by Dale Chappell
Washington Department of Corrections (DOC) medical director, Dr. Julia Barnett, was terminated on April 18, 2019 because she “failed to exercise sound clinical judgment and failed to provide adequate medical care” to prisoners at the Monroe Correctional Complex (MCC), resulting in the deaths of several prisoners.
Barnett had been on paid leave since October 2018 while the DOC investigated her provision of medical treatment at MCC, which is the state’s third-largest prison. In November 2018, Barnett’s staff – two other doctors and several physician assistants and nurses – submitted a vote of “no confidence” and complained to administrators that she had created “a toxic environment” and appeared to make decisions “to reduce health care costs rather than for the benefit of the patient.”
After working for private medical provider Corizon Health in Arizona, Dr. Barnett, a former pharmacist, assumed the role of medical director at MCC in 2017 with a starting salary of $260,000. Although she did not have all the necessary credentials, DOC administrators made an exception, citing a shortage of doctors willing to take the job.
Barnett’s 27-page termination notice, which was obtained from her personnel file through a public records request, detailed a host of incidents where she failed to provide adequate medical care to prisoners at MCC. Some 2,000 pages of supporting records also were obtained from a July 2019 DOC investigation, in which other doctors reviewing her cases described the care provided or supervised by Barnett as “shocking” or “bordering on ... negligence.”
“I no longer trust your clinical judgment and ability to be responsible for the health and welfare of the patients at MCC,” DOC Health Care Administrator Eric Hernandez stated in the termination notice. “You failed to advocate for the patients and delayed emergency medical care that was essential to life.”
Medical records obtained by the Seattle Times showed that Dr. Barnett was notified by nurses that prisoners with serious medical problems in need of emergency care were ignored. One patient was described in a clinical record as saying, “I ... can’t ... breath[e].” Another, who stuck a pencil up his urethra into his bladder to relieve “an itch,” was refused treatment by Barnett. The nurses recorded her as saying, “Don’t do anything as long as he can urinate.” Five days later, the 41-year-old prisoner was rushed to the Providence Regional Medical Center for emergency surgery to repair his ruptured bladder.
“He needed emergency surgery. He could have gone into septic shock,” the DOC’s chief medical officer, Dr. Sara Kariko, told investigators after her review of the case records.
That prisoner lived but others weren’t as fortunate. The termination notice listed six patients under Barnett’s care, three of whom died. All six suffered unnecessarily due to a lack of medical treatment and, in some cases, improper care.
During the summer of 2018, prisoner Lee Johnson, who had been diagnosed with lung disease, experienced declining blood oxygen levels. When Dr. Kariko later reviewed the case records – which showed Barnett never examined the patient – she told DOC investigators that she’d “be calling an ambulance to come get” Johnson. The 58-year-old was finally sent to a hospital in late August 2018, where he died the following week.
Dr. Patricia David, the DOC’s medical director of quality and care management, told investigators in January 2019 that Barnett had failed to make “the right decision on several of these cases and that resulted in bad outcomes and even death.”
After the DOC completed its investigation it forwarded its report to the state’s Medical Commission, whose subsequent investigation widened to include four additional MCC prisoner deaths in 2017 and 2018.
Washington attorney Nick Allen, director of the Institutions Project at Columbia Legal Services, said that regardless of the crimes someone has committed, prisoners have a constitutional right to adequate healthcare.
“Poor medical care is not part of the punishment for a criminal conviction,” he declared. “When you show up at court for sentencing, the court doesn’t say, I sentence you to 10 years in a state prison and 10 years of poor medical care.”
Concluding the termination notice, DOC Health Care Administrator Hernandez wrote that Dr. Barnett’s actions demonstrated her “inability to perform” her duties as medical director. “Accordingly,” he added, “I have determined that discharge is the appropriate level of discipline. Any lesser sanction would not express the seriousness with which I view your misconduct, deter others, or maintain the mission, integrity and reputation of the agency.”
Through her attorney, Barnett said she is appealing what she called a “wrongful dismissal,” and argued her care for prisoners was proper, “particularly in this medical setting.” She remains licensed to practice in Washington while the Medical Commission’s investigation is pending.
A DOC spokesman said prisoners affected by poor medical care during Dr. Barnett’s tenure have not been notified of the investigative findings and her subsequent termination. But the department has already received legal claims related to Barnett, including a $1.5 million lawsuit alleging misdiagnosis and negligent treatment of diabetic lesions on a prisoner’s feet.
Sources: Washington DOC termination notice for Dr. Julia Barnett (April 18, 2019), seattletimes.com, injurytriallawyer.com
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