Emily Bohatch

The State

When Sinetra Johnson discovered she was pregnant, she was two days away from going to prison for a parole violation.

The 24-year-old was set to deliver twins while behind bars.

“As they got bigger, as I started growing more, that’s when reality hit, like ‘I’m really going to be here, behind the walls having (the babies) and I won’t be able to see (them),’” said Johnson who lived in Cherokee County at the time. “First pregnancy ever in life.“

While serving her more than two-year sentence, she would be dealt an unimaginably devastating blow: the loss of one of her twins, who drowned in a toilet after prison guards refused to help, according to Johnson.

“It’s enough to go to prison in itself,” said Johnson, who now lives in North Carolina. “But to have to worry about — Am I going to be able to go home to my child? No mother should have to go through that.”

The 2012 tragedy was preventable if officials at Camille Griffin Graham Correctional Institution in Columbia, a facility for female inmates with medical needs, had responded to Johnson’s calls — and later screams — for help, according to her lawsuit, filed against the S.C. Department of Corrections, which runs the state’s 21 prisons.

SCDC is failing to meet inmates’ most basic health care needs, according to at least 83 medical malpractice lawsuits pending in local S.C. courts as of December. Additionally, 78 of 126 wrongful death or personal injury lawsuits reviewed by The State Media Co. also cite inadequate medical care inside the state’s prisons.

Collectively, the cases — along with interviews with more than 60 former and current inmates conducted by The State — offer an alarming picture of a prison system in crisis, leaving inmates broken, discarded and in some cases, dead, due to incompetence or negligence. And they raise questions about whether taxpayers’ dollars are reaching those for whom they’re intended.

“(This) shouldn’t have to happen,” Johnson said. “Inmate or not, we’re still people.”

There’s Julius Allen Munn, who says he was left blind because SCDC would not buy him diabetes test strips that cost 10 cents each, according to his 2017 lawsuit. And S.S., an inmate who was shocked back to life twice because of botched dental work he received in prison, according to his suit filed the same year. And C.C., who claims he’s waited more than a year for prison officials to fix his severely broken jaw in a 2018 lawsuit. And P.H., whose concerns about visible cancerous growths were pushed aside for four years, according to his 2016 lawsuit.

The full names of S.S, C.C. and P.H. are not being used in this story. Still behind bars, they fear retaliation from medical staff, correctional officers or other inmates.

SCDC does not respond to litigation.

When inmates don’t get help, whether its medical care, rehabilitative or otherwise, it affects them and the community when they are released, said the Rev. Chuck Pollak, a former SCDC chaplain. About 85 percent of S.C. inmates will be released within five years, according to prison data.

“The things that are done inside the prison in too many cases caused them to become angry. Angry at the system. Angry at the politics. Angry at all kinds of things,” Pollak testified in front of a S.C. House committee.

Bryan Stirling, who was appointed to run the Department of Corrections the year after Johnson’s tragedy and would not comment on her legal case, says he is working to improve health care for those behind bars, including pushing for more medical staff who are paid more. On his watch, the department has digitized inmates’ paper health records and is using “telehealth” — virtual doctor’s visits — in several prisons, he added.

“Systematically ... I’m going through and getting funding to address issues that are internal to the department,” Stirling said. “But it’s such a big department that it’s not going to happen overnight.”

Gov. Henry McMaster, who recently reappointed Stirling to run the department, stands wholeheartedly behind his choice, with his spokesman calling Stirling “one of the most innovative and effective corrections system leaders in the country.”

SCDC already has an established history of neglecting the mental health of inmates. Years of poor, inhumane treatment sparked a landmark class action lawsuit in which Judge Micheal Baxley ruled in 2014 that mentally ill inmates were dying “for lack of basic mental health care, and hundreds more remain substantially at risk for serious injury, mental decompensation and profound, permanent mental illness.”

While progress has been made, SCDC is still struggling to reach full compliance in about two-thirds of the 58 areas outlined in the settlement agreement, according to a November audit. Members of the settlements implementation panel wrote that they have “grave concerns that SCDC is highly unlikely, if not completely unable, to meet the conditions and requirements...”

