Colin County Jail Evaluating MRSA

When I first addressed concerns about MRSA with the jail's infirmary, they placed my cousin in lockdown as punishment for my inquiry. They said they didn't want the health department on their back.

In order to have MRSA addressed in the jail system, I called the Collin County Sheriffs office, Dallas FBI and 5 departments of the Texas Health and Human Services. I filed 2 formal complaints which were ignored through the Texas Commission on Jail Standards. Deanna Stone is finally addressed for her staff infection.

The 3rd party medical service company for Collin County Jail, Naphcare Inc. returned my call. They pulled my cousin for evaluation yesterday with the medical director and doctor. The problem with diagnosing her is: She has been given topical antibiotics which keep her wound/rash clusters dry. In order to get a culture of MRSA, a weeping wound, or jell filled cyst needs to be cultured and sent to a lab for diagnosis to confirm and report the stage of infection. I told them she has an abscess on her chin which should be sufficient for swab testing.

I have notified another inmate's lawyer that his client has the same infection/rash and should be checked. That woman is mentally challenged, but her family has been notified today. I hope this will keep MRSA quarantined, at least, in Collin County before its too late for the population.

Dallas County Jail or Collin County to blame?

The following update to Deanna Stone’s current medical case. There is a direct link missing between certified medial teams capable of diagnosing illnesses, and the state’s required intake procedure for inmates. My personal question is: where is the doctor? Real inmates should serve proper sentencing for a crime, but most of the infected I mention were/are still processing through a trial or sentencing. Months later if left untreated, inmates take the disease home to their family. In Dallas County, inmates are given tuberculosis prevention, but other underlying issues like long-term mental disorders or a common rash are rarely addressed.

September 27, 2007 Amy visited Deanna at the Collin County Correctional Facility. Deanna wore long sleeve thermal top under her jumpsuit. She has rashes around her arms, but she keeps them covered. Deanna has sores between her breasts, on her face, neck, chin, behind her ear, and on her back that Amy saw today. Deanna said she was told she will see the psychiatrist, and is requesting to be put back on 2 medications that she was prescribed by the psychiatrist in Lew Sterrit Jail, Dallas County. Deanna said the facility was monitoring her records for a health investigation. The infirmary still refuses a swab test for her skin rash. Again, Deanna will be requesting a swab test on her next visit. Her tooth, which was broken by another Dallas County inmate, needs to be treated. She is requesting antibiotics to fight any bacterial infection for her tooth. She has been In Collin County for 5 weeks without her complete bi-polar medication prescription. She was taken off her medications weeks prior to leaving Dallas County for her TDC transfer. She did enter the facility with booking numbers, then she was immediately transferred to Collin County for missing a bench warrant that Dallas County ignored multiple times.

September 28, 2007 Amy mailed a HEPA Act form to Deanna. It was not received over the last 2 weeks. Another 2 copies of the form were mailed Saturday September 29, 2007. The HEPA form was required by the Inmate Infirmary for Deanna’s medical history to be disclosed to Amy. They will not disclose any information otherwise.

September 29, 2007 That morning, Deanna was administered her medicine. Without gloves, they handed Deanna a high-blood pressure pill, tried to give her triazadone, which Deanna refused because it is the wrong medication for the morning, as it is given at night. She was not given her Celexa, benadryl, benzoid steroid cream for her face for the last 2 days. Deanna’s mother saw Deanna on her visitation at 7:30pm. She had open sores in her mouth and on her shoulders, in addition to what Amy has seen. She has an abscess is on her left jaw down to the chin. Deanna placed multiple requests to see the infirmary. Sherry did not forward any requests to the physician’s assistant Lisa. Deanna’s mother called Nurse Sherry to inform her that Deanna has an abscess tooth and has requested antibiotics. Deanna’s mother called Lieutenant Stewart. He said he knew who Deanna was, and she had seen the doctor 3 times this week. The Lieutenant said the nurse saw Deanna Sept 28th. Deanna did not see the nurse, or the doctor. Dr. Woo did not see Deanna, but was scheduled and never seen.

After Deanna’s mothers many calls to the department, and Deanna’s many infirmary requests all day, Nurse Sherry saw Deanna after 8pm on Saturday, September 29, 2007. Since no doctors were present to supervise, the nurse could only re-instate Deanna’s previous prescriptions from the Dallas County psychiatrist. Deanna called her mother via phone later that evening and said the nurse gave her antibiotics after seeing sores inside her mouth. The nurse re-instated Deanna’s medications. After writing a bill for services, Sherry tore up the bill, and said she shouldn’t have to pay. Deanna did not get a copy of the medications or the evaluation.

