NEWSPAPER INVESTIGATION FOUND CASES OF ALLEGED HEALTH-CARE NEGLIGENCE

A five-month Post-Dispatch investigation published Sept. 27 found more
than 20 cases nationwide in which prison and jail inmates died as a
result of alleged negligence, indifference, understaffing, inadequate
training or cost-cutting by private health care companies.

Many of the cases involved St. Louis-based Correctional Medical
Services Inc., the industry leader.

Some experts said the cases represented the tip of the iceberg in a
system of privatized health care behind bars that often neglects the
medical profession's creed to keep "free from all intentional
wrongdoing and harm." CMS, other companies and some public officials
denied the critics' claim.

In the special section, "Health Care Behind Bars: Death, Neglect and the
Bottom Line," the newspaper also reported that:

* Some companies put inmate health care in the hands of doctors who
have been disciplined by state medical licensing boards or even
committed crimes themselves.

* In Missouri, secrecy, buck-passing and conflicts of interest define
how state officials review prisoner deaths. For instance, the prison's
medical director is the first to review a death, even if the director
was the very doctor who treated the prisoner. The state has since
hired a Texas doctor to review deaths.

* A culture of skepticism permeates correctional health care
nationwide. Inmates fake illness frequently, which can leave nurses
and doctors blind to real sickness.

* Distant administrators intervene in the practice of medicine by
doctors, often second-guessing their decisions on economic grounds.
The extra steps can delay treatment or approval for medication.

* The National Commission on Correctional Health Care, which sets
standards and accredits prison and jail health care operations, does
not serve as the watchdog that private companies claim.

* Medical records are sometimes altered. Records have been changed to
falsely indicate that doctors gave medical orders when in fact a nurse
did.

* Whistle-blowers in four states say the company has routinely denied
or delayed expensive medical care.

NOTE: The Sept. 27 special section is available on the World Wide Web at
http://special.postnet.com/prisoncare/.