The medical care provider at the Shasta County Jail ("JAIL"), through failing to adequately address the serious medical needs of an inmate, exposed an unknown number of inmates and JAIL staff, and possible the public, to tuberculosis ("TB"). JAIL living conditions also contributed to the problem. 

Shortly after his arrival at the JAIL in April, 2003, Gregory Barlise, 33, a native American who should have been receiving close medical scrutiny due to being a diabetic, began complaining of not feeling well, having a deep and persistent cough, being tired all the time, in fact, often too tired to get up and eat or go for his diabetic medications. 

JAIL medical staff essentially ignored these classic symptoms, and his complaints, instead taking the attitude that he had a common cold or the flu, and that nothing can be done to treat these, that they must run their course. Since colds or the flu normally run their course in 7 to 10 days, any reasonable person, especially trained medical staff, should have quickly realized that when after the first two weeks the symptoms had worsened, that this was something much more serious than a cold or the flu. 

Instead, the JAIL's contract medical provider, the California Forensic Medical Group ("CFMG"), ignored all these clues and treated Barlise like a lazy faker, a status they all to often place inmates into. He was told to purchase some aspirin or Tylenol at the JAIL Commissary, exhibiting an attitude of appearing to place cutting costs and saving money over the health and welfare of the inmates. One of putting-off, stalling, or taking low cost ineffective or temporary actions, and then telling inmates they can get "this" taken care of after they are released. 

After continued complaints by Barlise, CFMG staff informed him he might have bronchitis or pneumonia, but he did not required any medication because, "It looks like the lung congestion is breaking up on its own." By this time, his August 31, 2003, release date was approaching, and following a pattern well known to JAIL inmates, he was told he could seek further treatment from his own doctor upon release. 

When taken to the Redding Medical Center ("RMC") on August 14, 2003, for what was called another problem, he was diagnosed with TB, returned to the JAIL, and placed in the Medical Unit in isolation in a negative pressure cell. It seems that the CFMG staff, and thus the JAIL which by law is ultimately responsible, had been ignoring an active case of tuberculosis. Thus, what appears to be a money saving attitude, when looking at this scenario and past patterns, that of treating inmates as hypochondriacs and telling them to seek medical treatment upon release, has now resulted in the unnecessary exposure of numerous persons to TB, a contagious and dangerous disease. 

The JAIL was unable to keep this latest gaffe quiet, as it is required by law to notify the Health Department whose representatives appeared on August 18, 2003, to interview potentially exposed inmates and staff. Later that same day, a TB testing program was commenced. Initially, TB Skin Tests were given, but these are not definitive as Skin Tests are essentially for screening purposes to help determine if further testing is necessary. 

According to a Health Department brochure, 15% of TB cases show a false negative on the Skin Test, so attention must also be paid to the observance of symptoms. Conversely, there also are many false positives on Skin Tests that require further testing to reach a conclusive diagnosis. A positive Skin Test only indicates that the person's immune system has produced TB antibodies. This can result from having been vaccinated against TB, as is common in Europe, or from having been exposed to TB at some point in their life. The Skin Test does not tell whether or not the person presently has, or ever has had, an active case of TB. It only calls for further testing. 

On August 21, 2003, after several positive Skin Tests appeared, further testing began with chest X-rays, ordered for certain individuals. In late August, three inmates began TB treatment medication. The JAIL then stated it was attempting to contact 21 past inmates who have been released or transferred to other facilities. Because tuberculosis is a very slow growing organism, it would appear that all of the potentially exposed staff and inmates will require follow-up testing at some point in the future, and inmates who are released should probably contact their personal doctors or the Health Department. 

The CFMG is not alone in culpability, the JAIL also shares responsibility after ignoring complaints of unhealthy living conditions, practices, policies and procedures. It has been reported by the World Health Organization ("WHO") that jails and prisons have very high infectious disease rates, particularly TB, largely due to poor ventilation, overcrowding, inadequate sanitation, repeated transfers, late diagnosis, and inadequate medical treatment. 

In Shasta County, inmates have made unanswered verbal and written complaints about sharing the same unsanitary cleaning rags for both toilet cleaning and food table cleaning. (See also separate article titled "Shasta County Jail Pestilence"), and for over a year inmates complained of poor ventilation, foul and unhealthy air. During the summer of 2002, complaints were made in the very same Housing Unit ("POD") with the present TB problem, only to be told by JAIL staff, "if you don't like it don't come to our jail!" Another wave of complaints began in 2003, followed by a never answered June 7, 2003, "Group Grievance." On June 28, 2003, another "Group Grievance" was filed by 22 inmates including Barlise. The problem was finally repaired on or about July 3, 2003, after determining that a failed fire safety device had completely shut down the air circulation. This discovery vindicated the inmates complaints as being real. The fears expressed in the inmates complaints of unhealthy JAIL conditions were finally realized with this TB incident. 

Even after Barlise had been diagnosed with TB, the JAIL made no effort to contain, isolate, or warn those inmates known to have had close contact with Barlise. Transfers were not delayed pending testing. Only when the Health Department became involved did the JAIL begin testing other inmates. The JAIL has yet to admit to their being a TB problem or to warn inmates still at the JAIL. How far this tuberculosis risk has or will spread, and whether it also escaped into the community at large is unknown at this time. 
 

Inmate Tom Watson 
September 2003