbil Wheel of Prison Health Care
28 Sept 2016 - NYC Reaches $5.75M Settlement in Rikers Inmate Death
19 Sept 2016 - Prison Health Care Delivery
09 Sept 2016 - We've Come a Long Way but Not Alone
05 Sept 2016 - Haunted on the Inside - Inmate Deaths
30 August 2016 - When An Inmate Dies—What You Need To Know
23 August 2016 - Do's and Don'ts When An Inmate Dies

The Power Of a Witness

29 July 2017
© KRusso/The Wrongful Death & Injury Institute 2017

THe Power of a Witness - Gavel

I received a phone call a few years back from a gentleman who had become a client after hearing me on a radio show I hosted for two years. We worked on his matter for two years or so. His child had needlessly died in a hospital. Out of nowhere 4 years later, he called. When I picked up the phone and said hello, he said, “Karen, I wanted to call you this morning because the Lord put it on my heart to call you and tell you, to show you that all came full circle. Everything came full circle. You were the one who gave me hope, to continue forward.”

My client who I will identify as “GL” went through 4 law firms before finding one lawyer that would take his case on. The lawyer he ultimately ended up with was a patent lawyer—the most unlikely type of lawyer to take on this type of case. The first lawyer sabotaged GL’s case. GL found out that the lawyers for the hospital he was going after were in the same building as the first lawyer. The conference room GL was ushered into for the first time was the very conference room the lawyers for the hospital used as a co-op with the first lawyer. GL knew then that the first lawyer was no good and he proved it true. All the while GL was giving the first lawyer information about his case that he had amassed over the years, that lawyer in turn was passing that very information on to the hospital lawyers. GL fired that lawyer.

Fast forward. GL and his family ended up in conference mediation between his patent lawyer, the lawyers for the hospital, the lawyers for the doctors and lawyers for the nurses. GL got his chance to speak and when he did, I bear witness to the fact that it was God in Christ through GL who spoke through him loud and clear. GL’s 5 years of research, of learning and understanding medical terms, of learning the laws, of learning everything and all things that he could about the disease that should not have taken his child’s life, the credentialing of doctors, the insurance companies, the hospital’s refusal to treat because they were on Medicaid—all of this he obtained, learned and processed. He became well-versed in the issues of his case. So well versed he knew more of the case than the very lawyers on the case – on either side. He was relentless. He was determined. And—he was successful. Why? Without a doubt because God was with him. GL’s motivation, his compulsion was out of what he had experienced out of grief and deep sorrow, to hold accountable those that knew and refused to take responsibility, knowing that they could have done what they should have done and did not do it.

God gave GL the gift of translation so the lawyers for the hospital and the lawyers for the doctors and the lawyers for the nurses themselves—knew beyond a shadow of a doubt that God Himself was convicting them through GL’s words of what they did not do and did not own up to. No one could argue to the contrary. God honors facts and He honors honesty. GL’s witness, his testimony was so powerful in that conference room that the lawyers for the hospital, the lawyers for the doctors and the lawyers for the nurses, were speechless. When GL was finished there was complete silence in that conference room until the lawyers one by one—settled. Then and there. And at the conclusion of that conference meeting, each one of them shook the hand of GL and told him they had never heard such an argument ever before and how sorry they were at the loss of his child. GL took the settlement and set up a foundation for other parents facing the same or similar problems.

GL’s patent lawyer subsequently emailed him and told GL he felt as though he had let him down. He had been unable to translate what GL ultimately had translated so well to win his own case. It is a problem with lawyers. Their ego, their pride, their arrogance, and their greed are forever in the way of translating to others in five cent language what needs to be stated so succinctly so clearly so all understand without a shadow of doubt the real, raw issues.

GL was gracious. He let that patent lawyer know that regardless of his inability to adequately translate, he was grateful for the fact that he had the guts and the wherewithal to step up and step out of his comfort zone to do the right thing.

One of the 4 lawyers GL had interviewed at the outset, a lawyer who subsequently turned mayor, told GL that the hospital would never settle and would not apologize. GL knew better and he literally kicked the dust off his feet as he left that lawyer’s office. GL bore witness to the fact as I do now, that “Greater is He that is in me than he who is in the world.” Not only did the hospital apologize, every single doctor and nurse apologized as did the lawyers—all of them. Put to shame they were each and every one of them.

GLs concluding comment to me, “God motivated me to call you this morning and let you know what happened; He wanted me to tell you how He worked through this. And it was God speaking through you years ago on the radio who gave me hope and the courage and know-how to keep moving forward and never stop.” GL drove the point home and told me to “ never stop telling all people that no matter what; no matter what they are facing, no matter what the trial, no matter what the loss, never give up. Take research seriously, be diligent about the issues facing you, learn about them—whatever it is you are facing, go after all the information and learn, learn, learn. Don’t settle for 2nd best. Ever. Go after it as if your life depended on it. Because it does.

God tells us we are to be witnesses of Him; witnesses of what He does to us, with us, for us and through us. You don’t have to be an intellectual phenomenon to be used of God. Jesus Christ didn’t call us to be lawyers; He called us to be witnesses. A lawyer argues a case, a witness tells what he has seen, heard and experienced. When you stop pretending that you know what you don’t know, people will start believing you when you tell them what you do know. That’s what a witness does. GL did that. And he bore witness of that fact to me.

I’m sharing this Truth again for those who need encouragement, who need hope in the darkness, to persevere and to be obedient to what He says. Never say “you can’t.” He will not honor that. Remember GL and what the Lord did through him. He will do the same for you.

LifeCare InterlockSM - What You Don’t Know Matters

19 January 2017
© KRusso/The Wrongful Death & Injury Institute 2017

LifeCare Interlock For the Incarcerated & Their Families

Phone: 816.941.0087

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Ensuring Adequate Health Care for Inmates is Family's Responsibility

16 December 2016
© KRusso/The Wrongful Death & Injury Institute 2016

Director - Wrongful Death and Injury Institute My message today is directed to families of inmates and those who are friends of inmates who have no family. And the message is this: It is YOUR responsibility to ensure that your loved one who's locked up is actually getting the health care he or she needs. It's YOUR responsibility to ensure he is getting the correct medications he needs. While you may hold the belief that it's the jail or prison's responsibility to ensure this, that belief you hold is unrealistic and extremely naïve. And I’m going to tell you why.

That belief that you buy into, directly affects the very life, health and safety of your loved one. As long as you buy into that belief—as long as you continue to operate in that mindset, the system has you exactly where they want you—under their thumb. And if you choose to stay in that mindset, they have succeeded in convincing you that you’re incarcerated too, right along with your loved one. And as a result, you fall in line –just like the inmate does. Even though you’re free on the outside—you’re imprisoned on the inside. You believe everything you’re told by correctional and medical staffers. You believe he has no rights of any kind, you believe that it's ok for the system to dictate to you what information you can and cannot have without so much as one question being asked. You don’t question; you don’t seek actual answers to any specific issues. And the system rolls right over you because they have succeeded in intimidating you. You end up spineless, weak and ineffective.

Moundsville Prison Penitenarye

The moment you know that your loved one is headed into the system, whether he's 18 years old or 70 years or older, that's your cue, that's the red flag being waved in front of your face, that you, the family member, better make the decision right then and there to step up, and learn about the very systems you’re going to be forced to deal with; because like it or not, you will be forced to deal with them. It's absolutely necessary for you to understand that when you have a loved one locked up it is YOUR responsibility to understand how that system operates and what you should be doing. It's YOUR responsibility to have key documents in place and it's YOUR responsibility to understand what you should be doing before, during or after an inmate death. Said another way, you the family member, has to be the CEO, President, Secretary and Treasurer of that inmate, because the inmate, your loved one is not going to be able to do what needs to be done on his or her behalf in getting the health care they need, because the system isn’t going to allow them to do so.

There are key documents that must be in place for the benefit of the inmate and you, specific to health care and death issues. Documents that authorize you to do “xyz”, request “xyz” and fight for the life of your loved one. These are not documents you pull of the internet and they are not documents provided by the jail or prison system. These customized documents are provided by the Institute specific to inmates.

Of course, you always have a choice. You can turn your back on the inmate, wash your hands of the entire ordeal for selfish reasons, and walk away. You can ignore his pleas for help, you can choose not to believe what he's telling you about his health concerns, you can choose not to answer his letters, and you can choose never to go visit. You can actually witness an inmate declining in health right before your eyes, as many families have, and do absolutely nothing about it, and yet shift blame to a system. Comments by families that they didn’t recognize a deceased indicates they haven’t been in touch with the inmate at all. These are all choices. And when you make your choices there are indeed consequences to each and every one of them. Your failure to do what needs to be done and can be done for the inmate can result in that inmate incurring a permanent medical disability or his coming out in a body bag. Too harsh to hear? It's true.

Inmates dying of dehydration and starvation, perforated ulcers, ruptured intestines, diabetic comas, gangrene, untreated liver disease, spider bites untreated—all are merely some of the horrible conditions these inmates die of. There are countless others. Let me give you some more examples.

How about the inmate who was told he had bronchitis when he was dying of cancer, and was treated with Robitussin.

Or the 28 year old Virginia jail inmate who was supposed to go out for dialysis; but wasn’t taken until 2 days later, got sick in the interim and died within hours.

Or how about the inmate in Missouri who got hit in the face with a lock in a sock resulting in two broken jaws, wired shut by a prison dentist who gave no anesthetic or pain medication.

Or the 28 year old Kentucky jail inmate who died while going through detox. He was never assessed while going through drug withdrawal.

Or the DOJ inquiry in Virginia that found that medical records failed to meet any known professional standard. That was in 1998; today is 2016, nothing has changed.

Or the 22 year old female inmate in Florida who was given Thorazine for unruly behavior and had a deadly reaction to the drug due to undiagnosed and untreated pneumonia.

Or the 42 year old inmate who died of blood poisoning after a diabetic ulcer on his foot became infected and never was treated.

Or the 30 year old female inmate in Nevada who was insulin dependent and was required to adhere to a strict diabetic diet. The Prison doctor who never examined her, cancelled her insulin and her diabetic diet. She was dead within 48 hours.

Or the Oklahoma jail inmate who died of a perforated ulcer. His pleas were ignored about severe abdominal pain. Nurses told the correctional officers (COs) to send him back to his cell and “let justice takes its course.”

How about the 17 year old NY jail inmate who committed suicide after the jail doctor took her off her anti-depressant drug after a 15 minute interview, knowing she was suicidal.

Or the 18 year old inmate who lost 50 lbs. in less than a month and suffered symptoms of mental illness, dehydration and starvation.

Or the mom of three who died in a Florida jail of a heart attack after 3 nurses ignored her requests for her medication prescribed by her doctor. When she collapsed the nurse said “stop the theatrics.” She was dead within minutes.

Or the 4 Alabama inmates who died because nurses used the wrong chemical in the kidney dialysis machine.

Another Alabama inmate lost 23 lbs. in 10 days in a county jail; begged and screamed for help until his screams were heard no more.

There are others; we’ve been indexing these cases since the mid-90s. Just in the last 8 years alone, we’ve reviewed, read and indexed 8500 of these types of illnesses and deaths that run the gamut.

