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Rikers Island Detainees Given Pricey Weight-Loss Surgery but Little Follow-Up Care

From New York City’s Rikers Island jail complex, detainee David Mustiga, 43, was transported to the city’s Bellevue Hospital in February 2023, after a jail medical staffer told him he could trim his 300-pound weight with bariatric surgery. Mustiga thought he was going in for a pre-operative visit, only to be locked in the hospital’s prison ward and put on a liquid diet.

A fellow Rikers Island detainee he met there, Luis Perez, had the surgery first. When he returned from the operation, describing incredible pain, Mustiga attempted to back out. But he ultimately succumbed to a doctor’s hard sell that this was his “last shot.” However, he said no one told him that recovery is difficult even for those not incarcerated, like him, with little say in what food he was served or when he ate it.

One in five surgeries performed at the hospital is now a bariatric procedure for weight loss—including Mustiga and Perez’s, plus those of at least eight other Rikers Island detainees. For them, as for many other Bellevue patients, the expensive elective surgery is funded by Medicaid. But so is most other medical care that detainees need, yet they are forced to see jail healthcare providers from whom they routinely struggle to get even the most basic attention.

Bellevue spokesman Christopher Miller said Rikers patients undergo screening and assessment for surgery “like all others,” insisting they are kept at the hospital afterward until ready for jail food again. But bariatric surgery patients are told to eat frequent small meals rich in protein, which isn’t an option at the jail. Most other post-operative instructions seem equally out of the question, like eating nonfat Greek yogurt, drinking eight daily glasses of Crystal Light or taking a Zumba exercise class.

Mustiga traded cigarettes with other detainees for protein powder, yet he still became malnourished and anemic, dropping weight at an unhealthy rate—100 pounds in six months—as his hair fell out in patches. Perez was transferred to a state prison, where he also worried about his protein intake, as well as frequent vomiting. Plus, with less body mass, he was targeted and badly beaten in October 2023 by fellow prisoners who stole his stockpile of protein powder.

Because the surgery shrinks a patient’s stomach, it can leave lingering problems with cramps and acid reflux. So most doctors will not perform it until patients have tried and failed less invasive measures to reduce body weight. Yet Bellevue patients report getting a surgery date after just one consult with a doctor lasting perhaps 10 minutes.

Why? Probably because Medicaid reimburses the procedure at a rate of $11,000. For the hospital, those 10 Rikers Island detainees represented $110,000 in revenue. Plus, with their poor healthcare back at the jail, the hospital runs a low risk of liability for any post-operative complications they may suffer. PLN has reported how prisoners are sometimes used as medical guinea pigs. [See: PLN, Nov. 2022, p.60.] They may also now look like a cash cow to yet another group of prison profiteers, this one wearing scrubs and stethoscopes.  


Source: New York Times

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