The Minnesota Department of Corrections will pay $200,000 to settle the case of an inmate who died in 2013 under the watch of two prison nurses who later admitted that they failed to provide proper care in the days before his death.
The department has now paid more than $1 million since 2011 to settle medical maltreatment lawsuits brought on behalf of inmates who died or suffered critical injuries while under prison care. A 2012 Star Tribune series documented the cases of more than a dozen inmates who died or suffered lasting injuries after being denied care in Minnesota prisons.
Department officials declined to comment on the latest settlement.
A day before inmate David Picard died, one of his nurses at the Lino Lakes state prison wrote in her medical log that he should be evaluated for his "overuse of health services," even though records documented that his teeth were black and he complained of difficulty breathing because of fluids filling his lungs.
The next day, Picard was found on his cell floor, gasping. He died of acute pneumonia and sepsis after being rushed the next day to St. Joseph's Hospital in St. Paul, according to court records.
The nurses who examined Picard did not call a prison doctor over the five-day period in which he sought medical attention, according to court documents and findings by the state Board of Nursing.
The nurses were later sanctioned by the nursing board after each admitted violating state law by not offering Picard proper care. Each was fined $1,000 by the board and ordered to undergo intensive supervision and retraining.
Nursing board records show that Jane Welch, the nurse who questioned Picard's "overuse of health services," has three previous care violations at the prison dating back to 2011 — including errors in making a lab request, ordering a blood thinner and transcribing an inmate's order for Lithium — that caused care delays or medication errors. In 2006, Welch was reprimanded by corrections officials for unprofessional conduct after uttering an obscenity at a physician.
In Picard's case, she "failed to recognize the patient's heart rate had been elevated for days, or that she needed to reassess abnormal findings," the board found, and could not articulate the facility's procedure for such cases.
Her nursing colleague, Stevie Lindsey, admitted to regulators that he could have contacted the on-call doctor during the two times that Picard made emergency calls for help because of his difficulty in breathing. During subsequent examinations, Lindsey failed to reassess Picard's heart rate and take his blood pressure, the board found. Further, he denied to regulators that the prison had a policy on when to call the doctor on call.
In 2006, Lindsey was reprimanded by DOC for injecting a Mantoux solution into patients rather than giving them flu shots.
The Corrections Department has come under fire in recent years from families of prisoners, health advocates and attorneys who say that the state's 9,800 inmates are at risk because the department has contracted with for-profit companies to provide rationed care.
Corrections officials say the prisons provide care similar to "community standards," as required by federal case law. Several incidents, however, have occurred after prison doctors have left for the day, as permitted under the state's contract with private providers, leaving nurses and guards in charge of complex cases.
There is typically just one on-call doctor responsible for assessing the needs of inmates throughout the prison system in the after-hours, and the physician must rely on verbal descriptions by phone because there is no central access to medical records.
Picard, 32, of Montevideo, Minn., was just weeks away from being released when he became critically ill with a respiratory infection. He was serving a four-month sentence for a parole violation related to a burglary conviction. Records examined by the Star Tribune following his death show that the prison's medical staff knew Picard's condition included seizures, diabetic-like symptoms and depression.
Picard's wife, Christina Regel, learned about the death while serving a sentence at the women's prison in Shakopee. She said this week that she's relieved a settlement was reached.
"David was a great husband, stepfather and friend to all who knew him," she said. "He made a few bad choices but he was still a person."