When an inmate gets sick and can’t get the medical attention he needs, when he submits multiple sick call requests and the resulting health care never addresses his actual complaints, when he submits informal and formal grievances and gets no satisfaction, when his mental health meds are withheld or denied or used as punishment, when you don’t hear from that inmate over a period of time, when you’re told by staff that the inmate has been moved to a prison infirmary, hospital or hospice, or that he's doing fine, when you get a call from prison administrators, chaplains or other inmates telling you that the inmate has died, in every one of these situations, you have no idea what you should do, can do and when it should be done. Instead, you are reactive. Not proactive. Always on the defense rarely on the offense. The results are predictable. And they are a direct result of your personal failure in refusing to learn how the systems actually operate individually and collectively, and how they are going to directly and indirectly affect not only the inmate but you.

Because of the mindset you’ve bought into, you have allowed that system to lead you around by the nose. In effect, you sit down and assume all is well until it isn’t. You’re paralyzed. And you’re paralyzed because you don’t have the information, knowledge or know how of how these systems actually operate and what you must do. And the result? The inmate gets no adequate health care, no correct medications, endures incredible physical and mental pain, abuse and torture. All unnecessary—all preventable. And so…

When death occurs, your first line of attack is directed towards the system. Instead of yourself. Your comments to us over the years have run the gamut. Here are some that I’m going to challenge.

"The system failed again. It's going to keep happening again and again."
"I want the system fixed"
"I don’t want whatever has happened to my loved one to happen to anyone else."
"I want someone to pay for what they’ve done."
"They won’t give me any information."
"I want justice."

To the comment that the system failed? On the contrary, the system hasn’t failed at all! It has succeeded in doing exactly what it's designed and authorized to do. The system is working just like it's supposed to work; just like your county and state legislators want it to work. As I’ve said before in past videos, in past articles, year after year, and as I’ve explained in our book, this pattern of health care is NOT new; it's been in place since the 70s and it has become increasingly worse—for the inmate, not the system.

And regardless of the thousands of articles written, highlighting the deaths of inmates, after the videos that surface highlighting medical abuses, after all of the investigative reports that have been written recently and will be written in the future, they are reporting nothing new. They are merely a flash in the pan. The situation has not improved and it's not going to improve for you or the inmate now or in the future, for very specific reasons.

The goal since the 70s and continuing on to this very day is only one: that of cost containment. The county or state must provide “adequate” health care to inmates—it's the law. The goal is to save money and still do what they’re required to do. The contracted health care provider is in the business to save the county and state money while at the same time, make money. They’re in business. Their goal is not to lose money. Their goal is to make money. And this goal is aggressively and relentlessly pursued and achieved by giving the façade of adequate health care without every providing it. This is the system I’m referring to that you must be knowledgeable in. And all of you are not.

The correctional system and the prison heath care system is not going to change for the benefit of the inmate or for you. You are not their concern. Their only concern is to keep you in the dark, intimidated and confused. And again, because of the mindset you buy into, they succeed at doing exactly what they set out to do, and your loved ones continue to die. The most recent flash in the pan reports have come out of Hampton Roads Regional Jail, and within the jail and prison systems in Michigan, Wisconsin, Tennessee, Oklahoma, Missouri, Florida, Illinois, Ohio, New York; New Jersey, the list is endless, and will continue.

To the comment it's going to keep happening again and again. Well, yes, it is. It will keep happening unless and until you family members quit playing checkers and learn to play chess. You have to be as knowledgeable if not more so about the systems and how they work than those who are working in those very systems. Sound impossible? I’m here to tell you it isn’t. We’ve been doing this for over 20 years.

To the comment someone needs to do something and fix the problem, that someone is you, the family member. The solution to the health care not being given to your loved one, the solution to the system not returning your phone calls, the solution to your loved one not being given mental health meds, the solution in not providing you with accurate and factual information and answers, the solution to not knowing where the deceased inmate's body is, or whether an autopsy is being performed and what your options actually are, the solution to all of this and more, rests with you—not the system. The system doesn’t care. However, you should. That inmate is a number. A commodity. And as long as they can lead you family members around by the nose and get you to do what they want you to do, when they want you to do it, they’ll do it.

Moundsville Prison Penitenarye

That “fix” doesn’t come from an outside government agency, or a lawyer or a church. And it's not going to come fast enough when a crisis arises. So in the meantime, my question to you family members and friends is, what are you doing? What are you going to do? What are you doing now? Do you sit down and just see what happens? Do you hang back and use the excuse you don’t have the money or the time to do anything? Unfortunately that's exactly what most of you do. It's that mindset again. That fix has to come from you, family members and friends learning—actually learning about and understanding how the very systems that are involved, operate. It's your responsibility to ensure the health and safety of your loved one while they’re locked up. How are you supposed to do that? We exist in part, to teach you how to do it. We educate you about those systems and what needs to be done for the benefit of you and the inmate, and we provide the tools you need to get it done. There is a learning curve involved. It takes your commitment and your time to save a life. Saving lives requires both. And it requires work.

To the comment you don’t want whatever has happened to your loved one to happen to anyone else. Well, that sounds charitable enough but regardless of what you want, it is going to happen to someone else. If your loved one has died and you’re watching this video, do what our past clients have done, pay it forward to families you know and don’t know, share the videos and website with them. Make them aware of the tools that are available to them so they don’t have to go through what you went through, because you didn’t have the knowledge or the tools. That's how it doesn’t happen to someone else. That's how you make your deceased loved one's life count—You save a life. That's how you make a difference. Go watch the videos on our website of our past clients do just that. If you want to add your video to our library, let me know.

While many of you may think litigation is the answer many times it is not, for very key reasons. The percentage of cases that lawyers actually take in these areas is miniscule compared to the thousands who are suffering and dead. And not every lawyer is qualified to handle these cases. We address this on our website.

To the comment you want someone to pay for what they’ve done. Most of you can’t define what you mean by that. Some of you mean you want a specific individual to be held accountable for whatever it may be. However, you have absolutely no idea what that entails or how it has to be achieved. Others mean they want the system to pay but when pushed to define specifically what they mean, they can’t define it either.

To the comment the prison won’t give me any information. That's by design. From the correctional side to the medical side. Their goal is to provide you with little to no information but get as much information out of you as they can. And it's just here, that if you had the knowledge, training, tools and documents in place and were taught by us how to play chess rather than react to a self-perceived injustice and fall into the tricks and traps they lay out for you, you would be getting all the information you needed right when you needed it. We’re here to teach you how to do that.

Lastly, to the comment I just want justice, this is one of the most over-used, pointless, meaningless comments that is ever made. When I ask clients what they mean by that, most can’t even define what the word “justice” means or explain well what they think it means. What comes through in countless conversations however, is that families really don’t want what happened to their loved one to happen to anybody else, but they’re not quite sure how to make the death of their loved one—count.

Some will say it isn’t about the money, and it may not be, but most hold the belief that's how you get so-called justice, by winning a certain sum of money. This is not always the case. Any money gained because of a death—we call blood money, and rarely is it a game changer that benefits the lives of living inmates and their families unless there is a selfless commitment on behalf of a family, to actually invest in meaningful avenues for change that actually helps others—not just themselves. Justice in a court of law is superficial exactitude between human beings. That's why so many aren’t satisfied in courts. The outcome of court cases results in a tightening up of policy, procedures and protocols within the jail and prison systems and in the policies, procedures and protocols of the medical providers, and both have a shared interest to ensure that it becomes more and more difficult for the inmate and for you to obtain the care and information that is needed. These policy and procedure changes can be initiated by new legislation which can be a direct result of the lobbyists for both correctional institutions and medical providers. But again, you don’t know this, because you don’t understand how the systems work.

Inmates are not able to fight for themselves when it comes to medical issues. The system does not allow them to do so; the system puts countless hurdles in front of them that they’ve got to jump over and hoops to jump through in order just to get the most basic of care or medications. It's all by design. It's all scripted out. And it's scripted out in every county in every state in every jail, in every prison. One size does fit all; but each system varies in policy, procedures and protocols but the bottom line goal is the same across the board: cost containment. Saving money and making money off the backs of inmates and you, the family members. Until you wrap your head around that fact as an actual fact, and make a commitment to saving the life of another by learning to play chess instead of checkers, by getting the required documents in place, you yourself stand as guilty as the very system you accuse of causing the permanent medical disabilities, abuses and death. You are no better than the system. We want to change that. We want you to know that you have more authority than you think you do. You merely don’t have any idea what it is or how to utilize it.

If you want to find out how we do what we do, contact us, we’ll be happy to explain the options available to you.

If you have specific questions you’d like to ask us directly, or concerns that you may have, email me your questions and concerns. I will welcome the chance to educate you and explain to you how successful you can be in doing what you don’t think possible. Let us help you save a life.

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State Departments of Correction Looking for
Cheaper Ways to Bury Deceased Inmates --

Don't Fall Into the Trap

09 December 2016
© KRusso/The Wrongful Death & Injury Institute 2016

Director - Wrongful Death and Injury Institute Hi everybody. I want to talk to you family and friends of inmates today about a very serious issue and problem you not only need to be aware of but you need to arm yourself with the correct documentation for the benefit of the inmate and yourself. I’m going to be using an article that was forwarded to me about DOCs looking for ways to cut costs on burying deceased inmates. You can access that article here at the Houston Harold. The article is specific to the state of Missouri and the Missouri DOC, but what I have to say doesn’t apply to any one DOC—it applies to all of them, in every state. And the way I’m going to handle this today is to read to you statements made in this article by designating them as "Statement #1,2,3" etc. followed by my comments.

Statement 1: An ever-growing and ever-aging inmate population means more Missouri prisoners are likely to die behind bars in the coming years. Against that backdrop, the Missouri Department of Corrections is seeking bids from funeral homes across the state in a search for the best deal on burial and cremation services for prisoners.

WDI Comment: This practice isn’t anything new. I want you to substitute the state of Missouri for the state that you live in. Because all of what I’m getting ready to say today applies in your state and applies to you too. It's not exclusive to the state of Missouri.

DOCs contract with area funeral homes and cremation services all the time. It's business. It's not a new practice. Nor is it new that the inmate populations may or may not increase. Whether they increase or decrease isn’t the issue. For DOCs the issue is this: What is the cheapest way we can dispose of an inmate body if there is no family, or the family refuses outright to claim the body, or the family can’t afford to bury or cremate the deceased inmate. Now, I want to zero in on this issue and dissect it for you.

First, if an inmate has no family member on the outside, more oftentimes than not the DOC is going to keep control of the body. What I mean by that is this: there will be no question that DOCs will bury, cremate or dispose of the body in some way. If however, that inmate prior to death designated in a Last Will what he wanted done with his remains upon death and filed that document with someone on the outside, DOCs must honor that request and wish.

Secondly, If family members refuse outright to claim the body, the DOC retains control of that body and can dispose of that inmate anyway they see fit. Families that refuse outright to claim bodies fall into two categories: the first category are those family members that actually do exist somewhere but have not kept in touch with the inmate and have written him or her off. These are the families that don’t write to the inmate and don’t visit. They are not listed with the DOC as next of kin or emergency contacts. In other words, those family members don’t exist. And because they don’t exist the DOC can do whatever they want to do with that body. They don’t have to order an autopsy; they don’t have to do investigations. Sometimes death certificates are issued; sometimes they’re not.

