by Matt Clarke

The news from Pennsylvania on April 4, 2021, had a sadly familiar ring to it: A prisoner died a preventable death in a county lockup, costing a bundle to settle, so county officials were turning to a private healthcare provider. They granted a multi-million-dollar annual contract—a million more than they’d spent on prisoner healthcare the year before—to make sure it didn’t happen again.

In this case, the officials in Lebanon County had been stunned in October 2018 by a $4.75 million settlement over the wrongful death of a county prisoner. They ended up in April 2021 handing out a $3 million annual contract to PrimeCare Medical, a firm that had settled eleven medical liability cases over the preceding four years. In five of those cases, the firm’s liability was kept under wraps, but the other six all settled between November 2017 and November 2019 for a total near $13.7 million.

However, County Administrator Jamie Wolgemuth wasn’t worried about that at the meeting of county commissioners where the vote was taken on the new contract, pointing instead to the liability the county would dodge by shifting it to the new contractor. Plus, neighboring counties in central Pennsylvania—Dauphin, Lancaster, Berks and York—had already hired PrimeCare to handle healthcare in their prisons. The benefits would surely outweigh the additional cost of outsourcing work that the county had been doing for two-thirds the price, right?

Before answering, Lebanon County officials might have checked with their counterparts in York County, who let their prison’s contract with PrimeCare expire on September 30, 2021. Again, the issue was money: PrimeCare’s $7.4 million annual deal was negotiated for a prison population of 2,200, which had dwindled by then to just 950. Yet there was also a lawsuit the county faced for the wrongful death of a prisoner, Veronique Henry.

When a Trip to Jail Is
a Death Sentence

Henry, 42, told investigators before she died that she and her 41-year-old husband, Paul, went to buy heroin at the Fawn Township home of Foday Cheeks, 31, on September 13, 2016, when Paul Henry—who was eventually sentenced to two life terms—fatally shot both Cheeks and Danielle Taylor, 26.

The Henrys were arrested and booked into the York County Prison, where guards felt based on her previous incarcerations there that Veronique should be placed on suicide watch and passed that recommendation on to their supervisor. But PrimeCare was solely responsible for placing prisoners on suicide watch. Its staffers on duty—none of whom was a doctor—interviewed Henry and determined she was not a suicide risk. She was placed in a regular cell, where she hanged herself with a bedsheet the next day and died.

York attorney Rich Reilly, the administrator of Henry’s estate, with additional assistance from attorneys Joshua A. Anstine and Leticia C. Chavez-Freed of the Chavez-Freed Law Office, LLC, then filed suit in federal court for the Middle District of Pennsylvania, alleging deliberate indifference to Henry’s serious mental health needs.

After that suit survived a motion to dismiss by both PrimeCare and the county on August 26, 2019, the estate reached a settlement agreement with PrimeCare for an undisclosed sum on April 26, 2021, the same day the county settled charges against its guards for $5,000. See: Reilly v. York Cty., 2019 U.S. Dist. LEXIS 142914 (M.D. Pa.); and Reilly v. York Cty., USDC (M.D. Pa.), Case No. 1:18-cv-01803.

“While it’s true that there’s this rubric of using private vendors, it is designed to absolve the sheriffs of responsibility and involvement,” observed Dr. Homer Venters, author of Life and Death in Rikers Island and the former chief medical officer for Correctional Health Services in New York City. “It does not, however, improve quality.”

Yet the privatized provision of health care to prisoners has metastasized with the expansion of Pennsylvania-based PrimeCare into jails in Maryland, New York, New Hampshire and West Virginia, despite questions about the quality of care provided and allegations of improper business tactics employed in securing lucrative government contracts.

In 1986, company founder Dr. Carl A. Hoffman incorporated Pennsylvania Institutional Health Services, Inc. The name was changed to PrimeCare Medical, Inc. in 1994, the same year that two subsidiaries were formed, PrimeCare Medical of New York and PrimeCare Medical of West Virginia, expanding prisoner healthcare services to correctional facilities in those states.

Over two dozen lawsuits filed just since 2009 allege PrimeCare’s substandard medical or mental health care resulted in injury or death to prisoners. The company has managed to keep details secret in most of those it settled. But it has been held liable for a total of $13,682,344 in six cases since November 2017, plus some undisclosed share of another $545,000 awarded in two other cases since March 2016.

Questionable Business Practices

For well over a decade, there have been questions about PrimeCare’s business practices. In 2008, accusations surfaced in federal court of a company staffed with founder Hoffman’s “cronies,” including a convicted felon, as well as unqualified employees who allowed the government to be billed for services PrimeCare never rendered.

Those charges were made by former Vice President of Operations Richard Smith in a suit claiming he was constructively terminated, following a 1992 scandal over a back-dated entry Hoffman added to a deceased prisoner’s medical records.

Smith said he tried to improve company ethics after being promoted to vice president in 1996, but he was defeated in his efforts by Hoffman, who hired relatives and other people with minimal qualifications who would not adhere to ethical standards. They allegedly billed the Pennsylvania Department of Corrections (DOC) for contractually required positions that were never filled. Smith also said the company used a “liberal interpretation” of contracts to increase billing for medical costs. The suit was settled in 2009 for an undisclosed sum. See: Smith v. PrimeCare Medical, Inc., USDC (M.D. Pa.), Case No. 1:08-cv-01397.

In March 2013, the Sunbury Daily Item reported that members of the Prison Board in Northumberland County, Pennsylvania, were investigating PrimeCare after a former company nurse was fired for raising concerns about substandard medical practices at the county lockup. His supervisor also resigned because the company refused to address the issues.

