Posted on Fri, Jul. 11, 2003
Medication mix-up at Missouri women's prison raises questions
By MATT CAMPBELL
The Kansas City Star
At least a dozen women inmates at the Vandalia, Mo., prison were given the wrong anti-depressant medication last Friday, sending them to a hospital.
Two or three of the women were held at the hospital in Audrain County overnight, but all are now back performing their normal prison duties, a spokesman for the Missouri Department of Corrections said.
The nurse who dispensed the incorrect medication worked for Correctional Medical Services, a private firm that has a contract to provide all medical care at Missouri's 21 prisons. The nurse has been suspended, and the Missouri Department of Corrections is investigating.
A special departmental team is to meet today with the inmate council at the eastern Missouri women's prison to discuss continuing concerns about medical care there.
Two inmates -- both from the Kansas City area -- have died at Vandalia this year, the most recent one on July 2.
The American Civil Liberties Union of St. Louis is looking into conditions at the prison, and the Civil Rights Division of the U.S. Department of Justice has reportedly made inquiries, although the department will not confirm that.
"Obviously it (the prison) is not functioning correctly," said Sister Fran Buschell, who coordinates prison ministries for the Catholic Diocese of Jefferson City. "I don't really know what the problem is. I think that's what people are trying to determine."
In last Friday's incident, an undetermined number of persons who were supposed to receive a tablet of Prozac, an anti-depressant, may have received instead another psychotropic drug called Sinequan, said Ken Fields, a spokesman for Correctional Medical Services.
Both drugs are anti-depressants, but the Physician's Desk Reference Web site says people switching from Prozac to Sinequan should "wait at least five weeks after your last dose of Prozac before starting Sinequan."
All of the women who may have received the wrong drug were evaluated by the medical staff, and 13 were taken to a hospital. At least two were admitted, and four others were kept for observation, Fields said. Sinequan has a sedative effect that leaves the body over time, he said.
"She (the nurse) reported the issue to us, and we took immediate steps and comprehensive steps to make sure there were no negative consequences," Fields said.
Buschell said one woman was taken to the hospital by ambulance and was in intensive care until Saturday night.
The nun said she had been contacted by the Department of Justice about complaints it had received from inmate families about the Vandalia prison before Friday's incident. A Justice Department spokesman said he could neither confirm nor deny that an inquiry was in progress.
Buschell said she met Wednesday with Bryan Goeke of the Adult Institutions Division of the Department of Corrections to relay her concerns about medical care at Vandalia. She said she was pleased at his interest.
Tim Kniest, spokesman for the Department of Corrections, said state officials continually monitor the quality of service provided by Correctional Medical Services. He said a new five-year contract with the company, expanded to include mental health services, began in December.
On March 23, Crystal Smith of Kansas City was pronounced dead after being discovered unresponsive at the Vandalia prison. Smith, 46, had been serving a five-year sentence out of Jackson County for drug possession.
Her sister, Angela Smith Hynes of Kansas City, said she was concerned that Smith might have been denied medications she needed. She is trying to learn more details about the circumstances of Smith's death.
On July 2, Al'Deana Simmons, formerly of Raytown, was pronounced dead after being found unresponsive at the Vandalia prison. Simmons, 33, was serving a four-year sentence out of Boone County for forgery.
Her former husband and the father of her three children, Jeff Simmons, said Wednesday that he, too, wanted more information about the death.
The Kansas City Star has requested an autopsy report and other documents regarding Smith and the autopsy report on Simmons. The requests are pending.
Kniest said a mortality review committee composed of medical staff from the Department of Corrections, Correctional Medical Services and outside physicians reviews the circumstances of each death.
Reviews of the deaths of Smith and Simmons were not available this week.
An August 1999 death at Vandalia prompted accusations from that inmate's roommate that she had been denied medication she needed. Those allegations were denied by Correctional Medical Services.
In 2000, the state of Virginia decided not to renew a contract with the St. Louis-based company after inmate complaints about medical services.
The Vandalia prison, officially called the Women's Eastern Reception, Diagnostic and Correctional Center, opened in 1998 and was built to house 1,460 inmates ranging from minimum to maximum security.
Jul 11, '03
AND THIS PRISON IS IN AMERICA!!!!!!!!!!!!??????? Makes me want to become an activist.................................Please keep us posted
Jul 11, '03
I work in a max security prison and a county jail.It is no surprise to hear of this type of mistake.Many of the medications appear so similar,such as certain doses of Sinequan and Fluoxetine.I can almost guarantee that this problem is far more common in the corrections setting than anyone would care to admit or anywhere else massive amounts of medication must be administered.The nurse is ultimately responsible for administering the accurate medication,but it would be a great help to have the drug companies be proactive in helping to differentiate between these types of medications.I am cautious and careful when pouring medications,but I have had to stop and look 2 or 3 times at sinequan 100 mg and fluoxetine 20 mg punch out medication cards for inmates during med administration to ensure that I was giving the right med.The mixup between these 2 drugs is no surprise.
Jul 11, '03
Hmmm, I thought you were supposed to check the label against
the medication administration record 3 times. It's what I practice
and what I teach. (Yeah,yeah, I know, takes time)
Jul 11, '03
13 women inmates on Prozac??
That seems a bit excessive doesn't it?
Jul 11, '03
I too work in corrections. County Jail, 1200 or so male inmates. I can undeniably state that we have over 300 currently on psychotropic meds and at least 40 on Prozac. Most of the inmates under mental health are on more than one drug. From the security point of view, the longer the medline takes, the larger the chance that a problem will occur. That means speedy meds and I must admit to shortcutting where I can, but not checking a med card against the MAR? What a mess that nurse must be in. My prayers go out to her.