The second category are those families who do exist but out of sheer ignorance and laziness fall victim to a DOC tactic that's used on them to get them to give up control of the body so that control stays in the hands of the DOC. It works like this: When an inmate dies, the next of kin or the person designated by that inmate as the emergency contact is called and told that the inmate has died. They’re not going to give you much information in that first phone call but eventually they’re going to come back to you and say something like this:

Moundsville Prison Penitenarye

"Mrs. Smith we are very sorry for your loss; your son was very well liked by many here at the prison . We know that these deaths can be a shock and an economic hardship on you when they happen suddenly like this. If you would like us to take care of the funeral arrangements or burial we'll be happy to do that.” To the untrained ear this offer sounds great; especially if you don’t have the money to handle the arrangements. So Mrs. Smith says this: "Oh yes, I would appreciate your help very much; I have some money I can put towards the expense, but it won’t be enough. Yes, I would like your help." The DOC then will tell her that they’re gonna email or fax to her a “form” that they need her to sign and send back to them, authorizing them to handle the arrangements. But those arrangements are not spelled out on that form. And once she signs that form and sends it back to the DOC, she has, right then and there, lost all rights to her son. Meaning: she cannot request his medical records. She cannot have his personal property or any money that may have been on his books. She cannot attend a funeral service to view her son, and she may or may not be told where her son is buried. If the DOC cremates a body, they may or may not send the cremains to the family. And if they agree to do so, families don’t know what they should require of the DOC to prove to them that the cremains they are receiving, are in fact the cremains of their loved one.

Statement #2: According to bidding documents, the state wants the cheapest wood box and the most inexpensive grave liners, to cut down on an expense that cost taxpayers $62,000 last year.

WDI Comment: Not all deceased inmates are buried. Most are cremated. DOCs prefer cremation to remove the possibility of body exhumation for further investigation or autopsy. Basic cremation costs, depending on what state you live in, average $1100 or less. Families have no idea how to negotiate these costs or what services to access in order to do so, to retain control of the deceased. If a DOC knows that a family is in the process of securing these services themselves to keep control of the body, DOCs can threaten families with cremation without their authorization if they don’t pick up the body within "x" number of hours. This is a strong-arm tactic used to get families to turn over control. Don’t buy into it. Only when an inmate has died of a contagious disease are they authorized to dispose of the body within hours if the family doesn’t do so. In all other circumstances, families can make the necessary arrangements within a reasonable amount of time without fear of retaliation and harassment from the DOC. They merely don’t know how. The Institute can teach you how to accomplish that.

Statement 3: When a prisoner has no family, the state pays for disposing of the remains.

WDI Comment: I've explained this already but let me add one more comment. When a DOC keeps control of a deceased inmate's body, they can do whatever they want to do with that body: they can cremate it, they can bury it, they can authorize a full body donation to some medical or research hospital or "the body farm", or they can authorize tissue, bone and organ donation. So while DOCs are stating they"ve spent thousands of dollars disposing of deceased inmates, understand that they can get rid of these bodies in many different ways that cost them little to nothing.

Statement 4: With more prisoners serving more time, states such as Missouri are grappling with more inmate deaths.

WDI Comment: Serving more time doesn’t necessarily have anything to do with more deaths.. More inmate deaths can be a direct result of inadequate medical and mental health care delivery, which can certainly contribute to suicides and fast track progression of treatable diseases such as asthma, diabetes and heart problems which aren't adequately treated at all.

Statement 5: As the state's bidding documents note, "As the offender population ages, the expense associated with offender deaths increases."

WDI Comment: This is only true if the inmate and his family members do not have the correct medical documents in place that keep control and authority of certain medical decisions with the family members for the benefit of the inmate, and control of the inmate's body with the family upon death. The Institute provides these documents for inmates and their families and the needed information that goes with them.

Statement 6: In 2015, Missouri officials say, 104 inmates died behind bars. Of those, the remains of 55 were not claimed by family. That number could increase. There are 1,415 incarcerated offenders over age 60.

WDI Comment: I’m speaking to you family members and friends of inmates that are over 55 in whatever state you live in. You need to get these medical documents in place, and you need to know how to use them. When they're in place, DOCs cannot perform certain tests without your authorization if the inmate is unable to speak for himself. If that inmate can't speak clearly on his own, when these medical documents are in place, they prevent DOCs and medical personnel from taking an inmate off of life support without your permission. Let me take this one step further. This doesn't just apply to inmates 55 and older. These documents should be in place for any inmate of any age in any jail or prison facility in this country. If your 18 year old is in jail, you need these documents in place. If you have a loved one of any age anywhere you need these documents in place. Your failure to get them in place puts you at the mercy of the system; and they can pull the wool over your eyes very, very easily and you won’t know how bad it is, until it gets worse.

Statement 7: But Corrections' officials will listen to family members if they express a preference on what they want done with their relatives."The department typically takes into account the wishes of family members, offenders and their religious beliefs when making the determination of cremation or burial. This will not change when a contract is in place."

WDI Comment: Don't count on it. They may ask you what your wishes are; the reality is they don't really care. The question and their listening is merely window dressing, and that's all it is. You will have no way of checking on it or overseeing whether or not they actually did what you requested, because the reality is, if you gave up your control of the deceased, you have no say-so in the first place about anything.

Statement 8: As for a headstone, it depends on how much a prisoner had in his or her personal prison bank account.

WDI Comment: Which translates to this: if the inmate had no money in his account then he gets no headstone. He may have his inmate number on a rock in a field somewhere.

Statement 9: "The department does pay for a marker if it chooses burial."

WDI Comment: Which points directly to what I stated previously, DOCs prefer cremation. If they opt for burial markers can vary from virtually nothing, to inmate numbers on crosses.

In conclusion, to avoid the problems associated with an inmate's declining health due to inadequate health care and death and the issues I’ve highlighted in this video, you have got to have these documents in place and you have to know how to use them. The Institute supplies both the documents and the know-how. I don’t know how differently or in how many different ways I can get the point across to you families and friends of inmates. Without the documents and the know-how, get your seatbelt on. You thought incarceration was bad enough, wait until you are subjected to the tricks and traps of the DOCs when your loved one dies. It'll rock your world. Life will never be the same. If you need confirmation of this as a fact, access the videos on our website of family members whose loved ones died.

Again, you can read the full news article I referenced today and the transcript of this video on our blog that you can access through our website at wrongfuldeathinstitute.com . Until next time...thanks for tuning in. Call with any questions or concerns. We’re here to educate you and help you and your loved one.

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The Perfect Storm—Prison Health Care & Death
Transcript of Video

10 November 2016
© KRusso/The Wrongful Death & Injury Institute 2016

Karen I’m Karen Russo of the WDI . . . in our ongoing effort to explain to you families how important it is for you to know what you can and should be doing if you have a loved one locked up in a jail or prison, I’m going to highlight a case out of Tennessee that was the equivalent of a “perfect storm” of every trick and trap thrown in front of a family by the prison system to deny them information and access to a dying loved one.

Before I get into the details of this case, let me say that most families are not prepared to handle any health care and death issues dealing with the correctional system. They’re not prepared because they’re not knowledgeable and they’re not knowledgeable because they rely on everybody else for the information they should be obtaining through reputable sources. But even when they do obtain this information they have the added problem of not knowing what to do with it. We want our clients, the families knowledgeable of the system they’re forced to deal with—whether that system is the correctional or medical system, medical examiner & coroner system, or funeral industry, and we want them to learn what to do, how to do it and when. Again, this is one of the key reasons the Institute exists.

So let me start by saying that if you have a loved one going into the system or if they’re already in the system, you must have in place key medical documents for the benefit of that inmate and yourself. And by key medical documents I do not mean documents that ARE given to the inmate to fill out by prison and medical personnel, and I do not mean documents pulled off the internet. Both are sub-standard, insufficient and not thorough enough for what has to be done for that inmate. The Institute has developed our own key medical documents specific to inmates and their families through LifeCare Interlock. These are proprietary documents that’re customized for the inmate, his specific medical needs and the family. Along with those documents we provide detailed instruction on how they are to be utilized. You can get more detailed information about them at: www.lifecareinterlock.com Bottom line is this: without these documents in place you’re not going to be able to aggressively advocate for the inmate about any health care issue or problem he or she may have, you’re not going to be given any information from medical or correctional staff, you’re not going to be allowed to access the inmate's medical records, and most likely you’re not going to be called by the prison or hospital for authorization to remove that inmate off of life support or a ventilator, and the list goes on and on. So LifeCareInterlock documents are a requirement.

Now, the Tennessee case. I’m not sharing the actual names of any of those involved. The inmate, I’m going to refer to as John Q. His brother I’m going to refer to as Sam. This is going to be a 2-part video because of the complexity of the issues in this case. My goal today is to relay to you the tricks, traps and tactics that a system can and will attempt to use on you to keep you away from a sick and dying inmate. What happened in Tennessee happens in every state, every day. I have talked and written about this for over 20+ years. Said another way, I want you to take what I’m saying today, and merely realize that it's happening in your state right now, and can happen to you at any time, without warning.

The Tennessee case was riddled with problems of bad health care, to no health care which morphed into undo suffering and ultimately, death. Within those problems additionally what had to be dealt with, was the arrogant, unprofessional behavior of DOC administrators, the deceit and lies put forth by the medical director, correctional and medical staff, the chaplain, and medical examiner's office—all of which was followed by the unethical behavior of lawyers the family consulted with. Like I said, a perfect storm.

JohnQ was in a state prison. He had a history of heart problems but those problems were handled and kept under control with medications he was taking. He had no other history of health problems. Sam visited him on a regular basis. JohnQ was able to walk on his own, speak well and was keenly alert. Then, on one particular visit JohnQ was wheeled out to the visiting room in a wheelchair. Battered and bruised with stitches over parts of his head and face, he told his brother, “I’m like this all over. I was on my way to get my meds and I was walking along and the next thing I remember I had all of these injuries.” Subsequent to that visit, Sam called the prison to ask about his condition and to tell the medical staff that JohnQ needed some medical attention immediately. They said they couldn’t talk to him about his health care but would look into it.

It was clear at the next visit one week later, they had done nothing. He still had to be wheeled out in a wheelchair, and while he looked only slightly better he had a new bruise on his face and neck. And there was clearly another medical problem: JohnQ's speech had changed—there was a marked difference in his ability to communicate. His words were garbled, his sentences were fragmented and his attention span was grossly impaired. Sam calls the medical unit again, and demands that they get him some help; He tells them that it's obvious he has a head injury they’re not treating and he's getting worse with each passing day. Medical staff tells him they’ll look into it.

Sam later finds out from other inmates that they have to get JohnQ dressed because he's unable to do it himself. Despite requests by those inmates to medical to get him help, all their requests were ignored.

When the medical director later told Sam that JohnQ was getting the best of care, Sam argued, telling the medical director that he couldn’t have been getting any care at all, because he couldn’t fill out the required sick call requests to be seen by medical. And if there were no sick call requests on file, then according to the medical unit, in their world, there wasn’t anything wrong with JohnQ.

The medical director pushed back again and said, “oh, that would never happen, a nurse would have helped him fill out the request.” We, the Institute, want you families to know that this is a lie. For that to happen, for a nurse to actually do that, the inmate has to fill out a form requesting that a nurse help him fill out a medical request form. If he can’t fill it out the form requesting his need for help filling out the medical request form, then he gets no assistance.

On the flip side, even IF he is able to fill out that form, they’re not going to make a nurse available to do so. Bottom line is this: No medical personnel on their own, help inmates fill out any medical request forms or any forms to request help with the medical request forms. Ever. The only medical form inmates will get help filling out are DNR forms—Do Not Resuscitate forms, and inmates should never fill out DNR forms while they’re incarcerated. Ever.

A week later JohnQ was sent to another facility that had a hospital. Not knowing any better, Sam drives to that facility hospital, asks the front desk for his room number, which they tell him, goes up to his hospital room, opens the door, sees his brother shackled to the bed and completely out of it, he's not even aware that Sam is there. Sam tells the correctional officer (CO) who he is and the CO quickly tells him he has to leave, that he's not supposed to be there and wants to know how he knew that JohnQ was even at that facility. Bottom line is: he was kicked out of the room and not allowed to visit.

