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Date of Alert: January 28, 2003

Date of Original Alert: September 21. 2002

Contact person for urgent alert:

Kenny H. Linn, J.D., L.L.M, Executive Director
Federal CURE. Inc.
P.O. Box 15667
Plantation, Florida 33317-1731


Medical Neglect of Federal Inmate with Muscular Dystrophy


Jeffrey Johnston Reg# 97497-071
Estill FCI, P.O. Box 699
100 Prison Road
Estill, SC 29918


Jeffrey Johnston (male) #97497-071, DOB 9-23-61, is incarcerated at Estill FPC in still, South Carolina. Jeff has been incarcerated since January 2002. His initial custody location was FMC Butner. Jeff is confined to a wheel chair.

Jeff has Limb-Girdle Muscular Dystrophy (MD), which was diagnosed by doctors at the Mayo Clinic in 1994. In addition to the MD, in the early 1990s Jeff was diagnosed with a lipid related metabolic myopathy by doctors at Presbyterian Hospital in New York. At FMC Butner Jeff was given MS Contin (morphine) for chronic pain management. In 2000, Jeff was in a severe automobile accident that left him with some cognitive deficits from the head injury, 17 major bone fractures below his waist, and multiple long bone fractures. Jeff also has hypertension. Throughout the 1990s and continuing up until his incarceration, Jeff was under the care of pain management specialists who prescribed pain control medications to be taken daily which included Oxycodone, Percocet, Nexium, Norvasc and Altace.

In a report prepared by a consulting forensic psychiatrist it is noted that Jeff suffers from chronic pain secondary to degenerative myopathic condition and complicating traumas that include closed head injury, retrograde nail in left and right femur, plate in left hip, pin in right ankle, esophageal spasms secondary to sternal injury, and depression. She reiterates what the doctors at Presbyterian Hospital and the Mayo Clinic previously stated and that is that Jeff will require for the rest of his life medication to handle the chronic pain as a result of these chronic conditions.

Jeff reports that he is not receiving the needed medications for his chronic conditions. The prison doctor, Zoltan Vendel, is not licensed to practice medicine in the state of South Carolina. The South Carolina Medical Board verified this. Jeff indicates that this doctor appears to have no understanding of the complexities of his medical condition. Vendel recently told Jeff his muscle enzymes (CPK or creatine Kinase) level was 22,8000. Muscle enzymes should be no higher than 220 which means Jeff's are 111 times beyond normal. This elevation of muscle enzymes is called myoglobinuria and occurs when too much myoglobin is in a person's system. Myglobin elevation can clog the kidneys and result in acute renal failure. Elevated muscle enzymes directly affect the liver enzymes also. The elevated liver enzymes will cause liver damage, producing cirrhosis type hardening of the large and small lobes of the liver. The kidney problems are allowing fluid to buildup in Jeff's body, most significantly in his lungs. This fluid buildup will result in Adult Respiratory Distress Syndrome that is fatal in 85% of cases like Jeff's.

We have only limited information on Jeff's current medical situation due to the barriers federal inmates face in accessing help from the outside world (300 minute per month phone limit), their fear of reprisal and the failure of a prison healthcare service to provide appropriate treatment. Jeff has requested his a copy of his medical records from the BOP's medical staff, but those records have not been forthcoming.

We do know that Jeff is currently experiencing severe kidney pain and bilateral weakness in all muscle groups. He has been to sickcall every day requesting that the medical staff do something to help him. The BOP medical staff's response is that they will check his blood levels again in 30 days. Jeff is very knowledgeable about his medical conditions, so he has expressed his concerns to Vendel telling him that the edema and enzyme elevation are putting him at risk of a stroke or heart attack. Jeff's legs are now swollen to abnormal proportions. Jeff's very life is in grave jeopardy.

Federal CURE in no way condones criminal activity, however, we believe that the neglect of any inmates' medical needs, particularly where it may result in death or unnecessary pain or suffering, is a serious breach of the federal government's responsibility as well as a serious breach of the inmate's human rights. This deliberate indifference to Jeff's medical needs clearly contravenes key international human rights conventions and the BOP's own Healthcare Rights and Responsibilities statement found in Program Statement 6000.05.

The International Human Rights Convention, Principles 9 and 24 of the Body of Principles for the Protection of All Persons Under Any Form of Detention or Imprisonment sets forth the standards for inmate medical care that are relevant to Jeff's medical care or rather the lack thereof. These principles provide that imprisoned persons shall be given medical care and treatment whenever necessary.

According to the Federal Bureau of Prisons' Health Services Manual, the mission statement of the Bureau Health Services Division is as follows: "The health care mission of the Federal Bureau of Prisons is to provide necessary medical, dental, and mental health services to inmates by professional staff, consistent with acceptable community standards." This claim stands in start contrast to the callous and deliberate indifference combined with gross negligence of the FPC Estill medical department in the case of Jeffrey Johnston. Jeffrey is currently experiencing inhumane punishment which could result in his death in custody. This situation is unethical, unprofessional and unacceptable.

The Federal Bureau of Prison's Inmate Health Care Rights and Responsibilities found in Program Statement 6000.05, state as follows:

  • Item 4 - You have the right to know the name and professional status of your health care providers.

  • Item 5 - You have the right to be treated with respect, consideration and dignity.

  • Item 6 - You have the right to be provided with information regarding your diagnosis, treatment and prognosis.

  • Item 8 - You have the right to obtain copies of certain releasable portions of your health record.

  • Item 10 - You have the right to receive prescribed medications and treatments in a timely manner, consistent with the recommendations of the prescribing health care provider.

Jeff's reality is:

  • Item 4 - He was not made aware that the doctor treating him is unlicensed.