The 25-year-veteran nurse told the Board that prisoners were not being treated in a timely manner—when medicines ran out, prisoners would sometimes wait a week for refills—and that medical records and charts were being falsified. Meanwhile supervisors’ complaints of inadequate medical treatment or misconduct were also being ignored. The nurse said that those medications not being delivered included prescriptions for diabetes, seizures, psychiatric conditions and heart disease. When he asked about the prisoners and their missing meds, he said, “I was told to mind my own business and not to worry about them because they are ‘just inmates.’”

“My supervisor was also very concerned, so we asked to speak with the regional manager,” added the nurse. “I was fired, and a few weeks later my supervisor quit because she said she felt she couldn’t be a part of what was going on anymore.”

The former supervisor confirmed to the Daily Item that she filed reports of staff misconduct and provided them to her boss.

“And nothing got done to them that I am aware of,” she said. “I brought these issues to her attention, and I was never instructed to do anything.”

Nothing much got done with PrimeCare, either, probably because the county remained focused on costs. It was still employing the company at the jail in July 2021, when County Commissioner Sam Schiccatano asked Jail Warden Bruce Kovach to meet with PrimeCare officials to negotiate a lower bill, which was still running over $98,000 a month despite a drop in the prison population.

Employee complaints

Other employees have taken their concerns over company business practices to court. On April 29, 2016, former PrimeCare nurse Tonya Gray filed a lawsuit in the U.S. District Court for the Eastern District of Pennsylvania, alleging that PrimeCare fired her for legitimate use of the Family Medical Leave Act and for requesting an accommodation to bring fruit juice to work during a lengthy religious fast.

The complaint, filed with the aid of attorneys Elizabeth D. Lubker in Exton and Joseph A. Ryan in Paoli, also accused PrimeCare and Montgomery County Correctional Facility staff of falsifying evidence that Gray brought a cell phone into the lockup. After surviving defendants’ motion for summary judgment, that case was also settled for an undisclosed sum in 2018. See: Gray v. PrimeCare Med., Inc., 2018 U.S. Dist. LEXIS 105848 (E.D. Pa.); and Gray v. PrimeCare Med., Inc., USDC (E.D. Pa.), Case No. 16-2193.

On March 25, 2020, a judge at the U.S. District Court for the Western District of Pennsylvania denied PrimeCare’s motion to dismiss a putative class-action lawsuit brought by former company therapist Kathleen Moore, who accused the firm of routinely violating the federal fair Labor Standards Act and Pennsylvania Minimum Wage Act by refusing to pay overtime to therapists treating prisoners.

Aided by attorneys D. Aaron Rihn and Sara J. Watkins of Robert Peirce & Associates, P.C., in Pittsburgh, as well as Nicholas A. Migliaccio of the Migliaccio Law Firm PLLC in Washington, D.C., Moore alleged she and other therapists were required to put in extra hours without overtime pay at the Cambria County Prison and the Washington County Jail between 2013 and 2017. That suit also was settled for an undisclosed amount on March 16, 2020. See: Moore v. PrimCcare Med., Inc., 2020 U.S. Dist. LEXIS 45332 (W.D. Pa.); and Moore v. Primecare Med., Inc., USDC (W.D. Pa.), Case No. 3:19-cv-106.

Allegations of improper business practices against PrimeCare persist to this day. In May 2021, commissioners of Belknap County, New Hampshire, heard from Dr. Christopher Braga, co-owner of American Institutional Medical Group, which was then providing physician services for prisoners in the county Corrections Department. Braga complained that, unlike PrimeCare, his company was not given ample time to draft a proposal for the provision of healthcare at the jail and he only “found out through the grapevine” that the department was in talks with PrimeCare.

Corrections Superintendent Adam Cunningham also advised county commissioners that PrimeCare’s $699,998 yearly bid was $55,442 over budget and $20,500 more than what was projected under Braga’s firm. Nevertheless, he recommended awarding the contract to PrimeCare, and commissioners agreed.

If PrimeCare engages in such questionable business practices and raises these complaints from its own employees, how does it treat the prisoners under its care? After all, wrongful discharge or theft of overtime wages is not fatal, which failures in providing healthcare can be.

Questionable Medicine

PLN examined 26 suits filed since 2009 accusing PrimeCare of negligence or inadequate medical care provided to prisoners. These do not represent all the litigation against the firm; many cases die struggling up the steep hill courts have built for prisoner lawsuits to overcome. But the lawsuits provide a closer look into allegations that obvious signs of mental illness, intent to self-harm, drug dependency and symptoms of withdrawal or cancer went ignored. And not all medical neglect deaths or serious injuries result in litigation for a variety of reasons.

Sometimes the prisoner had just attempted suicide. Sometimes jail and PrimeCare staff failed to consider the prisoner’s drug dependency when assessing the risk of death from withdrawal. Some prisoners even reported an existing diagnosis of cancer only to be ignored and left without medical or mental health care.

In all but three cases the prisoner died, either from suicide (9), neglect (9) or drug-withdrawal (5). All but six of the suits have been settled so far.

A recurring theme was the company’s drive to cut costs—at all costs. This included prohibiting prisoners from being issued asthma-rescue inhalers to keep in their cells, requiring prisoners to be released or transferred to prison if they needed surgery, and denying medically necessary medications or delaying their delivery.

In many cases, though—like the one filed by Henry’s estate—it’s unclear what PrimeCare paid in settlement because a court granted a motion to seal it.