When inmates are transferred like that, from one facility to another, family members have to get what's called “special visit” authorization from the warden, prison doctor or medical director to be able to see an inmate. There's a skill set involved in getting that special visit authorization approved that I won’t go into now, but suffice it to say, that when you have a loved one in a prison hospital, prison infirmary or hospice unit, do NOT allow any correctional or medical personnel to deny you visitation. Ever. I’m not going to go into the ins and outs of how to do that in this video, but if you’re faced with that problem, contact us.

Sam attempts to get visitation authorization from the prison but no one would call him back. He kept at it. He was then told that JohnQ had been moved to a hospice unit in yet another facility and that he doesn’t have long to live. Within hours, they called Sam back asking him for permission to run a certain test on JohnQ but wouldn’t tell Sam what that test was. We want you families to know that when you get a call like this requesting your permission to have certain tests performed on the inmate, and you’re not told what those tests are, you must demand the answer be given to you and the reasons for the tests before you give permission.

Now, there are three reasons why the system would even call you in the first place asking for your permission: one is that the inmate is not able to give permission for the test himself, he's either in a coma or so sick that he can’t talk, another reason is that you may have the LifeCare Interlock documents in place which require medical staffers to call you and ask you for permission. Another reason is to present a façade of actually performing some kind of health care test and treatment without ever doing it. Another reason, is to set you up to tell you that the inmate died—either before the test was ever done or shortly after the test was supposedly done or while you were on your way for that “last visit.” There have been inmates who have been dead for days and the system never told the families of that fact, while the families are trying to make arrangements for a last visit.

Sam demands visitation but the system still pushes back and cites Hipaa laws. They explained to him that authorization has to come from the prison doctor. Arguments prison doctors give will always be that “it's not in the best interest of the inmate for you to visit.” I am here to tell you families not to lay down for this explanation. Do not accept it. It's not a valid argument and it must be challenged immediately. If you’re told this, I want you to know that there is a way to get that visitation. Do not back off and do not buy into what you’re being told and do not back down. As Sam explained to us, “they know he's dying but they keep the family away. They cite Hipaa laws and any other tactic they can throw at you to shut you down and keep you away, but then at the same time they start sharing sensitive medical information with you over the phone, the very information they refused to give when they cited it was Hipaa laws that prevented them from talking to you in the first place.”

In part 2 of this video I’ll be talking about the death of JohnQ, the lies that were told to the family by the medical director, contract specialist and chaplain, and the unbelievable time it took to finally get an autopsy performed on JohnQ. Visit our website for more information at www.wrongfuldeathinstitute.com Until next time, thanks for tuning in.

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Jail & Prison Deaths - Stop the Madness
- Another 'Suspicious' Michigan Prison Death

06 November 2016
© KRusso/The Wrongful Death & Injury Institute 2016

All jail and prison deaths trigger a sequence of procedural events within the jail system and prison systems in every state. These events are not made known to the families but the effects of those events are painfully felt. In most jurisdictions the body of the deceased is the responsibility of the medical examiner or coroner's office. The death scene is the responsibility of the local law enforcement agency. However, neither is necessarily so in the case of jail and prison deaths.

While local law enforcement agencies and medical examiners (MEs) are usually the first responders to a death scene in free society, rarely are they ever called to the scene of a jail or prison death. First responders to prison death are usually in this order: correctional officers, then onsite contracted medical personnel then wardens (maybe) followed by EMTs/ambulance attendants, hospital personnel, contracted funeral homes, then coroners or medical examiners. Because of this practice any semblance of a qualified, non-biased death investigation is severely compromised if not impossible. Nowhere are investigative deficiencies in death investigation practices so sub-standard and glaringly apparent than when dealing with jail and prison deaths. This becomes even more problematic when correctional staffers or contracted medical services cause the death themselves. With respect to the former, by excessive force—be it by beatings, blunt force trauma, use of Tasers, or restraint chairs and with respect to the latter, delayed or denied adequate sufficient-to-the-need health care and required medications. Medicolegal death investigation protocols usually do not apply to inmate deaths regardless of what policy states; regardless of what you may have been told.

Let's look at a recent death that took place within the Michigan Department of Corrections of a 30 year old man who died in an Upper Peninsula prison on November 1, 2016 and how the DOC has badgered and harassed this family to dispose of his body quickly and to highlight facts and truth that are not being stated and revealed. You can access that article at: http://ht.ly/h4Mk305QiBK. For ease of reference, understanding and clarity comments from that article appear in bold below, followed by comments based on decades of experience and handling of these issues.

The family of a Saginaw man who died in an Upper Peninsula prison Nov. 1, is attempting to raise funds to bury him closer to home before his body is buried or cremated by the state.

First, there are extremely affordable ways to get this gentleman buried. The Institute deals with this all the time and provides the information to get it done. Further, while the family is trying to raise the funds to get him buried, the system—and by “system” I mean the medical examiner system in cooperation with the MDOC is bullying and harassing this family to get him buried ASAP or else. This is unacceptable behavior from both entities that should not be tolerated by the family. The wording used by this reporter “before his body is buried or cremated by the state” implies incorrectly that the state has the legal control of the deceased—a control that they do not in actuality have. The family does not have to be “under the gun” so to speak to hurry up and get arrangements made just because the DOC is giving them ultimatums. Bodies can in fact, be held at the medical examiner's office for months if necessary while arrangements are being made. Unfortunately families don’t know how to obtain this time. The only time a DOC has the authority to demand burial and disposition of a dead body is when that inmate has died of a communicable disease i.e., Hepatitis C, HIV, Meningitis and the like. State statutes usually require that a body must be disposed of within “x” number of hours—anywhere from 24 to 48 to 72.

Derrik Siminski, 30, died at the Marquette Branch Prison. He was serving a three-year sentence on charges of larceny, delivery and manufacture of marijuana, attempted robbery, and possession of a controlled substance.

Statements appearing in articles such as this one, giving the name, age, where an inmate died, and reasons for their incarceration are “cookie cutter templates” provided usually by the state departments of correction. They are written in a way to belittle the inmate and to discount his life in death; the message it conveys is “see he's in prison where he belongs because he committed this crime, and now he's dead, and the world is a better place because of it.” This tactic causes unspeakable sadness and sorrow to surviving family members while at the same time, stirs up the public's ill-will toward inmates generally; an ill-will that is predominantly devoid of any actual knowledge of the system itself. And the bottom line is, that when it comes to health care and death issues, what an inmate is incarcerated for—doesn’t matter. It's not the point nor is it the issue.

The state has offered to bury Siminski at a state cemetery in Jackson, or to cremate Siminski's remains and send his family the ashes, according to the blog Upper Peninsula Breaking News.

Regardless of the fact that the "state" meaning the Department of Corrections has offered to bury him at a state cemetery or to cremate him and send the family his cremains reveals multiple potential serious problems. Specifically:

  1. This is often a tactic utilized by state DOCs to keep control of the body. To the untrained ear, to a family that is having trouble coming up with the funds to bury their loved one, the DOCs offer to bury or cremate sounds tempting; an answer to a problem the family is facing. We’ve written of this on the Institute's blog before and devoted a chapter to it in our book. This tactic is effectively a “wolf in sheep's clothing.” And it is a tactic.
  2. In order for the DOC to have the authority to cremate or bury an inmate, a family has to “sign off” on the body. And when they sign off, rarely if ever, do they know what they have done when they do so. It is important that a clear understanding be had of what in fact the “state” i.e., the DOC in effect is doing. Most likely, when you sign off and allow the DOC to “take care of the body” you have effectively signed away any and all rights to your deceased loved one's personal property including his personal papers, his medical and mental health care records, death certificate or autopsy report—if in fact one was ever ordered, and your right to bring any cause of action if necessary through litigation does not exist because you signed that “right” away. You may easily be denied access to the whereabouts of where your loved one is buried. You will not be able to attend any funeral service because you won’t have access to the body. In this Michigan case, the fact that the DOC is stating they’ll cremate or bury is problematic. Why? If they cremate him and give the cremains to the family, the DOC has done what they wanted to do—cremate him so no further testing or autopsy could be requested or ordered; the body is gone. Additionally, if a family is given cremains they have little confirmation that the cremains are in fact of their deceased loved one. There is a way to get that confirmation. There are key things that should be required by family members if they elect for the state to cremate. In conclusion, when your loved one dies, unless you sign your rights away, his/her body is now in your control—no one else's . He no longer belongs to the state unless you give that right to them.

MDOC's Gautz says an ambulance was called as soon as prison staff realized Siminski was in distress. The spokesman was unable to give an exact time of death for Siminski. An autopsy was performed the day after the inmate's death, Gautz says, but a determination of Siminski's cause of death is pending toxicology test results.

“Distress” is one thing—death is another. The fact that an ambulance was called as soon as prison staff realized he was in distress, reveals the sequence of events explained in the second opening paragraph of this blog. Go back and re-read those sequence of events. Exact time of death is going to be questionable and should be investigated. This will depend on whether or not he was dead in the cell which in DOC language can mean “distress” or declared deceased by EMTs in route to a hospital, or declared deceased at by the hospital ER personnel. Most often inmates are found dead in their cell however, the DOC treats them as being alive. We devote a chapter to this issue of “Dead But Not Dead” in our book, Fighting For Life/The Tricks and Traps of the Death Investigation System—Guide for Families …” They want it to appear that the deceased inmate is alive for a couple of reasons: one so that other inmates “witness” that they saw the inmate being attended to by EMTs, provision of IVs, oxygen etc. Inmates “assume” that the inmate is alive and report that fact to others. Secondly, the system wants that death reported as a death occurring “off-site,” away from the prison, not at the prison itself. Doing so gives the façade of the system hustling around and doing all they can do to “help” that inmate; to come to the aid of that inmate, when in actuality the opposite is the case. Time-frames are key.

The quick investigation, immediate autopsy, and push to burn or bury Siminski's body strikes both blogger Greg Peterson and Siminski's mother Serena Daniels as suspicious. And, as we reported in October, inmates dying in Michigan prisons under murky circumstances isn't without precedent, to say the least. Siminski is one of several Michigan prison inmates to die in the last four weeks.

Jail and prison deaths follow prescribed investigation protocols. Family members nor the media have any idea what those protocols are or what to request. Immediate autopsies should always be countered with key requests to the medical examiner's office by the family to do and perform “xyz.” However and again, families do not know what to ask for. The “push to burn or bury” quickly, can be brought to an abrupt halt if only the family knew what to do.

Many of the issues this Michigan family is faced with are the same issues that the other families who have lost loved ones within the MDOC face. There are countless families across the country who are facing these same issues each and every day. The refusals, the non-answers, the questions that surround each and every jail and prison sickness and death, can be addressed and handled for the benefit of the family. We want families to know that they have much more power and authority than they think they do; they need to be knowledgeable of that power and how to use their authority. That's why the Institute exists.

