Wendy King never saw a doctor.
“Everybody in my family has some kind of uterine problem,” King told me. “My mom and three sisters have all had hysterectomies.” So when King started bleeding continuously while serving a one-year sentence at Dawson State Jail for a parole violation, she asked to see a doctor.
“I bled for nine months,” she says. “I’m sorry, I know this is gross, but I’d step in those metal showers and you could hear blood clots fall out as big as my hand.”
King says that at Dawson, prisoners must first fill out a form asking for medical care and wait five to eight days for it to be processed. “Then they schedule you for a doctor if they think you actually need to see a doctor,” she said. Getting an appointment can take another week.
The physicians’ assistants who saw King didn’t think she needed to see a doctor. They also didn’t give her an exam. “They gave me antibiotics,” she says, “They said it was something going around, a venereal disease.” With a week’s worth of antibiotics and a menstrual pad, King was sent her back to her cell.
King’s experience at the troubled Dawson State Jail, a privately run, 2,200-bed lockup for nonviolent offenders, isn’t unusual. Several inmates at the facility have complained of poor conditions and lack of access to medical care that, in a few cases, led to deaths. Dawson has come to exemplify the once unutterable, now bipartisan, cause of closing some Texas prisons.
Yesterday, two advocacy groups, The Sentencing Project and Grassroots Leadership, released a report summarizing the case for closing Dawson—primarily that it could save the state $24 million a year. That’s not counting how much the state could make by selling the property on which Dawson sits, a riverside plot in downtown Dallas that the city has been clamoring to develop for years.
Nearly every stakeholder wants Dawson closed, except, of course, for Corrections Corporation of America (CCA), which operates the jail; its contract is up for renewal in August. State lawmakers, including Sen. John Whitmire, a Houston Democrat and chair of the Senate Committee on Criminal Justice, want Dawson closed because Texas’ inmate population continues to drop and the state can save money by consolidating prisons. The American Federation of State, County and Municipal Employees (AFSCME), the union that represents prison guards, wants Dawson closed because chronic understaffing makes the facility an extremely stressful and dangerous workplace. Human-rights groups want Dawson closed because of documented, systemic failures in its health care services and the horrifying deaths of several inmates, allegedly due to medical negligence.
Compared to the seven inmates who have died at Dawson since 2004, Wendy King was lucky.
Back in her cell, she continued to bleed. “I lost so much blood, it’s amazing I could walk,” she says. Finally another inmate told a guard about King’s condition, and the guard escorted her down to the clinic personally. The physician’s assistants still didn’t allow King to see a doctor, nor, she says, did they give her an exam or run any tests. But they did give her two shots of Depo Provera within the space of a few weeks. Depo Provera is a powerful birth control hormone intended to be given only once every three months. The shots slowed King’s bleeding, and she lived with it for the next seven months, until her release in September 2011.
King never saw a doctor at Dawson. Once she was released, she sought help and her condition turned out to be non-lethal: endometriosis and a retroverted uterus. Endometriosis happens when the uterine lining grows outside the uterus, and can cause heavy bleeding and scar tissue, sometimes enough to tilt, or retrovert, the uterus. Though the condition required surgery and rehab, it could have been worse. King’s sister died in October 2011, a month after King was released, of an aggressive uterine cancer.
Unfortunately, King’s is among the least disturbing stories of medical horror at Dawson. In 2012, the Dallas news station CBS 11 ran a four-part exposé highlighting alleged medical negligence at the jail and detailing three cases:
• In 2008, a 30-year-old woman named Ashleigh Parks died of pneumonia six weeks before her release date. Her family says she was denied medication until it was too late, a claim supported by letters from other inmates who knew Parks.
• In 2010, Pamela Weatherby, 45, died while serving a year for drug possession. The lawsuit filed by Weatherby’s family against CCA details how she was taken off her prescribed insulin injections and given cheaper oral insulin, resulting in diabetic comas. Repeatedly, Weatherby was medically stabilized elsewhere and returned to Dawson, where she would again be denied her insulin injections and suffer another coma. Weatherby arrived at Dawson in May. She was dead by July. An autopsy revealed that she died from diabetes complications.