That is also what happened after Andrew Beers committed suicide by hanging at the Northumberland County Prison on August 13, 2013. The 27-year-old’s mother dutifully filed suit in U.S. District Court for the Middle District of Pennsylvania, accusing the county and its prison healthcare contractor of ignoring Beers’ requests for mental healthcare. With the assistance of attorney Wayne A. Schaible, a $75,000 settlement was reached with the county on October 23, 2015. The complaint against PrimeCare was dismissed the following January, following a settlement for an undisclosed sum. See: Beers v. Cnty. of Northumberland, USDC (M.D. Pa.), Case No. 1:14-cv-02349.

Not quite a year after Beers took his own life, 34-year-old Cyrus Lewis committed suicide at the same lockup on June 16, 2014. He had been arrested five days earlier when caught trying to steal a tire from a store, leading cops on a drunken chase—in a car taken without permission from his wife—which ended when he crashed the vehicle and threatened to kill himself.

Aided by attorneys Amy R. Boring and Michael Zicolello of Schemery Zicolello in Williamsport, as well as Timothy A. Bowers of Tim Bowers Law Office in Sunbury, Lewis’ wife filed suit in U.S. District Court for the Middle District of Pennsylvania, blaming the county and PrimeCare for her husband’s suicide.

After the suit survived PrimeCare’s motion for summary judgment on September 30, 2018, the case was settled on January 28, 2019—but again, only the county’s $300,000 payment was made public, with PrimeCare’s contribution kept under wraps. See: Lewis v. Cty. of Northumberland, 2018 U.S. Dist. LEXIS 168558 (M.D. Pa.); and Lewis v. Cty. of Northumberland, USDC (M.D. Pa.), Case No. 4:14-CV-02126.

In a sad coda to the tune played at this jail—the same one where his brother died nearly eight years earlier—Sean Beers, 34, took his own life in a cell at Northumberland County Prison on September 15, 2021. “It’s like it all happened all over again,” said Hope Dewalt, Andrew Beers’ widow. “Once is enough but then to have this happen a second time is something no family should have to go through.”

Ignoring Severe Symptoms, PrimeCare Loses Another Pennsylvania Prisoner

Another undisclosed agreement filed under seal in December 2020 settled a suit brought by the family of a Pennsylvania prisoner who died at the Montgomery County Correctional Facility. After his intake on July 21, 2018, things went quickly downhill for the prisoner, Eric Viney. Though PrimeCare staffers noted his 20-pound weight fluctuation, swelling extremities and jaundiced conditions, the lab tests they ordered were never conducted. Viney was supposed to be sent to special housing for observation, but he wasn’t. By August 7, 2018, just a few weeks later, he was unable to eat, urinate or walk.

When initially examined by PrimeCare staff, Viney told them he suffered from hyperthyroidism. But over the next few weeks he was examined by doctors only a few times. Even after his eyes turned yellow from jaundice, he was not rushed to a hospital. In fact it took two days to get him to a hospital emergency room. There he spent another 100 days in a coma before he died of multiple organ failure on November 17, 2018. He was 36.

Aided by attorney Jonathan H. Feinberg of Kairys Rudovsky Messing Feinberg & Lin LLP, Viney’s wife, Nakila, filed suit in the federal court for the Eastern District of Pennsylvania, accusing the jail and PrimeCare of his wrongful death. That suit was then settled for an undisclosed sum on December 7, 2020. See: Viney v. Montgomery Cnty., USDC (E.D. Pa.), Case No. 2:20-cv-00367.

$11.9 Million Jury Award Against PrimeCare in Suit over Pennsylvania Prisoner’s Suicide

In November 2019, the U.S. Court of Appeals for the Third Circuit reinstated an $11.9 million award made in September 2016 by a Pennsylvania federal jury to the family of Mumun Barbaros, 46, who committed suicide while incarcerated at the Monroe County Correctional Facility (MCCF) on March 22, 2009. Barbaros shredded his t-shirt and stuffed it down his throat. [See: PLN, Oct. 2009, p.26.]

The lawsuit filed by his estate by attorney Brian S. Chacker with Gay, Chacker & Mittin, P.C., accused PrimeCare staff of failing to properly evaluate Barbaros for risk of suicide and making mistakes with his antidepressants. An expert witness, Dr. Peter R. Breggin, testified that after holding Barbaros four days without giving him his regular dose of antidepressants, PrimeCare staff should have known that restarting it could very well lead to suicide.

The county settled its part of the suit for $25,000 prior to trial. PrimeCare turned down an offer to settle its part for $800,000 before the jury returned its $11,857,344 verdict, including compensatory damages for civil rights claims of $1,057,344 and another $2.8 million for negligence claims, plus punitive damages of $8 million.

PrimeCare asked the federal court for the Eastern District of Pennsylvania for a new trial, which was denied. But the district court granted a motion for Judgment Notwithstanding the Verdict, also vacating the punitive damages award, saying that “no reasonable jury could find PrimeCare’s conduct sufficiently recklessly indifferent so as to warrant punitive damages.” The estate appealed. The Third Circuit then reversed that ruling on November 21, 2019, saying:

“From the moment Barbaros entered MCCF, every person who interacted with him or was involved in his ‘care’ violated policies and procedures intended to ensure proper communication and patient safety. The record is filled with evidence of policies ignored, medical records not reviewed, medical orders not followed, medication prescribed but not given (after verification), and PrimeCare ignoring nursing staff complaints about insufficient staffing and doctors not visiting MCCF sufficiently frequently. The evidence is clearly sufficient to allow a reasonable juror to conclude that PrimeCare … recklessly disregarded Barbados’s welfare; and the jury here did just that.”

