Title: The ‘Problem Doctors’ in New York State Prisons.

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Brian Lehrer: Brian Lehrer on WNYC. We're going to turn now to the topic. Forgive me for just a second because I misplaced my notes on this. Now I have them. We're going to talk about an investigation from the news organization, The City, that reveals how doctors with alarming records of misconduct and malpractice are being hired to care for incarcerated people in New York state prisons.

We were just talking to Dr. Murthy about all kinds of public health. Well, here's a really dark side. Reporters Reuven Blau and Max Rivera uncovered cases like that of a doctor who was banned from working in hospital emergency rooms across New York State, only later to find work in the prison system, and be promoted into a leadership position heading medical operations in two of the department's five statewide regions.

The investigation from The City also reveals some of the troubling misconduct for which some physicians face board sanctions while they were employed by the State Prison System, like the case of one doctor who drained the wrong side of a patient's chest during a medical procedure and then altered the records to cover it up. These findings raise urgent questions. Why are doctors with such serious red flags being hired? What harm has resulted from their care? What is to say about oversight and accountability in prison healthcare?

Reuven Blau, senior reporter at The City, and Max Rivera, who contributed to the reporting and who's now with Bloomberg News, join me now. Reuven and Max, welcome to WNYC today. Hi.

Reuven Blau: Hi. Thanks for having us.

Max Rivera: Good morning. Thanks, Brian.

Brian Lehrer: Let's start with some quick context. How many people are currently incarcerated in New York state prisons and how many doctors are employed by the prison system? Reuven.

Reuven Blau: Sure. The population as of January 2024 was about 32,472. It's a little less than that, I believe now. The number of doctors fluctuates. Last figure we had was about 67 or 68 doctors for the entire population.

Brian Lehrer: Of the doctors that you investigated, how many did you identify as having significant red flags in their professional histories? Max.

Max Rivera: We identified 10 doctors who had either previously before they worked for the State Prison System or while they were employed at the State Prison System, had been sanctioned by the State Medical Board.

Brian Lehrer: When we talk about problem doctors, what kinds of misconduct or malpractice are we talking about? Can you give us a sense of how serious these issues are, Max?

Max Rivera: I mean, we found everything like you mentioned. In one case, a doctor who had drained the wrong side of a patient's chest. That same doctor missed a cancer diagnosis. The board's findings clearly stated that that patient had a number of comorbidities and lifestyle choices that would indicate that they would be someone worthy of a more intensive cancer screening. The patient ultimately died of lung cancer. We found another doctor who, without extensive OB training, nearly chopped off the pinky finger of a baby during a delivery. He later choked a few nurses in a fit of rage. The sanctions and the problems range a wide range.

Brian Lehrer: How do doctors with records of malpractice or misconduct end up working in the prison system? What's different about the hiring process for prison health care than in other health care settings, Reuven?

Reuven Blau: Yeah, that's a really great question. I think, to answer that, I'd also like to take a step back on this piece, the genesis of this piece. I think it helps answer that as well. Which is a bunch of years ago, somebody who was a doctor in the system told me they got a letter from a prisoner who had done research on the person treating him and indicated that this person had this terrible track record. There was always this insinuation that that was not the only person in the State Prison System who had that kind of history of malpractice and negligence.

To do the story, we had to research this and come up with the names and find these people. It was a real challenge. It was one of the hardest things I've ever done. I've been a journalist for about 20 years, and arguably is one of the hardest pieces I've ever put together. I've joked that it was like giving birth to a porcupine backwards, just putting this all together. I think that the answer to your question more specifically is how do these people end up there? Right?

Well, the prisons are, by and large, in upstate areas where there is already, even for the general population, a difficult system to get people, medical professionals to work there. They're struggling with that already. Then it's a very difficult population, right? Most doctors don't necessarily go to medical school to treat this sort of population. Then on top of it, it's the pay, it's not terrible, but it's largely less than the private sector as well.

Brian Lehrer: The location of many of the prisons often in rural or underserved areas, does that play into a difficulty in getting the best doctors?

Reuven Blau: Absolutely. That's a real struggle. It's difficult to convince people to work in these areas and to live in these areas. Yeah, I mean, it's definitely a pattern that we see not just in the prison system, but I'd like to stress that the prison system is the most vulnerable. Right? When you're out, you can choose who you want to be your medical professional or you can get a second opinion, or you can travel potentially to get better care. People who are locked up don't have that choice.

Brian Lehrer: I know we get calls sometimes from people in prison. If you're currently incarcerated or if you're just connected to someone behind bars in a New York State Prison and happen to be listening right now, we invite you to help us report this story. 212-433-WNYC. 212-433-9692. What's your experience of the medical system within the State Prison System? If you're a physician working in that system now or if you ever have, what's your experience?