  • Item 5 - Jeff has been treated with disdain by the medical staff. His condition is going untreated. His life has been placed in eminent danger as a result of the medical staff's deliberate indifference to his medical needs.

  • Item 6 - Although, Dr. Vendel told Jeff about his elevated enzyme levels, he subsequently refused to provide the treatment ordinarily provided to a person in Jeff's condition who is not incarcerated. Vendel's treatment of Jeff in no way conforms to a reasonable standard of care, as one would receive in the community in which the prison is located. By law, health care services must be provided to inmates at a level comparable to health care provided in the community or else their negligence meets the courts standard of deliberate indifference.

  • Item 8 - Jeff has submitted repeated requests for copies of his medical records so that he will know exactly what the BOP has to say about his medical condition. At FMC Butner, Jeff was being treated appropriately, but when he was transferred to FPC Estill, for all practical purposes, the FPC Estill medical staff ignored the treatment regime established at FMC Butner. The FPC Estill medical staff has refused to treat Jeff even to the extent of providing consistent care at the level he was receiving and that was prescribed by the medical staff at FMC Butner who did the medical intake screening at the beginning of Jeff's incarceration.

  • Item 10 - Jeff is not receiving the medications that were prescribed for him prior to his transfer to FPC Estill. The FPC Estill medical staff is showing deliberate indifference by ignoring the assessment of their colleagues done at FMC Butner.


Contact some or all of the officials listed below expressing concern that:

1. Inmate Jeffrey Johnston #97497-071 at FPC Estill in Estill, South Carolina is not receiving appropriate care for his numerous chronic medical conditions;

2. He has not been seen by either a pain management specialist or a neurologist, both of whom are critical to the management of his conditions;

3. Jeff is suffering severe pain and discomfort that is unnecessary and rises to the level of deliberate indifference and results in what amounts to inhumane punishment;

4. Jeff may be at imminent risk of death in custody as a result of FCP Estill's deliberate indifference to his medical needs that rises to the level of gross medical neglect.

Request urgent intervention for Jeff to ensure that:

1. Jeff is immediately examined by an independent medical specialists including a neurologist and pain management specialist, to assess and treat his conditions;

2. Jeff is immediately provided with all testing, treatment, medication, and any other medical recommendations made by these independent medical specialists;

3. Federal Bureau of Prison officials investigate and correct the violations of their own policies and procedures set forth in the Program Statements that ensure prompt, consistent, competent medical care for all inmates;

4. Federal Bureau of Prisons is reminded of the need to provide medical treatment in a prompt, professional and non-discriminatory manner to inmates regardless of the reason for or duration of their incarceration, and;

5. There is an investigation into the conduct of all FPC Estill medical staff that has been involved in the refusal of appropriate medical treatment to Jeff in contravention of community standards for medical care, international human rights conventions, and the Bureau's own policies;

6. Regional Office of the Bureau of Prisons in Atlanta, Georgia, take immediate responsibility for assuring that Jeff receive the same standard of care in FCP Estill that he would receive if he were an unincarcerated member of the Estill, SC community.


1). Please forward your concerns to some or all of the following: Note that they are ranked in order of priority. If you intend to send copies of your letters to journalists or members of Congress, please indicate to the government officials that you are doing so. Many of these action targets have e-mail, so you can contact them quickly and without charge.

Gerado Maldonado, Warden
Estill FCI
100 Prison Road
P.O. Box 699
Estill, SC 29918

Ph. 803-625-4607
Fax: 803-625-5635

Joe Kelley, Camp Administrator
Estill FPC
P.O. Box 699
Estill, SC 29918

Ph. 803-625-4607
Fax: 803-625-5635

R. Holt, Regional Director
Southeast Region
3800 North Camp Creek Parkway, SW
Building 200
Atlanta, GA 30331

Ph. 678-686-1200
Fax: 678-686-1229

MaryEllen Thoms, Assistant Director
Health Services Division
Federal Bureau of Prisons
320 First St. NW
Washington, DC 20534

Ph. 202-307-3055
Fax: 202-307-0826

Newton E. Kindig, M.D.
Medical Director
Federal Bureau of Prisons
320 First St. NW
Washington, DC 20534

Ph. 202-307-3055
Fax: 202-307-0826

Dr. Kathleen Hawk Sawyer, Director
Federal Bureau of Prisons
320 First St. NW
Washington, DC 20534

Ph. 202-307-3250
Fax: 202-514-6878

2). Send copies of your letters to the media. Letters to the media must contain your name, address, phone number and e-mail address.

The Post and Courier
Barbara Williams, Editor
134 Columbus Street
Charleston, SC 29403


3). Send copies of your letters to the South Carolina authorities governing licensing of doctors in South Carolina. If you use e-mail do not send attachments paste your letters into the body of the message.

South Carolina Board of Medical Examiners
P.O. Box 11289
Columbia, SC 29211

Ph. 803-896-4500
Fax: 803-896-4515

4). Send copies of your letters and any replies you receive to Federal CURE at:

Federal CURE, Inc.
P.O. Box 153
Reynoldsburg, OH 43086-0153

5). Send Jeff an encouraging card or letter to let him know that people are aware of his situation and care about him. You can also e-mail his mother, Gayle Johnston, copies of your letters. Gayle3@ftc-i.net

Jeffrey Johnston
Estill FCI
P.O. Box 699
100 Prison Road
Estill, SC 29918

6). Post this urgent alert to any other relevant lists, groups or individuals.

7). Visit our website at www.fedcure.org and learn more about Federal CURE's advocacy work on behalf of federal inmates and their families. You can help us assist federal inmates by becoming a member of Federal CURE. Membership information is available online at www.fedcure.org or by contacting us at Federal CURE, Inc., P.O. Box 153, Reynoldsburg, OH 43068.

Thank you for your help with this action alert.