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Former California Prison Doctor Admits Negligence, Gets Probation; CDCR Medical Care Issues Still Unresolved

by John E. Dannenberg

Dr. Bonifacio Esperanza, a physician formerly employed by the California Department of Corrections and Rehabilitation (CDCR), was accused of gross negligence by the Medical Board of California for his alleged mistreatment of seven prisoners at Centinela State Prison. The Medical Board filed a formal complaint against Esperanza in Administrative Law Court in July 2008.

Esperanza, 66, retired from the CDCR in 2007 pending termination proceedings; he is presently in private practice. He obtained his California medical license in 1980 following his graduation from Far Eastern University in the Philippines.

One of the Medical Board charges stemmed from a July 2006 case in which a 55-year-old prisoner complained of chest pain and shortness of breath. Even though a nurse gave him aspirin and oxygen, the prisoner’s electrocardiogram detected heart beat irregularities. Esperanza, who was on call, neither examined the prisoner nor sent him to an outside hospital for emergency care.

In a second case, Esperanza had removed a fistula from the buttocks of a 20-year-old prisoner but failed to provide follow-up treatment for four months despite the prisoner’s constant complaints. He never sent the prisoner to a surgeon; the prisoner subsequently developed an infection that spread throughout his lower body.

Other alleged negligent acts by Esperanza included prescribing antibiotics that were not justified and failing to order medical tests that were justified. He also failed to screen a prisoner for sexually transmitted diseases despite signs of infection.

On December 18, 2008, the Medical Board placed Esperanza on three years probation after he admitted providing negligent care to state prisoners. During his probationary term he cannot supervise physician assistants and must enroll in education classes on medical record keeping and prescribing drugs.

In an unrelated incident, six CDCR doctors at the Salinas Valley State Prison were named in a 31-count criminal indictment that was unsealed on November 25, 2008. The physicians, including Charles Lee, Randy Sid, Pedro Eva, David Hoban, Wade Exum and Mark Herbst, are accused of billing the state for medical services that were never provided to prisoners.

Louis Patino, communications director for the CDCR’s federal healthcare Receiver, stated “These are exactly the kinds of problems we are trying to fix.” The Receiver was appointed by U.S. District Court Judge Thelton E. Henderson to curtail cruel and unusual punishment resulting from grossly deficient medical care in the CDCR that was termed “broken beyond repair.” Although California has pledged $7 billion to build and upgrade prison medical facilities, none of that money has yet been allocated.

Healthcare Receiver J. Clark Kelso is demanding that $8 billion be released from the state treasury to commence such construction. After Kelso’s request for an initial $250 million down payment was refused by state officials, Judge Henderson threatened to hold Governor Schwarzenegger and the state controller in contempt. The California Attorney General’s office appealed to the Ninth Circuit, which intervened on November 7, 2008 and stayed Judge Henderson’s order pending further hearings by the appellate court. See: Plata v. Schwarzenegger, U.S.D.C. (N.D. Cal.), Case No. 3:01-cv-01351.

Even though the CDCR must answer to a federally-appointed healthcare Receiver, the California Court of Appeal recently held that prisoners may still maintain individual state court actions against negligent prison medical staff – which, given physicians like Dr. Esperanza, may be a necessary option. [See related article on In re Estevez, this issue of PLN].

Sources: San Diego Union-Tribune, Sacramento Bee

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