I'm sure our guests don't want to suggest that every doctor working in a prison setting is bad. In fact, I imagine they would say that many doctors working in a prison setting are very dedicated to public health and are doing that because these are underserved people. Listeners with any relevant experience to help us report this story or a question. 212-433-WNYC. 212-433-9692. Call or text.

Max, do you want to say anything about the range of doctors who do this and the reasons that they do it?

Max Rivera: You mean in terms of working in there?

Brian Lehrer: Working in the prison system? Yeah.

Max Rivera: Yeah. I think the mentality that I brought to the search, and first, I joined The City newsroom as an intern in June. That wouldn't have been possible without the Craig Newmark Graduate School of Journalism and the Revson Foundation, and their initiative to bring more diversity to data reporters. I brought my own lived experience and some fluency in state employment records, and just this bucket brigade philosophy to comb through every single record. It was like looking for a needle in a haystack. In this case, 10.

What we found time and again is that there were other doctors who attempted to be whistleblowers, who tried to speak out and advocate for people in the prison system. I think that, for the most part, there are doctors who are there for the greater good. Maybe it's a short stay, maybe it's a long stay, it's a closer proximity to home or they want a more rural experience. Oftentimes, these prisons are in places where that's the only industry and that's the only job close by.

For the most part, a lot of these doctors, I think, were there for the right reasons and wanted to do good things. That was evidenced in the documents that we reviewed in the court cases and witnesses that testified against the sanctioned doctors.

Brian Lehrer: Right. Reuven, how is the care provided by these doctors affected the health and safety of incarcerated people? Can you share an example or two from your reporting?

Reuven Blau: Yeah, absolutely. Part of the issue was with this story is we identify this doctor had a sanction, and somebody who covers criminal justice, I'm a big believer in that. Look people make mistakes and shouldn't necessarily be called out on mistakes that necessarily that were made and shouldn't be labeled like that forever. I don't believe in eternal punishment essentially. The challenge was to identify doctors that had been sanctioned and also to see if any of these doctors have had other cases that have come up while treating people who are incarcerated.

We did, we discovered that several of them had been sued by people who are locked up about are alleging poor treatment. One of them, his name was Aditab White. He had a very, very unique condition where he ultimately was diagnosed similar to ALS, but the doctors just believed-- initially he was seen by nurses, and that's very typical in the prison system. They're initially just seen by lower-level care essentially. That's something we see. You and I, and the outside have a similar experience with. It's not totally unique to the prison system.

For a long time, he wasn't actually seen by a doctor, and they just thought he was faking. He started to just be unable to walk. He was having seizures. He's unable to use the bathroom. He was using the bathroom, but he was soiling himself. They just kept on just arguing that he was faking it. His family finally, was able to get a doctor, an independent doctor in there to check him out. In the court case, it indicates he was just a memorable experience because he was just in such bad shape.

Finally, after a tremendous amount of pressure from the family, they ended up sending him to upstate hospital. Even there, they were struggling with how to diagnose him. They thought he had this unique condition called POEMS disease. That ultimately proved to be not the case. Finally, they diagnosed him with some type of branch of ALS. Ultimately, he's in really bad shape. The doctors just repeatedly-- in the court case, it indicates he's repeatedly discounted his complaints. He has a mental health issue as well, component, and they just felt that that was all part of his mental health struggles and that it had nothing to do with his physical issues.

Brian Lehrer: Once these doctors are hired, Max, is anyone monitoring their performance? What level of oversight is currently in place? For either of you, are there mechanisms for incarcerated individuals or prison staff to report medical misconduct?

Max Rivera: I feel like I'll let Reuven answer that first half, but there are mechanisms. I mean, they can file pro se cases, but that's pretty much. Oftentimes, when I read the documents, these were cases that were supposed to be very sophisticated, and they were in fact sophisticated cases, but they were handwritten, filed by the inmates themselves. It's a really challenging undertaking if you haven't gone to law school and you're not a powerhouse lawyer to take on this massive agency.

Brian Lehrer: What's the response been to your reporting, if any response, from state officials? Reuven, any?

Reuven Blau: Yeah, that's a great question. It goes back to a little bit of what you're saying; what's the oversight? There's something called the State Correction Commission, which investigates, has the power to investigate deaths and releases reports about those investigations. Some of my previous reporting has shown that they're incredibly understaffed and they tend to release these reports months, if not years after the death actually occurs. It just doesn't have the desired impact at all of any changes.

The recommendations that are part of these reports. They never follow up on the recommendations. Basically, problems just aren't addressed. There is actually a legislation in Albany that's been knocking around for quite some time to move medical care from docs, which is the State Prison System, to the state health department. At the same time, also have the state health department do these periodic yearly checks or or quarterly checks on staffing to make sure that there's enough staff.

