Jail death: When a ‘nurse’ is not a nurse

Target 8

MUSKEGON, Mich. (WOOD) — One of the two women identified in sheriff’s reports as nurses on duty the morning an inmate died after suffering 17 seizures in the Muskegon County Jail is not a nurse at all, state records show.

That raises new questions about the for-profit, private health care company that the jail pays to care for inmates.

The company, Wellpath, based in Nashville, Tennnessee, has faced lawsuits across the country over deaths and alleged poor care in jails.

“It’s hard to imagine good health care and dying of 17 seizures in a jail,” said Marc Stern, a former health director for the Washington state prison system and now a consultant and associate professor at the University of Washington.

Video obtained by Target 8 through a public records request shows the Wellpath workers who were on duty at the jail on April 4, the morning Paul Bulthouse suffered 17 seizures and died. It shows a registered nurse checking through Bulthouse’s cell window. State records show she is licensed as an RN.

Then there’s another Wellpath worker making two of the window checks at Bulthouse’s cell. She also responded to his cell after a jail deputy discovered Bulthouse was dead.

Muskegon County Sheriff’s reports on the death identify her repeatedly as a nurse.  Even the jail administrator, Lt. Mark Burns, calls her that.

But state records show she has never been a nurse. Instead, she’s a licensed EMT with far less training than a nurse.

“An EMT should provide first aid, CPR and transport people to a hospital in an ambulance,” Stern said. “That’s what an EMT is trained to do in their 81 or 90 hours of training.”

He said he was also troubled over what happened three days before Bulthouse died, when the inmate bolted from his cell. Video shows Bulthouse’s legs shaking violently after guards tackled him. That led a jail sergeant to ask a Wellpath EMT if she thought he was seizing. The EMT said she thought it was fake.

“When a patient is having an acute change in their health, that needs to be referred to somebody who is licensed and qualified to deal with it,” Stern said. “An EMT is not.

“If they looked into this case and discovered that an EMT was charged with making a decision of whether somebody was sick or not, I hope they would hit the roof.”

There’s no indication in reports that anybody consulted a doctor on the morning Bulthouse died, though the on-duty registered nurse, several hours before the death, told jailers there was no need to send Bulthouse to the hospital, records show.

Stern said reports that the inmate’s prior seizures were fake and that Wellpath workers weren’t taking them seriously could explain why a jail deputy watched one of Bulthouse’s seizures on the morning he died, then walked away.

“The expert said not to worry,” Stern said. “The expert knows more than he does, and he trusted the expert.”

Bulthouse suffered a dozen more seizures over the next two and a half hours before dying alone in his close-observation cell in a puddle of his own urine.

The Muskegon County Jail is among at least 11 counties in Michigan that pay Wellpath to care for prisoners. That also includes Allegan and Berrien counties.

Muskegon County Sheriff Michael Poulin has not responded to Target 8’s public records request for a copy of the Wellpath contract, so it’s not known how much the county pays.

What is known is that Wellpath has a long, troubled history.

“Private companies do this to make a profit,” Stern said.

Wellpath is the nation’s biggest provider of health care to prisons, jails and immigration detention centers, with revenues of up to $1.5 billion a year, according to published reports.

Under its former name, Correct Care Solutions, it has been sued nearly 1,400 times in federal courts over the last decade, records show.

A Target 8 review of those cases show 27 were filed in Michigan.

In Colorado, a federal jury in 2014 ordered the company to pay $11 million to a man who suffered a stroke that left him permanently injured in a  jail while his calls for help were ignored, according to court records.

Just this month, the Broward County, Florida, public defender demanded an investigation after two inmates were found dead in a jail also served by Wellpath. At the same jail in April, according to reports, a mentally ill pregnant inmate went through seven hours of labor and delivery alone in a cell when her cries for help were ignored.

In a lawsuit similar to the Muskegon County Bulthouse case, the company last year agreed to pay $4.25 million to the family of a man who died after it cut off his Klonopin “cold turkey” in a Colorado jail, court records show.

Bulthouse, 39, of Norton Shores, had been taking Klonopin for anxiety for years, his doctor has said, but Wellpath cut him off when he got to jail on a probation violation 11 days before his death.

“If you’re on that medication, I can pretty much predict that if you stop it suddenly, that person will continue to be very sick well beyond five days,” Stern said. “We know that. It’s science.”

The Muskegon County Sheriff had closed its internal investigation into Bulthouse’s death, finding no wrongdoing. However, he reopened it after a Target 8 investigation based on surveillance videos inside the jail.

Stern, the corrections health consultant, said he believes private companies shouldn’t be providing medical care at corrections center.

“There are certain things that I think are core government activities,” Stern said.

But, he said, private companies aren’t necessarily the reason for poor care.

“I’ve seen them all have bad days, and I’ve seen them all have good days,” he said.

The biggest problem, he said, is that jails and prisons don’t spend enough on health care.

“If you’re underfunded and you operate it yourself, or you’re underfunded and you give that money to a private company, either way you’re going to fail,” he said.

A Wellpath spokesperson did not respond to Target 8’s request for comment. The sheriff also didn’t respond.

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