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An examination of a health care system that runs counter to national standards, and often falls far short of meeting medical needs. While Kentucky counties look to cut costs, for-profit companies have stepped in. But inmates are suffering and state officials aren't doing anything about it.

Lawsuit Over 2013 Montgomery County Jail Death Settled

hand of a prisoner
Getty Images/iStockphoto
hand of a prisoner

A lawsuit resulting from the 2013 death of an inmate in the Montgomery County jail has been settled for more than $400,000.

A federal judge previously ruled that a doctor, a nurse and the county jailer all demonstrated “deliberate indifference” to the medical needs of inmate Ronald Gaunce.

The circumstances surrounding Gaunce’s death were detailed in a 2015 Kentucky Center for Investigative Reporting series on jail health care woes. (Read “ Dying For Dollars: For-Profit Health Care in Kentucky’s Jails”)

Gaunce, 37, lay in his cell in his own feces, wracked with pain from severe drug withdrawal, before dying of a seizure on March 25, 2013.

A $400,000 settlement -- paid out by Montgomery County’s insurance carrier -- resolves claims made by Diana Rice, Gaunce’s mother, against Jailer Eric Jones and several deputies.

The Kentucky Association of Counties, whose All Lines Fund insures Montgomery and most of the state’s other 120 counties, confirmed details of the out-of-court settlement late last month.

The settlement in Gaunce’s case represented more than one third of the $1,152,500 paid out through KACo in 2016 to settle 10 claims involving county jail inmates.

As part of the settlement, jailer Jones agreed to “regularly train” his employees on the “signs, symptoms and hazards” of drug and alcohol withdrawal. He further agreed to have available at all times an employee who is qualified to observe and report an inmate’s vital signs to the jail’s medical provider.

Rice has reached a separate settlement, involving Southern Health Partners, Inc., the jail’s health-care provider; Dr. Ronald Waldridge; and registered nurse Patrina Tipton, according to federal court records.

SHP President Jennifer Hairsine and the attorney for the company, Waldridge and Tipton did not respond to requests for comment.

Greg Belzley, an attorney for Rice, declined to discuss the terms of the settlement, saying they are confidential.

Waldridge, the jail’s contract physician, was 80 miles away, in Shelbyville, when Gaunce was incarcerated. He neither spoke to nor examined Gaunce before he died, even though there was evidence the doctor knew that Gaunce “had a serious medical need,” U.S. District Judge Karen Caldwell noted in her opinion last May.

Waldridge not only had a busy private practice, he also was medical director at 21 Kentucky jails for SHP, a private, for-profit healthcare company based in Chattanooga, Tenn.

In all, Waldridge oversaw the medical care of about 3,500 inmates — nearly one-fifth of the state’s entire jail population.

The doctor’s contract with SHP called for him to spend one to three hours each week at the Montgomery County jail, about 40 miles east of Lexington. But he actually went there only every two to three months, and then only briefly, according to testimony in the case.

Instead, Waldridge relied on advance-practice registered nurses, or APRNs, who made periodic visits to the jail and the 20 others for which he had assumed responsibility.

Lower-level nurses were responsible for providing regular care at the jails under contract with Southern Health Partners.

This for-profit jail health care model is entrenched in Kentucky and beyond.

R.G. Dunlop can be reached at rdunlop@kycir.org or (502) 814.6533.

Disclosure: In December 2016, Greg Belzley donated to KyCIR.

R.G. Dunlop is an award-winning investigative reporter whose work has exposed government corruption and resulted in numerous reforms. Email R.G. at rdunlop@lpm.org.

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