At Tennessee’s largest prison, diabetic inmates say they are denied insulin to 'maximize profits' CoreCivic, which runs Trousdale Turner prison, is facing three lawsuits over the care of inmates with diabetes

Brett Kelman | Nashville Tennessean

For several nights in a row, Douglas Dodson says he did not receive the drug that keeps him alive.

Dodson, an inmate at Trousdale Turner Correctional Facility, had been stuck in his cell for weeks as a lockdown dragged on and on at Tennessee’s largest and newest prison. The chow hall was off-limits, so food were served in his cell on cafeteria trays. Each meal was supposed to come with an insulin shot, which helps diabetics like Dodson control their delicate blood sugar, but sometimes the insulin wasn’t provided until hours later.

Sometimes, Dodson alleges, it wasn’t provided at all.

"For the past 2 ½ weeks we have been on lock down, and it has been several evenings that we have not been called to the clinic to get our insulin," Dodson wrote on a prisoner complaint form, now filed as an exhibit in a lawsuit against the prison.

"I know my insulin is keeping me alive and I really need it everyday. This has went on long enough here at this facility!”

This complaint, which Dodson wrote during a three-week prison lockdown two years ago, is representative of what inmates describe as woefully inadequate diabetes care at Trousdale, a for-profit prison run by CoreCivic. In a class-action lawsuit, Dodson and other former inmates allege that about 60 diabetic Trousdale prisoners face daily risk because of unhealthy food, unpredictable meal times and spotty access to insulin shots. Diabetics generally inject insulin when they eat, but inmates allege they often wait hours for the drug because of understaffing, which is designed to "maximize profits," and frequent prison lockdowns.

The class-action lawsuit is one of at least three ongoing suits that have accused CoreCivic of endangering diabetic inmates. Former Trousdale inmate Thomas Leach filed a separate suit levying similar allegations against the prison in 2016, and a third suit was filed this year after the death of inmate Jonathan Salada, who allegedly spent his final days in excruciating pain because of diabetes compilations and negligent care.

CoreCivic has denied wrongdoing in all three suits and insisted that the plaintiffs in the class-action case are responsible for their own diabetes complications. In a court filing, the company has claimed that Dodson and the other inmates have a documented history of skipping meals, refusing insulin shots, using illegal drugs and buying sugary snacks at the prison store in "willful non-compliance" with a diabetic diet.

In a statement on Tuesday, CoreCivic declined to respond to discuss the specifics of the lawsuits but said it is committed to "high-quality healthcare" for inmates and "appropriate levels of staffing" in company facilities.

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Private prison protesters shut down CoreCivic

The three diabetes lawsuits against Trousdale, each filed over the past two years, have drawn little attention until this week, when mistreatment allegations were revived by a protest at the CoreCivic Nashville’s headquarters.

A few dozen protesters on Monday blocked entry to the company parking garage by chaining themselves to cement-filled barrels and erecting a makeshift crow’s nest on a 20-foot tripod. Police dispersed the protest after about nine hours and more than a dozen arrests.

During the protest, a former CoreCivic employee said she heard Salada shouting, desperately in need of help, in the days before his death.

“He screamed in pain for three days,” said Ashely Dixon, who resigned from Trousdale about eight months ago, as she was chained to fellow protesters. “I tried to get him help, but nurses told me he was faking it.”

Dixon's statements follow the lawsuit filed by Salada’s family alleging the inmate was left screaming in pain in his cell in the days before he died. The lawsuit claims that Salada had three blood tests revealing his blood sugar was alarmingly high, and was taken to the prison infirmary twice, but still never received “appropriate or proper medical care.” Salada was returned to his cell still in pain, the lawsuit said, then later found unconscious. He died about an hour later.

But Salada’s death appears more complicated than the lawsuit presents. According to Salada’s autopsy, his blood sugar was dangerously high when he died, but his official cause of death was an overdose of buprenorphine, a prescription opioid painkiller. Diabetes was listed as a contributing factor.

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Tennessee's biggest and newest prison

CoreCivic, previously known as Corrections Corporation of America, is one of the largest private prison companies in the U.S. with about 65 prisons and eight immigration detention facilities. The company has a five-year $276-million deal to run Trousdale, a 2,552-bed minimum security prison in Hartsville, Tennessee.

The diabetes lawsuits follow other allegations raised against the prison since it opened in 2015, most of which stem from claims of understaffing. Last year, a scathing audit said the prison is plagued by gangs because of insufficient security and that staffing data provided by CoreCivic could not be trusted.

This understaffing claim also central to the class-action diabetes lawsuit, which alleges that Trousdale is run by a skeleton crew. The lawsuit says that that Trousdale goes into lockdown, sometimes for weeks at a time, purely for manpower reasons because CoreCivic does not hire enough staff to secure the entire facility. Inmates are confined to their cells and can't visit exercise yard or the chow hall.

It is during these lockdowns, the lawsuit says, when diabetic care is the worst.

"Meals are provided at irregular and often unpredictable times and are often not diabetic appropriate despite medical directions for a diabetic appropriate diet,” the lawsuit states. “At such times, inmates are frequently forced to eat their meals and only then, sometimes two to three hours after eating, allowed to go for blood sugar checks or insulin injections.”

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This allegation appears to have specifically resonated with the American Diabetes Association, which has filed a court motion in March to join the class-action lawsuit against Trousdale. In a news release earlier this year, the association said it hopes the lawsuit will set a standard for all CoreCivic facilities, and by extension, all prisons.

“Just as children depend on adults to assist with their diabetes care, individuals who are incarcerated are at the mercy of prison staff to provide them with access to the health care tools, medications and reasonable accommodations necessary to manage their diabetes,” said Sarah Fech-Baughman, an attorney for the American Diabetes Association, in a news release.

“These individuals do not have access to appropriate medical care and have been subjected to discrimination on the basis of their diabetes. The ADA challenges both of these issues on behalf of this vulnerable population.”

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Tennessean reporter Natalie Allison contributed to this report.

Brett Kelman is the health care reporter for The Tennessean. He can be reached at 615-259-8287 or at brett.kelman@tennessean.com. Follow him on Twitter at @brettkelman.