Another prisoner murdered in Delaware prisons through medical negligence

This is from the Caesar Rodney Institute

Comment:  Lee Willams, while employed as a reporter for the Wilmington News Journal, wrote many powerful stores stories about the horrific abuse and denial of medical care in Delaware state prisons.  Now he’s working for the Caesar Rodney Institute, a right wing think tank.

When Jack Markell became governor, he retained Carl Danberg as Commissioner of Corrections and retained the same vendor of medical services.  (This was one of the first clear indications that my personal support of Markell had been an error of judgement.)  So it is entirely unsurprising that the abuse, the medical murders, has continued.

Alan Muller

“Always and forever your son, Daniel”

By Lee WilliamsThe Delaware Department of Correction killed Daniel Kern.

Kern, 41, was serving a one-year sentence for his third drunk-driving conviction.

None of his arrests involved accidents or injuries.

Kern became sick last summer, but rather than treating what experts say was a preventable and treatable illness, the Department of Correction did little more than watch him die.

“DUI has a penalty, but in no case is it death,” said Daniel’s father Robert Kern.

Experts say more inmate deaths are a certainty because the DOC’s medical vendor Correctional Medical Services (CMS) has a reputation for providing shoddy care, which frequently results in inmate deaths and litigation.

CMS has staff in more than 200 jails and prisons nationwide. There have been nearly 1,000 lawsuits filed recently against the company, according to the LexisNexis data firm. Many inmate lawsuits are dismissed as frivolous or because the inmates frequently represent themselves in court, but a cursory search of the Westlaw database conducted Saturday, revealed a total of 2,018 cases nationwide, in which CMS appeared in written opinions filed by the various state and federal courts.

In Delaware, CMS receives nearly $39 million taxpayer dollars per year to provide health care to 6,900 inmates.

Delaware is breaking an agreement with the U.S. Justice Department, in which the Department of Correction promised to improve its medical care, which federal investigators determined was violating the civil rights of the 6,900 inmates in state custody.

Gov. Jack Markell said during his campaign he would fire CMS from the state’s prisons. Markell refused to comment for this story.

“Everybody knows there’s been substandard medical care for years,” said Dover attorney Steve Hampton, one of the few attorneys in the state willing to accept inmate cases.

“You have to know that substandard care will lead to deaths and here we are, getting exactly what you can expect from continued substandard care,” Hampton said. “More people are going to die.”

Kern was being held at the Sussex Correctional Institution. He acquired pancreatitis, an inflammation of the pancreas, which can be caused by alcoholism, other infections or gallstones.

The illness causes intense abdominal pain. It should have been easy to detect. A simple blood test would have revealed that Kern’s blood contained elevated levels of digestive enzymes, which are formed in the pancreas.

Pancreatitis is usually not considered life threatening. It is very treatable.

Kern, however, never received a blood test, much less any treatment.

When he complained of severe abdominal pain, the prison medical staff prescribed Tylenol and sent him back to his cell.

When his legs and feet started to swell, making it difficult to walk, he was given a cane.

When the swelling became more pronounced, he was given a wheel chair.

Kern was moved to the Plummer Center so he could participate in the DOC’s substance abuse treatment program. He’s had a long battle with alcoholism, his family said.

At Plummer, too, his illness went undiagnosed.

On Sept. 15 around 3 p.m., Kern’s body started failing. He was taken to St. Francis Hospital. He died three hours later.

The first inkling that the death could have been prevented came at the hospital.

“Both a doctor and a nurse said we had to follow through on this, and find out what happened, because a perfectly healthy 41-year-old man died, and we didn’t want this to happen to someone else’s son,” said Daniel’s mother Jean Kern.

“That doctor took care of Danny every way he could, but it was too late,” Robert Kern said. “He knew Danny was passing. He was praying for him.”

St. Francis spokeswoman Jenifer Harris said ministering to the medical and spiritual needs of their patients is part of the hospital’s core values.

“We are grateful for Mr. Kern’s kind expression about the care his son was provided,” Harris said.

The next day, Robert Kern went to the medical examiner’s office to identify his son and retrieve some of Daniel’s personal property. He was accompanied by Alan Smick, Daniel’s partner of seven years.

Deputy Chief Medical Examiner Adrienne Sekula-Perlman, MD and Forensic Investigator Hans Southerland told them what their post mortem investigation had revealed.

