Thursday, November 13, 2003
Copyright © Las Vegas Mercury

Web of misery

Inmate says her spider bite was mistreated by jail doctors

By Andrew Kiraly

When convicted criminal and admitted drug addict Sara Eggert is transferred from the Clark County Detention Center to drug rehab as early as this week, she'll be taking some souvenirs with her: four large purple scars. Those scars are from a brown recluse spider bite that, she charges, was mistreated by hospital staff for more than two months.

"Something's wrong here," says Eggert, 27, who phoned from the detention center last week. "If it's not a bite, then it's an infection. If it's an infection, it's not getting taken care of. Just because I'm a criminal doesn't mean I shouldn't have proper medical services. It's not like I came in here with health problems. This happened here." She says her repeated complaints that antibiotics weren't helping her were ignored.

But hospital staff counters that Eggert is overreacting. They say if Eggert felt like she was misdiagnosed or mistreated, there are official grievance procedures she could have taken. Metro Police Capt. Marilyn Rogan, who works at the detention center, says it's unlikely Eggert's case is so dramatic, considering the network of doctors and nurses who work at the jail.

"We have doctors on site and available for on-call emergencies 24 hours a day," she says, "as well as a nursing staff that makes visits into the modules at least three times a day. If there was a concern that she wasn't getting appropriate care, she can address that through the request or grievance process. If she's not comfortable sending it through the nurses or the doctor, she could send it in my direction."

Others chalk it up as another troubling episode that reflects badly on Prison Health Services, the Tennessee-based company contracted by Clark County to handle inmates' medical needs. Indeed, Eggert's not alone in her criticism. In May 2002, ACLU attorneys filed a lawsuit alleging inadequate medical care at the detention center and seeking to dissolve the contract between Clark County and Prison Health Services. The lawsuit represents at least 10 current and former inmates who allege they were denied necessary medications while in jail. ACLU attorneys say it's a textbook case of privatization gone bad: cutting corners to fatten the bottom line--at the expense of the health of inmates.

"The problem with privatized prison health care is that it provides a financial disincentive to provide adequate health care," says Gary Peck, executive director of the ACLU of Nevada. "In other words, the less care you provide for the less money, the greater your profits." Peck also envisions scenarios in which doctors might "wait out" the sentences of inmates with serious health issues; if private prison docs can get away with not treating an inmate's serious (and expensive) medical problem during his stay, the inmate will likely visit a public hospital upon being released--thus saving the contractor money.

Eggert's story: Convicted on burglary charges a few months back--she was caught stealing to support her drug habit--she was sentenced to a year in rehab. Catch was, she had to wait in the Clark County Detention Center until a new rehab center had space.

As Eggert and her mother, Robin Butters, tell it, Eggert suspects she was bitten by a brown recluse spider about nine weeks ago. One morning, she discovered a pimple on her buttocks. A day later, it was the size of a baseball; Eggert was nauseous and in severe pain.

"Two days later, the skin started eating away from the middle," she says. "I could barely get up. I had terrible migraines." Eggert says she was allowed to see a doctor three days later, but says her requests for a blood test were ignored. She was put on K-Flex, an antibiotic; over the next three weeks, however, at least three new cysts formed--some of them breaking and oozing. Again, her requests for a blood test, she says, were "blown off." Eggert says that, through talking to other inmates, at least five other prisoners began showing the same symptoms, but were also denied blood tests.

"The whole thing seems real fishy to me," says her mother, Robin Butters. "Sarah's a tough kid, so when she complains, I know something's up. Whether she's in jail or not should have nothing to do with the treatment she's receiving."

Dr. Harvey Hoffman, the jail's medical director, says a blood test wouldn't have been the quick fix Eggert was seeking. "There is no blood test for [determining whether Eggert was bitten by a brown recluse]. I'm no epidemiologist, but some react more strongly to bites than others. You could get bit by a brown recluse and need a week of antibiotics and then be fine, while another person might need antibiotics for four weeks." He says he's not certain, though, that it was necessarily a brown recluse bite.

"If Dr. Hoffman feels part of the treatment isn't doing what he wants, he'll send the patient to an outside specialist," says Capt. Rogan. "He's one of the best and most dedicated physicians I've seen."

But he's something else altogether in the eyes of at least one inmate who can't wait to be transferred from the Clark County Detention Center.

"I'm feeling physically okay now, but I just think they're keeping whatever it is at bay until they get rid of me," Eggert says. "Either way, I'm scarred for life."