CBS 11 obtained internal documents from CCA showing that the chief of security reported that Dawson staff “didn’t follow proper procedures in that they did not call a medical professional” the night of Weatherby’s death and recommended termination of shift supervisors. But a week later, Senior Warden Raymond Byrd determined, “The actions by employees were consistent with TDCJ policy and procedure. No training needs have been identified at this time.”
• Parks and Weatherby aren’t alive to tell their stories, but Autumn Miller is. Miller didn’t know she was a few weeks pregnant when she arrived at Dawson in January 2012 to serve a year for violating her probation. But by May, she knew something was wrong. She’d been missing periods and felt sick. A mother of three, Miller recognized pregnancy. Miller is still at Dawson, but her mother, Jean Burr, told Miller’s story to CBS 11 after seeing its coverage of Weatherby’s death. Burr says that in May, Autumn Miller requested a pap smear and pregnancy test but never got them. Three weeks later, she started bleeding and cramping, feeling pressure and pain. The staff brought her to the medical unit on a stretcher, and Burr says a doctor was on a video screen—Dawson is one of many facilities that use telemedicine to save money—but that an assistant told the doctor he wasn’t needed and turned off the screen. A guard suggested, “You probably need to go poo,” gave Miller a menstrual pad and locked her in a holding cell. “The pressure was so bad that she went to the toilet,” Burr told CBS 11. Then, “the baby came out and went into the toilet and started screaming.” The baby girl, named Gracie, was just 26 weeks along. She died four days later. Miller had a tubal ligation and was allowed to stay in the hospital until Gracie passed away in her arms. Half an hour later, Miller was shipped back to Dawson, where they placed her in solitary confinement for two days, because, they said, she was on “suicide watch.”
• Shebaa Green, 50, suffered from diarrhea and difficulty breathing for three days before she was allowed to go to the medical unit at Dawson last August, according to records obtained by CBS 11. She lay there unexamined for three hours before anyone arrived to look at her. Seven hours later, a doctor called an ambulance as Green struggled for breath. She died the next day of complications due to pneumonia.
CBS 11 reported that 15 women talked to the station about mistreatment they witnessed or experienced at Dawson; two said they had extremely high fevers and were left in segregation for days or weeks without ever seeing a doctor. Another, Lorraine Brown, said that, like Weatherby, she was diabetic and never received her insulin at set times. She also said she watched a woman have a stroke, become paralyzed, and be left for other inmates to bathe and care for.
Other former inmates echo these stories on Topix.com, in an online forum about Dawson State Jail conditions, though the details of their stories haven’t been confirmed.
But the case against Dawson’s medical care isn’t just anecdotal. A January 2012 audit of Dawson health services by the Texas Department of Criminal Justice found multiple systemic failures: noncompliance more than half the time in areas of preventative, gynecological, dental, HIV and elder care. They even failed the basics: conducting inspections, having enough first aid kits, providing medically appropriate diets to sick prisoners, and keeping adequate records.
CCA has issued statements in response to the CBS 11 reports, saying that its “dedicated, professional corrections staff is firmly committed to the health and safety of the inmates entrusted to our care.” They point out that CCA is not the health care provider—the state contracts with the University of Texas Medical Branch for care—but in each case of alleged mistreatment, the problem was not bad treatment but a denial of access to treatment. CCA staff at Dawson, the ones whom Senior Warden Byrd said had no training needs, are the gatekeepers. CCA says it can’t comment on the Weatherby case because of the ongoing lawsuit, and “As for the other allegations, there are no complaints on record from those inmates about their access to quality health care.”
Perhaps the most amazing part is that Dawson’s closure still isn’t a sure thing. Despite financial, practical and moral reasons for closing Dawson, the state may renew CCA’s contract for the facility in August. The simple reason is that CCA, the largest private prison company in the world, is a powerful lobbyist.
Sen. Whitmire has been trying to close Dawson since 2008. In December, Robert Wilonsky of the Dallas Morning News asked Whitmire about the chances of successfully closing Dawson this time.
Whitmire laughed, paused for a long time, and then said, “Better than 50-50.”