“Dr. Adrienne said she knew within minutes what had killed Danny. It was pancreatitis, and very preventable, and that he died from ‘gross medical negligence,’ ” Smick said. “The doctor said all Danny needed was a blood test and intravenous antibiotics and he would have been perfectly fine.”

“She said it was totally conclusive. Danny died strictly due to neglect,” Robert Kern said. “She was very compassionate. She said it was her job – her duty – to speak for Danny.”

The revelation that Daniel’s death could have been so easily prevented stunned his family. They are calling on lawmakers to do something before more inmates die from easily preventable illnesses. The Caesar Rodney Institute is in contact with the families of several inmates who are suffering from life-threatening illnesses and diseases, yet receiving little care. One inmate has a baseball-sized hole in his buttocks caused by flesh-eating bacteria. This open wound is continuing to grow. These families are also asking for help.

“I hope my boy didn’t die for nothing,” said Jean Kern. “There has to be a reason for why he died.”

Prior warning
Poor medical care, or the complete absence of care, was highlighted in the Caesar Rodney Institute’s ongoing series “Rogue Force.”

The series revealed how guards at the Sussex Correctional Institution are physically abusing inmates in their care.

It tells David Sully’s story, who was beaten severely by guards at SCI, and that of inmate Benjamin Sudler, who had both legs amputated because of diabetes that went unchecked.

This series reveals how the state’s well-compensated prison monitor is doing little to fix the problems.

After the series was published, Sen. Bruce Ennis, D-Smyrna, said he was disturbed by the allegations raised by the series. Ennis, who chairs the Senate’s correction committee, told the Caesar Rodney Institute he was going to hold joint hearings into the DOC with his colleagues in the House. One day after his announcement, however, Ennis backtracked, saying he was going to allow the DOC to conduct its own internal investigation before any hearings were held.

His announcement came after Sen. Colin Bonini, R-Dover South, sent a letter to state officials calling for a special prosecutor, the empanelling of an investigative grand jury, investigations, audits and new legislation as a result of the findings presented in “Rogue Force.”

“I believe that it is the job of the Delaware General Assembly to determine the facts and to fix that which is broken, and to do so as quickly as possible,” Bonini said in his letter. “We must, and we will, be a part of the solution.”

A painful death
Dr. Irwin Lifrak, a physician and attorney practicing in Wilmington, said pancreatitis is not considered a fatal illness.

“Pancreatitis can occur for many reasons,” Lifrak said. “Gallstones or kidney stones can cause it. Stones can also form in the outlet of the pancreas. Infections can cause it. Too much drinking can also cause it.”

Once the illness starts, Lifrak said the pancreas begins to digest itself as the enzymes it produces to digest foods have nowhere to go.

The illness is easy to diagnose.

“A blood test will usually tell if someone has pancreatitis,” he said.

Depending on the severity, treatment ranges from “resting” the organ by putting the person on an IV, then moving to clear liquids. Antibiotics, Lifrak said, are used, but are somewhat controversial. Surgery is another option.

“The surgeon can cut out a part of the pancreas that’s affected, almost akin to gangrene, where they’ll remove a gangrenous toe,” he explained.

Lifrak said it is important to diagnose the illness early, because as the pancreas digests itself, the person can develop diabetes, and might not know they’ve become diabetic.

“If it’s not known, there are major complications with that,” he said.

One complication faced by diabetics is edema, or the swelling of the ankles and lower legs, a condition that Kern’s family witnessed when he became unable to walk because of swollen ankles and feet.

“At some point pancreatitis can become self-perpetuating and the person dies,” Lifrak said. “It’s a selfdigestive process. It’s a rather painful death.”

Unanswered complaints
Kern had tried to get medical care.

“He had been complaining since last summer,” Smick said. “He had to be in a wheel chair because his legs and feet were so swollen. When he went to seek help, they wouldn’t do anything other than give him Tylenol.”

Smick said prison staff was convinced his partner merely had a bad back.

“Even when it got worse, they wouldn’t send him out to a doctor,” he said.

Daniel’s father became involved.

“I called down there demanding, pleading for help, trying to make sure he got the medical help he needed,” Robert Kern said. “People there are not being taken care of. The care is not adequate or sufficient.”

