Date of Alert: January 15, 2003

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
director@fedcure.org

ISSUES:
Medical Neglect of Federal Inmate with Coronary Artery Disease

INMATE:
Eduardo Mantilla, Reg #14869-050
Coleman Med FCI, P.O. Box 1032
846 N.E. 54th Ter.
Coleman, FL 33521-1032

BACKGROUND:
Eduardo Mantilla (male) #14869-050, DOB 10/04/37, is incarcerated at Coleman Med FCI in Coleman, Florida. Eduardo has been incarcerated since May 1991.

Eduardo has Coronary Artery Disease. Since his incarceration in 1991, he 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 PLV branch.
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, he was sent back to FCI Coleman without further medical treatment. As of, Monday, January 13, he has not been transferred to a facility where the proper medical care he urgently needs can be provided.

According to the FBOP Clinical Guidelines for the Management of Coronary Artery Disease (Sept. 2001) Eduardo 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.” (See page 14-16 of the above underlined document). This proper and urgent measure had not been taken as of Monday, January 13, 2003 when Eduardo’s daughter last spoke with medical personnel at FCC Coleman. Calls by Eduardo’s daughter to the Federal Bureau of Prisons have not generated any response. His daughter was unable to secure from the medical personnel at FCI Coleman assurances that the family would be notified when Eduardo’s surgery was scheduled. His daughter was simply told that next of kin would not be notified in case of a “routine medical procedure”.

We have only limited information on Eduardo'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. We do know that Eduardo 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 Eduardo'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 Eduardo'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 stark contrast to the callous and deliberate indifference combined with gross negligence of the FCI Coleman medical department in the case of Eduardo. Eduardo is currently experiencing inhumane punishment which could result in his death in custody. This situation is unethical, unprofessional and unacceptable.

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

1. Inmate Eduardo Mantilla #14869-050 at Coleman Med FCI in Coleman, Florida is not receiving appropriate care for his critical medical condition;
2. Eduardo is suffering severe chest pain, difficulty breathing and discomfort that is unnecessary and rises to the level of deliberate indifference and results in what amounts to inhumane punishment;
3. Eduardo may be at imminent risk of death in custody as a result of FCI Coleman's deliberate indifference to his medical needs that rises to the level of gross medical neglect.

Request urgent intervention for Eduardo to ensure that:

1. Eduardo is immediately provided with all testing, treatment, medication, and any other medical recommendations made by medical specialists;
2. 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;
3. 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;
4. There is an investigation into the conduct of all FCI Coleman medical staff that has been involved in the refusal of appropriate medical treatment to Eduardo in contravention of community standards for medical care, international human rights conventions, and the Bureau's own policies;
5. Regional Office of the Bureau of Prisons in Atlanta, Georgia, take immediate responsibility for assuring that Eduardo receive the same standard of care in FCI Coleman that he would receive if he were an unincarcerated member of the Coleman, FL community.

WHAT YOU CAN DO TO HELP EDUARDO
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

Mr. Carlysle Holder, Warden Coleman Med FCI 846 N.E. 54th Ter. P.O. Box 1032 Coleman, FL 33521 Ph. 352-330-3200 Fax: 352-330-0552 cholder@bop.gov	Robin Cuffey, Camp Administrator Coleman Med FCI 846 N.E. 54th Ter. P.O. Box 1032 Coleman, FL 33521 Ph. 352-330-3200 Fax: 352-330-0552 rcuffey@bop.gov
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 rholt@bop.gov	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 mthoms@bop.gov
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 nkindig@bop.gov	Dr. Kathleen Hawk Sawyer, Director Federal Bureau of Prisons 320 First St. NW Washington, DC 20534 Ph. 202-307-3250 Fax: 202-514-6878 ksawyer@bop.gov

Bryan Pownall, Executive Asst.
bpownall@bop.gov

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

NBC, Michelle Cohen Michelle.cohen@nbc.com	FOX News, At Large with Geraldo Rivera atlarge@foxnews.com
NPR, Talk of the Nation totn@npr.org	CNN public.information@turner.com

3. 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
director@fedcure.org

4. Send Eduardo 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 daughter, Cathy Falkenberg, copies of your letters.

Eduardo Mantilla, #14869-050
Coleman Med FCI
P.O. Box 1032
846 N.E. 54th Ter.
Coleman, FL 33521

Cathy Falkenberg
cfalkenberg@attbi.com

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

6. 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 (select "Join Now") or by contacting us at: Federal CURE, Inc., P.O. Box 15667, Plantation, Florida 33317-1731.

Thank you for your help with this action alert.