Newly filed court documents show a medical investigator for the prison system expressed reservations about the care of an inmate, who charges in one of a growing number of medical-neglect lawsuits that his cutaneous T-cell lymphoma was diagnosed for more than two years as psoriasis.
The testimony at a Jan. 19 deposition of Timothy Bombard, an advanced practice registered nurse who works directly for the medical director of the Department of Correction, provides insight into one of a string of inmate medical cases, including at least eight prisoner deaths, where procedures and protocols were found to have not been followed.
With medical-neglect lawsuits beginning to queue up, state officials on Thursday formally ended its prison medical-care agreement with UConn Health, which since the late 1980s had dispatched more than 600 doctors, nurses, and technicians into the state’s prisons to provide medical and mental-health care. The arrangement, for which competitive bids were never sought, is valued at about $100 million a year, including employee fringe benefits. It was criticized last year by state auditors as lacking fundamental checks and balances and quality control.
The unit that provided the prison medical care was called UConn Correctional Managed Healthcare. Many of those employees will move to the Department of Correction.
UConn Health said in a statement Friday that shifting the “provision of inmate medical services back to the DOC from UConn Health is something we support and will work collaboratively to accomplish without negative impact to the patients or the employees who provide their care .
The statement said that any suggestions “that this change is driven by quality of care concerns are not accurate. We are proud of the work of our people who deliver this care, often under very challenging circumstances.”
UConn Health said it is on pace to lose $1 million providing the services to the Department of Correction for this fiscal year. For next year, funding is scheduled to be reduced by $8 million, UConn Health said in its statement. Bombard was deposed on Jan. 19 as part of a medical-malpractice lawsuit filed by inmate Wayne World. Bombard testified that delays in treatment, the failure to do timely biopsies, and the decision by a UConn Health Center panel to deny requests for diagnostic testing, amounted to substandard care. The state attorney general’s office on Friday declined comment on the deposition.
“First of all, he was originally diagnosed with psoriasis ... he did not improve, a dermatology consult was requested, that consult was denied; it was recommended a biopsy be taken, that biopsy did not take place,” Bombard testified. “The initial dermatology consult should have been approved,” Bombard continued, according to a transcript attached to a motion in World’s federal case. “And I adamantly disagree with the fact that it was not approved.” The rejection came from a UConn Correctional Manged Healthcare panel known as the utilization review committee, or URC, which must approve a wide range of diagnostic tests and preventative treatments before they can be performed. “I would say that the URC team did not have the same level of concern” in this case,” Bombard said. It is Bombard’s job to investigate and report on inmate deaths and other cases in which questions arise about the quality of medical care. Correction officials last year hired an outside consultant to examine 25 problem cases — situations in which the officials were being sued, or anticipated a lawsuit. State lawyers representing the correction department and Commissioner Scott Semple have denied The Courant’s request for the consultant’s report, claiming attorney-client privilege. State lawyers were on hand during Bombard’s deposition and invoked the privilege as they objected to dozens of questions posed by the inmate’s lawyer, Kenneth J. Krayeske.
In court motions filed by Krayeske on Wednesday, he asked for the consultant’s report, as well as hundreds of emails from Bombard to top prison officials that contained his reports and assessments on troubling medical cases.
Krayeske’s client was convicted of manslaughter and received a 17-year sentence in 2009. He first sought medical care in May of 2013 after black spots began to appear on his body. More than two years would pass before he was diagnosed with cancer, according to his federal lawsuit.
Bombard testified that he raised questions about World’s care with another APRN named Marilyn Rodriguez.
“How did she respond?” Krayeske asked, according to the transcript.
“She was equally concerned and, to generalize, she would have expressed that she tried to get the consult, and it was denied,”