The Court also affirmed the lower court’s denial of PrimeCare’s motion for a new trial, saying that the section of the jury’s instructions incorrectly labeled “Negligence Per Se,” rather than “Negligence,” was a harmless mistake—a part of the ruling with which Judge Jane Richards Roth took issue in her dissent from the majority on the Court’s panel. See: Ponzini v. Monroe Cty., 789 Fed. Appx. 313 (3rd Cir. 2019).

$190,000 Paid by PrimeCare to Settle Lawsuit Over Pennsylvania Prisoner’s Suicide

A settlement was reached in October 2019 over the death of Kyle A. Flyte, 21, who was booked into the Northampton County Prison on March 5, 2017, and placed on “Level II Suicide Watch” the next day. The day after that, he was seen by PrimeCare psychiatrist Kishor Kumar Dedania, who had Flyte removed from suicide watch and transferred to a disciplinary confinement cell.

Flyte was being disciplined for lying about prior drug use on his intake form. He had denied using drugs, but a drug test was positive for opioids. Dedania apparently did not consider the effect of isolation on someone who already had suicidal tendencies. Flyte hanged himself using his shoelaces and died a few days later on March 13, 2017.

The lawsuit filed by his estate in federal court for the Eastern District of Pennsylvania resulted in a $252,000 settlement on October 11, 2019, with $190,000 paid by PrimeCare and the remaining $62,000 by the county. Family attorney John Vivian, Jr., received $101,000 in attorney fees and $8,553 in costs. [See: PLN, Apr. 2020, p.57.]

$355,000 Paid to Bucks County Prisoner Whose MRSA Went Undiagnosed

No death was involved in a settlement reached in September 2019, but the case was gruesome. It began with Michael Farrington’s MRSA infection in April 2015, after he was incarcerated in the Bucks County Prison. That infection “abated by summer,” according to court documents. Yet by October 2015, Farrington had returned to PrimeCare staff at the prison to complain of leg pain.

PrimeCare sent him away, saying no further treatment was needed, even after a fall while out on work-release sent him to a hospital in December. Another fall that same month eventually got him back to a hospital, where MRSA was again diagnosed, followed by multiple surgeries “to save his leg from amputation.”

With the assistance of attorneys Dawna M. Coffey and Harry J. Oxman of Oxman, Goodstadt, Kuritz, PC, Farrington filed suit in federal court for the Eastern District of Pennsylvania, accusing jail and PrimeCare staff of deliberate indifference to his serious medical need. After that suit survived a motion to dismiss on May 16, 2018, the parties proceeded to reach a settlement for $355,000 on September 23, 2019. Again, it was unclear how much of that amount PrimeCare was responsible for. See: Farrington v. Cty. of Bucks, 2018 U.S. Dist. LEXIS 82891 (E.D. Pa.); and Farrington v. Cty. of Bucks, USDC (E.D. Pa.), Case No. 2:17-cv-05826.

Pennsylvania Prisoner Suffocates for Want of Asthma Inhaler

In June 2019, a settlement was reached in a lawsuit filed by the family of a woman who died of untreated asthma at the Lehigh County Prison on November 12, 2014. With the aid of counsel Philip D. Lauer and Joseph E. Welsh of Lauer & Fulmer PC, the family of the dead woman, Carol Williams, claimed in the suit that PrimeCare provided substandard medical care by requiring her to report to the infirmary for Albuterol mini-nebulizer treatments rather than giving her a rescue inhaler to keep in her cell.

The U.S. District Court for the Eastern District of Pennsylvania largely denied a motion for summary judgment made by PrimeCare and the county on February 22, 2019, after which the county settled for $50,000 on June 19, 2019. Once more it was unclear what PrimeCare paid. See: Fargione v. Sweeney, 2019 U.S. Dist. LEXIS 28243 (E.D. Pa.); and Fargione v. Sweeney, USDC (E.D. Pa.), Case No. 5:16-cv-05878.

$1.4 Million in Settlements Reached Over West Virginia Prisoner’s Withdrawal Death

Settlements were also reached in 2019 over the death two years earlier of Dr. Charles Knouse at West Virginia’s South Central Regional Jail. Shortly after he was booked into the jail in the summer of 2017, he told PrimeCare staff that he was using numerous medications, including Suboxone, and sudden withdrawal of the drug would cause him to experience cardiac arrhythmia and become suicidal.

He would have known; he was a 66-year-old physician.

As an extra precaution, Dr. Knouse secured an order from a federal magistrate mandating that he be placed on all medications and housed in the jail’s medical unit. But neither happened. Knouse died of cardiac arrest a few days later on August 4, 2017.

With the assistance of James D. McQueen, Jr., and Amanda J. Davis of McQueen Davis, PLLC, in Huntington, as well as Christopher J. Heavens of Heavens Law Firm, PLLC, in Boothwine, Pennsylvania, Knouse’s family filed suit in U.S. District Court for the Southern District of West Virginia.

They obtained proof that PrimeCare nurses falsified medical logs to show wellness checks that never happened, a lie for which three of them were fired. A guard was also fired for falsifying 15-minute suicide watch logs and telling Knouse to “shut up” when the detainee requested medical help about five hours before he died.

The jail authority then paid $400,000 to settle its part of the suit, with $160,000 of that going to plaintiff’s counsel for fees and another $47,623.24 in costs. After the Court dismissed cross-claims from the guards against PrimeCare on February 5, 2019, the company settled its part of the suit for $1 million, the maximum payout its liability insurer provided, on November 25, 2019. See: Knouse v. PrimeCare Med., 2019 U.S. Dist. LEXIS 18266 (S.D. W.Va.); and Knouse v. PrimeCare Med., USDC (S.D. W.Va.), Case No. 2:18-cv-01014.

