As medical director of Orleans Parish Prison (OPP), I would like to respond to the Gambit article concerning the care of HIV-infected inmates at OPP ("Released in the Night," Dec. 10). The article contained numerous falsehoods and misrepresented the quality of medical care delivered at the jail. The inmate in question, "Robert," was incarcerated on Dec. 18, 2001. He had not picked up his medications for more than two months prior to being arrested and was suffering from end-stage AIDS. Over the next 11 months, Robert was seen by a physician 30 times. Twelve of these appointments were with an HIV specialist. Moreover, he was also taken to Charity Hospital's HIV clinic on five occasions for care. In addition, Robert resided in the jail's HIV Specialty Unit and received daily attention from nurses specializing in HIV care.

Robert's medical treatment at OPP significantly exceeded community standards, and his condition improved dramatically during his incarceration. He gained substantial weight, and intensive medical therapy was reestablished. The article alleges that OPP "dumped" a debilitated patient onto the streets of New Orleans. That is completely untrue. At the time of his release on Nov. 7, 2002, Robert showed no signs of debilitating illness. OPP routinely transfers impaired patients to the Charity Emergency Room when they are released from jail. This practice would have been followed had Robert shown significant distress. Furthermore, Robert's bed was less than 100 feet from the nurse's station yet he did not request help at the time of release. Also, numerous telephones are available in the release area, and Robert could have called family for assistance. Clearly, Robert had ample opportunities to obtain aid.

The article also focused on HIV case management at the jail. HIV is an enormous problem for city jails. Nearly one-quarter of people with HIV pass through a correctional facility each year. OPP has an aggressive, top-notch, HIV program (superior to any I've encountered elsewhere in correction). This program costs more than $1 million annually. The jail also provides case management for incarcerated patients, linking those with HIV to community resources. Unfortunately, no state or federal monies are available to support our efforts. OPP has met with the New Orleans AIDS Planning Council, the city's Office of Health Policy and the Grace Project in an attempt to obtain additional funding and expand transitional services. At this time, no such funds are available. The jail will continue to provide quality health care while exploring ways to increase case-management services.
--R. Demaree Inglese, MD

Medical Director, OPSCO

KATY RECKDAHL RESPONDS: I stand by my story. The story centered around the accusations made by Robert's family -- that OPP released a seriously incapacitated inmate just before 1 a.m. on Nov. 7. I also reported the independent account of Octavia Henry, a nightshift waitress who saw Robert lugged into her restaurant by another newly released inmate within one hour of his release from OPP.

Robert's family has requested medical records but has not yet received them, and so I cannot fully verify Inglese's statements about Robert's overall medical care. I also can't check anything with Robert himself because he died on Christmas Day.

Much of what Inglese cites in his letter was included in the story. I reported that Robert had been seen by a doctor 30 times, 12 of those visits by an HIV specialist. The data that Inglese cites about the growing burden of HIV-positive patients on jails nationwide was also in the story.

I did not know the $1 million annual figure that he cites -- even though I asked for that very number from Sheriff Charles Foti in my telephone interview with him for this story. Inglese knows that I made this request because he told me later he was listening, unannounced, to that phone call.

During that interview with Foti, I asked about the growing number of inmate HIV cases and its effect on the OPP budget. I asked about studies showing that inmates have HIV-AIDS rates between 5 and 10 times higher than the general population. I asked about available monies like Ryan White HIV-AIDS funds. I have no doubt that Inglese knows specific answers to those questions. But I did not receive those answers from him. That's because, unlike many city jails across the nation, OPP does not have a press policy that allows reporters, upon request, to speak with OPP staff and inmates. Instead, all information comes from the sheriff.

Foti has tremendous responsibilities as head of a 6,000-person facility. I would not expect him to render medical opinions any more than I would expect him to know the ingredients of everything served from the OPP kitchens. Nor would I expect him to be an expert on the cases of all of the inmates he holds. That's why it would be helpful if reporters like me could speak with his expert staff and his inmates -- in order to convey more first-hand information to the public.

I expressed interest in interviewing OPP medical staff and observing them at work, something Inglese invited me to do -- but only if he and Foti were able to view the story prior to publication. Gambit Weekly, like most newspapers, cannot make such an exception to its long-established editorial policy.

Within the next few months, according to the American Correctional Association (ACA), their auditors will be visiting OPP to determine whether the prison's medical care qualifies for ACA accreditation. Shortly after that visit, the auditors will issue a private report to the prison. I would encourage Foti and Inglese to share the entire contents of that report with the public, in an effort to better convey the accomplishments -- and ongoing challenges -- of the OPP medical staff.

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