Lawsuit: Indifference by medical staff at Forsyth jail led to woman’s death

A lawsuit filed in Forsyth County court alleges that a private healthcare company and medical staff at the local jail displayed deliberate indifference, causing the death of a woman awaiting trial in 2014.

A lawsuit filed in Forsyth County court last week alleges that medical staff at Forsyth County jail acted with deliberate indifference, causing the death of a pregnant woman who was undergoing withdrawal from opiates while awaiting a hearing on charges of prescription drug fraud in 2014.

The lawsuit, filed on Aug. 17 by the estate of Jen McCormack, names Correct Care Solutions — a Tennessee-based healthcare company with extensive contracts in detention facilities across the country — as defendant.

McCormack’s unexpected death at Baptist Hospital after being found unresponsive in the jail in downtown Winston-Salem first came to light in a series of articles [1, 2, 3] published by Triad City Beat in 2015 that included details of her deteriorating health during the 16 days of her detention while calling into question an official narrative suggesting she died as a result of a hunger strike.

McCormack’s death certificate, which is cited in the lawsuit, notes an “uncertain contributory role of reported intent to starve self v. deficient pre-emptive custodial intervention.”

Meanwhile, on Aug. 18, the US Justice Department announced that it will gradually phase out contracts with private prison providers, noting among other factors that “they do not provide the same level of safety and security” as those directly administered by the government. A review of inmate medical records by the Nation that focused on 11 immigrant-only contract prisons, including one in west Texas where Correct Care Solutions was the medical provider, found “prison medical units repeatedly failing to diagnose patients correctly despite obvious and painful symptoms, as well as the use of under-qualified workers pressed to operate at the borders of their legal scope of practice.” The investigative report, published in February, also said the files showed “men dying of treatable diseases — men who very likely would have survived had they been given access to adequate care.”

The lawsuit filed in Forsyth County court last week by McCormack’s estate fills in critical gaps about her access to medication in the jail and about concerns raised by an obstetrics nurse at an off-site clinic as to whether her deteriorating condition warranted her hospitalization.

McCormack had received Subutex — a brand name for the opioid-withdrawal medication buprenorphine — during a stay at Forsyth Medical Center prior to her arrest, according to the lawsuit. She also received Zofran to treat nausea. McCormack had wanted to receive treatment for her addiction to prescription drugs at an inpatient facility, but because no beds were available she planned to go home and begin outpatient rehabilitation, according to the lawsuit. Instead, she was arrested for multiple charges of felony prescription-drug fraud and booked in jail.

McCormack experienced nausea and vomiting for much of her time in jail, complaining of dizziness and chest pain, and exhibited lethargy and disorientation that worsened over time. The lawsuit alleges that although Zofran was ordered to treat her nausea, it was only administered to her once. The complaint alleges, “As a result of her uncontrolled nausea, decedent was unable to take many of the medications that were prescribed for her symptoms of opioid withdrawal, anxiety disorder, depression, and prenatal vitamins for her unborn baby.”

The lawsuit alleges that Registered Nurse Miriam Cornatzer Hauser and Nurse Practitioner Emma Aycoth, who worked in the medical unit at the jail at the time of McCormack’s detention and who are named as individual defendants in the lawsuit, and other members of the nursing staff “failed to properly and adequately assess decedent’s signs, symptoms and her severely deteriorated condition.”

The complaint alleges that Cornatzer and Aycoth violated McCormack’s constitutional rights “by intentionally, willfully, maliciously and with conscious and deliberate indifference, failing to secure adequate and reasonable medical care for decedent when they subjectively knew or should have known that decedent had an objectively serious medical need and faced a substantial risk of harm, by disregarding such risk of harm and by failing to take reasonable measures that were readily available to avoid that risk.”

The complaint goes on to say that the two nurses “had actual knowledge that decedent had failed for several days to take in and retain amounts of food and/or liquid sufficient to sustain life, as a result was exhibiting a seriously declining physical condition, and required immediate medical attention and intervention.

