Pubdate: Thu, 28 Feb 2002
Source: Denver Rocky Mountain News (CO)
Copyright: 2002, Denver Publishing Co.
Contact:  http://www.rockymountainnews.com/
Details: http://www.mapinc.org/media/371
Author: Karen Abbott
Bookmark: http://www.mapinc.org/find?143 (Hepatitis)
Bookmark: http://www.mapinc.org/prison.htm (Incarceration)

LAWYER: INFECTED INMATES NOT TREATED

Thousands Have Hepatitis C; State Defends Medical Regimen

State inmates infected with hepatitis C are being routinely refused medical 
treatment, says a lawyer who is considering suing the state to force 
medication.

David Lane, who represents a death row inmate with the disease, said he is 
considering suing the state to prompt medication of infected prisoners.

But Dr. Bob McGarry, chief medical officer for the state prison system, 
said prisoners are getting the right treatment.

At least 17,000 prisoners are infected, Lane said. The cost of drugs would 
be about $25,000 a year for each infected inmate.

About 17 percent of inmates are sick with hepatitis C when they enter state 
prisons, McGarry said. More catch the blood-borne viral infection in prison.

That means more than 1,100 of the 6,800 prisoners admitted in fiscal year 
1999-2000, the most recent year for which admission numbers are available, 
had the disease.

Lane says 20 percent to 40 percent of Colorado prisoners have hepatitis C, 
a blood borne viral disease that attacks the liver.

Twenty percent of the state's 17,150 prisoners would be 3,430 infected 
inmates and annual treatment costs of more than $85 million, if Lane's 
estimates are right.

Lane said hepatitis C is spread in the same ways as the HIV virus that 
causes AIDS: by the sharing of dirty needles in drug use, by unsafe sexual 
activity and by the comingling of blood. He said many inmates get the 
disease in prison.

Lane's client, Frank Rodriguez, whose death sentence the 1984 murder of 
Denver bookkeeper Lorraine Martelli is being appealed, is said to be 
critically ill with hepatitis C.

But he said he knows that numerous Colorado prisoners have the disease.

He said the current standard drug treatment for hepatitis C is interferon, 
administered by injection, and ribavirin, taken orally.

Half the people with hepatitis C who take the two drugs go into remission, 
Lane said.

He said Colorado's prison system places so many restrictions and 
requirements on obtaining treatment that prisoners can't get the drugs 
easily, if at all.

He said the prison system won't let inmates have the drugs if they have 
smoked cigarettes within the past year.

He said the prison system also refuses the drugs to inmates who have 
consumed alcohol within the past year or who are sentenced to serve less 
than two years.

"You have to go through drug class for a year before they'll let you in, 
even if you're not a drug addict," he said.

He said those are stalling tactics. When hepatitis C has progressed to the 
point where a person develops cirrhosis of the liver, the drugs aren't very 
effective, Lane said.

And then, Lane said, prison officials tell infected inmates, "You know 
what? Sorry, we're not going to treat you, because now it's too late."

He said such failure to treat afflicted inmates is cruel and unusual 
punishment, which is prohibited by the eighth amendment to the U.S. 
Constitution.

McGarry said the Department of Corrections started testing new inmates for 
hepatitis C a year and a half ago. He doesn't know how many prisoners 
already in the system have it.

The doctor also said about 80 percent of people with hepatitis C "have no 
problem with it," developing no liver failure or cancer.

He said the chief way of contracting hepatitis C is through intravenous 
drug abuse.

McGarry said there are reasons for the delays in beginning treatment.

"There are certain things that are reasons not to treat a person," McGarry 
said. "If a person has far advanced cirrhosis, usually it's felt that that 
person is not a candidate for treatment with interferon or ribavirin."

He confirmed that inmates first must go through a year of drug and alcohol 
training, during which they must have negative random urine screens.

He said they must not use any illegal substances. "Smoking," he said, "is 
illegal in the prison."

He said delaying treatment for that year is "pretty unlikely" to cause such 
deterioriation that a person isn't eligible for drug treatment.

"Hepatitis C is a process of decades," he said.

"And," he said, "it's never been proven that treatment with interferon or 
ribavirin has ever saved one person from dying from liver failure or dying 
from cancer of the liver."

Still, he said, Colorado prison officials have gone so far as to ask the 
University of Colorado Health Sciences Center to perform liver transplants 
on two hepatitis C infected inmates in the last year.

Both were turned down by the hospital's transplant board, McGarry said.

He said a third inmate presently is being presented to the board for a 
possible liver transplant. He would not identify the inmate.
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