ST. LOUIS • About an hour after a doctor instructed St. Louis jail staff to send inmate Courtland Lucas to a hospital immediately, medical records show, the 31-year-old prisoner collapsed in a cell and soon died.
The lapse is among a variety of medical missteps alleged in a wrongful-death and malpractice lawsuit against the private contractor that provides medical care for the St. Louis Justice Center.
Medical records obtained by lawyers for Lucas' family also contain a nurse's notes indicating a belief at the time that his episodes were 'staged."
Lucas died May 25, 2009, from complications of a heart problem, congenital aortic valve stenosis while under the care of Correctional Medical Services Inc. CMS merged last year with PHS Correctional Healthcare to form Corizon. It provides medical coverage to more than 400,000 inmates at 400 correctional facilities across the country, including St. Louis, where its operational headquarters is located.
A company spokesman, Pat Nolan, said: "Corizon and its employees work hard every day to provide quality care to thousands of inmates across the country."
Mayor Francis Slay's spokeswoman, Kara Bowlin, would not comment on specific allegations. She noted that the city spends nearly $7 million each year on inmate health care and "takes seriously its obligation to provide health care services to the people it confines, many of whom come to us with serious medical problems."
The suit, filed this month by the St. Louis Lawyers Group on behalf of Lucas' minor son, Trayon Lucas-McNairy, seeks unspecified damages over $25,000 from CMS but does not name the city as a defendant.
Burton Newman, one of his attorneys, said in an interview: "We found several individuals who were quoted on the record as recognizing the care that this gentleman needed, but other individuals seem to have failed to recognize the care needed, or ignored the care needed."
It is the second attempt at compensation in the case. A prior wrongful-death suit, filed by the American Civil Liberties Union against the city and the health care provider, was voluntarily dismissed last year on a legal technicality.
Lucas, the youngest of 14 children, was a jokester who wrote poetry and announced a new commitment to God, his family told the Post-Dispatch in 2010. He had been a restaurant manager but struggled with drugs, including heroin, for the last four years of his life.
Medical records show Lucas long suffered from serious heart problems, which required several valve replacements and a hospitalization in 2009 for swelling and an irregular heartbeat. He was diabetic, suffered from hypertension and had a pacemaker.
When he was arrested by St. Louis police May 20, 2009, on a parole violation — he had a record of drug and traffic offenses — he was taken to St. Alexius Hospital, complaining of chest pain.
Doctor's orders from that visit set out a plan for checking his blood sugar and administering insulin. Later orders from a jail physician offered a similar schedule. But Lucas' lawyers, one with a medical degree, say evidence shows the orders were not consistently followed.
The suit refers to medical records it says reflect neglect. The plaintiff's lawyer provided a Post-Dispatch reporter with CMS documents that show:
• May 24, afternoon: Lucas, in a narcotics detoxification unit, shows signs of trouble. His blood sugar level is elevated, at 228. Nurses administer insulin but don't record another blood-sugar check until the next day.
• May 24, 7:15 p.m.: Lucas complains of a fast heartbeat and hallucinations, talking of "little people" in his room. A nurse notes he is agitated and perspiring. A jail physician has asked to be called about any changes in Lucas' mental status but there is no record of such a call; Lucas' lawyers maintain it wasn't made.
• May 25, 4 a.m.: Lucas asks to go to a hospital and says he doesn't want to die in the jail. He is taken by wheelchair to an examining room. Nurses try to draw blood but note that it's too thick. Existing hospital orders call for a doctor's care if his blood sugar rises above 300; it is now 325. There is no note of any insulin being administered.
• May 25, 1:10 p.m.: A nurse notes Lucas' altered mental status and also writes that "all episodes appear to be staged as (Lucas) easily comes back to normal conversation."
• May 25, 5:30 p.m.: Lucas is found lying in his cell in a 'stuporous condition" and answers questions 'sluggishly," according to a nurse's notes. Insulin is administered but there is no note of his sugar being checked. Nurses have trouble detecting his pulse and blood pressure, but ultimately find his heart rate is high, at 160.
• May 25, 5:45 p.m.: The on-call physician orders Lucas taken to a hospital emergency room immediately.
• May 25, about 7 p.m.: Lucas is still waiting for transport. A sheriff's deputy reports that Lucas has collapsed while sitting in a wheelchair. Records indicate a lost minute while medical staff struggles to have the doors to the holding unit opened by master control.
• May 25, 7:10 p.m.: Paramedics arrive and take Lucas to St. Louis University Hospital.
• May 25, 7:54 p.m.: Lucas is pronounced dead.
OTHER CLAIMS OF NEGLECT
CMS which has worked for Missouri's prison system since 1992 and has for decades been one of the biggest inmate health care contractors, has been a target of criticism before.
It was the main subject of a 1998 Post-Dispatch investigation, which showed that inmates died in more than 20 cases due to negligence, indifference, understaffing, inadequate training or cost-cutting.
Such concerns rose again in 2007 after the death of LaVonda Kimble, 30, from an asthma attack at the St. Louis Justice Center. A fire department report, obtained by a lawyer for her family, showed paramedics encountered delays and apathy when trying to get into the jail.
Autopsy findings showed no trace of a drug that jail nurses said they repeatedly administered to ease Kimble's breathing.
"The discovery in this case showed they did little to nothing for her. They just watched her die," according to her family's attorney, John Wallach.
A confidential settlement of that suit was reached last year and fulfilled in the past few weeks. Wallach said that "justice was done to the extent that the law would allow..."
In 2010, the ACLU alleged in federal court that an HIV-positive John Doe plaintiff was deprived of medications for 17 days, even though he told jail staff of his condition and his physician faxed information about his medicines and dosages.
Also that year, Vanessa Evans, 37, died hours after she complained to staff about having trouble breathing. Jail officials said she appeared fine a half hour earlier. Evans' family complained that the company failed to take her claims seriously despite her history of asthma.
Newman said Lucas' case is another chapter in a sad history.
He complained: "It's tragic that a man with known medical conditions was incarcerated in the city jail and did not receive any of the medical care that he was not only entitled to, but ... the medical officials at the jail knew he needed."