“Are we all the way there? No.” said Stirling, who worked to settle the case. “But are we working on it? Yes. A lot of stuff we’re doing is good stuff, and we need to do more.”

Meanwhile, new lawsuits, alleging that basic medical care needs are also not being met, are piling up.

Pleading for help

Johnson tried her best to prepare for the arrival of her twins while in the dorms of Camille Graham Correctional Institution.

But about 26 weeks into her pregnancy, Johnson woke up in intense pain and hurried to the prison’s medical station, she said.

“I knew something was wrong,” Johnson said. “It just wasn’t the normal feeling that I had during the 25 weeks prior.”

A nurse checked the expectant mother’s vital signs and sent her on her way. She was not given a vaginal exam or taken to an OB/GYN, a doctor specializing in women’s health, according to a lawsuit filed in a Richland County court.

Instead, Johnson, still in pain, was sent to work at the facility’s clothing plant. Hours later, she returned to the medical station, but was sent away again. It sounded like her ligaments were stretching, a worker said. No vaginal exam. No OB/GYN.

The entire process repeated itself again after the workday. Still no exam, no outside doctor, according to the lawsuit.

At 11:15 p.m., the first-time mother got out of her bed in the prison dorm and rushed past correctional officers at the guards’ station and into the bathroom, screaming.

“I still wasn’t sure … that it was labor because it was my first child. I had never been pregnant,” Johnson said. “I’m doing this alone. I’m in prison.”

She sat on a toilet, alone in the communal prison bathroom, and felt something come out of her.

“I had my first child inside the restroom there at SCDC in the dorm,” Johnson said.

A little girl, Karmin Elisha Geter, was born fully formed but still inside her amniotic sack on October 11, 2012 — 14 weeks premature.

Other inmates called to guards for help, but none came, according to the suit. So, they grabbed a wheelchair, lifted Johnson into it and dashed her off to the medical station as she labored to deliver the second twin, according to the suit.

Drawn to the screams of multiple inmates, guards eventually entered the bathroom, according to the lawsuit.

Some inmates tried to save Karmin, but guards ordered them to not go near the baby, who was suffocating inside the amniotic sack, according to the lawsuit. Karmin was left in the toilet until nearly midnight — 45 minutes after her traumatic birth — when she was placed in a hazmat bag by correctional officers. No medical professional examined the child until she arrived at the coroner’s office, according to the lawsuit

When Johnson arrived in medical, an ambulance was called. She would later gave birth to her son, Kamrin, in the vehicle’s back while still on prison grounds. The pair were rushed to a local hospital, where Johnson caught a glimpse of her son before he was rushed to the hospital’s neonatal intensive care unit.

Five hours later, Johnson was back in her bed in the same dorm where her first born child — Karmin — died after asphyxiating, according to the lawsuit.

“(It was) Just like, ‘OK, I guess (I’m) supposed to forget about it,’” Johnson said. “I couldn’t use the restroom there. It was traumatic.”

Though she was later moved to another unit, Johnson said the weeks following the birth of her son and the death of her daughter were devastating.

“I was still supposed to be pregnant,” she said.

An autopsy concluded Karmin could have survived if the sack had been manually ruptured, according to the lawsuit. She could have joined her brother as he walked out of the NICU three months later, a happy and healthy boy.

“In the beginning, it was really hard,” Johnson said in September, nearly six years after her daughter’s death. “I couldn’t go into clothing stores. I would avoid the little girl’s section all together. I would see people with twins and I would just ... break down. I became angry inside. Angry at myself. Angry at the situation. At the way things happened.”

Officials at the Department of Corrections did not comment on the case, but have denied many of her allegations in a response to her lawsuit. A trial is scheduled for May.

The diagnosis

According to the S.C. Constitution, the state must provide for the health and welfare of all incarcerated men and women.

Additionally, it’s the humane thing to do, said Warren Lokey, a Charleston lawyer who regularly represents inmates in cases against SCDC.

“That’s a problem because nobody is suggesting that these inmates be provided a hotel, a nice hotel, but this is pretty basic human stuff,” Lokey said.

