Testimony: TCSO ordered medical staff to falsify records, punished unruly inmates

Tulsa jail staff punished unruly inmates by placing them naked in suicide watch cells, pouring water over their food or having the kitchen grind up food to make a “loaf,” the jail’s former medical records director testified Tuesday.

The former director, Elandia Maloy, also testified that former Sheriff Stanley Glanz, former Undersheriff Tim Albin and others ordered staff to falsify or hide inmates’ medical records in order to pass audits.

Maloy’s statements came Tuesday during the 10th day of a civil trial in Tulsa’s federal court over Williams’ 2011 death. She testified about the jail treatment of inmates and practice of falsifying medical records during the time of her employment.

Maloy worked in Tulsa’s jail from 1998 to 2009. Before being promoted to the jail’s medical records director in 2000, she worked there as a certified medication aide.

Before a 2007 outside review of the jail, Tulsa County Sheriff’s Office administration — including Glanz, Albin and former Maj. Tom Huckeby — told staff with the jail’s private medical provider to falsify records, Maloy testified.

Top officials with Correctional Healthcare Companies Inc. (CHC), which held the jail’s lucrative medical contract at the time, instructed her and other supervisors during the meeting to alter medical charts, showing that inmates’ sick calls were answered and medications were dispensed.

Medical supervisors were told in a meeting how important the audit by the National Commission on Correctional Health Care was and that “heads will roll” if it wasn’t passed, Maloy said. The jail’s medical unit had to pass the audit in order to be accredited with the organization.

“We were told no matter what happened, what you need to do, the (medical) charts had to pass the audit,” Maloy said.

Glanz and current Sheriff Vic Regalado are the defendants in a lawsuit alleging Williams’ Eighth and 14th amendment rights were violated when he was allowed to languish on his jail cell floor without eating or drinking for days before dying from complications of a broken neck. The jail’s former medical provider, CHC, settled with Williams’ estate and is no longer a defendant.

Williams begged for help and repeatedly told jail staff he couldn’t move and that his neck was broken. However detention and medical staff concluded that Williams was faking paralysis, although testimony and records indicate they did no medical tests to confirm their assumption. Williams was placed in a cell equipped with video for 51 hours and never moved his feet on his own. He lacked motor control in his arms to grasp the trays of food jailers tossed into his cell and spilled the single cup of water he was given.

Pam Hoisington, Maloy’s supervisor, also directed staff to create “dummy charts” for the auditors, Maloy testified.

Hoisington gave medical staff a list of inmates’ charts — deemed “troublemakers by TCSO — to hide from auditors, Maloy testified. She said these inmates were actually people with complex medical problems who needed more assistance.

Hoisington then directed Maloy and other staff present to select “low-maintenance charts” of inmates and alter them so the jail would appear in compliance with the accrediting body’s standards.

Some charts were altered to make them look as if they were signed by doctors and nurses. If a chart didn’t have signatures, the inmate requesting health care wasn’t seen, Maloy said.

While CHC’s policy was to respond to all inmate requests for medical attention within 48 hours, Maloy said it was not unusual for such requests to go unanswered for up to 10 days. The practice of nurses and doctors not seeing inmates put inmates’ health in jeopardy for medical emergencies, she said.

After favorable “low-maintenance” medical charts were selected, they were given to Albin, who put them aside for auditors, Maloy testified.

However, when the commission’s auditors arrived, they selected from random charts instead of the ones chosen to pass the audit. Administrators at TCSO and its medical provider went into “sheer panic,” Maloy said.

The jail was cited with failure to meet several important standards and was required to correct them, she said. When NCCHC’s made recommendations to the jail to meet standards, they weren’t followed, Maloy testified.

In another meeting, jail administration ordered medical staff not to call an ambulance for inmates unless jail staff approved the request, Maloy said.

“We were told we couldn’t call EMSA because it would cost too much money,” she said.

If the jail’s medical staff thought an inmate needed outside emergency care, TCSO supervisors including Huckeby had to make that call, she said.

Huckeby was a key figure in the scandal that brought down Glanz last year. He was among officials at the jail named by black employees at the jail who said they were treated unfairly.

In a deposition, he once described the Sheriff’s Office as “a paramilitary type of organization,” adding: “We brought that structure and discipline to the jail.”

Maloy testified that if jail supervisors ruled the inmate could get emergency care, he or she would be transported in a car or van to save money.

The Sheriff’s Office and the owners of Correctional Healthcare Companies Inc. were “pissed off” because medical staff was “blowing the budget,” Maloy said.

Under the contract between the jail and CHC, a cap existed limiting how much the provider would pay for inmates’ medical expenses outside of the jail, such as ambulance services or care provided in a hospital. When the cap was exceeded, the cost fell to Tulsa County.

A similar cap exists with the jail’s current medical provider, Oklahoma-based Turn Key Health Clinics. The contract covers up to $500,000 annually for hospitalizations and other off-site medical services such as dental, X-rays and lab work.

Maloy said Hoisington directed medical staff to take other money-saving measures. For inmates who only needed half of a pill, the medical staff were told to save the other half, which Maloy said is not considered sanitary.

During testimony, Maloy recalled jail staff treating inmates inhumanely.

In one instance, a man was “screaming and urinating blood.” Maloy said he needed to see an outside doctor, but TCSO would not approve the inmate to be seen.

“He would scream every night,” she said.

If a detention officer felt inmates were being disrespectful, the officer would often place them on suicide watch even if they did not meet the qualifications as a suicide risk, she said. That involved placing the inmate in a segregated cell without any clothes on, Maloy testified.

