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Collier sheriff, jail medical provider sued over death of inmate’s baby


Saturday, November 13, 2010

NAPLES – A 24-year-old woman who lost her baby while she was an inmate at the Collier County jail has sued the sheriff and the jail’s medical provider, alleging they violated her civil rights by denying her necessary medical treatment.

Joan Small, a former Bonita Springs woman now known as Joan Graeber, is suing Tennessee-based Prison Health Services and Collier County Sheriff Kevin Rambosk after suffering pregnancy complications that led to her baby’s death.

Prison Health Services is the target of pending lawsuits in Collier and Lee counties – and nationally – involving denial of medical care in jails.

Publicity over baby Elena’s death in February 2009 ended in other pregnant inmates with complications getting released in the weeks afterward.

The lawsuit was filed this month in Collier Circuit Court by Naples attorneys Sharon Hanlon and Ted Zelman. It’s been assigned to Judge Cynthia Pivacek. Hanlon declined comment.

A year after the death, Graeber and her new husband, Elias Guzman, who live in New Jersey, had another baby.

The sheriff says he supports Prison Health Services (PHS), which is contracted to provide medical care to inmates.

“PHS has a successful history in treating inmates and our position has not changed on this case,” Rambosk said. “We feel PHS acted appropriately under the circumstances and that the plaintiff’s allegations will be resolved by the courts.”

PHS spokesman Pat Nolan declined comment, adding: “It is PHS Correctional Healthcare’s policy that the company does not comment on pending litigation due to patient privacy laws.”

Small landed in jail when her estranged husband, Ken Enright Small, was stopped for a traffic violation in September 2007. He was taking her to a bus station so she could go home to New Jersey, ending their six-year marriage, but asked her to hold his drugs in her purse when he was stopped. Deputies searched and found $30 of crack in her purse.

She was released on bond and sentenced that July to probation as part of a plea bargain that withheld an adjudication of guilt. But she landed back in jail after returning late from a voluntary parenting class in Naples, arriving after curfew with her probation officer waiting.

The lawsuit gives this account:

Graeber was booked into the jail on Dec. 19, 2008, and placed within a medical unit weeks before her Feb. 4 due date.

“Over the next 30 days, plaintiff had no treatment at the Women’s Clinic, despite plaintiff making repeated requests for treatment. Among her requests was that she receive an RH-negative RhoGAM shot that was prescribed for her.”

On Jan. 19, 2009, she was examined at the clinic, when a doctor told her and a sheriff’s employee that she needed an RH-negative RhoGAM shot and a late-term ultrasound. “The treatments did not occur.”

On Jan. 28, a PHS progress note reported vaginal spotting, but further medical treatment was denied. When she was taken to the clinic on Feb. 3, 2009, a doctor told her the baby was dead and recommended immediate delivery.

“The clinic doctor’s recommendation was not followed. Plaintiff’s dead baby was not delivered until Feb. 5, 2009.”

As a jail detainee, Graeber had the constitutional right to medical care and also a right to medical treatment once jail officials were alerted to her “potentially serious medical condition.”

But Prison Health Services acted with deliberate indifference to that threat and her serious medical needs, failing to obtain or provide adequate medical treatment, and ending in pregnancy complications that caused injuries.

PHS had an existing policy or custom of withholding medical treatment from inmates. If it had a policy of providing medical care, PHS and the Sheriff’s Office were deliberately indifferent and deprived Graeber of her constitutional rights to care. The defendants also were deliberately indifferent in their failure to supervise jail staff in their treatment of inmates, the lawsuit concludes.

Graeber is seeking compensation for her injuries, mental anguish, pain and suffering, expense of hospitalization, medical care and nursing treatment, loss of earnings and the ability to earn money, and aggravation of a previously existing condition.

In an interview last year, she said the ultrasound showed her fetus was dead and the baby’s skull had collapsed after all her amniotic fluid had leaked out, although she’d repeatedly complained about spotting.

She wasn’t taken to a hospital until her public defender, Amy Shirvanipour, persuaded a prosecutor and judge to agree to release her; Graeber said jail officials didn’t plan to take her until Feb. 5, 2009.

Although Collier Circuit Judge Fred Hardt’s Feb. 4, 2009, order said Small’s condition was “grave” and she should be immediately released, jail officials refused to release her to Shirvanipour. Three hours later, a deputy drove her and tests showed her blood-pressure was rising, the first signs of septic shock. Medical experts say leaving a dead fetus inside a woman can lead to septic shock – and death.

PHS has been sued before by inmates alleging denial of medical care, including several mothers who lost babies.

In November 2008, an Idaho jury awarded a woman and her son $3.6 million after the woman, a state inmate, gave birth on a prison ramp while being moved outside in a wheelchair. Her baby struck his head on a concrete ramp, his umbilical cord and placenta were run over by the wheelchair and he now has cerebral palsy.

In a case similar to Graeber’s, Lee County jail inmate Michelle Goebert’s lawsuit alleged that for 14 days after her 2001 arrest, she asked for medical help or to visit an obstetrician because she was leaking amniotic fluid and feared her baby would die. She was taken to the hospital, but had lost too much amniotic fluid for the baby to survive and it was stillborn. She received a confidential settlement in May 2008.

In April 2008, PHS settled a lawsuit filed by Ajadyan Venny of The Bronx for $210,000. She gave birth at the Albany County jail in 2001 as she sat bleeding on a toilet. A nursing supervisor assumed he was dead in the toilet, but ambulance technicians told guards to check the baby. He was scooped out and died at a hospital two days later.

In April 2007, Kimberly Grey of Tampa accepted a $1.25 million settlement from PHS as a federal jury was deliberating; the Hillsborough Sheriff’s Office already had settled for $350,000. She delivered her boy over a jail cell toilet in 2004 after complaining of labor pains for nearly 12 hours; he died on the way to a hospital.

© 2010 Scripps Newspaper Group – Online

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