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General Health Care Prison Health Care.. Medical, medications and all that go with it related to health care in the prison system...

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  #1  
Old 01-05-2009, 11:09 PM
JOinTX JOinTX is offline
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Default Dialysis in prison?

Does anyone have any loved ones in federal prison who are currently on dialysis? My father is scheduled to go into an unknown Federal Medical Center on 01-27-09 and I am trying to gather as much information as I can for him and for my peace of mind. I have heard from everyone in my everyday world that they have to take excellent care of him legally. I just want to know if anyone has any first hand knowledge on this. Thank you so much!

Julie O in TX

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  #2  
Old 01-06-2009, 03:06 PM
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Jo,
While not on dialysis myself, I was up at medical enough with my condition to be able to tell you that at least at FMC devens they are pretty much on the ball as far as it goes. The company thats contracted to provide the service is naphcare. You will find that for the most part, your dad will depend on them. if an issue arises that needs immeadiate attention, while medical is a bit overworked and understaffed, if they can't provide the right treatment, trust me they will not hesitate to transfer him to an outside hospital for treatment, at least that was the case for me. I had liver failure and a bout of hepatic-renal syndrome while in and trust me after a check and vitals i was out of there within the hour. 2 co's were constantly by my side in the hospital, but for the most part, those co's were really cool and i was transported via ambulance to the hospital so i can't complain. i guess each facilty, protocol and situation may be a little different, but I can't see them being all that much different that proper treatment is delayed or denied, but i'm going by what took place with me. I can tell you some guys did have a problem on dialysis and they were transfered pretty quick too. if it were a ct state facility, i'd worry but my opinion is for a federal medical facility while not completely blowing it off, you should be worrying alot less. Stay strong.

joe
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Old 01-06-2009, 03:07 PM
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I am going through the same thing, however not for dialysis. I wish you all the best.
If you know which facility, maybe you could call and ask them about the dialysis unit.
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Old 01-06-2009, 07:09 PM
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Default Dialysis

Thank you both for your replies. It means a lot to me to have the opportunity to talk to people who have first hand knowledge of the situation. I have found a lot of very useful information on here, but not much about dialysis. God bless you both and thanks again for taking the time to reply.

Julie
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Old 01-08-2009, 07:42 AM
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In NY where my husband is he works in the RMU/hospice units and has said that several inmates are on dialysis and that the treatment seems to be very good. They have even recently done a kidney transplant on an inmate. I know that the health care systems vary from state to state but it appears that in NY they take pretty good care of inmates with kidney failure.
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Old 01-09-2009, 03:17 PM
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In NY where my husband is he works in the RMU/hospice units and has said that several inmates are on dialysis and that the treatment seems to be very good. They have even recently done a kidney transplant on an inmate. I know that the health care systems vary from state to state but it appears that in NY they take pretty good care of inmates with kidney failure.
A prisoner getting a transplant?? Are you sure?? I talked to a transplant coordinator before for a family friend and they said there are no inmates on their list.

You would think anyone in the free world would get priority over an inmate.
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Old 01-09-2009, 03:23 PM
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As far as dialysis goes that is hell even in the free world. I've heard many people on dialysis say it's not worth living like that very long. They tear up your arm and even your chest to implant a dialysis catheter. The catheter is no good because it doesn't last long because it gets infected.

Or they can put in a graft or fistula that looks awful on your arm and it can get infiltrated and just torn up from all the constant needle pricks. Dialysis is living hell and that's why the average life span on dialysis is only about 5 years.

So Dialysis in prison must be all that worse because for a good number of those inmates they'll end up dying there unless they get out fairly soon.

