For the past several weeks, James Leonard has peed once every two days, or every day and a half if he really exerted himself. For a while, what came out was bright orange. More recently, his urine turned dark brown and foul-smelling.
Leonard, a 37-year-old inmate at Lewis Prison in Buckeye, has also lost 50 pounds since last July, shrinking from 195 pounds to 145. In mid-March, he began wetting himself uncontrollably. That was before he stopped being able to urinate much at all.
It's not clear what's wrong with Leonard. His family fears that he could have kidney problems, or early signs of prostate cancer. Since late April, Leonard has repeatedly requested medical care, and his mother has lobbied on his behalf. Those requests went nowhere until last Friday, the day Phoenix New Times contacted prison healthcare provider Corizon asking about Leonard.
Yet even then, a doctor provided Leonard with a temporary and woefully inadequate solution for his bladder problems.
In the four weeks between April 26 and Friday, Leonard had submitted repeated requests for medical care. A week and a half after his first request, he was able to see a nurse practitioner, who gave him panty liners that proved useless in Leonard's prison-issue boxers. In mid-May, he had another appointment. This time, they drew blood.
His family, already worried about his weight loss, began to panic. Leonard's symptoms were serious, potentially life-threatening, yet Corizon, the for-profit correctional health care company to which the Arizona Department of Corrections outsources medical care, had done hardly anything for him over the weeks that his mother desperately called and emailed people at both institutions, begging for medical attention for her son.
At noon on Friday, New Times contacted Corizon and the Arizona Department of Corrections (DOC) asking about Leonard. A spokesperson from Corizon, Eve Hutcherson, said Corizon could not disclose information about Leonard per federal health care privacy restrictions, but she offered to provide answers to general questions the following week.
Two hours later, Leonard was told, to his surprise, that he was being taken to see a doctor for his bladder issues. He had just had X-rays done for a separate medical issue (a pin in his ankle from a childhood accident was migrating up toward his thigh) and thought he was on his way back to his cell.
The doctor gave Leonard two long, thin rubber tubes for catheters, so he could empty his bladder. But medical providers did not give him a bag to catch the urine. Nor did they give him any sterilizing equipment or solution. The catheters were supposed to be single-use, Leonard said, but he was expected to clean and reuse them.
"They said, Just use soap and water and put it back in the plastic container it came in,” Leonard told New Times by phone on Sunday. At that point, he hadn't yet attempted to insert the catheter. His unit, Barchey, has three sinks for about 30 people, he estimated, and he can't empty his bladder directly into one of those sinks. He'd have to do it in the shower area, where there was no lighting, he said.
Afterward, he would have to clean the catheter as best he could using shampoo.
"I don't know how I'm gonna clean inside the tube," Leonard said. “I'm going to get a serious infection from that." He wished the doctor had simply given him a catheter with a bag, so he could attach the whole apparatus just once, even if it stayed on for a week.
The doctor also admitted to Leonard that having people on the outside lobbying on his behalf had helped.
"He's like, 'You're a top priority, because my bosses' bosses are calling," Leonard recalled. Otherwise, "I probably wouldn't have been seen." Imagine what happens to other inmates when they need medical care, who might not have people on the outside calling, he added.
Meanwhile, the bloodwork from mid-May revealed little. No diabetes. No HIV.
"They said that it doesn't seem there's a problem," Leonard told New Times.
Next, Leonard said, doctors would be testing for tumors, though he wasn't sure how they would be doing that. On Sunday, Leonard said expected to see the doctor again on Tuesday.
"I'm never one of those people that put in a bunch of [medical requests]," he said. "This is worrying me. I'm 37 years old. I've lost almost 60 pounds since July."
He eats everything he is given, and supplements it with food purchased from the commissary, he said. Leonard's mother, Laurie Torner, also said she has sent him protein drinks.
In addition to contacting New Times, Leonard's sister, Jamie Aragon, requested help from the Prison Law Office, a Berkeley, California, legal nonprofit that focuses on prisoners' rights.
The group has access to medical records, and after reviewing Leonard's, told Aragon in an email that they would write to the Department of Corrections and "[request] that he be seen as soon as possible by a provider."
Corene Kendrick, an attorney for the group, said the group emailed a letter to attorneys for the DOC shortly before 5 p.m. on Friday. Those lawyers acknowledged receipt Tuesday morning with a form response, she told New Times.
Torner has kept detailed notes on her efforts to get the DOC and Corizon to give her son the medical care he needs.
Those records show blatant unresponsiveness and responsibility-ducking by the state and the for-profit company, in addition to other systemic barriers that could effectively bar inmates from seeing a nurse or a doctor.
In January, for example, Torner called the DOC with a question about Leonard's medical care and access to his medical information. A woman named Mary Fuller advised Torner to call a toll-free number run by Corizon. Torner told her that, in the past, when she'd called that line, she never received a response, but she tried again, leaving messages two days in a row that were never returned.
Torner spoke with Fuller again in mid-April, concerned about the imminent expiration of the release her son signed authorizing the prison and Corizon to share medical information with her. The release was good only until May 11, and although Leonard had been asking for a new form to sign, he hadn't been given one, Torner said. Without the release, the state and Corizon cannot discuss her son's health or medical issues with her.
Fuller told her that the department could not bring Leonard a form, because they couldn't force him to sign it. Torner recalled telling Fuller that they wouldn't have to force her son to sign anything — he would do so willingly.
On May 10, the day before the release was set to expire, a representative at Corizon told Torner that her son had managed to procure and submit a medical information release form, but it would likely take a week for the prison to scan and process it.
Corizon also told Torner that medical requests were free, despite the fact that Leonard said he was being charged $4 for each submission. Filling out medical request forms can be difficult for Leonard, who has a learning disability, Torner added.
By pretty much all accounts, Corizon has done a terrible job providing medical care of Arizona's inmates. Numerous reports of its wrongdoing, extensively covered by local NPR affiliate KJZZ, include medical neglect, forcing inmates to pay medical bills that Corizon should be covering, or sacrificing patient care in order to avoid paying fines. A former doctor has accused Corizon of withholding care in an effort to cut costs.
Last year, the state paid the privately owned company $189 million for its contract. The DOC decided earlier this year not to renew with Corizon. Instead, on July 1, Centurion of Arizona will take over.
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Lewis Prison has been beset with its own problems lately. Broken locks on some cell doors led to several inmates assaulting and beating another so badly he died of his injuries, an investigation by ABC15 found in April.
The DOC then started installing hundreds of padlocks on cell doors instead. In mid-May, the DOC moved more than 700 inmates out of Lewis Prison over safety concerns.
Leonard was not one of them. Last week, he was transferred from the stricter Buckeye unit to the lower-risk Barchey unit. He entered Lewis in May 2017 after he pleaded guilty to charges of conspiracy and money laundering, court records show. He is scheduled for release in March 2021.
“My brother committed a crime and is set in time for that crime. I accept this and am comfortable with it," Aragon, his sister, told New Times in an email. "However, his crime should not result in the possibility that he develop an irreversible and adverse medical condition or that he pay for his crime (which he was not sentenced to death for) with his life."