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Prison Health Care & In-Custody Deaths
— Families Need to Step Up

01 November 2016
© KRusso/The Wrongful Death & Injury Institute 2016

Prison Health Care & In-Custody Deaths-Families Need to Step Up There have been, over the last 30 years, endless yet sporadic waves of investigative reports from newspapers and magazines across the country covering jail and prison health care delivery, in-custody deaths and the handling of both. If anyone should know that fact to be true—it's the Institute. In the last 8 years alone, we have indexed, read and reviewed over 8500 articles specific to health care delivery and in-custody death issues across the U.S. We’ve consulted with families and attorneys in these matters and know the patterned behavior which manifests in each issue. No matter the state, no matter the county, we know well the issues specific to jail and prison health care delivery, inmate deaths and the players involved—correctional, medical and political. What we also know well is the failure of families to do that which can and should be done for the benefit of that inmate—from the moment s/he enters the system to the time they exit that system, hopefully on their own two feet. It is to this issue this article is addressed using a recent investigative report.

The most recent investigative reports come out of Milwaukee, Wisconsin. In a series of articles by the Milwaukee Journal Sentinel, highlighted are unanswered questions surrounding in-custody deaths in Milwaukee County, natural deaths and suicides that are not fully investigated, as well as, inadequate assessments and diagnoses, lack of training with respect to medical and mental health care delivery and death investigations generally and specifically. All of these issues— are not new .

The stories and cases highlighted in these articles are merely “repeats” of past investigative reports done in other states and counties over the last 30+ years about the very same issues. All one has to do is take a 1995 investigative report, change the date to today's date, up the numbers—and you’ve got an accurate picture of the prison health care delivery model and systemic death-related problems today. Again, these issues are not new. They still persist. Despite the rhetoric. Despite the continuing permanent medical disabilities inmates suffer from as a result of inadequate health care. Despite the proverbial “outrage” of the legal community, advocacy groups, politicians and media. Despite the cancelling of one medical contract provider and contracting with another one. What was taking place 30 years ago, is still taking place today.

This pattern of health care and death investigation has been in place since the 70s and has become increasingly worse. The goal since the 70s and continuing today is only one: cost containment. And that goal is aggressively and relentlessly pursued and achieved by giving the façade of adequate health care without ever providing it. We call it channelized and sanitized health care delivered by Teflon tactics. Not unless and until families and inmates wrap their head around this fact and learn how to fight, nothing—let me repeat, nothing will change...

  • Broken bones will be ignored and not set
  • Stage IV wounds will not be treated
  • Inmate cries and pleas for help from their cells will be ignored
  • Your phone calls into the system will continue to be ignored
  • Mental illness will be ignored and treatment will continue to be delayed or denied
  • Inmates will continue to commit suicide
  • In-custody deaths will continue to be reviewed by those with a vested interest in a certain outcome
  • Information will be denied
  • Sub-standard autopsies performed
  • Death certificate cause and manner of death will continue to be inaccurately assessed ... and the list goes on and on.

                responsibility to oversee heath care of inmate The moment you know that a loved one is in jail awaiting trial or is headed to prison, that is the time when you should be obtaining key information and gathering a working knowledge of the systems that you, the family member, will be required to deal with over time—be it at the jail level or the prison level. It is your responsibility to ensure that the system is doing that which they are required to do. Your responsibility. And there is much you should be doing immediately to ensure the health and safety of your loved one. The problem? You don’t do it. And you don’t do it for any number of reasons—one being clueless as to what all that entails. And that is one of the key reasons for the Institute's existence—to educate you immediately. Otherwise without the information, without the knowledge and how to apply that knowledge, you, like your loved one incarcerated, will be and continue to be at the mercy of the system itself and the incompetence of that system; a system comprised of multiple players. Not just one or two or three—but multiple.

Inmate sick, dying or dead? Don’t believe everything you’re told Instead of holding accountable in real time, those charged not only with the public trust but with the care, custody and safety of your loved one who is in need of medical and mental health care, many of you choose to operate in the dark. You sit down and wait. You go along with what you are told. When bad outcomes happen, you are in shock, dumbfounded and clueless as to what is to happen next and what you should do. As a result you say and do the wrong things at the wrong time. While there's enough blame to go around the “buck stops with you” first. Many blame the system; a system that is not going to change and has not changed for the better for over 30 years. Any changes that may in fact occur are reflected in the tightening up of policy and procedures by the correctional and medical systems across the board; making it more difficult to obtain the care needed and the answers required.

For example:

  • When you’re told that a medical staffer can’t talk to you, citing medical confidentiality laws and that the department cannot release medical records or documents to the media, you or others that clearly would show whether nurses checked vital signs between arrival at an assigned detention facility and a death, you need to know that citing Hipaa laws is the default standard cookie cutter answer for jail and prison administrators and contract medical providers. However, if you had been diligent, there would be no necessity to even ask for the records; they would have already been in your possession. Again, there is much you can and should be doing during the course of incarceration of your loved one.

  • When you read an article of an in-custody death that states “no details were released by a medical examiner's office about the circumstances surrounding a death and an autopsy was to be performed on a Friday,” families are clueless of the fact that these medical examiners are contracted medical examiners. It doesn’t matter if they profess to be forensic pathologists and it doesn’t matter if a system touts that they contract with a forensic pathologist. Contracted medical examiners do not and will not conduct a forensic autopsy. They are not hired to do so. They are hired to do a straight–line generic autopsy. They do not review medical records, their testing of any samples is premeditatedly restricted and they effectively get their instructions from the jail or prison administrators. It is your responsibility to know what you can do and should do with respect to these contracted medical examiners. But alas, you don’t do what needs to be done—due to your own lack of information, knowledge and how to apply both. As a result, key information falls by the wayside, is not requested or documented.

  • Comments that “medical records from past prisons stay stored at offsite locations are generally transferred to the secure assigned detention facility within 24 to 48 hours,” is laughable at best. That is usually not the case. If they are by chance forwarded at all, the accuracy and totality of those records is not complete. Again, families should be doing much to ensure that this is done.

  • Comments to the effect that “officials at a Sheriff's Department don’t evaluate medical decision-making as part of their death investigations,” isn’t quite accurate. In-custody deaths demand a complete Morbidity and Mortality Review which comprises and requires all administrators from all departments—including medical contractors to be in attendance. That review requires that all participants “lay out” all information and what specifically took place in order to determine what went wrong. Part of that actual process involves correctional and medical staffers collectively reviewing their individual and collective processes. That obviously includes evaluating medical decision-making and how those decisions diverted from correctional policy and procedure. Policies and procedures of all participants do in fact dovetail one another.

The situation in Milwaukee as highlighted in these recent articles depicting systemic problems which have been ongoing for over a decade continues. Do your own research. Go back 10 years; review the articles of 10 years ago. Square-up the issues of 10 years ago with the issues today. They’re the same. Inmates sick and dying or have died. Families get their moment in the spotlight to merely voice the horror they and the inmate have gone through and then it's forgotten. And so, the pattern continues.

Little will change even when lawsuits are filed. That fact in and of itself is another blog-piece entirely. Unanswered questions, little accountability, and health care that falls short will continue. It will continue to be the “norm” rather than the exception unless and until families of those incarcerated do what needs to be done for the benefit of their loved one going into the system or already in it. You have more power than you think you do. But until you stop operating in the dark and seeking “justice” which is a misnomer, count on the next 10 years being the same. Your loved one may become sick, incur permanent medical disability or die. In many instances this can be avoided only if you know what to do. Change starts with you; you have the power to save a life. Learn how to do it.

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Prison Medical Paroles aka Compassionate Release
 —  Not About Compassion At All

20 October 2016
© KRusso/The Wrongful Death & Injury Institute 2016

The October 20, 2016 article "Among state lawmakers, compassionate release of inmates is divisive issue" by Milton Valencia from the Boston Globe, highlighted the problem/issue of compassionate aka medical paroles. Specifically as it pertained to Sal DiMasi, a former speaker of the Massachusetts House of Representatives whose family wants a compassionate release / medical parole granted as a result of cancer. The article does not indicate however, whether Mr. DiMasi has been given “x” number of months to live. You can access the article here:   https://www.bostonglobe.com/metro/2016/10/19/program-that-could-benefit-dimasi-has-stalled-state-level/EmrtDbksrMS9jQ9JL7qycM/story.html

The article is talking about two different systems—the federal system i.e., the Bureau of Prisons (BOP) and the state of Massachusetts' Department of Corrections. The BOP clearly has medical paroles/compassionate release policy for implementation of 18 U.S.C. §§ 3582(c)(1)(A) and 4205(g). That policy, as is all policy whether federal or state policy specific to compassionate release/medical parole, involves a long, convoluted process that not only families and inmates don’t understand but few lawyers understand.

The comment made by Will Brownsberger that "People are unwilling to release someone who has committed a serious crime, even if they are bedridden," isn't exactly accurate. He either doesn't understand the scope of the issue or as is the case with most politicians turns the other way and refuses to address head-on the reason for actually not releasing someone that's going to die. And that reason is—cost; what it costs the prison to maintain them. And therein is the rub. The cost of taking care of a terminally ill inmate patient—is nominal. It's nominal because they don't take care of them. They were not provided the adequate, sufficient-to-the-need health care that should have been delivered in the first place. And that absence of health care morphed into and ultimately lead to the terminal illness. Nor are the dying inmates going to be provided the end of life care that is needed without family pressure and intervention.

In the correctional system—whether it be the federal or state system, a fast death is a cheap death. And that's their goal. Their goal isn't compassion at all. Their goal is only one—cost containment. And that goal is aggressively and relentlessly pursued and achieved by giving the façade of adequate health care without every providing it. We call it channelized and sanitized health care delivered by Teflon tactics. They are ambivalent to the fact that their families want them to be released to spend whatever time is left—especially if terminal illness is a result of inadequate delivery of health care. The system nationwide denies the most basic of care and compassion to dying inmates and their families: disallowing end of life visits, removing life support without consent, premediated non-provision of food, water and medications, sending "deceased" inmates to the morgue—that weren't dead. The list is endless.

The system's goal is only one—cost containment and revenue. That terminally ill, dying body sitting in a prison infirmary or TCU or prison hospice unit makes money. It's a body count. That body registers as a population number. That number equates to revenue. And when that terminally ill inmate's existence cuts into the bottom line, the tactics used to end that life would blow your mind. Sal DiMasi is one inmate; considered a "high profile inmate;" one with political connections and pull. This article, this story has a back story that few if any address—that of the cost and the politics involved in these medical paroles at a level that's never been exposed. There are countless numbers of inmates dying in federal and state prisons across this country that are left to die under the most torturous and abusive of conditions imaginable.

Statements made by Robert DeLeo and Governor Charlie Baker and others quoted in this article, are the tip of the iceberg. It's what they’re not saying that's the story. Multiple policies and procedures of the Massachusetts Department of Corrections dictate all movements –policy and procedure specific to health care delivery itself, to DNR policy, clinical contract personnel, inmate medical records, death procedures, pharmacy and medication policy, inmate co-pay policy, early parole consideration—(which is abstract and exceeding vague), down to policy on visiting procedures. It's the inadequate delivery of health care across the board in that State system coupled with internal mechanisms that are put in place to delay and deny adequate sufficient-to-the-need health care to that inmate population, followed by misrepresentation of fact in medical records, death certificate cause and manner of death that are not accurately assessed, and sub-standard state ordered autopsies (if ordered at all) which are the norm, not the exception that is—the actual "rest of the story."

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What's It Gonna Take?

19 October 2016
© KRusso/The Wrongful Death & Injury Institute 2016

"What's it gonna take for these families of inmates to do what needs to be done on behalf of someone they’ve got in jail or prison before they end up deathly ill or dead? They need to be proactive before something happens and it's too late." This is a comment made consistently to us from past clients from across the country who are on a mission and committed to spreading the word to other families of inmates about what they should be doing, what they should not be doing and what they need to have in place immediately, on behalf of their loved one incarcerated in order to fight for their life and obtain the needed health care before sickness escalates to death or disability. It is their way of "paying it forward" since they have lost their loved ones.