Over $335,000 Paid to Family of Pennsylvania Prisoner Who Committed Suicide

Settlements were reached in late 2018 and early 2019 in a suit over the death of Bryan A. Applegate, 29, who took his own life at the Northampton County Prison on July 8, 2015, where he had been detained after being identified from a photo lineup on a charge of “involuntary deviate sexual intercourse by force” and related offenses against a 17-year-old girl.

Aided by attorneys Adam Meshkov of Meshkov & Breslin and John Vivian of Easton, his family filed suit in U.S. District Court for the Eastern District of Pennsylvania, saying his previous suicide attempts while a pretrial detainee at the jail should have put PrimeCare and jail staff on notice of his suicide risk. The lawsuit also alleged the jail’s policies and practices regarding the treatment of mentally ill prisoners allowed Applegate to hang himself, as did a defectively designed suicide smock.

The county settled for $100,000 on December 10, 2018, and PrimeCare settled for $235,000 on January 16, 2019. Suicide smock designer Bob Barker Co., Inc., settled for an undisclosed sum on February 26, 2019. See: Applegate v. Cnty. of Northampton, USDC (E.D. Pa.), Case No. 5:17-cv-03885.

$275,000 Settlement Reached over New York Prisoner’s “Easily Preventable Death”

On March 20, 2018, commissioners for Niagara County, New York, voted to pay $125,000 to settle a lawsuit brought in state Supreme Court by the estate of a man who died at the county jail, where PrimeCare provided healthcare. The firm then reportedly agreed to fork over another $150,000 in the settlement with the estate of the dead man, DeJuan Hunt II.

After the 25-year-old was found unresponsive in his cell at the Niagara County Jail on August 29, 2016, the Medical Review Board of the New York Commission on Corrections issued a report highly critical of the medical care he received from PrimeCare, the jail’s healthcare contractor, finding that “this was a wholly preventable death if not for the shockingly inadequate medical and mental health care provided Hunt by contract medical providers Correction Medical Care Inc. and PrimeCare Inc.”

“During his 26 days of incarceration, Hunt was never examined or treated by any physician,” the report continued, adding that the prisoner’s “inadequately treated mental illness resulted in progressive hostility toward correction staff” that led to a scuffle with guards nine days before he died.

That was when a guard used his baton to press against Hunt’s shins in a technique called a ‘shin sheer.’ Proteins from the damaged muscle were released into Hunt’s bloodstream, creating a life-threatening condition called rhabdomyolysis, which can cause kidney failure. By the time his dead body was discovered nine days later, his jaw was stiff from rigor mortis.

The Medical Review Board report faulted both Correctional Medical Care, which provided healthcare at the jail during the first week of Hunt’s incarceration, and PrimeCare, which took over thereafter. The former should have recognized and treated Hunt’s severe mental illnesses—including delusions, hallucinations and thoughts of self-harm and suicide—while the latter missed both his mental illness and developing rhabdomyolysis, even as Hunt’s foot became so swollen that he could not put on shoes and screamed in pain when guards escorted him to the jail’s infirmary.

A medical examiner’s report classified the death as a homicide. The Medical Review Board agreed and recommended that the Assistant Attorney General for Civil Rights initiate a criminal civil rights investigation. But Niagara County District Attorney Caroline Wojtaszek announced in July 2017 that no charges would be filed.

Hunt’s mother, Jenine Townsend, filed a suit, Est. of Hunt v. Cnty. of Niagara, which was settled on behalf of his estate in state Supreme Court for Niagara County with the assistance of Buffalo attorney Scott M. Schwatz.

Lawsuits Follow String of Opiate-Withdrawal Deaths at Bucks County Prison

In November 2017, PrimeCare paid a quarter-million dollars to settle a suit filed by the family of Marlene Yarnell, 49, who died of cardiac arrest triggered by heroin detoxification at Bucks County Correctional Facility (BCCF) on March 22, 2014.

That was three days after she was arrested for a probation violation and just one year after she suffered another detoxification-induced heart attack at the prison. Assisted by attorney Kenneth B. Grear of de Luce Levine LLC, her family filed suit in U.S. District Court for the Eastern District of Pennsylvania in March 2016.

PrimeCare settled the suit for a total of $250,000 on November 22, 2017, with $87,500 going to counsel and another $22,090.76 to litigation costs, as well as $5,855 in funeral expenses and $335.39 to satisfy a Medicare lien. The remainder was split between $120,796.96 allocated to the wrongful death claim and $13,421.89 for her family’s survival claim. See: Yarnall v. Cnty. of Bucks, USDC (E.D. Pa.), Case No. 2:16-cv-01291.

A few months before that settlement, another was reached in the death of Vallia “Valene” Karaharisis, 29, who succumbed to opiate withdrawal at BCCF on September 29, 2013, three days after she was detained for a probation violation. Aided by Jonathan H. Feinberg and Susan M. Lin of Kairys Rudovsky Messing Feinberg & LLP in Philadelphia, her mother filed suit in U.S. District Court for the Eastern District of Pennsylvania on September 10, 2015.

After a great deal of foot-dragging by the county, several “Doe” guards in the suit were identified, though the Court had to force the county to allow the complaint to be amended to include their names on July 5, 2016. See: Lopez v. Bucks Cty., 2016 U.S. Dist. LEXIS 87383 (E.D. Pa.).

The county then settled its part of the suit for an undisclosed amount, resulting in plaintiff’s dismissal of the action on February 3, 2017. It was unclear what role PrimeCare played in that settlement. See: Lopez v. Bucks Cty., USDC (E.D. Pa.), Case No. 2:15-cv-05059.