Though Stirling, Correction’s director, maintains the department is providing adequate medical care, inmates and advocates disagree.

“Getting to medical is like getting a ticket to a sold-out concert,” inmate Jomo Bailey told The State. “I’ve seen guys seriously hurt and go days without medical attention. I’ve seen guys sew themselves up.”

During the last four fiscal years, South Carolina has paid more than $10.5 million due to medical-related lawsuits filed against the Department of Corrections, according to the S.C. Insurance Reserve Fund. More than $7 million of that came from settlements and lost legal battles.

SCDC officials say settling suits is sometimes more cost-efficient than litigating them, even when the department has done nothing wrong.

Tending to inmates’ health care needs is a big task, handled by too few health care professionals. As of 2018, 56 percent of the state’s roughly 19,000 inmates suffered from some sort of medical condition, ranging from diabetes to late stage cancer, according to SCDC records.

Just 11 physicians and 221 nurses work in the state’s prison system. That’s one doctor for every about 1,700 inmates and one nurse for every about 86. The department does not employ enough doctors to have one in each of its 21 prisons. To help with that shortage, the department contracts out with temporary agencies, Stirling said. Two contract doctors and 74 nurses fill in the gaps, improving the ratio somewhat.

As the department moves to modernize, it has also partnered with the Medical University of South Carolina and now provides digital doctor’s visits in five prisons.

“Things don’t happen overnight, obviously, but that is going to exponentially help us with getting folks in front of a doctor,” Stirling said.

The department also drives inmates to see outside doctors. During the 2018 fiscal year, nearly 10,000 transports were made. The issue with transporting, though, is that two correctional officers must travel with patient inmates, leaving understaffed prisons even more short staffed, Stirling said.

Hiring additional staff, particularly medical staff, is Stirling’s top priority, he said during a recent interview.

But that is proving challenging.

S.C. House members recently denied a budget request made by Stirling and his advocate, Gov. Henry McMaster, for about $6 million budget, to hire more staff, including medical personnel, and boost the pay of current employees. Prison nurses currently earn about $20,000 less than those working for other agencies, Stirling has said. And its doctors make a median of $50,000 less than their counterparts outside of corrections systems, according to data from the U.S. Bureau of Labor Statistics.

Adding to the problem: nearly a quarter of the state’s prison population has been diagnosed with mental health issues, said Stirling, who has increased the number of psychiatrists working in the prisons from two to 16. He’s also piloted virtual psychiatrist visits in prisons in the last few years, he said.



The shortages are creating long waits when an inmate needs medical attention, say inmates and advocates.

Thirteen inmates told The State Media Co. they have been denied access to sick call — SCDC’s way to request a doctor’s visit — or denied medical care from a department doctor all together. Some claimed they did not have access to the terminal where they could request care while others said correctional officers refused their requests.

“Inmates are given access to health care professionals when they request to be seen,” said department spokeswoman Chrysti Shain, adding that inmates should never be denied medical care.

That’s not happening, said Charleston lawyer Aaron Mayer. “I don’t think that’s conscious, because I believe the people in the administration of SCDC think they’re providing better care than they actually are.”

Mayer, who represents a number of inmates on medical cases against the department, described SCDC’s approach to medical treatment like a checklist. If they are required to have a doctor, they hire a doctor. If they need to have a medical department, they have one.

But those hired don’t always do their jobs well, and “you end up with just rampant neglect,” he said.

For example, before Stirling was appointed director, SCDC employed two psychiatrists to care for the department’s whopping population of about 24,000.

It wasn’t until the department entered a settlement in a landmark mental health case that officials adjusted that number to meet requirements in the agreement. Now, the department employs 14 psychiatrists.

“You can say they’re paltry, but you need to look at is as, ‘What did the experts in the case say? What did we agree on?’” Stirling said.

Even when they could get in to see a doctor, 24 inmates and current lawsuits reviewed by The State claim prisoners received little to no follow-up after being attacked or seriously injured.

In one 2017 case, inmate JaBari Moore said he was placed in lock-up at Columbia’s Broad River Correctional Institution — similar to solitary confinement — a day after being rushed to the hospital with stab wounds to his chest and liver.