Currently, there's several hundred vacancies for nurses that exist in the State Prison System. I mean, it's just, the status quo, it's just frankly unimaginable. As far as the response goes, we've got a tremendous amount of response from advocates and from some people who have loved ones in the system. Somebody emailed us about their own personal experience was really heartening, but it's been somewhat muted on the legislative front so far.

Brian Lehrer: Let's take a phone call from somebody who may have had a personal experience along some of these lines. Jay in Brooklyn, you're on WNYC. Hi, Jay.

Jay: Hey, Brian. Longtime listener, first time caller. Yeah, I was incarcerated for 10 years in the New York State Prison System. I was in Globe Land, and I had fractured my tibia. They did an X ray and the doctor said nothing was wrong with it. I walked around with a fractured tibia for a week. Then I was transferred to Arthur Kill eventually. I was with a gentleman. He was going home in like a week, and the doctor refused to renew his asthma pump. He wound up having an asthma attack and dying the day before he was going home.

Brian Lehrer: Why do you think these things happen, Jay? Were the doctors being sadists because you were prisoners? They didn't care about your health? Or was it incompetence? What do you think happened in these cases?

Jay: I think it was a little of incompetence. Also, they just don't care because there's really no oversight for them. When you're incarcerated, the only thing you can do is file a grieving and that has no recourse, and then you have to sue. By the time you file up an NPA free lawsuit, the damage is already done.

Brian Lehrer: Jay, I'm sorry that happened to you, but thank you for sharing it. Hopefully, it will help it not happen to others as much in the future. Max, any reaction to that call?

Max Rivera: I mean, that's a narrative and a story that's consistent with a number of the grievances and ultimately pro se cases that we reviewed. Again, Jay, I'm sorry that that happened, and sadly, it's not the first time, but hopefully it's the last.

Brian Lehrer: Listener asks in a text message. "As a hospital professional in New York City, I know that so called sentinel adverse events, the most egregious errors, occur even in the most prestigious non prison hospitals in the country. Is there evidence that the frequency of such events in prisons is far above that of non-prison health care settings?" Reuven, do you have that stat?

Reuven Blau: I don't and that's a great question. I mean that's hard to categorize. What I can say is, is that over and over, and over again, people who have are doing time, who have done time, their number one complaint is the lack of proper medical care. It's not violence, it's not the food. It could be other things that you would think would be normally like the primary issue, it's the lack of proper medical care.

It's the idea that you could be suffering from some serious illness or have some serious pain, and the knee jerk reaction is, "Take an Advil and let me know in a week." I don't necessarily-- there aren't stats that are with those sort of sentinel issues, but it is clear that this is a major problem behind bars. It has been for years and more needs to be done to make this better.

Brian Lehrer: Reuven, last question. Last month Robert Brooks, a man named Robert Brooks was beaten by a team of correctional officers while he was handcuffed to a hospital bed at Marcy Prison Upstate. Brooks died hours later. You reported a piece with a headline, "Former Prisoners Say Deadly Robert Brooks Beating Is Sadly Routine." Do you want to just summarize that story briefly before we run out of time? I wonder if you see these two stories as related.

Reuven Blau: Absolutely. Again, just to clarify, he was handcuffed behind his back, knock to the actual bed. Yeah, I mean, I would strongly suggest to your listeners, it's one of those stories that the video was released right around holiday time. The story's been buried somewhat. It's difficult. It's one of those absolutely horrific videos that has been released. I don't know if people have the stomach to watch it necessarily to read about it.

We talked to people who said that this is like the Ronnie King moment in the same prison system. Is that like there's been allegations, horrific allegations of abuse, including multiple allegations of waterboarding and other similar beat down teams. It's always been the allegations and this is literally the first time that something like this has been captured and shared with the public on video. The officers did not know that their cameras-- It was captured by 4 officers, 12 have been suspended. There was a nurse there that's also been suspended.

There's a potent pending criminal probe right now. It is like nothing I've ever seen in my life. It's truly horrific. Robert Brooks, he was moved there. There's a lot of questions about what happened, why he was moved there, but the video clearly shows some of the officers hitting him seem to be covering his face and he ultimately died several hours later.

I should add, there's a broader issue here. Last year in 2024, 143 people incarcerated died behind bars in the state system. That is the highest total since 2018, which was 137, and 221 in 2021 during COVID, when there was 137. This is clearly a case that advocates and reformers are hoping bring some serious changes to the system.

Brian Lehrer: Reuven Blau, senior reporter for the news organization The City, and Max Rivera, who helped report the piece we've been discussing, though he's now with Bloomberg News. Their investigation for the news organization, The City, is headlined Doctors Sanctioned for Glaring Medical Mistakes Find a Place to Practice in New York State Prison. Thanks so much to both of you.

Reuven Blau: Thanks for having us.

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