Two more suits filed over BCCF deaths are still pending.

One concerns the death of Frederick Adami, 52, due to complications caused by opiate withdrawal on January 28, 2018, a day after he was booked into BCCF for failure to pay child support. With the aid of attorneys Shanin Specter, David K. Inscho and Michael Caliveri of Kline & Specter, his family filed a wrongful death lawsuit against PrimeCare and the county on May 20, 2019, in U.S. District Court for the Eastern District of Pennsylvania.

Because Adami was under PrimeCare’s supervision, the Court granted summary judgment in favor of three guards on April 8, 2022. See: Adami v. Cty. of Bucks, 2022 U.S. Dist. LEXIS 65358 (E.D. Pa.). The case remains pending against PrimeCare and the other county defendants. See: Adami v. Cnty. of Bucks, USDC (E.D. Pa.), Case No. 19-cv-2187.

The other suit arose from the death of Brittany Ann Harbaugh, 28. When she was booked into BCCF for a probation violation on September 26, 2018, she told a PrimeCare nurse she had used three bundles of heroin the day of her arrest. She was prescribed detox medications and placed on “medical watch” for opiate withdrawal. But she was not seen by a physician, even after a nurse noted withdrawal symptoms.

After Harbaugh’s withdrawal medications were skipped several times without explanation, she died of complications from withdrawal on her fourth day of incarceration. Also aided by Inscho and Caliveri of Kline & Specter, her family filed a suit against PrimeCare and Bucks County in federal court for the Eastern District of Pennsylvania on March 31, 2020, which is still pending. See: Harbaugh v. Cnty. of Bucks, USDC (E.D. Pa.), Case No. 2:20-cv-01685.

PrimeCare’s Dr. Von Kiel and Another Death at Lehigh
County Prison

Not quite half a year before the suit
over Karaharisis’ death in Bucks County was
settled, another case in which PrimeCare was a named defendant was settled in August 2016 over a former prisoner’s death following her incarceration at Lehigh County Prison (LCP).

That prison’s medical director at the time, Dr. Dennis Erik Fluck Von Kiel, had held the position since 1989, becoming a PrimeCare employee when it took over provision of prison healthcare in 2004. His employment later ended in January 2015, not long after IRS agents arrested him on tax evasion and fraud charges.

Von Kiel pleaded guilty to fabricating membership in a Utah church to avoid paying federal taxes and federally guaranteed student loans. ‘Living Soul, Erik Von Kiel,’ as he was called in the phony church, also confessed to “draft[ing] a letter, as part of a scheme to collect Social Security benefits,” by stating he suffered from post-traumatic stress disorder which had rapidly increased in severity over the preceding year, rendering him unable to care for patients.

Giving the lie to that claim, he was the medical provider of record for Barvina Berrios, who was booked into LCP following an arrest over a traffic altercation on February 4, 2013. At intake, Berrios told PrimeCare staff that she suffered from asthma, bi-polar disorder and diabetes and that she was in a long-term methadone program. She was seen by Dr. Von Kiel, who prescribed medications for her illnesses.

Nevertheless, Berrios’ health soon declined. She reported severe chest pains and began coughing up blood. Four days into her incarceration, she had to use a wheelchair to attend her preliminary hearing and could “barely speak above a whisper,” according to a complaint later filed by her estate. But she received no medical attention for her worsening condition.

Even after she began calling out for help from her cell, and other prisoners raised their concerns, she was placed in solitary confinement “so that she would not disturb the other inmates.” A week after she arrived in the jail, her family was finally able to post bond. They rushed her to a hospital, where she was diagnosed with pneumonia, fever and septic shock. She died the following night.

Aided by attorneys Joseph E. Welsh and Philip D. Lauer of Lauer & Fulmer PC, her family filed suit in federal court for the Eastern District of Pennsylvania, alleging that her pneumonia had been present for around five days and the sepsis for about 25 hours, yet both had been ignored by PrimeCare personnel. That suit settled for an undisclosed sum on August 2, 2016. See: Berrios v. Sweeney, USDC (E.D. Pa.), Case No. 5:15-cv-00510.

$190,000 Settlement Reached in Lawsuit Over West Virginia Prisoner’s Drug-Related Death

A settlement was reached in March 2016 with the estate of Donald Wayne Cline, 47, who died at the Eastern Regional Jail in Martinsburg, West Virginia, on July 22, 2009. He had been taken into custody after his pickup truck rear-ended another vehicle, and responding police conducted a field sobriety test during which he nearly fell into the road. Yet his blood alcohol level was 0.05, below the legal limit for driving. Nonetheless, he was booked into the jail for driving under the influence of controlled substances or drugs. He was also admitted without medical clearance from a physician and not placed under any kind of special supervision.

A few hours later, he died. The cause of death was intoxication by a mixture of methadone, carisoprodol, diazepam, and butalbital. Aided by attorney Henry P. Waddell, Cline’s widow filed a lawsuit in the state’s 23^rd Judicial Circuit Court, accusing jail officials and PrimeCare of negligence. At a hearing on March 16, 2016, Waddell reported that the case had settled for $190,000, with $90,000 of that going to attorney fees and expenses. It was unclear how much PrimeCare contributed to the settlement amount.

PrimeCare Settled Lawsuit Over Death of Another Pennsylvania
Jail Prisoner

In January 2016, a settlement was reached with the estate of Eileen DiNino, 55, who died shortly after she was arrested and ordered to spend two days in a Pennsylvania jail in June 2014 for failing to pay a $2,000 fine, which was owed for school absences recorded for some of her seven children. She was booked into the Berks County Prison, where she reported having “some difficulty and trouble breathing.” She was seen by PrimeCare medical staff, who observed her high blood pressure. But they returned her to her cell without treating it, instructing guards to check on her.