For days, he went without medication, showers, soap or bedding, Moore said.

“Almost every nurse refused me help,” he said. “...For 30 plus days … I was in agony.”

Though one nurse did eventually bring him medication, Moore said he contracted an infection from his wounds while in lock-up. Later, he filed a lawsuit over the incident.

“I was expected to shut up and deal with it,” he said.

Stirling said he believes the Telehealth system will help with shortening wait times to see doctors, but maintains the department tries to get inmates medical attention as quickly as possible.

Getting care outside of an SCDC facility, even when recommended by prison doctors, can be difficult, according to five inmates who spoke with The State Media Co.

One inmate suffering from a heart condition reported being taken about four months late to see a specialist to determine whether he needed a pacemaker. After having intense chest pains for two weeks, he asked his siblings to get ahold of SCDC officials to ask about the canceled appointment, but has heard nothing back, he said.

Fearing retribution, he asked that his name not be used. His brother, who has acted as his advocate on the outside, confirmed his account.

“They are very delinquent in getting him to the doctor, which they’ve always been,” he said. “Nobody seems to be concerned unless you get really ugly with them. My family has been dealing with this since 1992.”

SCDC did not respond to a request for comment about the claim.

Spokeswoman Shain has said inmates with urgent medical issues are taken to an outside doctor immediately, but non-emergency appointments are subject to doctors’ availability.

“Like community members, there can be a wait time before the provider has an available appointment,” Shain said.

The bare necessities

Julius Allen Munn was 13 when he was shot in the stomach and underwent an operation to remove the remains of his pancreas, according to his lawsuit filed against SCDC. Without the vital organ that regulates the body’s blood sugar, Munn became diabetic.

When he first entered SCDC’s system, he was given test strips, which he used to monitor his sugar three times a day, according to the lawsuit.

After 2003, a nurse told him the institution would no longer provide them, saying, “There’s no money to pay for all those test strips,” according to the lawsuit.

The test strips, essential to the life of the diabetic prisoner, cost about a dime each at the time. Munn offered to pay the $109.50 a year for the strips, but SCDC still refused, according to the lawsuit.

Munn went from testing his blood sugar three times a day to once every four weeks, according to his lawsuit.

He suffered diabetic attacks. He fell into comas. And, in 2004, he started losing his vision, according to the suit.

In September 2005, he went totally blind. In 2007, his left eye had to be removed.

Since losing his sight, Munn has been housed with dangerous, gang-affiliated inmates multiple times, his lawyer Aaron Mayer said.

“That’s terrible as a sighted person, but as a blind person, when you can’t even see the punches coming, I just can’t fathom that,” Mayer said.

The Department of Corrections does not comment on litigation. But generally speaking, the department follows the treatment plans set out by doctors for blood sugar testing, said Shain, CDC’s spokeswoman. She added the department provides one test strip at a time as needed. And some inmates are allowed to self-test under supervision of medical staff.

Inmates are allowed to purchase their own medical equipment if they are given permission by a warden or their designee, Shain added.

“This is done to ensure the safety and security of the site is not compromised,” Shain said.

Munn, his prosthetic eye making his face hard to recognize , is far from the only person who claims they were denied or given substandard basic medical care while inside one of South Carolina’s tax-funded prisons.

“If you have a chronic condition and you’re in the SCDC system, you’re in a lot of trouble because they just can’t handle you,” said Georgetown lawyer Carter Elliott, who represents many inmates.

Eight inmates told The State they went weeks without medicines that are essential to their functions, regulating everything from blood pressure to managing pain from nerve damage. Three say they were given the wrong medications — including an instance where an inmate who was not diabetic was given medication to manage diabetes regularly — and seven said they were denied medication all together.

Shain said that a licensed nurse is in charge of doling out medication to inmates, and if an error ever occurs, they are required to immediately document the error and notify the health care provider.

While the lacking medical care can prove detrimental to some, actually getting treatment killed another, according to a lawsuit filed against the Department of Corrections.

After having a tooth pulled by a prison dentist, S.S. soon reported feeling sick, but did not receive follow up medical attention, according to a lawsuit filed against the department.

