UTAH STATE PRISON — A physician assistant and supervising nurse were fired by the Utah Department of Corrections on Thursday following a pair of investigations into the death of a Utah State Prison inmate who was stood up for two kidney dialysis treatments in April.
Richard Garden, the department's clinical services bureau director, will no longer fill that leadership post in the aftermath of the incident and was reassigned to work for the department as a doctor, according to the Department of Corrections.
A second supervising nurse was demoted and another nurse received a 40-hour suspension in the wake of 62-year-old Ramon Estrada's death.
Garden was placed on paid administrative leave immediately following Estrada's death. Three of the other employees were put on paid leave in early July. One of the employees was never placed on leave, said corrections spokeswoman Brooke Adams, though she didn't know which one.
A dialysis technician failed twice to show up for their appointment with Estrada and six other inmates on April 3 and April 4. Estrada died about 10:30 p.m. Sunday, April 5, while prison employees were preparing to take him to University Hospital for dialysis treatment. His cause of death was cardiac arrest from apparent kidney failure, but the state medical examiner's office had not completed a fully autopsy of Estrada as of Thursday.
Estrada began serving his prison sentence in 2005 for the rape of a 13-year-old girl. He was scheduled to be released on parole on April 21, when U.S. immigration officials were to take him into custody.
Estrada's family filed a federal lawsuit against prison officials in June, alleging disregard for his medical condition. Garden is named as a defendant in the lawsuit, as is prison warden Scott Crother, South Valley Dialysis Clinic medical director Arsalan Habib, University of Utah Health Care, and 20 prison and hospital employees.
The technicians who failed to show up at the prison were employees of South Valley Dialysis, whose parent organization is University of Utah Health Care.
“(We) had two employees who faced disciplinary action as a result of this incident," said Kathy Wilets, spokeswoman for University of Utah Health Care, as part of a prepared statement Thursday. "They remain employed. Our internal investigation revealed this was a tragic breakdown in communications."
Wilets didn't comment specifically on how the employees were disciplined.
Wilets also said in April that nobody at the prison attempted to contact South Valley Dialysis until late afternoon on April 5. She said a prison nurse reportedly left a message at the center's office, which was closed because it was a Sunday. A 24-hour on-call phone number was available to prison staff, she added.
The Department of Corrections did not release the names of its disciplined employees Thursday.
"All the employees had some responsibility for the care of seven dialysis patients who were receiving treatment at the prison’s onsite dialysis center," Adams in a prepared statement.
The Department of Corrections' own findings, in addition to an investigation performed by outside health care consulting firm WELLCON, resulted in Thursday's firing and other discipline, according to Adams. The Utah Department of Health is conducting a separate review of Estrada's death, using both concluded investigations to aid its findings, she said.
The Department of Corrections is now looking for a new clinical services bureau director, Adams added.
The prison reportedly made several changes in its communication with South Valley Dialysis since Estrada's death. Adams said these include weekly summaries showing prisoners' treatment, the monitoring of inmates who aren't receiving dialysis treatment, and mandatory training for dialysis center and prison employees.
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