In their efforts to spread the word, they have shared with us what they believe to be an unsettling trend and attitude that troubles them greatly—troubles them from the standpoint that even after they give first-person knowledge based on their own experience of what has happened to them when certain things are not done and key documents are not in place on behalf of a loved one who is not sick, is sick, dying or deceased, and share the details of their own personal horror and what they went through, the consensus is that far too many family members continue to do— nothing. They find that those they speak with exhibit a know-it-all attitude when it's clear they know nothing about the issues at all. That fact coupled with the excuse of cost—their fear what it's going to cost them – monetarily and in personal time take first place and precedence over the well-being and life of their loved one.

As a result of their concerns and observations, they've aggressively suggested to the Institute that we share requests we've received for help and assistance in hopes of "driving the need and point home" of how important it is not only to have the knowledge and tools in place but to learn how to use both for the benefit of their loved one. In the spirit of their collective requests, below you will find some of those requests that exemplify in part, the scope of the Institute's work.

" ... my husband was found dead in a jail cell, as of now it has been almost four month and the correctional facility has not provided any police or autopsy report ..."

" ... I have been trying to locate my husband for 5 years. He was born 6-20-56 and died 7=2005. I learned of his death today while typing his name into a different search engine and came across his name on your website. Can you help me?"

"My son died as a result of medication he was given by jail personnel- his death was ruled a suicide- by ingesting an anti-psychotic drug- somehow he ingested over 4000 mg of this substance while sitting in his cell. He had been in county jail awaiting trial. I need advice and guidance".

"I am seeking out help for myself. My only son was murdered on July 13 in a Texas unit; he was murdered and they act like he killed himself. They had him in lock down in a one man cell but documenting like he was not suicidal from January 2010 until his death ..."

"My son is in jail. He is a diabetic with heart problems. He had surgery on one of his legs before he was jailed. The jail nurse is supposed to clean and wrap his leg twice a day. She does not do this. He was without his insulin for the first 2 days he was in there, then she gave him insulin that he was not prescribed that did not work. He spent 2 nights in the hospital. Now they have him in the hole because they think he might have a staph infection from his leg they have failed to treat. When his blood sugar got dangerously low, the sergeant told him ... "It's not low til you pass out. He has passed out twice. He called sounding very sick from his sugar registering HIGH… I called the jail to tell them that he needs to be checked on, they said they would after a while... I don't know what to do or who to turn to for help. I don't want my son to die in that place, or go into a diabetic coma. Is there anything you can do or suggest that I do?"

"My brother was severely harmed which left him in a vegetative state. Since our last conversation all the issues that you indicated would occur—are happening. His safety and health care are of grave concern to me and my family and are asking for your help to make sure they don't pull the plug on him or move him out of state. Thank you for your willingness to reduce your fees to help us; we are taking you seriously now, never could we have ever imagined this".

"My son is dying from Metastatic lung cancer and I have been trying to get a medical furlough for him to come home to die. I have been unable to get anything done even though I have filled out the proper papers twice. They won't return my calls or letters. We need your help and expertise. We know what it's going to take. We're willing and committed".

"I was told by prison officials my son overdosed on drugs, was in a coma, and not expected to live. But he did. He's in a medical facility run by the DOC. This is the third near fatal incident since his incarceration in less than 2 years. He was severely beaten within hours of his first day in prison and taken by helicopter from the prison to a local hospital where he spent several days in the intensive care unit. Then he was stabbed 16 times prior to that and only three hours after being placed in general population in a new facility. He spent several weeks recovering and was transferred again. As it stands now, he suffers among other things, from septic shock and hypoxia. They supposedly found drugs in his system according to the officials I've been in contact with however, I find no toxicology report in the medical record at all, and my requests are denied. My son now suffers from complete renal failure, brain hemorrhage, stroke, and sepsis. My son did not overdose. Interestingly, this is the third inmate overdose in this facility in a year…the other two did not survive. What happens to all the inmates with no one to speak for them? You probably more so than anyone would in fact, believe the level of harassment I was subjected to by the DOC because I demanded to stay at the hospital and pray for my son ... I am sickened by the hints of corruption I am uncovering as I speak to more and more people many of whom work in the DOC but don’t have the courage to do anything about anything. And the abuse and the deaths continue. Please help us."

"Your name was given to me in hopes that you could assist me in my despair. My son is in a prison unit currently given a medication that doesn’t help him. He has gone weeks without eating and refuses to come out of his cell due to his illness; panic attacks, bi-polar, etc. When I call the unit a doctor tells me my son is "doing good and is eating"—a total contradiction when I get my son's letters saying he is always weak, nauseated and fearful. I've written and called these doctors and nurses; they do nothing but threaten to send him to another unit. He tells me not to visit, because he doesn't feel safe walking to the visiting room. Is there anything you can do for him or let me know what I can and should be doing to help him. This is what my friend says your Institute excels at. Others say file a lawsuit; a lawsuit isn’t going to save my son. I want real-world action and results. Not a lawsuit that takes years while my son continues to suffer and then die. My friend said to get in touch with you."

"I'm an attorney in _____. I'm getting ready to file a federal lawsuit on behalf of an inmate who supposedly hung himself in jail while his cellmate watched. Apparently the guard was alone on duty and left the tier. Inmates were pounding on the windows and yelling for a guard for over 20 minutes before a passing guard on his lunch break noticed the commotion. You were referred to me by another lawyer. I wanted to touch base and see how you can assist us in this matter down the road."

"My son was sentenced to less than 6 months in a county jail. While there he has become very ill. The jail will give me no information and I'm denied visitation to see my son. The last doctor who saw my son, told me my son had to be put on a ventilator. Prior to that he was not allowed to call us and let us know of his condition. He was in that hospital one week then transferred back to the jail. I finally got a call from him and I asked him why he hadn't called for so long. He told me he had pneumonia and was in the infirmary and they would not let him call home. Within weeks my son was getting sick again. I don’t know what type of medical treatment or medication they were giving him, I had none of the documents you indicated I needed to have in place in place. Oh, how I wish I had known! I do know my son needed a ventilator to keep him alive by the time the prison infirmary got around to taking my son out to the hospital again ... or one day, then back to the jail where he was put in a regular cell and denied an extra mattress because of his bones sticking out and the pain he was going through. Those thin mattresses on steel are worthless. The staff told him "if we give you one everyone will want one". Within hours they transferred him again to another hospital, alone in a room with no communication with anyone, no tv, not allowed to use the phone. He asked for his pin# every day. It took them over two weeks to get him a pin# to use the phone but by then he was too sick and unable to get to the phone on his own. He asked the officers to call his family and let them know of his condition and they refused! After not hearing from him I began to realize something must be terribly wrong started making calls to find out what was going on. The medical unit told me he was in "stable condition". That's all they'd tell me. I asked them to have him call me. They said 'we don't give inmates messages.'

After calling several times a day for days, I demanded to speak to an officer in charge. After crying and pleading my case he agreed to have one of the deputies give my son the message to call home. After not hearing from him I called again and was told that maybe there wasn't anyone available to help him to the phone. I was needless to say, shocked to hear he needed help to get to the phone! The officer said, "Yes, He's not getting around too good." Days went by, finally went to see my son. I didn’t recognize my own son. I thought I had walked into the wrong room. He had lost so much weight and was in so much pain he could barely speak. He was not in stable condition as I was told, but in grave, critical condition. Within hours my son died. The outside hospital physician told me that "if they had sent your son to us when he first got sick he would have received the proper medical treatment and medications; he would still be here". I need the Institute's help. Still getting no answers and the constant run-around that I just refuse to accept any further, and all at the same time we're grieving our loss."

"Hello. my name is _____. I read your article on deaths of inmates in jail and I was terrified. My husband was diagnosed with end stage renal disease and congestive heart failure before he went into jail. He also has to undergo dialysis every night for over 8 hours. He has a pace maker and just recently had a tube placed in his heart to drain fluid. I need the documents you explained to me. I want to make sure he gets the care he needs to get."

If you are a family member or friend of an inmate that is healthy, sick, dying or who has died you need to be proactive on their behalf. It takes commitment and focus on your part. Incarceration is literally a matter of life and death—spiritually, physically, emotionally and mentally. Ignorance and complacency are not options. Do all that you can do to keep your loved one healthy and alive. We exist to help you do that. Contact us and let us know your concerns.

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The Gerbil Wheel of Prison Health Care
 — Families of Inmates Just Don't "Get It"

14 October 2016
© KRusso/The Wrongful Death & Injury Institute 2016

Inmates die every day in the U.S. jail and prison system. You may be the family member of one such death or will be in the not-too-distant future. Oftentimes these deaths can be prevented if only family members stepped up and did what needed to be done on behalf of the inmate before sickness and death occur. However, that presupposes that family members know what to do. And the reality is—they don’t. Inmates know only in part what they need to do and unfortunately, don’t do all that they can do. While they are required to jump through multiple hoops and hurdles in order to obtain adequate, sufficient-to-the-need heath care, rarely is that health care delivered. As a result of families not stepping up and stepping in, coupled with the inmates lack of full knowledge of what to do even after they have submitted the required forms and requests, this cycle of non-care can continue for months—or years. And in this constant quest for sufficient-to-the-need health care, the inmate's medical condition does not improve but precipitously declines over time, to the point of escalated preventable disease, terminal illness and death.

Over the years we have encountered many cases involving these issues and the sequence of events within the prison system after death; the movements and tactics of prison and medical administrators used to prevent information being given about that death and refusal to provide key information with respect to options. But there is one case that stands out. It was the " perfect storm”—a result of inadequate health care that lead to death. This particular case topped our list with respect to egregious health care delivery, inefficiency of correctional and medical staff, lies and deceit exhibited by prison medical directors, all of which was only surpassed by the harassment and lies of the Chaplaincy, topped off by the sub-standard state ordered autopsy and the inaccurate assessment of cause and manner of death.

John Q
The inmate, we’ll call him John Q, was visited regularly by his brother. Visits were consistent. John Q had had a history of heart problems for years; that was no news, nor news to the prison medical staffers. That condition was being managed satisfactorily due to the persistence of John Q. He was able to walk around on his own without trouble or effort, received his daily medications for that condition.

On one visit, in particular however, this was not the case. Rather than walking to the visiting room on his own, to the visiting brother's horror, John Q was rolled out in a wheelchair badly injured. He had cuts, scratches and bruises over his face and neck and said to his brother, " I’m like this all over. I was walking and then I don’t remember a thing.” He had stitches on one side of his face, his eyes swollen. The brother subsequently inquired of medical staff as to what had happened and was told little to nothing.

A week passed and the brother went back to visit John Q. Although he looked a little better he had new bruises on his face. The long cut that had been stitched up was very red and new redness appeared on his neck. His speech had markedly changed—words were slurred and not understandable. He was unable to hold his head up and drool was dripping out one side of his mouth. The brother demanded that his brother be seen by a doctor; that something was horribly wrong.

Two weeks passed. John Q was sent to another facility; a prison medical facility where the brother was denied visitation—visitation that he did in fact have a right to exercise. Countless numbers of families fail to pursue their visitation rights. They " sit down” far too easily when told by administrators that an inmate " can’t have visitors.” It's challengeable. Families however, don’t know how to challenge it.

Days passed. John Q was then transported to another wing of the facility supposedly in a coma. John Q's brother was initially refused visits but after much persistence was allowed—one. He couldn’t believe what he saw.