She was later found unresponsive. An autopsy attributed the death to heart failure, with high blood pressure as a contributing factor. No criminal charges were filed. With the help of attorneys David Rudovsky, of Kairys, Rudovsky, Messing & Feinberg LLP, and Michael J. Olley of Coffey Kaye Myers & Olley, her estate filed suit in U.S. District Court for the Eastern District of Pennsylvania against PrimeCare and Berks County. The county was soon dismissed from the suit. PrimeCare then settled under terms which are sealed. [See: PLN, Jul. 2016, p.60.]

Treating Prisoner’s Acute-Onset Diabetes With Pepto Bismol

Also in January 2016, a settlement was reached for an undisclosed sum in a case filed by the family of Pennsylvania prisoner who died of untreated diabetes.

“It was a totally unnecessary death,” said Michael Barrett, the attorney for the family of the dead man, Rae-Mone Carter, Jr. “He wasn’t being seen by nurses, he wasn’t being seen by doctors. He wasn’t being treated for diabetes, he was being treated with Pepto-Bismol.”

Carter, a 26-year-old father of four, was serving time for drug possession at the Chester County Prison in March 2013. He sought medical treatment five days before he died because he had been vomiting for two days and had a sore throat. PrimeCare staff gave him Pepto-Bismol and antibiotics for the next three days, yet his condition rapidly deteriorated. He was admitted into the medical unit on the fourth day but did not see a physician until the following morning, when a nurse noticed his extremely high blood sugar level. She called for an IV and insulin, but it was too late. He died the next morning, March 16, 2013.

After that Barret and his co-counsel, Joseph G. Deangelo of Saltz, Mongeluzzi, Barrett & Bendesky, P.C., filed suit on behalf of Carter’s estate in federal court for the Eastern District of Pennsylvania. A motion to quash plaintiff’s discovery demand for PrimeCare’s corporate financial records was granted on September 16, 2015. It was affirmed on a motion to reconsider two weeks later. After that, the parties reached and sealed their settlement on January 15, 2016. See: Shelton v. Cty. of Chester, 2015 U.S. Dist. LEXIS 123343; and 2015 U.S. Dist. LEXIS 132227 (E.D. Pa.); and Shelton v. Cty. of Chester, USDC (E.D. Pa.), Case No. 13-4667.

Pennsylvania Jury Finds PrimeCare Merely Negligent, Not Liable for Prisoner’s Death

PrimeCare caught a break at trial before a Pennsylvania jury in March 2015, which was hearing claims brought over the death of Travis Magditch, 27, at the Lehigh County Prison on January 3, 2012. After his arrest for possessing drug paraphernalia, the asthmatic’s lung function was noted by PrimeCare staff to be “severely low.” But PrimeCare had instructed staff to stop handing out rescue inhalers at the jail because their cost increased.

After Magditch’s lifeless body was discovered in his cell the next day, an autopsy report listed the cause of death as asthma. Aided by attorneys Thomas R. Kline and David K. Inscho of Kline & Specter, Magditch’s family filed suit in the state Court of Common Pleas, alleging that PrimeCare’s practice of refusing to give prisoners rescue inhalers led to Magditch’s death.

During the jury trial, PrimeCare’s attorney presented experts who opined that Magditch died not of asthma but rather choked on his own vomit due to withdrawal from heroin. That same lawyer called the coroner’s finding that the death was caused by asthma “an oversimplification.” The jury apparently bought this, finding that PrimeCare was negligent in its provision of healthcare to Magditch but refusing to hold it responsible for his death. See: Magditch v. Lehigh Cnty., Pa. Comm. Pleas (Lehigh Cnty.), Case No. 2012-C-5428.

More Suicide Cases

Another sealed settlement was reached on February 5, 2016, in a lawsuit brought by the widow of Stephen Schnee, who committed suicide at the Berks County Prison on September 13, 2013. Aided by attorney Paul Messing of Kairys, Rudovsky, Messing & Feinberg, his widow, Diane, had filed a complaint in U.S. District Court for the Eastern District of Pennsylvania, accusing the county and PrimeCare of failing to provide sufficient medical care for his needs. See: Schnee v. Berks Cty., USDC (E.D. Pa.), Case No. 5:14-cv-03195.

Charles Freitag, Sr., 57, committed suicide at the Bucks County jail on August 25, 2018, the day after he was sentenced for crashing his pickup truck into his ex-wife’s house. Months earlier, he told a PrimeCare psychologist that he would need a follow up with a mental health professional after the sentencing hearing. However, the follow up was not scheduled until a date three days after the hearing, by which time he had taken his own life.

According to a wrongful death lawsuit filed for Freitag’s family in U.S. District Court for the Eastern District of Pennsylvania by attorney Jonathan H. Feinberg of Kairys Rudovsky Messing Feinberg & Lin LLP, warning signs of Freitag’s increasing suicidal distress in the weeks preceding the sentencing were ignored by PrimeCare staff, who also neglected to consider his extensive mental health history: Freitag had twice attempted suicide and been hospitalized in a psychiatric facility in the 16 months preceding his death. Since his death, another four people have taken their own lives at the prison. The case is still pending. See: Freitag v. Bucks Cnty., USDC (E.D. Pa.), Case No. 2:19-cv-05750.

