Shelved report details 14 COVID deaths in Washington prisons

“However, the patient’s nurse saw the front of the cell and advised the patient to write down the causes and effects of his thoughts, and use the word search to ‘eliminate problems,'” according to the report. “There is no documentation of any biomarkers being taken or other evaluation done.”

Shortly thereafter, patient D died in a nearby hospital of COVID-19.

Draft Report of the Corrections Ombudsmandated September 2021, identifies delays in medical care and flaws in documenting COVID cases in Washington prisons during the pandemic, which have particularly hit pool facilities.

But this Ombudsman’s report has not been made public, and none of the recommended changes to improve health care in Washington prisons have been implemented. Crosscut obtained the report last week via a public records request.


The report is one of several vetting cases within prisons to be suspended after Governor Jay Inslee appointed one of his staff to temporarily oversee the Office of the Corrections Ombudsman.


It is one of more than six reports that have been delayed or postponed Following the departure of the inaugural Director of the Ombudsman’s Office in November 2021. Governor Jay Inslee then appointed an interim director – one of his most senior staff – who acknowledged halting the COVID report and several other investigations.

Inslee in June appointed a new director, Kaitlyn Robertson, a former investigator working in the office. Both Robertson and Inslee’s employee, Sonya Hallum, defended their decisions to delay publication of the reports.

They said they inherited an office that needed to be reorganized, and that it needed to be remodeled to better serve the incarcerated people asking for help. Robertson and Hallum also said they believed the ombudsman’s office could be more responsive by working through individual complaints and through negotiations with corrections officials, rather than emphasizing public monitoring reports.

Prison advocates, prisoners’ families, and people in prisons questioned the decision to withhold these reports from the public. They say the loss of public investigation reports deprives prisoners of opinion, reduces government transparency and raises questions about how the Inslee administration handles prison conditions.

The delay in reporting COVID-19 deaths also raises questions about state officials’ response to the pandemic. The Washington Department of Corrections received a copy of the draft report last year, according to the document, but because the department has never received a final version, it has not made any changes, according to a spokesperson for Chris Wright.

“The administration is awaiting the final version of the report from the Office of Correctional Ombudsmen,” Wright added. “Once this occurs, the DOC looks forward to continuing to work with the OCO and considering next steps to address any issues raised in the report.”

Meanwhile, in an emailed statement Monday, Robertson said a direct discussion between her office and prison officials about COVID-19 deaths has yet to begin: “The facilitated conversation has not occurred and the list of participants is not final yet.”

Robertson also wrote that she plans to release an updated version of the COVID-19 mortality report publicly in the future. This is a change from July, when it did not commit to releasing the report. “Each individual death is not systemic, because each of them was a different reaction,” Robertson said at the time.

The Department of Corrections has struggled for years to provide adequate health care within prisons, something that has been highlighted in previous ombudsman reports on the subject. COVID-19 response And the cancer care.

Those struggles continue. Last week the Ministry of Labor and Industry Corrections officials fined $84,000 For not following safety rules following an outbreak of tuberculosis at Stafford Creek Corrections Center in Aberdeen.

A draft COVID-19 death report released to Crosscut indicated that Washington’s prisons have performed better than many other states during the pandemic, with fewer COVID-19 deaths. But she outlined several concerns.

According to the report, of the 14 inmates who died between June 2020 and August 2021, six were not adequately evaluated after they asked to be seen for symptoms. In five cases, a physician was not contacted for evaluation, despite worrying symptoms. Documentation processes were not followed in five cases, which delayed the evaluation of patients.

In four cases, it took three to six days for incarcerated people who had been tested for COVID-19 to get test results. By contrast, incarcerated people who were tested after being taken to hospital received their results on the same day, according to the report.

The draft report recommended several improvements. She urged better screening processes to encourage symptomatic patients to report their illness, and work to remind inmates to seek care for acute cases.

The review also called on corrections officials to move more quickly to provide care when patients’ symptoms worsen or their condition deteriorates. It also recommended faster lab tests.

In an email, Inslee spokesperson Jamie Smith wrote that the virus “has tested and strained each organization’s ability to deliver care, goods and services to patients, clients, and customers.”

“The OCO findings highlight where DOC health care delivery needs to be reviewed,” Smith wrote. “It is hoped that the new approach of engaging the Unexpected Death Review Committee in facilitated discussions that consider these deaths and public order will identify any systemic issues and, most importantly, how to fix them.”

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