Montana

Prisoners with hepatitis, other ailments sue the state
By JENNIFER McKEE, IR State Bureau - 07/21/02

HELENA — A group of inmates with hepatitis and other ailments at the Montana State Prison have sued the state, saying the Department of Corrections refuses to treat their medical problems, allowing them to grow ever sicker behind bars.
The class action civil lawsuit was filed in late May in U.S. District Court in Helena. The suit details a host of alleged problems with medical care at the state men’s prison in Deer Lodge, among them that prison medical staff refuse to give inmates needed medical diets, water down prescribed pain medications and, in one case, refused treatment to a man who had a “painful, spreading rash on his body.”
The only named plaintiff in the suit is Gary Quigg, a 54-year-old Lewistown man serving a life sentence for a 1968 murder.
Right now, the suit is being reviewed by U.S. District Magistrate Caroline Ostby, to see which of the many inmate allegations hold enough legal water to proceed to court.
At least one of the men’s allegations, however, may be a complaint whose time has come — the fact that Montana, like many states, does not treat inmates with hepatitis.
The American Civil Liberties Union, which has filed suit before over the state of medical care at the men’s prison, is “looking very hard at Montana” and considering its own suit against the state over the matter, said Eric Balaban, a lawyer with the ACLU’s National Prison Project and one of the lawyers involved in the organization’s previous suit against Montana.
Roughly one-third of the more than 2,000 men at the state prison have hepatitis, said Sally Johnson, health administrator for the Department of Corrections, although a previous survey conducted at the prison pegged the number at 35 percent.
Hepatitis is an infectious disease of the liver caused by a virus which can cause severe liver damage and, ultimately, death. The disease has several strains, some caused by contact with fecal matter, another that can only be spread through contact with tainted blood.
Vaccines exist for two of the strains, but a newer strain, hepatitis C, has no vaccine. A growing number of prisoners nationwide are testing positive for hepatitis C. Many believe prisoners brought the disease with them to prison, but it has been spread to other inmates behind bars primarily through tattooing, sharing needles and, to a lesser degree, sex.
The disease is slow-growing, but it can lead to cirrhosis and even death. The disease is expensive to treat, with drugs costs running more than $1,500 in some cases. The disease can also be difficult to treat. One 2002 study showed that at an urban public health clinic, 73 percent of those with the disease did not qualify for treatment.
Johnson cites those reasons and more as she explains why Montana has chosen to screen inmates for hepatitis, educate them and monitor their progress, but not treat them.
“If you treated all of them, it would make the state go broke,” she said.
The state has made strides since February 2001, when the whole picture of hepatitis among Montana inmates was shown to the Legislature for the first time.
Montana now screens every new inmate for the disease, Johnson said. Those who have hepatitis are monitored and told how to avoid spreading the disease to others. If they have hepatitus C, they are vaccinated against hepatitis A and B, other strains of the disease which can be prevented.
Johnson said the department is in the process of singling out inmates who would be good candidates for treatment, but the department doesn’t have the money now to treat anybody and would have to go before the Legislature to get the extra cash.
“Given the state budget picture, I don’t see that there’s much of an option for that,” she said.
Montana is hardly the only state being sued over hepatitis, in particular the incurable hepatitis C.
“I would be surprised if not every state had a lawsuit going,” said Phyllis Beck, director of the National Hep C Prison Coalition, based in Oregon. “The prisoners are frightened. They want to be treated. They want to be educated.”
Part of the problem, she said, is that there is no national consensus on what to do with prisoners with hepatitis C.
The Centers for Disease Control and Prevention has yet to issue firm guidelines. The agency is expected to announce its hepatitis treatment for prisoners guidelines early next month.
Johnson said the Montana department will be watching.
But federal guidelines or no, Balaban said, from a public health point of view, it only makes sense to treat people with chronic, infectious diseases. What’s more, it is the right thing to do.
“They have a right to be treated,” he said. “They have a serious medical condition which, if not treated, can lead to unnecessary pain, suffering and death.”
 

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