Sitarah Daniels, 32, hanged herself with a blanket in her cell at the Monroe County Jail in Syracuse on September 4, 2018, three weeks after she was taken off suicide watch. Aided by attorney Michael A. Bottar of Bottar Leone, PLLC, her mother filed a wrongful-death lawsuit against PrimeCare and other defendants in state Supreme Court for Monroe County, alleging that staff ignored Daniels’ history of severe mental health disorders, psychiatric hospitalization, and suicide attempts—including an attempt using a bedsheet at the same jail in 2015.

After the case was removed to U.S. District Court for the Western District of New York, it went to mediation on March 10, 2021. It is still pending. See: James v. Monroe Cty., USDC (W.D. N.Y.), Case No. 6:20-cv-07094.

Pennsylvania Prisoner Left Quadriplegic in Failed
Suicide Attempt

A suit that also settled for anundisclosed sum in 2014 was filed by a prisoner over a severe injury he sustained at the Chester County Prison on March 29, 2010. Ignoring his mental health history and psychotic state, PrimeCare staff allegedly allowed guards to keep the man, Robert Stewart, in restraints in a medical observation cell, where he twice attempted suicide by throwing himself off the top bunk. Stewart also alleged PrimeCare staffers were present when guards moved him into a prone position after the second attempt, contributing to injuries which rendered him quadriplegic.

Aided by attorneys Harry J. Oxman and Joseph S. Oxman of Oxman Goodstadt Kuritz, Stewart fought back the county’s motion to dismiss the case, which was denied by the U.S. District Court for the Eastern District of Pennsylvania on March 27, 2014. Another motion to dismiss by PrimeCare was also denied by the Court on September 9, 2014, paving the way for an undisclosed settlement on November 24, 2014. See: Stewart v. Emmons, 2014 U.S. Dist. LEXIS 41467; and 2014 U.S. Dist. LEXIS 126615(E.D. Pa.); and Stewart v. Emmons, USDC (E.D. Pa.), Case No. 2:12-cv-01509.

More Negligence

A lawsuit pending in U.S. District Court for the Middle District of Pennsylvania accuses PrimeCare of medical negligence in the death of Ty-Rique Riley, 21, at the Dauphin County Prison on July 1, 2019. The suit, filed with the aid of attorneys Kevin V. Mincey and Riley H. Ross III of Mincey Fitzpatrick Ross, LLC, also seeks to hold the firm and county employees liable for the mentally ill young man’s wrongful death at the county lockup, where he was allegedly beaten by guards.

A motion to dismiss the suit by guard Angela Swanson was denied and the case remanded to a magistrate judge for further proceedings on March 7, 2022. See: Riley v. Clark, 2022 U.S. Dist. LEXIS 40035 (M.D. Pa.).

Another suit filed in the same federal court by a former prisoner at the Monroe County Correctional Facility, Shawn Ravert, alleges that PrimeCare should have diagnosed a cancerous skin lesion on his leg after his incarceration in 2016, but that its failure to do so—despite nine visits to the medical unit to complain about it—delayed treatment for 18 months.

Filed with the assistance of attorneys David J. Caputo of Youman & Caputo and Zachary Arbitman of Feldman Shepherd Wohlgelernter Tanner Weinstock Dodig LLP, Ravert’s suit says he sought treatment for a skin tag on his leg in December 2016, two months after his incarceration. At one point, the “highly suspicious appearing” lesion became detached from his leg, which Ravert’s suit maintains should have been sent to a lab for a biopsy. Instead PrimeCare personnel allegedly told the nurse treating him to throw it away.

In June 2018, after his release, he was diagnosed with malignant melanoma in the same area. He underwent surgery in January 2019, but the following month was diagnosed with Stage IIIC melanoma, which has a 5-year survival rate of just 69%. That same month, February 2019, he sued. PrimeCare’s motion to dismiss and another by the county were both denied on March 17, 2021, leaving the case to proceed. See: Ravert v. Monroe Cty., 2021 U.S. Dist. LEXIS 49654; and 2021 U.S. Dist. LEXIS 49655 (M.D. Pa.); and Ravert v. Monroe Cnty., USDC (M.D. Pa.), Case No. 4:20-cv-00889.

Lessons Learned

A few observations from examining the 26 prisoner lawsuits involving PrimeCare detailed in this article: First, contracting with PrimeCare does not necessarily improve healthcare for prisoners. Second, contracting with PrimeCare does not prevent lawsuits against the county or other legal authority, and some of those suits will result in large settlements or awards. However, since standard language in prison and medical contracts typically has the medical care provider indemnifying the government entity for any litigation expenses resulting from inadequate medical care it typically does save the government from paying litigation expenses related to inadequate medical care. For companies like PrimeCare, their fundamental business model is to get as much money from the government and then provide as little medical care as possible. The resulting litigation is merely the cost of doing business and given the company’s longevity and growth, seems to be a very successful and profitable business model.

These observations stem from the fact that PrimeCare has a profit motive in denying or delaying health care—especially expensive medical interventions such as surgery and cancer treatment. Layered over that is an apparent failure to recognize the seriousness of some medical and mental health problems, including suicidal thoughts, detoxification and asthma.

One thing is certain: There should be a serious national discussion on whether it is moral or ethical to corporatize and privatize the provision of healthcare to prisoners. 

 

Additional sources: Altoona Mirror, AP News, Courthouse News, Ellwood City Ledger, Erie Times-News, Hagerstown Herald Mail Media, Johnstown Tribune Democrat, Laconia Daily Sun, Lebanon Daily News, Lehigh Valley Live, Lehigh Valley Morning Call, Pennsylvania Record, Philadelphia Inquirer, Private Corrections Working Group, Sunbury Daily Item, West Virginia Record, WITF, York Daily Record, York Dispatch

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