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'Cruel and Unusual Punishment': The Questionable State of Medical Care at Louisiana State Penitentiary

Several groups representing inmates at Angola claim the prison's poor living conditions violate the Eighth Amendment.
The entrance to the Louisiana State Penitentiary.

The entrance to the Louisiana State Penitentiary.

Repeatedly refusing medical attention to someone in the grips of a stroke, preventing a patient with cancer from seeing an oncologist for four years, keeping a blind man from obtaining a cane for nearly two decades—these are just some of the allegations made by the representatives of inmates at Louisiana State Penitentiary, better known as "Angola." Those representatives, which include the American Civil Liberties Union of Louisiana, the Southern Poverty Law Center, and The Promise of Justice Initiative, have filed a federal class action lawsuit against the Louisiana Department of Public Safety and Corrections, alleging that the prison's lack of medical care is so severe, it constitutes a violation of the Eighth Amendment's prohibition against cruel and unusual punishment.

The lawsuit, Lewis v. Cain, is currently in trial in federal court, but it was originally filed back in May of 2015. Among the named plaintiffs are inmates Joe Lewis and Shannon Hurd, who were both denied cancer treatment for years, contributing to their untimely deaths. As a class action lawsuit, the case covers all of the approximately 6,400 men currently imprisoned at Louisiana State Penitentiary, as well as those who will be incarcerated there in the future. The defendants are former Louisiana State Penitentiary warden Burl Cain, current assistant warden of health services Stephanie Lamartiniere, the Louisiana Department of Public Safety and Corrections, and current department secretary James M. LeBlanc. (The Louisiana Department of Public Safety and Corrections declined to comment for this article, with communications director Ken Pastorick stating only, "The Department doesn't comment on pending litigation.")

"People incarcerated at Angola have suffered from permanent injury and death as a result of prison officials' chronic failure to provide adequate medical care," says Mercedes Montagnes, lead counsel for the plaintiffs and executive director of The Promise of Justice Network, a New Orleans-based non-profit that advocates for criminal justice reform.

In their court filings, Montagnes and the prisoners' other representatives argue that the Louisiana Department of Public Safety and Corrections is responsible for the medical care of all inmates at Louisiana State Penitentiary, as prisoners have no other means of obtaining treatment. Despite this responsibility, inmates receive dangerously deficient care, most of which provided by on-site staff. In reviewing the medical records of 58 current and former prisoners, experts found "preventable deaths and inadequate care in almost every medical chart." Patients reporting serious symptoms were provided with superficial treatment by EMTs. Those lucky or persistent enough to see doctors did not undergo basic diagnostic techniques, such as physicals, medical history review, or testing. Referrals to specialists were often delayed or canceled outright by the Department of Public Safety and Corrections. Unsurprisingly, inmates at Louisiana State Penitentiary face harrowing outcomes. In reviewing the the cases of 28 deceased inmates, experts found that the deaths of all but two were "preceded by serious medical negligence," such as delays in diagnosis, failures to provide treatment, and denial of timely hospital transport.

Considering the widespread negligence, prisoners' representatives argue that conditions at Louisiana State Penitentiary violate multiple laws. Paramount among these are the Americans With Disabilities Act, which prevents any recipient of federal funding from excluding individuals with disabilities from obtaining services (the Louisiana Department of Public Safety and Corrections receives federal funding, and Louisiana State Penitentiary incarcerates inmates with disabilities), as well as the Eighth Amendment to the United States Constitution, which prohibits the state from inflicting "cruel and unusual punishments." Prisoners' representatives argue that the degree of medical negligence at Louisiana State Penitentiary is so extreme, an ill prisoner incarcerated there is, in effect, sentenced to "slow torture by an untreated medical condition." In response, Lewis v. Cain seeks increased staffing of qualified health-care providers, greater access to timely and appropriate treatment, and the detangling of medical issues from security ones, all to be overseen by three independent monitors.

As Montagnes puts it, "The only thing the patients at Angola are seeking in this suit is access to basic health care, which they can receive in no other way than through the state."

Inmates' struggles to obtain medical care are obstructed by legislation like the Prison Litigation Reform Act. Signed into law by Bill Clinton in 1996, the act sought to reduce the number of federal cases prisoners brought against their institutions by forcing them to first work through any existing processes of remediation established on the institutional or departmental level, even in cases of constitutional violations. (The legislation has become so despised by inmates that repealing it was included prominently among the demands of the recent nationwide prison strike.) Despite the challenges presented by the Prison Litigation Reform Act, Lewis v. Cain was certified to go to federal trial earlier this year—a testament to the tenacity of inmates, as well as their representatives.

Access to adequate medical care in prison has long been an issue in the U.S. During the 1971 Attica Prison uprising—perhaps the best-known event of its kind in U.S. history—the prison rebels' second demand, after legal representation during parole hearings, addressed the "inadequate, understaffed and prejudice" health care provided to inmates. But, as Lewis v. Cain suggests, these demands remain unfulfilled over decades and across local, state, and federal facilities.

"While access to medical care is a nationwide issue," Montagnes says, "Angola is an outlier both for the brutality of its past and the cruelty of its present."

Louisiana State Penitentiary is the largest maximum security prison in the U.S. It was established in 1880 by ex-Confederate army officer Samuel L. James on the site of a plantation called Angola—supposedly named after the area in Africa where its former slaves originated. Following the end of slavery, James entered the convict leasing business, in which he paid the state in exchange for the labor of inmates, who were forced to pick cotton and housed in old slaves' quarters. (The popular documentary 13th identifies convict leasing as perpetuating slavery by allowing it to continue under the guise of incarceration.)

Although the state of Louisiana took control of the prison in 1901, its gruesome history still pervades the grounds. In 1997, Burl Cain—the former warden named as a defendant in Lewis v. Cain—established Angola Museum, which operates within Louisiana State Penitentiary, welcoming 120,000 visitors each year to ostensibly learn from "the horrors of the past." On the museum's website, an archived article describes the inadequacy of the prison's medical care in 1943. Fast-forwarding to the present day, the site boasts of the prison's "accreditation through performance-based health care standards." No one, it seems, told the inmates about these standards.