For five days, he laid in a cell, coughing up bloody phlegm, running a fever and vomiting.

“I begged them for help for days,” he said. “They told me to lie down and drink fluids.”

Eventually, a guard called the captain on shift and got him to the prison’s medical wing, he said.

“I know she saved my life,” S.S. said.

Before his life could be saved though, he had to die first. Twice.

S.S.’s heart stopped in the ambulance on the way to a local hospital, suffering from septic shock and a staph infection started by a simple pulled tooth, according to his lawsuit.

The case has been settled for an unknown amount of money.

When help comes too late

Getting the correct diagnosis can often be like rolling the dice, some inmates say.

In early 2011, P.H. found a bump on his chest he believed to be a blackhead. He tried to pop it, but the growth kept expanding and became painful to the touch, according to a lawsuit.

An SCDC nurse cut the growth from his chest. Later, she told P.H. the lump tested negative for cancer, according to the lawsuit. That was that.

In 2012, more lumps appeared around his neck, he said. He returned to medical several more times, but couldn’t seem to get a diagnosis. With a family history of colon cancer, P.H. grew fearful and asked to get checked, but was denied access to a specialist, according to the lawsuit. He began losing weight, he said, and the knots spread to his forehead.

In March 2014, he was finally diagnosed with male breast cancer, more than three years after his initial biopsy came back negative for cancer.

The pathologist got the wrong sample in 2011 — one that tested negative for cancer — said attorney Ed Bell.

“By the time that I had gotten to the oncologist, he said that he could only treat me to help me survive, and that had they gotten me to him sooner, that he could have possibly treated me to be cured,” P.H. said.

The cancer had already reached stage four, metastasizing to his lymph nodes and skeletal system, according to his lawsuit filed against SCDC. It was an aggressive cancer.

According to his lawyer, the inmate is right. If he’d been seen sooner by a doctor, he could have been a cancer survivor, medical experts who work for attorney Bell told him.

“I always feel like for a place where these men and women are sent for punishment for not following the rules, I feel like SCDC doesn’t follow the basic rules of taking care of folks,” Mayer, who was also involved in the case, said.

P.H.’s case was eventually settled, though the terms of the settlement and the settlement amount are unknown.

Failure to top the violence. Failure to heal afterward

When Charleston attorney Lokey met C.C. in late 2017 for a legal consultation, he thought the guards had put the wrong man in the meeting room. This man looked nothing like the picture that SCDC provided to the lawyer.

“When I met with him, for the first five minutes, I wasn’t convinced it was him,” Lokey said.

Having lived a year with a severely broken jaw, C.C.’ face is deformed beyond recognition. He’s lost about 50 pounds because he can’t close his mouth and it hurts to chew, Lokey said.

In October 2017, C.C. was attacked by armed gang members after a guard allegedly circulated a rumor that he was a snitch, according to a lawsuit filed against SCDC. His jaw was broken with a pipe, a common makeshift weapon used in SCDC facilities.

Since then, he has been shipped from institution to institution, jaw still broken and awaiting corrective surgery, he said. “I feel they’re hoping that someone kills me before so they don’t have to pay,” C.C. said.

C.C. spent months asking to be placed in protective custody. He felt vulnerable because one hit to the jaw could leave him incapacitated and unable to defend himself in a fight.

In late 2018, the inmate said SCDC transferred him to the same yard as the men who broke his jaw in the first place.

“I know they’re going to try and kill me, and I’m scared. I don’t want to die back here,” he said.

C.C. is far from the only inmate to get poor medical care after being attacked. I 24 cases, inmates reported little to no follow up after being beat up or stabbed.

In one case, an inmate was stabbed in the chest and his lung collapsed. Doctors at a nearby hospital warned prison officials that he could not be placed back in a general population setting for at least 10 days or his lung may collapse again.

Officials placed him right back on the yard anyway, the suit claims.

“You asked how to fix this prison system? You can’t fix it if you don’t have people who give a damn,” Bell said. “And if the leader of that prison system can’t see that and can’t get something done, he ought to resign.”