Officers also at times “mashed up” inmates’ food and poured water on it if they were perceived as unruly. In other instances, jail staff had the food ground up and made into a “loaf.”

When asked if the practices were common, Maloy said yes.

If inmates needed specialized procedures, jail staff would request to move their court dates to an earlier date in order to get them out of the jail sooner so the jail wouldn’t have to pay for their health care, Maloy testified.

Medical staff had a policy to answer sick calls within 48 hours, but in many cases they weren’t answered for at least 10 days, she said.

Many inmates weren’t receiving the medical care that should have been given because of staff shortages, Maloy said. At one point, there was only one nurse on duty when there should have been six.

There was a practice of not reporting nursing violations to the Oklahoma Board of Nursing — which regulates nursing licenses — because administration didn’t want to call attention to the jail’s medical unit and be audited, Maloy said.

Williams treated inhumanely, without compassion

Elliott Williams’ treatment by staff in Tulsa’s jail was inhumane and lacked compassion, a former acting Tulsa County sheriff testified Tuesday.

A video of Williams lying naked in a medical unit over five days shows detention officers placing a cup of water out of Williams’ reach and tossing food trays at his feet.

The video — which has been seen in court several times — played once again while the former interim sheriff — Rick Weigel — testified Tuesday.

“Do you see compassion in the way Mr. Williams was treated in this video?” asked Dan Smolen, an attorney representing Williams’ estate.

“No,” Weigel answered.

Asked whether Williams lying on a blanket soaked in his urine and feces over five days was inhumane, Weigel said yes.

“If Mr. Williams begged for food and water for five days and it was never provided, would that be inhumane?” Smolen asked.

“Yes,” Weigel replied.

Following the death of Williams in Tulsa’s jail, Weigel, the sheriff’s jail administrator at the time, held three meetings with medical staff to remind them “not all inmates are trying to con you,” that inmates are innocent until proven guilty and should be treated with kindness.

Weigel also had no idea the Tulsa County Sheriff’s Office designated him as the agency’s contract monitor, to oversee quality of care being given to inmates by the jail’s private medical provider.

“As far as me reading the (medical) charts, the medical treatment, I’m sorry I didn’t know what that meant,” said Weigel, a widely respected veteran law enforcement officer who had no medical background.

Weigel served with the Tulsa Police Department for 35 years, spent a year as an intelligence analyst with the federal government and then joined the Sheriff’s Office as a captain at the jail in 2008.

Weigel became acting sheriff in November 2015 after Sheriff Stanley Glanz was indicted on two criminal counts and resigned. He announced his retirement two months later, reportedly following a heated meeting with county officials over financial issues involving the beleaguered Sheriff’s Office.

While serving as the interim jail administrator, Weigel held a meeting with the jail’s medical staff three months after Williams died to review how inmates should be treated. He testified that former Undersheriff Brian Edwards asked him to hold the training meetings specifically because of Williams’ death.

A memo from the meeting was also shared with Albin, as well as a city of Tulsa employee.

“All inmates should be treated in the fashion a nurse would treat a patient in the hospital,” the memo stated. “Take time to listen to the inmate, not all inmates are trying to con you.”

The memo addressed security issues between detention officers and medical staff, treating inmates as any other patient would be treated and taking the time to listen to inmates.

During cross-examination, Guy Fortney, an attorney representing the Sheriff’s Office, pointed to the jail’s policy regarding detention officers handling situations in which inmates appear to need medical care. In situations where staff is concerned about an inmate’s medical or mental health, policy requires them to notify medical staff.

“They should also contact their immediate supervisor,” Weigel said. He agreed detention officers weren’t responsible for inmates’ health care.

Weigel said it appeared jail staff — including Glanz — acted in line with the memo to treat inmates well.

Smolen asked Weigel whether anyone at the jail had made him aware of the numerous deficiencies outlined in reports and audits.

Weigel said he wasn’t made aware of any of the failings.

A 2007 review by the National Commission on Correctional Health Care found that “the follow up of inmates with mental health needs is not of sufficient frequency to meet their needs.” The study found a “noted delay” in responding to routine mental health requests by inmates. A 2010 audit by the same commission found more standards not in compliance.

A 2009 report from consultant Betty Gondles, who was hired by the Sheriff’s Office, warned the agency of systemic problems with the jail’s medical and mental health care.

Gondles’ report highlighted 16 areas jail administration needed to shore up to improve health care.

Asked whether any of those recommendations were addressed, Weigel said he could recall only three issues responded to: The suggestion of monthly meetings between jail administration and health services; improvement of inmates’ medical access through a kiosk system; and the jail’s medical unit being cleaned up.

During testimony last week, Glanz agreed that he could not name any policy or procedure that changed as a result of the the studies’ findings in 2007, 2009, 2010 and 2011. The audits found failures in nearly every area of the jail’s medical and mental health care, including a finding just weeks before Williams’ death of a “prevailing attitude among clinic staff of indifference.”

Smolen asked the former sheriff if he had any evidence to refute a key statistic: Out of 64 deficiencies cited by government agencies and consultants since 2007, at least 38 were repeat violations. Glanz has repeatedly claimed that any time a deficiency was found by an review, the jail’s medical provider corrected the issue.

Glanz has also testified he didn’t read a 2010 audit conducted on the jail’s health care.

Asked whether Weigel would have made the effort to read the expensive audits and make the suggested changes, Weigel said he would have taken the steps to do so.

“It would just be the right thing to do,” he said.