“Decedent’s condition would have been diagnosed by a physician as mandating treatment and/or was so obvious that even a lay person would easily recognize the necessity of medical attention,” the lawsuit continues. “Defendants RN Cornatzer and NP Aycoth failed to notify physician staff or otherwise secure reasonable and necessary medical attention for decedent. Their failure to do so and deliberate indifference ultimately led to her death.”

[pullquote]The lawsuit charges that the company’s cost-cutting policies were “a moving force” in Jen McCormack’s death.[/pullquote]Aycoth declined to comment and Cornatzer could not be reached for this story.

The lawsuit accuses Correct Care Solutions of maintaining “policies, practices and/or customs” that constituted deliberate indifference to McCormack’s serious medical needs and that “were a direct and proximate cause” of the nursing staff’s conduct.

The lawsuit charges that the company’s cost-cutting policies were “a moving force” in McCormack’s death, while alleging that “CCS has stated that it is committed to measures that minimize the need to transport inmates offsite.”

Jim Cheney, a spokesman, said Correct Care Solutions would not be able to comment because the case is under litigation.

The lawsuit alleges that “misconduct of nursing staff” at Forsyth County jail and other detention facilities served by Correct Care Solutions was “widespread,” adding that at least seven inmates, including McCormack, have died at the local jail “due to inadequate or improper medical care.”

Correct Care Solutions, along with the Forsyth County Sheriff’s Office, is currently defending itself against a lawsuit filed by the family of Dino Vann Nixon, a man who died in the jail in 2013. The lawsuit alleges that medical staff refused to provide Nixon with Xanax, an anti-anxiety medication also known as benzodiazepine. A report by a local medical examiner found that his death “was related to withdrawal from benzodiazepine.”

Despite the finding by the medical examiner, the defendants deny that Nixon’s death was related to withdrawal from the medication, while maintaining that he received appropriate care.

Correct Care Solutions also provides medical services in the Guilford County detention center. A woman named Ellin Schott who had been arrested for panhandling died at Cone Hospital after her health rapidly deteriorated during a brief stay in one of the jails in downtown Greensboro. A local medical examiners report chronicled medical staff’s apparent unwillingness to provide Schott with her prescribed anti-seizure medication and concluded that the immediate cause of death was “complications of prolonged seizure activity.”

According to the lawsuit filed in Forsyth County court last week, McCormack reported to the nursing staff on the fifth day of her detention that she was weak and dizzy, that she had been vomiting, and that the anti-nausea medication she had been receiving “is not sufficient.”

The lawsuit alleges that Dr. Alan Rhoades assessed that McCormack was apparently fainting, further concluding that she was exhibiting “drug seeking behaviors.” The complaint continues, “Decedent had been placed on Vicodin because CCS did not have access to Subutex. Dr. Rhoades ordered that Vicodin dose be decreased and ordered, ‘no change in management otherwise,” with the doctor emphasizing the first two words in all capitals.

Rhoades’ LinkedIn page identifies him as the medical director for the Forsyth County jail, along with the three Guilford County detention centers. Rhoades could not be reached for comment for this story.

The next day, according to the lawsuit, McCormack visited an OB/GYN at a clinic off site from the jail. “The obstetrical nurse contacted NP Aycoth expressing concern about decedent seeming drugged and drowsy and because decedent had vomited ginger ale she had been given,” the lawsuit alleges. “The obstetrical nurse questioned whether decedent should be hospitalized, and NP Aycoth instructed the obstetrical nurse to have decedent returned to the jail.”

Later that day, the lawsuit alleges that despite discovering that McCormack had vomited in her wash basin back in her cell and was struggling to eat, Aycoth failed to report those developments to physician staff.

“After September 9, 2014, nursing staff made no assessment of blood pressure or vital signs until September 13, 2014,” the lawsuit alleges. “Meanwhile, decedent was becoming more and more dehydrated due to continued nausea and vomiting. Nursing staff made no measurement of decedent’s food and water intake or output except for one notation of water intake that was made on September 13, 2014. Decedent was becoming at high risk for a serious and significant dehydration setting the stage for injury to her brain, kidneys and heart that did, in fact, cause a severe downward spiral in decedent’s condition, including changes in cognition, damage to her kidneys placing her at high risk for kidney failure, and culminating in a cardiac arrest that led to hypoxic brain injury and death.”