LOUISVILLE — Timothy U. Bell knew something wasn't right with the sore, swollen spot near his right armpit. Then he spent more than 18 months trying to get the attention of the administration of the Big Sandy federal prison in Eastern Kentucky to arrange an appointment with a doctor.
"I still don't know what it is and it's getting bigger, it's starting to hurt more, it's more irritating than ever, it keeps me up throughout the night (because I can't sleep with the pain), and I'm scared," Bell wrote to warden J.C. Zuercher in July 2009.
The growth proved to be non-Hodgkin's lymphoma — a cancer spread through the body via the lymph nodes. Bell didn't get a CT scan on the mass in his arm until the cancer was in the late stages. He died in 2010, a year after being released from prison. Now, his family in Michigan and the federal government have reached a $975,000 settlement over negligence claims related to the case.
"He deserved better," said Bell's attorney, Sheila Hiestand of Louisville. "By the time he died, he was just a small, skeletal thing."
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Bell and his family in Dearborn Heights, Mich., sued the federal government twice in U.S. District Court in Pikeville — in 2009 and again in 2010. Both suits related to Bell's medical treatment while at Big Sandy.
Interviews and court records filed in the two suits, as well as other, similar but unrelated cases give a glimpse of how the Bureau of Prisons' medical system works. Of the 173,896 inmates in federal prisons in 2009 (the last year available), 399 died — with a steady rise each year from 268 in 1999, according to the Bureau of Justice Statistics.
The rise in deaths matched the rise in prison population, from 121,854 in 1999 to 173,896 in 2009.
Bell was a 36-year-old drug offender from Michigan serving time at the prison in Inez, near the Kentucky-West Virginia border, when he first noticed a patch on his right armpit and thought it might be a bad reaction to a bug bitee.
Dr. Norbert Rosario examined Bell and requested a biopsy of the mass. Prison officials say he labeled it "Priority!!!" A month later, prison officials gave approval for the test. More than a year later, with no biopsy done, Bell wrote a letter to Zuercher asking about the status of his medical request.
The prison approved Bell for a CT scan on July 21, 2009 — the same day Zuercher responded to Bell, saying the exam was "pending scheduling" and a treatment plan would be developed after the visit with the doctor.
Court records do not indicate why it took so long for Bell's medical visit to be approved. In court filings and depositions, prison staff and attorneys all outlined the process, but none could recall seeing Bell's specific request for medical attention.
"Prisoners get the short shrift," Hiestand told The Associated Press. "It's assumed any problem they have is fake."
Deborah Golden, an attorney with the Washington Lawyer's Committee for Civil Rights and Urban Affairs, a group that often handles inmate complaints, said inmate medical requests are frequently delayed, resulting in pain and suffering among the incarcerated. Her colleague Ivy Finkenstadt said paperwork "in the extreme" clogs up an overcrowded prison system that is under budgeted, often resulting in delays for inmates getting treatment.
The Bureau of Prisons transferred Bell to a facility in Ashland on July 26, 2009, further delaying his medical procedure. A doctor conducted a CT scan on Oct. 8, 2009, concluding that Bell had stage 3 or stage 4 cancer, making his death a certainty, Hiestand said.
Bell served a total of 30 months in prison and walked out a sick man on Nov. 10, 2009. He died Dec. 26, 2010 in Michigan. The suits were pending when he died and his family and estate carried on the legal fight.