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Old 01-09-2009, 03:58 PM
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i know devens had some guys that had transplants prior to coming in and they were watched like hawks so that they didn't get sick because their immune systems are shot from the anti-rection drugs. IDuring my stay there were no transplants, however there was one guy that went in for testing on his heart and they did major open heart surgery on the guy. he had 24 hour guards at the outside hospital but he was there for 2 almost 3 weeks. then when he came back he was on a full blown hospital ward at the facility. but like i said they pretty much take care of you there.

joe
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Old 01-09-2009, 04:38 PM
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Originally Posted by joetnymedic View Post
i know devens had some guys that had transplants prior to coming in and they were watched like hawks so that they didn't get sick because their immune systems are shot from the anti-rection drugs. IDuring my stay there were no transplants, however there was one guy that went in for testing on his heart and they did major open heart surgery on the guy. he had 24 hour guards at the outside hospital but he was there for 2 almost 3 weeks. then when he came back he was on a full blown hospital ward at the facility. but like i said they pretty much take care of you there.

joe
Yeah, they had transplants PRIOR to getting locked up but a kidney transplants cost $250,000!! That's a quarter of a million dollars PLUS tens of thousands every year for medication.

I REALLY doubt that any state or fed prison is going to pick up the cost for that because they can just put them on dialysis.
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Old 01-12-2009, 07:47 AM
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I am 100% positive. I have met the inmate, who is a friend of my husband's. I have met his wife and children too. Of course I do not know all of the dynmaics of his particular case in regard to why he got the preference but he is walking around alive and well with a new kidney.


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A prisoner getting a transplant?? Are you sure?? I talked to a transplant coordinator before for a family friend and they said there are no inmates on their list.

You would think anyone in the free world would get priority over an inmate.
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Old 01-16-2009, 03:31 PM
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I am 100% positive. I have met the inmate, who is a friend of my husband's. I have met his wife and children too. Of course I do not know all of the dynmaics of his particular case in regard to why he got the preference but he is walking around alive and well with a new kidney.
Is he a state or federal inmate? What state? Is he in minimum custody? It is REALLY hard to believe the state picked up about a quarter million dollars of expenses for an inmate.

I know for a fact prisons just put prisoners on dialysis instead of giving them a transplant.
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Old 01-16-2009, 03:49 PM
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ADX,
I thought my upcoming liver transplant would be around that cost but it is actually alot lower. The costs for my meds are 44k for the 1st year and then down to 24k every year after. With that being said, I actually took the time to look up costs of a kidney transplant and this is the average costs as opposed to dialysis which costs 44k a year. This is from the university of maryland medical center:

"The cost of kidney dialysis averages about $44,000 per year per patient, using 1993 figures. The average cost for the transplant patients in our study, including the transplant surgery and medical care for the first year following surgery was $89,939. After the first year, costs for the transplant patients averaged $16,043; mostly for medications to prevent rejection"

This winds up being a savings of: about 27K a year for the facility in the long run.

Granted these numbers are based on figures from years ago, however per the doctors I see at Hartford Hospital Transplant Program, the costs for transplants are actually lower as they are preformed more often than years past.

joe

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Old 01-16-2009, 03:54 PM
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ADX,
I thought my upcoming liver transplant would be around that cost but it is actually alot lower. The costs for my meds are 44k for the 1st year and then down to 24k every year after. With that being said, I actually took the time to look up costs of a kidney transplant and this is the average costs as opposed to dialysis which costs 44k a year. This is from the university of maryland medical center:

"The cost of kidney dialysis averages about $44,000 per year per patient, using 1993 figures. The average cost for the transplant patients in our study, including the transplant surgery and medical care for the first year following surgery was $89,939. After the first year, costs for the transplant patients averaged $16,043; mostly for medications to prevent rejection"

This winds up being a savings of: about 27K a year for the facility in the long run.

joe
I've actually SEEN an insurance bill for a family friend who had a kidney transplant and it was indeed $250,000. That doesn't mean the family paid that much because insurance picked up most of it. I don't know if that hospital overcharged or Maryland is a great deal but that price does seem low.

Other places I've heard it is AT LEAST in the 6 figures.
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Old 01-16-2009, 04:25 PM
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Actually the nation kidney foundations site says the average costs for the transplant and 1st years meds comes out to about $116 K. Remember though that is the national average, some states may charge more, some less. But remember that's the national average. While I have no doubt that what you are saying the costs were to your friend. They may not be figuring in the hospital stay, the ICU charges, the Rehab afterward, it can be a bunch of stuff. Remember the study said the cost of the transplant and also gave the cost of meds. it didn't say hospital costs, etc.

