Dear CURE Members and Supporters:
is a copy of the letter that I have sent to Dr. Sawyer in regard
to Eduardo Mantilla, #14869-050. I have attached Federal CURE's
initial request for action on his behalf for your background information.
What Federal CURE needs you to do is to send follow up requests
to the following people asking that the BOP immediately provide
Eduardo Mantilla with the medical care he needs at Leesburg Regional
Medical Center, where he was receiving appropriate treatment for
his critical medical condition under appropriate FCI Coleman supervision.
The broader question that the BOP must begin to answer is who is
monitoring the quality of medical care that they are providing to
federal inmates in all their institutions. On a daily basis, Federal
CURE receives complaints from federal inmates about both the lack
of medical care and the poor quality of medical care in federal
institutions. Please contact the following people so that we can
assist all federal inmates in securing competent medical care:
Dr. Kathleen Hawk Sawyer - email@example.com
Dr. Newton E. Kindig - firstname.lastname@example.org
MaryEllen Thoms - email@example.com
Bryan Pownall - firstname.lastname@example.org
Christopher Erlewine - email@example.com
Carlysle Holder - firstname.lastname@example.org
Robin Cuffey - email@example.com
R.L. Matthews - firstname.lastname@example.org
Florida Medical Board - MQA_Medicine@doh.state.fl.us
CNN - email@example.com
Fox News - firstname.lastname@example.org
NPR, Talk of the Nation - email@example.com
Michelle Cohen - Michelle.firstname.lastname@example.org
Forbes - email@example.com
January 15, 2003
Dear Dr. Sawyer:
This letter is an initial inquiry in regard to Eduardo Mantilla,
Inmate #14869-050. On Monday, January 12, 2003, I received a copy
of a letter directed by Catherine M. Falkenberg to Captain Newton
E. Kending, II, MD regarding the medical treatment of her father,
Eduardo Mantilla, has been in the custody of the Federal Bureau
of Prison since 1991, has suffered two heart attacks, undergone
a six vessel coronary artery bypass, and is currently experiencing
chest pains and considerable shortness of breath. Dr. Garcia and
Dr. Kim at Leesburg Regional Medical Center examined Eduardo Mantilla
on Monday, January 6, 2003. The doctors performed three procedures:
left heart catheterization, left ventriculogram and thoracic aortogram.
The left heart catheterization determined: Caliber vessel with
a branching distal segment. The OM2 was 100% occluded. The right
coronary artery was diffusely degenerated and had severe obstructive
disease with a 40% proximal stenosis, 80% mid stenosis, and a 50%
mid to distal stenosis. There was diffuse degeneration throughout.
The PLV was a small caliber vessel with an 80% proximal stenosis.
The PDA had a diffuse 20% to 30% stenosis.
The saphenous vein graft to the distal circumflex was diffusely
degenerated with 10% to 20% diffuse luminal irregularities. There
was a 30% proximal stenosis of the PLV branch. The saphenous vein
graft to the RCA was occluded proximally. The LIMA was nonselectively
visualized, was patent, and was not used for bypass.
The left ventriculogram determined: The EF was 45% to 50% with
interior lateral kypokinesis. No mitral regurgitation.
The thoracic aortogram determined: There is an occluded saphenous
vein graft to the RCA.
These three procedures concluded the following:
1. Severe three vessel coronary artery disease.
2. Occluded saphenous vein graft to the RCA.
3. Patent, but degenerated saphenous vein graft to the distal circumflex
4. High grade 90% mid LAD stenosis involving the first diagonal.
5. Diffusely degenerated and diseased right coronary artery.
6. Overall preserved ejection fraction with inferior hypokinesis.
7. Mild aortic insufficiency.
8. Mildly elevated filling pressures at rest.
The specific recommendations by Drs. Garcia and Kim were as follows:
Recommend CT surgery consult for redo bypass surgery.
Rather than undergoing the recommended medical procedure, Eduardo
Mantilla was sent back to FCC Coleman without further medical treatment.
As of, Tuesday, January 14, arrangements had not been made to initiate
the proper medical care he urgently needs.
According to the FBOP Clinical Guidelines for the Management of
Coronary Artery Disease (Sept. 2001), Eduardo Mantilla is an inmate
with “high to intermediate risk for an acute MI or sudden
death and should be aggressively managed as having significant risk
for an evolving MI and transferred to a community hospital setting
in a timely manner,” (page 15). This proper and urgent measure
had not been taken as of Tuesday, January 14, 2003 when Eduardo
Mantilla last called his daughter, Ms. Falkenberg. Ms. Falkenberg
was not able to secure from the medical personnel at FCI Coleman
assurance that she would be notified when her father’s surgery
was scheduled. She was simply told that next of kin would not be
notified in case of a “routine medical procedure”. Further,
Ms. Falkenberg was directed to speak with Mr. Brian Pownall, Chief
Nurse Jan Ulston, Ms. Whitock and Mr. DeJesus at Coleman, none of
whom provided an informative response.
