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ACLU Probes Collier Jail’s Policies on Pregnant Inmates

Published Sunday, March 1, 2009

NAPLES – After an inmate lost her baby and two other pregnant inmates were released due to complications, the American Civil Liberties Union of Florida is asking the Collier County jail to disclose how many inmates reported miscarriages or stillborn babies – and to detail its policies for pregnancies in jail.

The request, filed under the state public records law, followed several reports in the Daily News about pregnant women’s complaints about the jail’s medical provider, Prison Health Services, including an inmate whose dead fetus was left inside her, inmates shackled to hospital beds, and one who said her cries that she was in labor were ignored so long that her baby was delivered inside the jail.

Defense attorneys quoted in the Daily News articles were contacted by Maria Kayanan, ACLU of Florida’s legal director.

“The ACLU of Florida is committed to ensuring pregnant women who are incarcerated get the health care they need and that their constitutional rights are not violated,” Brandon Hensler, spokesman for the ACLU of Florida, said of its check on jails and prisons in Florida.

The ACLU request, sent to Collier County Sheriff Kevin Rambosk last week, also asks for the number of inmates who gave birth full-term and prematurely; grievances filed by inmates involving pregnancy and birth-related complaints about treatment or lack of treatment; how grievances were handled; how many inmates sought prenatal care; and its policies and procedures for testing pregnant inmates for gestational diabetes and sexually-transmitted diseases.

In addition, the ACLU sought information that included the jail’s policies and procedures involving the care of pregnant inmates; policies involving shackling inmates during delivery; diet and nutritional guidelines, including prenatal vitamins; whether educational information is provided; and information on providers who treat pregnant inmates.

Jail officials and a spokeswoman for Tennessee-based Prison Health Services have defended their medical care.

Hensler said the ACLU has been gathering information from various sources throughout the state since December 2008 about prenatal care provided to pregnant inmates in jails and prisons, but added that it was too early to determine what the results will show.

Karie Partington, a spokeswoman for the Collier County Sheriff’s Office, which operates the jail, said the office is in the process of compiling all items under the ACLU’s request that can be released under the state’s public records law.

On Wednesday, former inmate Joan Small, 22, of Bonita Springs, who wasn’t immediately taken to a hospital after her fetus died, sought medical treatment for a pregnancy-related infection, according to her mother, Jennifer Graeber of New Jersey. Four days earlier, Small and her boyfriend, Elias Guzman, buried the ashes of their baby, Elena Laurel Guzman, over the grave of Small’s grandfather in Washington Township, N.J.

Small was arrested on Dec. 22 on a probation violation involving a curfew. When she arrived in jail, she said, officials canceled her scheduled appointment for an ultrasound to determine why her baby was so small.

Later, she complained for nearly two weeks about a heavy discharge that worsened, she said, but was given a sanitary napkin and told to monitor it and wasn’t looked at by a doctor or taken to a hospital. On Feb. 3, she had an ultrasound at the county health department, next to the jail, and it showed her fetus was dead; the baby’s skull had collapsed after all her amniotic fluid had leaked out.

Several doctors told her the baby could have been saved if she’d been taken to a hospital when the discharge began. Small said she’d also been denied a RhoGAM shot to protect her baby against her RH negative blood until the day of the ultrasound, beyond the time recommended for the shot. On the day she was arrested, she had an appointment to get the needed shot.

Despite the dead fetus inside her and her doctor’s orders to take her to a hospital, Small wasn’t taken until her public defender, Amy Shirvanipour, successfully persuaded a prosecutor and judge to agree to immediately end her sentence.

Though Collier Circuit Judge Fred Hardt’s Feb. 4 order said Small’s condition was “grave” due to the dead fetus and she should be immediately released, jail officials refused to release her to Shirvanipour. Three hours later, a deputy drove her to the hospital, where tests showed her blood-pressure was rising, the first signs of septic shock.

Jail officials took credit for making the hospital arrangements Shirvanipour had handled and for transporting Small to The Birth Place at North Naples Hospital. Small said jail officials didn’t plan to take her to the hospital until the next day. Medical experts say leaving a dead fetus inside a woman can lead to septic shock – and death.

Partington, the sheriff’s spokeswoman, said that due to a pending lawsuit by Small, she could not comment on why Small wasn’t immediately released after Hardt’s order terminated her sentence, which ended their custody.

Small has hired Naples attorneys Sharon Hanlon and Ted Zelman of Zelman and Hanlon for a possible medical negligence and wrongful death lawsuit.

“I have been contacted by several current and former CCSO inmates regarding their medical care while incarcerated during their pregnancies,” Hanlon said Thursday. “We are checking into their concerns. We have also been informed about the ACLU’s study, and have provided the inmates with this information.”

A week after Small’s release, Michelle Nicol, 27, an inmate who developed gestational diabetes while incarcerated and wasn’t given a requisite test, was released an hour after Hardt ordered her release “without any delay” and modified her sentence to house arrest. She was eight months pregnant.

Last week, Felicia Marie Martin, 23, who also was eight months pregnant, was granted a furlough after she developed Group B Strep infection, which can be passed on to her baby and possibly cause death. She must surrender herself in April, a month after the baby’s delivery, to serve a drug sentence.

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