Dallas County acknowledged Deanna’s rash, prescribing a topical antibiotic. Collin County treats it with Benadryl. Again, M.R.S.A. is a very serious bacterial infection resistant to most antibiotics, including a weak topical agent. In order for infection and future infections to be quarantined and controlled, guilty parties responsible for ignoring health concerns should be removed. In both cases, Dallas and Collin County witnessed the skin rashes. Without the inmates’ mother’s involvement, her infection would have gone untreated, ultimately resulting in leukemia.

There is another inmate in Deanna’s cell who uses the same telephone to make calls. Deanna says the girl seems mentally challenged and is very infected with the same rash as Deanna, which covers the side of her face and cheek. I am aware the disease is one of many in the inmate system. But, if a certified doctor was on-staff full time, they could have a capacity to correct the problem with pharmaceuticals, which help quarantine. A proper swab test sent to a certified laboratory should be required to determine Deanna’s state of infection, as well to inform the health department about disease for a control method. The current state’s plan is not being applied.

Sunday, September 30, 2007 PA Lisa found out Deanna was pulled to the infirmary after she left her shift the night before. Lisa pulled Deanna and said she had never been told Deanna had requested to be seen on Saturday. The nurse gave her the wrong antibiotic, so she changed the prescription. She saw Deanna 2 more times before the end of her shift at 12:30pm. When Lisa left her shift, Nurse Sherry had Deanna into the infirmary’s isolation unit, where she sat all day and was not given dinner at 5pm. Deanna cried until 7:45pm before they fed her. They brought an apple. She has a tooth abscess and cannot eat an apple. She ate the balogny sandwich. They kept her in the infirmary until the next morning, then they placed her into a different cell pod. Again, they did not give her Celexa that day. She cried all day. She’s still crying. Deanna has a medical tab for her infirmary pull which was not requested, nor was it a punishment for any action. The infirmary still refuses to test her M.R.S.A. Her white blood cell count would indicate the rate of infection.

October 1, 2007 Deanna called her mother. She can’t eat normal food, now that she has an abscess in her mouth. She cries obsessively, due to her severe bi-polar mind with a lack of proper medication.

MEDICAL NOTES ON MRSA
Antibiotic Resistance Profiles of MRSA:1
* All B-lactam antibiotics
* 94% resistant to clindamycin and erythomycin
* 89% resistant to ciprofloxacin
* 56% resistant to trimethoprimsulfamethoxazole
* 33% resistant to tetracycline
* 3% resistant to rifampin
* 3% resistant to fusidic acid
* 2% resistant to mupirocin
If SA bacteria are able to enter the bloodstream (bacteraemia) they can affect almost any part of the body. They can cause:
* septicaemia (blood poisoning),
* septic shock (widespread infection of the blood that leads to a fall in blood pressure and organ failure),
* severe joint problems (septic arthritis),
* bone marrow infection (osteomyelitis),
* internal abscesses anywhere within the body,
* inflammation of the tissues that surround the brain and spinal cord (meningitis),
* lung infection (pneumonia), and
* infection of the heart lining (endocarditis).
SA bacteria can also cause scalded skin syndrome and, very occasionally, toxic shock syndrome.
Severe Methicillin-Resistant Staphylococcus aureus Community-Acquired Pneumonia Associated With Influenza—Louisiana and Georgia, December 2006–January 2007
JAMA. 2007;297:2070-2072. MMWR. 2007;56:325-329 (1 table omitted)
Staphylococcus aureus infection has been reported infrequently as a cause of community-acquired pneumonia (CAP) and typically has been associated with influenza virus infection or influenza-like illness (ILI).* During the 2003-04 influenza season, methicillin-resistant S. aureus (MRSA) gained attention as a cause of 15 cases of influenza-associated CAP.{dagger}1 No formal surveillance has been conducted, and few additional cases of MRSA CAP were reported to CDC during the 2004-05 and 2005-06 influenza seasons. However, in January 2007, CDC received reports of 10 cases of severe MRSA CAP, including six deaths, among previously healthy children and adults in Louisiana and Georgia during December 2006–January 2007. These were the first reported cases of severe MRSA CAP during the 2006-07 influenza season in the two states, and 10 was a higher number than expected for the 2-month period. A case of severe MRSA CAP was defined as pneumonia requiring hospitalization or resulting in the death of a patient from whom a specimen (i.e., sterile site or sputum sample) yielded MRSA when collected <48 hours after hospitalization or arrival at an emergency department (ED). Association with influenza was determined by either a positive result on a laboratory test or a diagnosis of ILI. This report describes three of the MRSA CAP cases as examples and summarizes all 10 of the reported cases. These cases underscore the need for health-care providers to be vigilant, especially during the influenza season, for severe cases of CAP that might be caused by MRSA.