Horrors of Prison Infirmaries & Hospice Units
His brother was in a room devoid of any personal belongings of any kind. No television. No writing material. No radio. No water. He was lying in bed at a 45 degree angle with his head slumped to one side, off of the pillow, butted up against the side rails unable to lift his head on his own. He was not in a coma but unable to speak well. One guard was in the room " standing guard” over an individual who couldn’t even move let alone get up and escape.

A " nurse” brought in a food tray and arrogantly dropped it down on the side table. The visiting brother asked her if she was going to feed John Q since he was unable to feed himself. Her reply: " Oh, we don’t do that unless the inmate files a written request to be fed meals bedside.”(!) Well, one can’t very well fill out a written request of any kind if you’re unable to feed yourself—let alone hold a pen and fill out a prison form. The result of this " policy?” Inmates like John Q—don’t eat. Not because they don’t want to but because they can’t. Nor can they drink. Nor can they take their medications. They can’t hold a glass or the utensils. The result? Dehydration, starvation then death. Non-care scripted by policy and protocols.

John Q was subsequently moved to the prison " hospice unit”. The best description of this " unit” is best described using the brother's own words—" The so called hospice unit was really nothing but a killing field for the unmet medical needs of the dying laying helpless.” And that they are.

This is a picture of a prison infirmary and a prison hospice unit. To be sure, there are undoubtedly some prison hospice units and prison infirmaries actually manned by qualified caring medical personnel and inmates who are assigned to care for the dying in hospice, but even in the best of units, their activities are little known. But this case is not about a unit like that. This case is about a prison infirmary and hospice unit that dumped John Q in a bed and left him to die.

Despite pleas and requests by the brother for answers and for health care and testing to be performed on his brother, those pleas and requests were premeditatedly ignored. John Q died within days. Staff called and told the brother that " despite resuscitative efforts they did all they could do and he passed away.” The brother however, knew that there were in fact, no resuscitative efforts ever performed. John Q was merely left in a room, lights out, alone, dehydrated and starving, with no medications given to die. No family around him. Alone.

If this wasn’t horrific enough, just when the brother didn’t think things could possibly get any worse—it did. The horror and medical abuse that had taken place up to that point was only surpassed by not knowing the whereabouts of the body, the subsequent refusal by the warden to order an autopsy, harassment, lies, threats and deceit of the prison chaplain and prison medical director about the circumstances leading up to death, then the autopsy issues themselves and securing funeral arrangements. He knew he needed help getting the answers and choreographing all of the moving parts surrounding his brother's death in order to get what needed to be done—done.

Whereabouts of the body: Location of the body was initially not disclosed then incorrect information was given as to the whereabouts; first a hospital, then a morgue, then a funeral home, then a medical examiner's office. Ultimately, it was discovered that John Q had been " on ice” at the medical examiner's office since the date of death where he remained for the next 6+ months due to the system's refusal to perform an autopsy at the brother's request and the brother's relentless pursuit of having one performed.

In this case there was more than one " Office of Medical Examiner”. Locating the body demanded the know-how of how to go about determining that location and the name of the assigned medical examiner.

Refusal of autopsy: Repeated attempts for autopsy were initially ignored with no explanation. As a result of a documentation campaign setting forth the arguments as to why autopsy should be performed, one was in fact finally ordered—over six months from the date of death. Much had to be done in order to prevent the medical examiner's office from disposing of the body. They are not in the business of housing corpses for extended periods of time. The brother prevailed.

Autopsies are required to be performed on inmates who do not die of natural causes. And that decision authority rests with a warden. The problem however is that most deaths may not be a result of natural causes even though they are documented as such. Most likely these deaths are a direct result of inadequate or no sufficient-to-the-need health care ever being delivered for the actual symptoms presented by the inmates to medical staff. For example, if an inmate with a history of heart problems, presents himself to medical for increased chest pains, medical can give him Maalox, document that in the medical record when in fact Nitro Glycerin was required. The medical staff did not deny him medical care; they just did not provide the sufficient-to-the-need health care for the symptoms presented. Again, it's the façade of giving adequate health care without ever providing it.

Another example: if an inmate has been unable to request medical care due to illness there is no accurate record of what has taken place health-wise with that inmate. If there's nothing submitted by the inmate, then the inmate (per the system) has no complaints; he's fine. In other words, the system is going to document a façade of heath care that was in actuality never delivered. The care given to the inmate looks great on paper; the reality is—it never occurred.

In between the requesting of the autopsy and the actual autopsy being performed, prison and medical staff were relentless in their tactics to get the brother to back down and back off through lies, deceit, and harassment.

Lies • Deceit • Harassment

Medical Director: In that six month time-frame, the prison medical director refused to provide the location of his office. The state he professed to be working in didn’t connect with the phone numbers he provided and comments made in his conversations. Promises to " review the medical records” as the brother had requested in multiple correspondence to the DOC and medical provider were followed up by the comment " We want to do and perform everything to your satisfaction. I’ll get back with you and let you know my answer about the autopsy.”

The reality of the situation is—this medical director had no say-so in whether or not an autopsy should be performed or not. That decision fell on the DOC. And they were digging their heels in. While waiting for this " doctor's assessment” the prison chaplain was threatening, harassing and lying to the brother.

Prison Chaplain: The prison chaplain, we’ll call him " PC” set out to verbally harass the brother with threatening phone calls to bury his brother without his approval or consent if he continued to not sign a consent form for release of body and back off his request for an autopsy. At one point the PC went on vacation, came back to find that the situation had not been resolved, called the brother and stated, " I thought this was all over with! Can we just maybe say a quick prayer or Bible verse and get this behind us?”(!) On another occasion, the PC provided the brother with a phone number of the medical examiner where the body was supposedly being held, so he could be assured by their staff that no autopsy was necessary. However, the phone number the PC provided was the cell phone number of the PCs secretary who posed as a technician of the medical examiner!

Prison chaplains are employees of the DOC. A good rule of thumb is to believe nothing they tell you. They have a vested interest in protecting their employer and ultimately their paychecks. Unfortunately they implement lies, deceit and harassment at an unconscionable level for someone who professes to be in ministry. On the contrary they are in fact, " wolves in sheep's clothing.”

Autopsy: It was discovered that autopsy had been approved and performed without the medical director ever notifying the brother as to that fact. Nevertheless, documentation was forwarded into the medical examiner by the brother, putting him on notice of the details leading up to his brother's death and what he should be aware of.

Notwithstanding that fact, the reality is that medical examiners are contracted by State DOCs and jail systems to perform generic autopsies. Even though the medical examiner may be a forensic pathologist as many DOCs will throw up as a banner of credit, the reality is—it doesn’t matter. It doesn’t matter because that medical examiner is not going to perform a forensic autopsy. All he is paid to do is a generic autopsy to determine cause and manner of death. They do not review medical records, they do not interview medical staff, they do not interview prison administrators or personnel, and they don’t talk to family members or hold their hands. However, prison administrators may tell that medical examiner over the phone that " the guy had a history of heart problems” which plants the seed to ascertain a cause and manner of death a specific way.

It's not the job of the medical examiner to determine if medical malpractice or neglect has been committed. It's not his job to point fingers at the DOC and medical personnel. All he's hired to do is a standard run-of-the-mill autopsy that basically says this individual died as a result of " xyz” and the manner in which he died is " natural causes.” This is standard operating procedure of all medical examiners and systems across the U.S. who are contracted by state DOCs and jail systems. As a result of these sub-standard autopsies and non-review of medical records, and the " see no evil, hear no evil, speak no evil” mentality, death certificate cause and manner of death are not accurately assessed. And as a result of this fact death statistics for inmate deaths within the U.S. jail and prison system are not accurate.

In conclusion families do not know what they can, cannot and should do with respect to ensuring that their loved ones get and obtain the needed medical care and attention they need while incarcerated. There is much they should be doing and there are key documents that they must have in place for the benefit of the inmate in order to get the results that are needed.

Inmates themselves have limited knowledge of what they can do and how it should be done for their benefit and best outcomes. For example, they fail to fill out medical requests correctly that hold the system responsible. They fail to realize the importance of filing informal and formal grievances regardless of what they know will be the outcome. There's a specific reason these must be filled out—correctly. The Institute choreographs all aspects of these issues by educating and training families of what to do how and when. They in turn relay the requirements to the inmates.

Navigating through the death investigation system is multi-faceted and multi-tiered expertise. Key documents must be in place on the front end to ensure best outcomes whether the inmate is alive or dead.

From health, to sickness, to disability, to terminal illness resulting in death, without key documents in place at the outset and without the knowledge of what needs to be done when and how, families of inmates and inmates themselves are on a gerbil wheel; a never-ending cycle of pointless requests that have no power or authority and result in no positive outcomes for the inmate—no actual sufficient-to-the-need health care. Or in the case of death, answers families are in need of. The Institute exists to educate and train you on these issues and to obtain the needed results.

Without the knowledge and needed tools and how to use both you will remain on the gerbil wheel of prison health care. And—that's right where the system wants you to stay. Learn how to break the cycle.

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NYC Reaches $5.75M Settlement
in Rikers Inmate Death

28 September 2016
© KRusso/The Wrongful Death & Injury Institute 2016

You may have heard or read about the recent settlement of a Riker's inmate who died as a result of egregious medical and mental health care. NYC recently reached a $5.75M settlement amount as a result of that death. You can read the article at:

Although the article touts that this settlement is the highest paid out for NYC, rest assured it is not the highest ever paid out, nor is it the worst case of medical and mental health neglect. There are cases as bad and worse that have occurred in the last 30+ years that are all too soon forgotten. These types of deaths are nothing new. They have been ongoing since the 70s and they will continue on from this point forward. So while the attorneys have walked off with a victory and the family walks off with a " win,” that " win” isn’t really a "win".

Based on experience of what transpires after deaths such as this, little to no change most likely will occur. What will occur is a tightening up by Corizon of policies and procedures and elements of their contract with the city and state to close the loop-holes and gaps that caused this event to take place in the first place. The family of this gentleman should have intervened way before the death event. There was plenty they could have done. Unfortunately however, they failed to do so, most likely because they were clueless as to what it was they could have done on his behalf.

Most families across the country who have a loved one in jail or prison not receiving the medical and mental health care that they are in need of, do not know that they not only can intervene but should intervene to ensure that their loved one gets the care they are in need of—consistently. They have the power to do so; they just don’t know what that power is and what it requires to be put in place. And the system wants them kept in the dark so you don’t exercise that power. A tragedy all the way around, to be sure. A tragedy for the family of the deceased and a tragedy for the inmate who didn’t need to suffer in the first place. A preventable situation? Yes. For anyone who has a medically ill and/or mentally ill loved one in juvenile detention, jail or prison, you MUST know what to do on his/her behalf.

The Institute educates you on the systems and provides you with the knowledge and the tools to fight for the life of your loved one in situations just like this situation that occurred at Rikers in NYC. But you have to take the initiative and do what needs to be done to prevent the system from doing what they don’t believe they need to do. We can help you do that. We can help you ensure that your loved one survives his/her sentence and doesn’t come out in a body bag.

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Prison Health Care Delivery

To Families: Quit Playing Checkers—Learn To Play Chess
19 Friday, Sept. 2016
© KRusso/The Wrongful Death & Injury Institute 2016

5-Alive Network is part of The Wrongful Death & Injury Institute, designed and created for families dealing with inmates who are sick, dying or who have died within the U.S. prison system.