As for doubting a state or the feds paying for the transplant costs, I'm sure a lot of thought goes into that process. Remember even though someone is an inmate, it doesn't make them so bad that if they died in custody, the media wouldn't pick it up and run with it. I know everytime an inmate kills themselves or is seriously injured in my state, the media does cover it and DOC takes the heat, so imagine what would happen if someone was doing a year say for theft or bad checks and the associated larceny charge with each check. They are a non-violent low level inmate who is serving a minimal sentence and their kidneys fail. Well, the guy didn't get a death sentence, and his kidney issue may be undiagnosed, so i tend to think the state would not just stand by and let the guy die as they are required to provide adaquate medical care. Look at this scenerio. An inmate goes into kidney failure, he (or she) is rushed to the ER. Now the doctors determine the inmate needs a transplant, this is a catch 22 for both the hospital and the facility. They either act or watch the inmate die and face possible lawsuits for such from the inmates family. The reason they have to treat the inmate to the fullest is they (both the facility's medical staff and the hospital staff) have to provide the inmate with treatment that meets or exceeds the standard of care. See what I'm getting at? I know from being a road medic for a great many years that even us guys on the road had to meet the levels of care dictated by both the state and the feds. They have written protocols for treatment and if you don't do the protocols you can lose your cert or your license to practice. There is also what is called "a duty to act" If you do not provide treatment to the level of care you are trained to you can get slapped with a lawsuit and the plaintiff will win no doubt because you ignored that duty to act. You can aslo get slapped with negligence in the event you do not perform treatments which you were trained to provide (withholding treatment) or you can get slapped for providing medical care for something you do that is outside of your scope of practice for doing something you were not trained to do. that's why in many states an emt can not intubate a patient, or do cardiac care, or administer drugs in the field. The protocalls say that for those types of intervention, a medic needs to be there and has to perform these treatments. So the state in this case and the hospital would have to do what they could to save this patient or face the possible problems afterward. Everything I have just stated concerning treatment is from what I was taught and what I practiced in the field. You may agree or disagree but these are just the rules.

joe
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Old 01-16-2009, 04:33 PM
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Joetnymedic, yeah I know our family friend was required to stay in the hospital a full week after the transplant and that is a LOT of money. TENS of thousands because hospitals WAY overcharge. Also the medications in a hospital are a lot more than out on the street. Plus who knows whatever charges they throw in there while you're in the hospital.

They try and bleed you or the insurance company dry for every little thing they can think of. LOL!

Are you a medic like the medics who drive ambulances? Did you work as a medic in a prison?

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Old 01-16-2009, 05:10 PM
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Street medic on the ambulance and one of the ones that drive what they call a fly car which is an SUV with all your gear. you intercept with the ambulance either at the location or while it's going to the hospital. Started as an EMT and worked my way up. Was on the job for 23 years. Retired due to an illness in 2002. Worked in CT, Westchester County, NY and the city. BTW, 1 reason the hospitals charge so much believe it or not, is that the insurance company's, medicare, and medicaid do not cover the full cost of the things provided. It's actually the same thing with ambulance service bills. So what gets done alot of the time, is they pad the bill. I'll give you an example. A paramedic ambulance takes you to the hospital, they bill whatever your insurance company is and the insurance company pays let's just say half of the cost of the run. So what is done is you get a base rate of say $300 bucks, then an IV tacks on 150.00, Cardiac monitoring is say another 150.00 and any drugs used for intervention. So the ambulance company sends in the bill and the insurance company pays like 325-400 for the run. Which if the insurance company paid the full price is what the service would have billed in the first place. It's just like the handicap vans you see taking people to doctors appointments, etc. base rate is say 60 bucks. State and the insurance companies pay 12 bucks for the ride. And as the companies I worked for ran both types of vehicles, emergency and non-emergency, that 12 dollar figure is really 12 dollars not just a guestimate, Same thing with the rig charges. It's pretty sad that everyone puts a pricetag on what it's worth to help someone. But like everything else, it's a business.

joe
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Old 01-19-2009, 07:55 AM
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He is a NY state facility. This is max prison.

I have to keep faith in the prison health care system, even though it does fail sometimes. I am glad to hear of cases like this where they really do take care of the inmates physicial health regardless of the cost.

