What you should know
- Michael Salvana, a doctor who worked for the New York prison system, sued the agency on the grounds that he was forced to resign and faced harassment for seeking proper care for his patients.
- What is at stake is a policy change the system made five years ago to increase oversight at a time of heightened concern over the over-prescribing of painkillers in prisons.
- The lawsuit filed last month claims the state prison agency violated Salvana’s rights to speak out against the policy.
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NEW YORK – A former doctor in the New York prison system, who opposed the crackdown on prescription drug abuse, sued the agency because he said he was forced to resign and faced harassment for seeking adequate care for his patients. .
What is at stake is a policy change the system made five years ago to increase oversight at a time of heightened concern over the over-prescribing of painkillers in prisons. Some critics, including the plaintiff, physician Michael Salvana, argue that the new restrictions have left patients with conditions ranging from multiple sclerosis to spinal injuries suffering unnecessarily.
The lawsuit filed last month in federal court in upstate New York claims the state’s correctional agency violated Salvana’s rights to speak out against the policy. Salvana said that “inhumane” interference by his superiors in the care of his patients caused him to leave his role as director of facilities in the center of New York at the Walsh Regional Medical Unit in Rome, New York, which has 125 beds for inmates. with complicated medical needs.
“It was very depressing,” Salvana said in an interview. “It is depressing to see these patients and to know that nothing can be done to change it. You are fighting a battle that you essentially cannot win. It was very depressing, and as a result, I couldn’t see it anymore. “
A centralized review process launched by the state in 2017 requires prison doctors to obtain approval from regional medical administrators to prescribe certain drugs, a list that includes federally controlled narcotics as well as the drug for nerve pain. and the anticonvulsant gabapentin, the allergy medicine Claritin-D, the cough medicine Robitussin DM, and Imodium, used to treat diarrhea.
State prison officials say the policy has increased oversight over the prescribing of potentially addictive drugs.
Salvana said the policy led to the “abrupt” halt of “effective treatment of hundreds of inmates” with seizures, multiple sclerosis, cancer, sickle cell anemia and spinal injuries.
Department of Prisons spokesman Thomas Mailey said the agency declined to comment on the pending litigation.
New York is fighting a separate lawsuit over the policy by people in prisons who claim they have been forced to live with untreated chronic pain and other conditions because some drugs have become too hard to come by behind bars.
The state has argued that the problem is about disagreements about the best way to treat patients rather than a violation of the constitutional rights of incarcerated people.
“It is justifiable that a physician prefers conservative treatments that carry less risk of harm, including abuse and addiction,” reads an April 2020 motion to dismiss the lawsuit filed by the office of the State Attorney General Letitia James.
Attorneys for prison patients said in a January court docket that the Department of Prisons has re-examined the medical records of individual patients.
As of January, at least 39 of those 88 patients were receiving restricted or unrestricted medications or awaiting follow-up from specialists, according to Amy Jane Agnew, an attorney representing incarcerated patients. But Agnew said the state had not provided enough evidence to show whether all “patients received constitutionally appropriate reevaluations.”
It’s not uncommon for prison settings to require an on-site health team to obtain external approval or restrict access to medications, said Matt Tobey, a professor at Harvard Medical School, director of rural medicine programs at the Hospital. Massachusetts General. While such policies may offer more guidance to medical providers, he said, “they generally place the facility’s administrative priorities, limit costs, or reduce the potential for drug diversion, above health.”
Salvana said she filed complaints, asked for patients to be excused from her unit, sought revocation of denied care, and met with prison officials, all to no avail.
In June 2019, Salvana ordered a benzodiazepine to sedate a brain cancer patient who broke a water pipe. A supervisor ordered a nurse not to administer the drug to the patient, who then attacked a prison officer who suffered “permanent cervical spine injuries,” according to the lawsuit.
When Salvana detailed the incident to state prison officials, he said his supervisor “reprimanded him” for prescribing the drug and filing a complaint about her. The supervisor then ordered the nurses not to assist Salvana with several patients, according to the lawsuit.
Salvana eventually left the state prison system and now works as a doctor treating prison patients at a correctional facility in another part of New York state.
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