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Georgia Prison Doctor Rewarded for Cutting Costs as Prisoners Died Under His Care

by David M. Reutter

In September 2015, a Georgia prison doctor was fired for lying on his employment application. The misrepresentations were uncovered earlier that year during an investigation by the Atlanta Journal Constitution (AJC) into the deaths of nine female prisoners under the doctor’s care. He was cited in a report for providing substandard treatment – as a direct result of which two women died. But a loophole in state law prevented the state medical board from disciplining him, and he now has an application to practice medicine pending in New Jersey.

The AJC investigation found that Dr. Yvon Nazaire had neglected prisoners in obvious distress and regularly canceled requested outside consultations. Prison officials ignored repeated red flags about Nazaire’s care of prisoners and even applauded his ability to control costs by giving him a pay raise.

Nazaire moved to Georgia in 2006 following a 20-year career as an emergency room physician in New York. When the Haitian-born doctor left, he had served less than a year of a three-year probation sanction imposed after being cited for gross negligence in the treatment of five ER patients; in one of those cases he failed to diagnose a 28-year-old patient’s heart attack, resulting in the patient’s death. The sanction required that his practice be monitored by a state-approved physician.

Typically, a doctor who relocates to Georgia while under a disciplinary order in another state would receive a similar sanction on his Georgia license. But the medical board didn’t take that step with Nazaire, granting him a license with no restrictions. He was hired to work for Georgia Correctional HealthCare (GCHC), the branch of Augusta University that employs and oversees physicians for the Department of Corrections (DOC), as the medical director at Pulaski State Prison, a facility that houses 1,200 female prisoners.

He held that position for nine years, often receiving praise from his supervisors for his ability to rein in expenses by limiting outside medical consultations. But the AJC’s reporting cast serious doubt on Dr. Nazaire’s competency as well as the university’s decision to hire him. The newspaper described how at least nine women prisoners under his care died under questionable circumstances. It also found that he had lied about his employment history on the résumé submitted when he was hired.

The news coverage prompted Augusta University, then known as Georgia Regents University, to appoint one of its most respected administrators, Dr. William Kanto, to look into the allegations. Kanto’s review led to Nazaire being fired for misrepresenting his work history, as well as a report on the medical care he provided to prisoners. Kanto, who has served as the chief medical officer for the university’s health system as well as the medical director for Children’s Hospital of Georgia, determined that three of the nine prisoners whose deaths were reported by the AJC received treatment that fell below “community standards.” Most significantly, two had died as a result of Nazaire’s inadequate care, he determined.

When obtaining his medical license in February 2006, Dr. Nazaire misled the Georgia Composite Medical Board by failing to report a $3 million malpractice award against his New York license for the 28-year-old ER patient’s death. He also lied on his GCHC application by falsely stating he was an attending physician in the emergency room of three New York hospitals at the time. Yet in a personal bankruptcy case, Nazaire submitted a petition that said he had been unemployed for seven months.

The GCHC hired Nazaire in August 2006 as medical director at the Pulaski State Prison, and in April 2011 he assumed the position of medical director at the Emanuel Women’s Facility. Prison officials praised Nazaire.

“I never had a problem with him,” said former Emanuel warden Alexis Chase. “In fact, he was one of the best prison doctors I worked with in my prison career.”

A May 2007 performance review noted that Nazaire had “dropped the [outside] consult rate to [a] low number thus keeping Pulaski below budget.” Another evaluation in 2010 said he used “new data from the medical world” to “better manage the medical problems of the inmates thus saving GCHC and [DOC] ... money.”

Five months after two prisoners died, Pulaski health services administrator Betty Rogers sent an email to Dr. Edward Baily, then the statewide medical director for GCHC, urging that Dr. Nazaire receive a raise from his current $168,300 annual salary.

“He is saving the [DOC] so much money and goes above and beyond any other physician in the system,” Rogers wrote.

At the time of the AJC’s investigation, Nazaire was earning $174,300 a year.

But some of his fellow medical professionals were so concerned with the care he provided to prisoners that they began raising red flags.

Advanced practice nurse Marilyn Ringstaff was scheduled to work at Pulaski for three months in the summer of 2011. But she was fired after two months when she complained that Nazaire had rejected her requests to have several seriously ill patients consult with outside specialists. Two of those prisoners eventually died.

Ringstaff sent emails to Chase and Bailey to warn them Dr. Nazaire was creating a dangerous environment. Chase, however, said Ringstaff was a troublemaker who was “overstepping her boundaries, [acting] like she was a physician.” Ringstaff recalled that Nazaire had told her, “You are never, ever to call Dr. Bailey about anything, ever.”