Also, when I think about this from a purely financial standpoint, it would cost the state much more if they did nothing for these inmates and they died and the families sued. They would pay out millions in damages later versus providing care for the inmates now.


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Is he a state or federal inmate? What state? Is he in minimum custody? It is REALLY hard to believe the state picked up about a quarter million dollars of expenses for an inmate.

I know for a fact prisons just put prisoners on dialysis instead of giving them a transplant.
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Old 01-19-2009, 04:31 PM
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He is a NY state facility. This is max prison.

I have to keep faith in the prison health care system, even though it does fail sometimes. I am glad to hear of cases like this where they really do take care of the inmates physicial health regardless of the cost.

Also, when I think about this from a purely financial standpoint, it would cost the state much more if they did nothing for these inmates and they died and the families sued. They would pay out millions in damages later versus providing care for the inmates now.
But if he was in custody when the kidney transplant happened then how did they do it?? Did the handcuff him to the operating table or something?? I've heard when inmates are in custody they are handcuffed the entire team they are out of the prison.
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Old 02-07-2009, 11:47 PM
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Post Dialysis amd Transplants

Joe, I wanted to let you know that I appreciate the in-depth medical information that you have provided for all the thousands of kidney patients that are incarcerated and for thie families too.Being a kidney patient myself,also a diabetic ,with severe hypertension, nueropathy, and retinopathy the very thought of having to deal with the serious nature of these conditions as an inmate absolutely terrifies me. Especially since I am from a state that does not seem to provide adequate and proper care for inmates, my husband being one .So I have firsthand knowledge both as a patient and as the wife of an inmate with medical conditions . The death rate in this state is enough to cause great concern . Your knowledge helps to put into perspective what issues seriously ill inmates face. In addition to yuour own liver complications. I wish you all the best.I just wanted to let you know you are in my prayers. We are the voice of those inside and of those who lack sufficient medical and legal knowledge to make sure they get the treatments they are entitled to both morally and legally.Good luck to you. I hope you and the others on this thread continue to keep the info and help available to those who may already need it for themselves or a family member inmate. Thank you very much for your obvious care and concern.
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Old 02-08-2009, 04:19 PM
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But if he was in custody when the kidney transplant happened then how did they do it?? Did the handcuff him to the operating table or something?? I've heard when inmates are in custody they are handcuffed the entire team they are out of the prison.
This varies from hospital to hospital but the guards are NOT permitted in the OR suite. They must wear surgical coverings over the uniform, including the bonnet and booties, and sit outside the door. As for the hand cuffs, that is the nurses call. There are times when it is impossible to care for a patient in cuffs and in those situations we make the guards remove them. Once a patient enters the hospital, their social and insurance status is irrelevant. They will be given the same care as any other patient. If it is possible to care for the patient with the cuffs on, we try to accomodate! I only had one guard complain, and I told him to call his superiors and do whatever he needed to do to feel better, but the cuffs were OFF. There can be NO metal whatsoever around during a defibrillation and that includes hand cuffs, ankle cuffs and anything else they have.
In 32 years of critical care nursing in the hospital that had the contract for dialysis patients, and all inmates for the state, I have never had one problem with any inmate - ever!
So, don't worry. What needs to be done will be done and it will be done correctly in the hospital.
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Old 02-09-2009, 02:14 AM
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I wish that what you said applied here. I don't know about ervry case , only my husband's. He was taken to the hospital. I was not notified. And after I found out, even though I am his wife and even though I have a Durable Power of Attorney , I WAS NOT allowed to know where he was or to see him or know How he was !! There was a 24 hour guard in his room so my husband could not speak freely with the Dr. . The guard knew more than I did . And even though he was critically ill, there were metel cuffs on both wrists and both ankles . When I saw him about a week later the bruises were horrendous. That was unnecesary, the leather straps would have served the same purpose ! But most of the time he was not even aware he was in the world ! This was in the intensive care unit.And to further add to the cruelty anf injustice ,I was told "If he dies you'll get a phone call" .It was only from the strenght given to me from thr Lord above that i and my husband survived that hospital stay. I beginning to find out that humane doesn't apply to prisoners in Mississippi !!!!
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