Complaints about inmate heath care made by family members to others experiencing the same problems are a waste of time. It's a low-level activity that nets no meaningful results for the inmate and does nothing but cause you frustration, worry and stress.

The system is not going to improve without your obtaining actual knowledge of the systems, how they actually operate and how to get the actual, real results you are seeking.

If you're a family member or an advocate of some kind, quit focusing on the overall system itself, a system you cannot change. Your focus must be on the health care that your loved one is not being provided. Your focus should be that inmate's health first and foremost, and how you go about achieving that health care. As long as you stay focused on the system itself, as long as you keep lashing out at correctional and medical personnel you achieve nothing other than giving them their defense. You effectively play right into their hands. The system has you exactly where they want you--ineffective; an ineffectiveness that's been in existence from the early 1970s to today. They count on it.

Families themselves exhibit a victim mentality which adds to a further inability to obtain needed health care for the inmate. The result is failure—in doing what must be done on behalf of the inmate to ensure s/he receives adequate health care and survives their sentence—instead of being released in a body bag.

Through the 5-Alive Network, the Institute teaches the specifics regarding those systems and how to do what needs to be done. As long as you continue to complain to the system, as long as you merely compare notes with others " in the same boat” you will fail. You must learn how to "play chess" while the system plays checkers.

You must obtain the knowledge and information to do what needs to be done and learn the tools that enable you to get it done. The Institute teaches you how to play chess. Change starts with you. Not the system.

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Haunted On The Inside – Inmate Deaths

05 Monday, Sept. 2016
© KRusso/The Wrongful Death & Injury Institute 2016

How each of us deals with a serious illness, death and tragedy says a lot about what kind of person we are. We hurt for our loved ones and mourn over our own losses but just how prepared are we to face sickness, dying and death as a realty and deal with the difficult challenges each creates?

My comments today are addressed to a specific group—families and friends of inmates who find themselves with their backs to the wall not knowing what to do as a result of trying to do what should be done to ensure that their loved one is actually getting the sufficient-to-the need health care s/he is in need of.

No matter how hard you may try to do what needs to be done, you are stonewalled in every attempt. Your calls go unanswered and your concerns are ignored. All the while your loved one is in agony, suffering or dying. Although it is your loved one that is in prison, the system has somehow succeeded in convincing you that you’re in prison right along with them. You’re told what you can and cannot do specific to health care issues and issues surrounding death. You are literally lead around like a bull with a ring through its nose and told nothing or you’re told what you know to be lies—one after the other. The frustration that this causes, the agony that it causes, the anger that it causes within you rages. And yet, you do not know what to do that you haven’t already done.

That health care that your loved one is not getting, more often times than not can lead to permanent medical disabilities and death. And when either of those events happens, you, the family member oftentimes harbor an overwhelming, oppressive inner guilt that is rarely talked about out loud but forever haunts you on the inside. That guilt and what leads up to it is what I want to address today.

Guilt—whether it's real or false is a burden too heavy to carry. If it's allowed to run on its own, it can destroy your inner life and ultimately your outward life, your day to day life. Try as you may to keep it at arms-length it will find its way back into your heart and mind. Until you take it by the throat and deal with it, it will haunt you no matter where you go; no matter what you do.

Guilt is a gripping force that can come to all of us when a loved one dies. We all go through the " what if's ” and " if only's ”—What if I had gone to dinner with her when she called the night before I found her the next morning " asleep” in her car? What if the EMTs hadn’t been so slow? If only I had visited him or her more than I did. If only I had known what to do to get him/her the health care s/he needed. If only I had known what was available to me and how to use it to get that health care s/he needed. If only I had known I had options I could have exercised during the dying process. If only I had known how to answer the arrogance, the badgering and harassment of prison personnel, prison medical staff, the Chaplaincy and the contracted funeral industry. If only I had had the knowledge and understanding of what to do when, it would have given me the power to take control and do all that actually could have been done in spite of what I was being told I couldn’t do.

This type of guilt is the guilt most individuals go through when their loved one has died in a jail or prison. Shock is accompanied with guilt and grief. And while guilt is in fact one of the normal emotions we feel out of grief when someone dies, false guilt can wedge its way into your very soul and convict you over and over and over again for something over which you had no control. And it will continue to do that to the point where you don’t feel like doing anything. Nothing satisfies. Reflection on the sickness and death brings tears and pain that can come out of nowhere with no warning.

After an inmate sickness and death nothing looks the same. And one of the key reasons why nothing looks the same anymore is because you have literally been awakened to the realities of the scenery behind what is seen. The curtain has been pulled back. You are thrown into an arena, a realm you not only didn’t know existed but you are subjected to all that your loved one was subjected to on a scale you can barely imagine let alone handle.

Past conversations you had with your loved one, words said to you in person or by letter or unspoken words that let you know something was wrong, come flooding back across your mind and you see that they were saying something that you didn’t understand at the time or that took for granted that you did.

Throughout Scripture grief is a normal part of life. But out of grief can come depression and that depression can become dangerous. Dangerous depression accompanied with guilt results in an attitude of resignation that can paralyze you to the point where you allow it to control your life. And when it controls your life you are not able to stand up for the loved one who lost his or her life as a result of the evil and wrongdoing that may have caused it. You’re not able to shine the very light you received as a result of his/her sickness and death, out to others who need to know—and not just other inmates and their families but the public at large; society needs to know the truth—not what they assume the truth is or what they are told by the system or the media.

Your loved one's sickness matters.
Your loved one's death matters.
The way in which she or he died matters.
What happened matters.
What you went through matters.
The way you were treated from beginning to end, matters.
It all matters.

And it can only be "seen" when you step out of the dark shadows that keep you in chains and bear witness to what you experienced first-hand. You have to step out of that darkness that wants to keep you down; that wants you to stay ignorant of the system, that so devastated you that your grief and guilt keeps you quiet, guilt and grief stricken to the point where the very system that took your loved one, destroys your life too.

I can guarantee you that your loved one never wanted you to become a victim of the very system he or she was in. And this is a key problem. I have known many inmates who have died. And their dying one wish, their one request, and their prayer was always for that curtain to be pulled back, for people to listen, for people to see all that was taking place behind that curtain. They wanted their loved ones to stand up and take a stand. And they knew what it would take. They knew what the Institute was doing and what it could do for their families and for others—educating them about a system and how to handle it; how to get answers even after years have passed. Not so much for litigation purposes but for the healing of their loved ones left and for the benefit and lives of those that came behind them.

Those inmates known to me are representative of so many millions of others. They ultimately had a faith that gave them the power to pass through the grief and pain—not avoid it. I encourage you families to do the same. There is light in the darkness. But you have to take the first step. Your loved ones were warriors in trying to do what needed to be done to get the care they needed. You need to be warriors too. Join hands with us. Lock arms with us. Allow us to do for you what we know can be done for your benefit and the benefit of countless others.

Join the "5-Alive Network" FB page to get updates and information and post questions about problems you’re encountering with a loved one incarcerated.

Visit the 5-Alive Network on our website.

Please donate to "5-Alive Network Go Fund Me Campaign". 

Watch the videos posted on our website.

If you have a concern or problem with a loved one sick, dying or who has died contact us at:

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When An Inmate Dies—What You Need To Know

30 Tuesday, Aug. 2016
©KRusso/The Wrongful Death & Injury Institute, LLC 2016

When family members are notified by administrators from a department of corrections of an inmate death, it's essential they understand what authority they have with respect to all issues surrounding the deceased inmate's body and his/her personal belongings. More oftentimes than not, they have no information or understand the procedures regarding an inmate death. Making decisions without accurate information in any situation is irresponsible and unnecessary.

As a result of your lack of information on policy, procedure and protocols, in addition to poor, biased and ineffectual death investigations of inmate deaths, it's no surprise families attempt to do too little too late; and talk to the wrong individuals at the wrong time. As a result, evidence is often lost or destroyed that would support questionable practices, policies and procedures.

The Wrongful Death Institute & Injury Institute's consulting services provide key information and guidance regarding the handling of inmate deaths, investigation of those deaths, state autopsies and second (forensic) autopsies.

If you have been notified of an inmate death or death is imminent for an inmate there are specific issues you must address immediately. There are specific questions that must be asked. There are certain things that you should and should not do. It is vital that families understand the steps that need to be taken immediately when notified of an inmate death.

The Institute:

  • Enhances family awareness and consults with families regarding key documents that should and should not be in place for the benefit of the inmate and his/her family.
  • Consults with families who must make 'quick' decisions regarding death issues in response to questions presented by State departments of correction when an inmate dies.
  • Researches death investigation practices within the State departments of correction and the State medical examiner systems as their contract vendors.

It is important that families understand:

  1. Their authority regarding the control of the deceased inmate's body, the scope of authority of State departments of correction upon an inmate's death--where it stops and where the family's begins.
  2. Funeral home liability.
  3. First and/or second autopsies and what is involved.
  4. The issue of the inmate's personal belongings.

Excerpted Fighting for Life-Tricks and Traps of the Death Investigation System, A Guide For Families Navigating Through Death in Prisons, Hospitals, Nursing Homes, Jails (The Wrongful Death & Injury Institute Publishers). Copyright © 2011 KRusso/The Wrongful Death & Injury Institute. All rights reserved. Used with permission.

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Do's and Don'ts When An Inmate Dies

23 Tuesday, Aug. 2016
©KRusso/The Wrongful Death & Injury Institute, LLC 2016

The following information is provided as a courtesy should you not be able to contact the Institute quickly. It is not exhaustive information. It is basic information only. It is provided as a guideline of what you need to do and not do in order to obtain and/or retain control of the deceased's body if you’re not able to contact WDI immediately. The information is expanded on in our book Fighting For Life, The Tricks & Traps of the Death Investigation System—A Guide for Families Navigating Through Death in Prisons, Hospitals, Nursing Homes, Jails.

Do not agree to allow the department of corrections to "take care of the inmate's funeral arrangements.” This is a tactic that is used on many that do not have the finances to bury their loved one. Inmate deaths sometimes are sudden and unexpected. Funerals are expensive. Departments of correction are fully aware of the financial burden. If the death is perceived as a potential problem for the department of corrections, they may offer to "handle" the funeral arrangements for you. SAY NO. Their offer is not out of concern or sympathy. There is a reason they offer. Sympathy is not one of the reasons they do so. Specifically, if you agree to let the department handle the funeral arrangements the following can (may) happen.

If you allow the department of corrections to "handle" the funeral arrangements, if you sign a cremation order or a burial order, you will automatically lose all rights to the deceased's body. The deceased will now be in the control of the department of corrections. The body will be the property of the department. The inmate's correctional and medical records, all personal belongings will also be the property of the department of corrections. You will have NO right to have them. You have signed them away.

You will NOT be allowed to bury your loved one.

You may NOT be allowed to know where the department of corrections buries your deceased loved one. That's assuming they bury the deceased. The body may be given over for research or science. You will NEVER be able to visit their grave because you will NOT be told where it is.

The Wrongful Death & Injury Institute can assist you in navigating through the procedural landmines and pitfalls. What you don't know, refuse to know, and choose not to do could very well prevent you from ever knowing the facts surrounding the death of your loved one. It's all so unnecessary.

Excerpted from Fighting for Life-Tricks and Traps of the Death Investigation System, A Guide For Families Navigating Through Death in Prisons, Hospitals, Nursing Homes, Jails (The Wrongful Death & Injury Institute Publishers). Copyright © 2011 KRusso / The Wrongful Death & Injury Institute. All rights reserved. Used by permission.

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updated 10/19/2016

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