Homophobia
Kern’s family insists his mistreatment and lack of medical care was the result of his sexual orientation.

“I’m 100 percent certain of it,” Robert Kern said.

Other inmates and staff knew his son’s sexual preference.

“Within his first six months there, his counselor announced to the general population that he was gay,” Smick said. “From then on his treatment went from here [gesturing three feet off the floor] to here [gesturing near the carpet]. It made him a target.”

Three inmates felt sorry for Kern, his family said. They looked out for him. When he became sick, they too tried to get him care. Their complaints were also ignored.

Smick is stunned and grieving, but he is becoming angry.

“This shouldn’t have happened,” he said. “The DOC should have given him the treatment he had requested. He didn’t have to die.”

Drewry Nash Fennell, executive director of the American Civil Liberties Union of Delaware, had a warning for prison officials.

“Prisons, like all other institution, are marked by homophobia in what is already a violent and difficult environment,” Fennell said. “It takes on a whole new level of importance and requires extra vigilance on the part of wardens and others in authority.”

No official response
Correction Commissioner Carl Danberg refused to be interviewed for this story.

Danberg, a holdover from Gov. Ruth Ann Minner’s administration, was not willing to comment for any of CRI’s investigative series, which revealed abuse and substandard medical care in the state’s prisons.

In an e-mail to Danberg, the Caesar Rodney Institute posed several questions. These too went unanswered.

Danberg would not say why Kern was allowed to die from such an easily preventable and curable illness.

He would not say whether the decision to deny Kern care based on his sexual orientation, as his family strongly suggests. Nor would Danberg give an update on his internal investigation into physical abuse of inmates by guards at SCI.

A musical prodigy
Kern had a genius-level IQ. More impressive, however, were his musical abilities.

He had a musical ear. After hearing a song only one time, he could play it near perfectly on a piano or guitar.

Brother RJ Kern recalled watching a musical performance as a child, a concert pianist performing on PBS.

“The next thing I knew, Danny was playing it on the piano downstairs – playing it perfectly without missing a beat,” RJ Kern said.

“We wanted to give him music lessons, but he could already play,” mother Jean Kern said.

“He could do the same thing on a guitar,” said sister Misty Kern. “He was a genius. He could do anything he ever wanted to do.”

Matthew Kern, Daniel’s twin brother, said the two shared a bond that was hard to describe.

“He was a good brother, awesome,” Matthew Kern said. “I knew what he was thinking pretty much all of the time.”

All of Kern’s family said Daniel was known most for his willingness to help and please others.

Final letters home
Kern would have been eligible for weekend passes this week, his family says. His letters indicate he was looking forward to seeing his family, but they also show he knew his health was failing.

One week before he died, Kern seemed to know that litigation would likely result from his death. He knew who was at fault. He sent a warning to prison officials.

“If the right staff was hired, and the right training was provided, and people were not in such a rush to get things done so they can have their own free time to spend mostly on computers online, maybe lawsuits would not be enforced on or against your prison system,” he wrote. “It’s your responsibility to make sure situations like this never happen.”

Six days before his death, Kern wrote to his parents, pleading for help and saying goodbye.

“All I can do is wait for something to happen. I’m tired of all this, and I’m not sleeping any more. I’m worried about me for a change,” he wrote. “Mom and dad please help me. I love you both very much. Always and forever your son, Daniel.”

A call for change
The Rev. Christopher Bullock, senior pastor of Canaan Baptist Church in Wilmington, is one of the founders of the Delaware Coalition for Prison Reform and Justice.

“Once again the DOC has dropped the ball, and another human being has suffered the ultimate level of suffering and lost his life. It could have been prevented,” Bullock said. “Again, I am calling on the governor to fire CMS. We need another health care provider in our institutions. Until we get a new health care provider, and moral leadership, this will continue to be a trend and a problem for the State of Delaware.”

Bullock said the federal monitoring agreement, in which the DOC promised to improve its medical care rather than face legal sanctions, is not being taken seriously.

“I am asking the governor and Carl Danberg to reconsider their approach toward CMS, and to get to the bottom of this latest tragedy, and report their findings to the public and the legislature,” Bullock said.

Contact investigative reporter Lee Williams at (302) 242-9272 or lee@caesarrodney.org

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