County denies newspaper request for jail detox protocol

Posted: Wednesday, May 7, 2014

Bucks County officials won’t release the medical protocols and drug lists used for inmates undergoing drug or alcohol detoxification at the county jail, citing the information as “trade secret or confidential proprietary information.”

“As PrimeCare Medical Inc. has spent considerable time, energy and resources to develop its internal procedures, they hold the same as confidential proprietary information and disclosure would not only cause harm to PrimeCare but would also offer an unfair advantage to his competitors,” the county wrote Monday in its denial of a Calkins Media request under the Pennsylvania Right to Know Law.

Last year, Bucks County contracted with the Harrisburg-based PrimeCare to provide health care services at its correctional centers. The agency also provides health care for the Montgomery County jail.

Calkins Media will appeal the rejection after consulting with Melissa Melewsky, legal counsel for the Pennsylvania News Media Association. She said she believes the county failed to meet its burden of proof under the state law.

“The denial does not meet the burden of proof, and if you file an appeal, they will have to meet their burden with the OOR (Office of Open Records),” Melewsky said. “The agency would have to submit evidence to show that the treatment protocol is worthy of protection under the (Right to Know Law). It seems like a stretch to me.”

The request was filed on March 28, following the March 22 death of Marlene Yarnall, 49, of Bensalem. She died of a cardiac arrest during heroin detox at the county jail.

“As the selection of appropriate medication will vary on a case by case basis, as well as factor in which substance(s) is involved, it is impossible to provide a complete and accurate list of all medications used in the detoxification process,” according to the county’s rejection letter. “Therefore, PrimeCare does not possess a record identifying this information.”

“It’s hard to believe they don’t have different records that would be responsive,” Melewsky said. “If there’s no comprehensive list, that’s fine and they don’t have to create one as they said in the denial, but if there are multiple sources from which you can make your own list, those records should be provided.”

Yarnall was the second inmate to die during opiate detoxification in less than six months since PrimeCare took over last July. The inmate deaths were the first at the jail since 2010.

Yarnall was incarcerated in the Doylestown Township jail on March 18 on a probation violation.

County officials said Yarnall was taking medications to ease her withdrawal symptoms and was placed on normal medical watch with guards or another inmate checking her well-being every 15 minutes. Yarnall had chronic health problems — and had suffered a heart attack last year also while undergoing heroin detox at the prison, authorities said.

Bucks County detectives are investigating her death, but a report hasn’t been released. The Courier Times was unsuccessful in reaching District Attorney David Heckler on Wednesday for an update on the investigation.

Medical experts said chronic health issues, such as heart disease, combined with an opinoid addiction, put individuals at a higher risk for dangerous complications during drug or alcohol detoxification. Standard medical protocols, including federal prison guidelines, recommend such inmates undergo medically supervised detoxification, a process that uses drugs designed to ease withdrawal symptoms and an opiate substitute that is gradually tapered.

An opiate taper drug or mental-health related medication can be added to a detox plan, as well as “comfort” medications, PrimeCare Vice President of Operations Todd Haskins has said previously. Medical staff also perform vital-sign checks twice a day on detoxing inmates and examine them three times during the first 10 days of detoxification, Haskins said.

Medical staff conduct daily checks to ensure inmates are taking prescribed medications. If not, staff is supposed to meet personally with the inmate to discuss the situation and perform additional wellness checks. Inmates who cannot be medically managed or experience “extenuating complications” are transferred to a hospital for treatment, Haskins added.

Jo Ciavaglia: 215-949-4181; email: jciavaglia@calkins.com; Twitter: @jociavaglia