In a call to Ms. Liz Nagy on January 14th, Ms Falkenberg was informed
that the Medical Director’s Office had made the decision not
the transfer Eduardo Mantilla to a Federal Medical Center since
the resources were available in the community to perform the necessary
surgery. No additional information on a set surgical appointment
had been established.
Although it is true that federal prisoners forfeit many of their
pre-conviction constitutional rights upon entering prison, “the
one right they do retain, under the Eighth Amendment, is the right
to be protected against cruel and unusual punishment.” Bell
v. Wolfish, 441 US 520 (1979). In Wolf v. McDonnell, 418 US 539
(1974); the Court stated that there was “no iron curtain drawn
between the Constitution and the prisons of this country.”
Two years later, the Court stated “an inmate must rely on
prison authorities to treat his medical needs; if the authorities
fail to do so, those needs will not be met. In the worst cases,
such a failure may actually produce physical torture or death.”
Estell v. Gamble, 429 US 97 (1976). In Gregg v. Georgia, 428 US
153 (1976), the Court held that the “infliction of such unnecessary
suffering [is] inconsistent with contemporary standards of decency.”
When the Court set forth its “deliberate indifference”
standard in Gamble it was addressing the degree of indifference
that resulted in unnecessary infliction of pain.
Unarguably, the directives contained in the BOP healthcare policy
statements appear to rise to the level of humane treatment mandating
the provision of necessary medical care at levels comparable to
accepted community standards. BOP Program Statement 6000.05 assures
humane treatment of prisoners, yet in reality healthcare at FCI
Coleman appears merely symbolic in nature. The vast divide between
BOP healthcare policy and the reality of healthcare provided by
FCI Coleman medical staff contravenes both Supreme Court rulings
and congressional mandates. Given the paucity of medical care being
provided Eduardo Mantilla, one could easily conclude that the BOP
operates a symbolic healthcare system.
Although quick to hide behind the U.S. General Accounting Office
report when reducing inmate phone calls to 300 minutes per month,
clearly the BOP ignores a 1994 report by that same office that describes
the inadequate healthcare system available to federal prisoners.
Are we to conclude then that the BOP places more importance on limiting
criminal conduct via inmate phone calls than it does on the healthcare
needs of federal inmates?
Recognizing that accountability of prison medical personnel has
become a pervasive issue; some federal courts have recently limited
the defense of qualified immunity where prison officials should
reasonably know that their actions are violating an inmate’s
constitutional rights. The Seventh Circuit recently held that Dr.
Ivy Benjamin, Dr. Adrian Feinerman, Dr. Ansar Ansari, Dr. Virgilio
Pilapil, Nurse Pamela Dunbar and Nurse Vickie Rowland were “deliberately
indifferent” when Inmate Walker repeatedly complained of pain
and manifested physical indications that he was in pain. The Walker
court clearly indicated that the deliberate indifference standard
was applicable to pain medication. Perhaps, the medical staff at
FCI Coleman is not aware that they can now be found personally liable
for their deliberate indifference.
The bottom line is how much longer must Eduardo Mantilla suffer
because of the deliberate indifference of FCI Coleman’s medical
personnel? That’s a question that Federal CURE cannot answer.
The answer lies solely in the control of the Federal Bureau of Prisons.
The liability lies solely with FCI Coleman’s medical personnel
and the BOP personnel under whose supervision they work which include
Camp Administrator Cuffey, Warden Holder, Regional Administrator
Matthews, Medical Director Dr. Newton Kindig, Assistant Director
of the Health Services Division MaryEllen Thoms, and ultimately,
with Federal Bureau of Prisons Director Dr. Kathleen Hawk Sawyer.
FCI Coleman’s medical personnel have not followed appropriate
recommendations. On January 6, 2003, the treating physician at Leesburg
Regional Medical Center recommended that Eduardo undergo “CT
surgery consult for redo bypass surgery.” We are requesting
that Eduardo Mantilla be immediately transferred via an emergency
medical transport to Leesburg Regional Medical Center for the recommended
treatment, and any other necessary and appropriate treatment.
Karen S. Bond, J.D.