Prison misdiagnosis brings suit

SEATTLE – A man who was attacked by flesh-eating bacteria while he was in prison and wound up grossly disfigured is suing the state prison system, claiming he had been told he simply had an allergic reaction.

The federal lawsuit filed in Tacoma on behalf of Charlie Manning names as defendants the state Department of Corrections and Dr. A. Muhammad Khurshid.

The suit accuses Khurshid of “deliberate indifference” in his handling of the necrotizing fasciitis case at the Stafford Creek Correctional Center west of Aberdeen.

“This is the most outrageous case of medical neglect in a prison or jail in this country I’ve ever seen where a patient lived,” said Paul Wright, editor of Prison Legal News in Seattle, a murder convict who was serving time in prison when he started the national watchdog magazine.

“This has all the common elements of the prison medical-neglect cases: It starts with something easy to diagnose, they botched the diagnosis, and they botch the treatment. It’s a miracle the guy didn’t die.”

Takes morphine for pain

Manning, 60, is disabled following extensive surgery in which six pounds of flesh was removed from his pelvis. Left with one testicle and a reconstructed penis, he has been released from prison and lives in a dilapidated motor home in Hoodsport, taking at least 30 milligrams of morphine a day for pain.

“There will never be a return to normal,” said Manning’s lawyer, Daniel D. DeLue, of Seattle. “No individual who’s been compromised physically and emotionally at this level can ever return to normal.”

State prison officials have denied Manning’s accusations and wouldn’t discuss the lawsuit in detail with the Seattle Times.

“We’ve had Mr. Manning examined by a medical doctor, who didn’t find support for many of the medical claims,” Assistant Attorney General Eric A. Mentzer said.

Khurshid also would not discuss the lawsuit.

A slightly built former housepainter with a history of mental illness, alcoholism and an IQ of 78, Manning was sent to Stafford Creek in March 2004 to serve a 13-month sentence for threatening a neighbor and stealing the man’s pistol in a drunken argument.

Three months later, on July 4, he developed an infected hemorrhoid.

Given ice pack, Benadryl

Manning claimed he repeatedly asked for medical attention but received no response until July 6, by which time he was hiding under his bunk because of the pain. His genitals were swollen and he was bleeding from the rectum, had a rash on his torso and was running a fever.

As the prison’s lead doctor, Khurshid was at Manning’s bedside for a time after the inmate was admitted to the prison hospital on July 6. There is no indication in prison medical records provided to the Seattle Times that Khurshid performed an examination.

Manning was diagnosed as having an allergic reaction to cold medicine. He was given an ice pack and some Benadryl, an antihistamine, and told not to scratch. Over the next two days Manning’s blood pressure dropped, his pain increased, and blisters began to form on his genitals. Besides Benadryl, he was given fluids, a pain reliever and Medrol, a prescription steroid which is used to treat inflammation but which also depresses the immune system.

Dark blotches, open sores

By July 8, when Khurshid diagnosed an infection, Manning had dark blotches – a sign of dead tissue – on his penis and open sores on his scrotum. He was sent to Grays Harbor Community Hospital in Aberdeen, where a doctor quickly recognized “Fournier’s gangrene,” a type of necrotizing fasciitis that kills about a quarter of the people who get it.

Manning was immediately flown to Harborview Medical Center in Seattle. Over the next week he was subjected to four “debridements” – the removal of dead tissue which left him scarred from rectum to ribs. Surgeons eventually made a replacement penis with skin from his thigh.

After about two weeks at Harborview, Manning was returned to Stafford Creek, where his medical chart still listed him as allergic to the same cold remedies that were wrongly linked to the pain in his groin.

The delay in diagnosing flesh-eating bacteria allowed the infection to spread and cause permanent disfigurement, and prescribing Medrol was “like putting gasoline on the fire,” DeLue said.

Dr. Beck Bay, a Seattle expert in prison medical care hired by DeLue, said Khurshid and his staff failed to recognize obvious signs of infection and should have ordered blood tests. “That is off-the-charts unacceptable,” Bay said. “It’s hard for me to understand what they were thinking.”