Dr. William Thorneloe, a psychiatrist, ran into problems with Dr. Nazaire over the treatment of prisoners who engaged in self-harm behavior. Nazaire wanted them placed in segregation while Thorneloe sought to have them housed in the infirmary.

“The whole thing made no sense to me,” said Thorneloe. “I was very worried about [the] safety of patients going into that situation.”

The women prisoners under Nazaire’s care paid a high price for his negligence and cost cutting. Mitzi Butler, for example, was denied a consult for an X-ray as she suffered severe abdominal pain.

“It took me being unable to get out of bed at inspection to get to the hospital,” she said.

Emergency surgery revealed that her appendix had essentially “dissolved”; she spent a week in the hospital to recover from an infection.

When Diane Blalock entered Georgia’s prison system in June 2011, she suffered from hepatitis C that could not be treated with medication. Under Nazaire’s care her condition quickly deteriorated.

“You’d have to be blind [not] to see it,” said former prisoner Billie Duke. “Her skin, her eyes ... at the end she couldn’t get out of bed.”

“From the time she got [to the Emanuel Women’s Facility], it was like a snowball rolling downhill,” added Joe Blalock, Diane’s brother. He said she was “yellow as a banana” when he saw her at the hospital.

Prisoner Peggy Leifh Walker was also denied a consult with an outside specialist despite having a distended stomach that made her appear pregnant. She was not taken to a hospital until she experienced heavy vaginal bleeding two weeks before her death. Walker was diagnosed with cancer when 4.8 liters of fluid – more than a gallon – was removed from her abdomen at the hospital.

The AJC also reported other cases of medical neglect and malpractice at the hands of Dr. Nazaire. One prisoner’s attorney, Steve Lanier, sought an answer that may never be fully known: “My question is, how many lives were lost because of inaction?”

In April 2017, eighteen months after Nazaire was fired, his negligence claimed another life. Kimery Finger, 52, a former prisoner at the Pulaski State Prison, died of complications from diabetes. Her right leg had to be amputated below the knee after a cut on her toe was allowed to fester while she was incarcerated. Her attorney, who had already filed notice of intent to sue the DOC and GCHC for malpractice, filed a new notice to sue on behalf of Finger’s family for her wrongful death.

Despite the body count he left behind in Georgia prisons, Nazaire is off the hook with the state’s medical board. In January 2017, before the board could complete its investigation, Nazaire let his license expire – putting him out of the board’s reach. Georgia does not retain disciplinary authority over a medical professional after his license lapses.

“My reaction is outrage,” said Terri Trask, whose sister, Sherri Cavender, died of cancer that went undiagnosed for months at Pulaski. “Just because his license expired, why can’t you take disciplinary action? He shouldn’t get off scot free. He neglected these people.”

In an AJC interview, the medical board’s executive director, Bob Jeffery, and his chief deputy, Karl Reimers, said they understand how the result could be seen as unsatisfactory. However, when a physician is no longer licensed the board has no jurisdiction, they said.

“There was nothing more the board could do,” Reimers stated. “The board can’t step in and suspend somebody’s license that’s already lapsed.”

The website for the New Jersey Division of Consumer Affairs, the umbrella agency for the state’s licensing boards, currently indicates that Dr. Nazaire’s license to practice in that state is “pending” but offers no other details. A spokesman for the agency did not respond to an email from the AJC seeking comment on the vetting of Nazaire’s license.

Although Nazaire is out of the reach of Georgia’s medical board, he is still being pursued by attorneys in the state. At least three lawsuits over his treatment of prisoners have been filed since 2015.

Attorney Brandon Taylor deposed Dr. Nazaire in March 2017. Now living in New Jersey, Nazaire testified that he was unaware of Kanto’s recommendation that he be permanently barred from treating Georgia prisoners. In fact, he said he had no idea who Kanto was, and also claimed he was unaware that his Georgia medical license had expired.

“I’m licensed in Georgia, I’m licensed in New York and I’m applying now for my license in New Jersey,” he testified.

Taylor, whose client Kari Quinn alleges she suffers from permanent vision loss in her right eye because Nazaire did not properly treat her at Pulaski State Prison, said he was “terrified” when he heard the doctor said he was seeking a license in New Jersey.

“Based on what’s out there in the public domain, it’s difficult to understand how this guy could apply to any medical board for a license,” he stated. 

Source: Atlanta Journal Constitution


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