By Jim Brunner
The Seattle Times
SEATTLE — Washington state has paid $9.9 million to settle a lawsuit by a woman whose cervical cancer grew terminal while she was incarcerated after prison doctors failed to adequately diagnose and treat the disease.
In the latest of a series of deadly and expensive health care failures in state prisons, Paula Gardner, who was serving time for drug and burglary convictions, didn’t receive appropriate medical care for more than two years despite tests showing signs of possible cancer — and eventually a scan revealing a growth inside her uterus, according to her lawsuit.
By the time her cancer was diagnosed at the Washington Corrections Center for Women in Gig Harbor, it was too late.
“Because the cancer was left unchecked for this period of time, it became advanced when it was otherwise treatable. It has spread to her lymph nodes (Stage IV) and Paula has been informed she will never recover,” Lincoln Beauregard and Marta O’Brien, the attorneys representing Gardner, wrote in the lawsuit complaint filed in late 2022 in Pierce County Superior Court.
“As a result of the negligent, reckless and grossly negligent conduct and medical malpractice of DOC ... Paula has, and will, endure incredible pain and suffering up to the time of her death,” the complaint stated.
The settlement, which exceeds other DOC-related lawsuit payouts in recent years, was reached on the first day of a trial in the civil case in December. The state paid out the money in January.
Gardner, 42, was released from prison following her diagnosis and is receiving palliative care in Tacoma, O’Brien said in an interview.
In a court filing before the scheduled trial, an assistant attorney general representing the DOC acknowledged prison health care had harmed Gardner and said the only issue for a jury to decide was a dollar figure to award in the case.
“Our heart goes out to Ms. Gardner and her family. In recent years, the agency has focused its attention on improving health care for our incarcerated patients,” Chris Wright, a spokesperson with the state’s Department of Corrections, said in an emailed statement.
Wright pointed to efforts including the hiring of a national expert in corrections health systems, who helped launch a new model to improve DOC patient outcomes. In late 2021, DOC implemented a new system of reviews for unexpected deaths of incarcerated persons. And the agency has sought funding from the Legislature for electronic health records, which would eliminate its outmoded reliance on paper files.
The $9.9 million settlement is more than the total amount paid by DOC in lawsuit and tort claims during any of the past six fiscal years dating to 2018, according to reports by the state’s Office of Risk Management.
For example, in fiscal year 2023, DOC paid out $8 million total in such legal claims.
The state must provide health care for incarcerated people, both under state law and the U.S. Constitution’s ban on “cruel and unusual” punishment.
But the DOC has struggled with serious lapses in medical care.
In 2019, the medical director at Monroe Correctional Complex was fired after an investigation found men incarcerated there had suffered and died as a result of negligent care.
In 2021, a state prison watchdog office issued a highly critical report detailing 11 cases of delayed cancer diagnosis and treatment leading to the deaths of some incarcerated persons. The same year, the state admitted negligence in paying $3.25 million to the family of a man who died at the Monroe prison of a festering abdominal wound that was not properly treated.
In 2022, the state paid $3.75 million in a settlement to the family of Kenny Williams, a man who died at the Monroe prison after his cancer went untreated despite his increasingly desperate pleas.
The story of Gardner bears similarities to those cases.
Gardner had been incarcerated off and on since 2011, according to her lawsuit. In 2019, she began serving a 40-month sentence for burglary and possession of a controlled substance, according to DOC spokesperson Tobby Hatley.
She had a history of abnormal Pap smears showing she had a carcinogenic type of the human papillomavirus, HPV, which meant she should have received specified regular screenings, according to the lawsuit.
In April 2019, an ultrasound found a 1.9-centimeter-sized growth in her uterus and a radiologist recommended a follow-up ultrasound in six weeks along with an MRI of her pelvis.
But, according to the lawsuit, Gardner was never told about those findings or recommendations.
She was transferred for a time to a Yakima County jail due to crowding issues at the DOC women’s prison. No follow-up scans or treatment was done at the jail, nor when she returned to the DOC prison in 2020.
By May of that year, she was having “troubling symptoms” and asked for a follow-up screening, her lawsuit stated. But DOC staff delayed that for nearly a year. In March of 2021, an examination found lesions on her cervix, which biopsies confirmed were cancerous.
A medical expert hired by Gardner’s lawyers said such gaps in care led to her fatal diagnosis.
O’Brien, in an interview, said she was particularly struck by the DOC’s failure to tell Gardner about the potential cancerous growth that had showed up in the ultrasound — an omission that was only discovered through the lawsuit.
“It’s just such a basic tenet of medical care that you inform the patient what is happening to them,” O’Brien said.
If she had received a colposcopy, an examination of the cervix and vagina, in March of 2020, “more probably than not, she would have survived her cervical cancer,” wrote Dr. Reed Paulson, the former chief medical officer at Oregon State Penitentiary, in his expert report for the case.
The settlement money will benefit Gardner for what remains of her life, as well as her two sons, who were also plaintiffs in the lawsuit.
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