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Suit: Pregnant woman denied necessary medication

Thankfully this woman is suing the jail!

Suit: Pregnant woman denied necessary medication, put in solitary confinement, while in Montana jail on traffic offenses

 

Bethany Cajune is a young woman in western Montana who sought treatment from the Confederated Salish and Kootenai Tribal Health Clinic Behavioral Health Program for an addiction to the painkillers she was given following a surgery. She made good progress there. As part of that recovery, Cajune – who was five months’ pregnant – sought to complete an outstanding sentence at the Lake County Jail. That’s when things began to go downhill. The Missoulian’s Vince Devlin tells her story here:

POLSON – A Ronan woman who says she was repeatedly denied a prescribed medication while pregnant and serving time in the Lake County Detention Facility for traffic violations has sued the county, Sheriff Lucky Larson, chief detention officer Luke Mathias and Dr. Stephen Irwin, the jail’s medical doctor.

The American Civil Liberties Union of Montana announced the lawsuit in a news release issued Thursday, shortly after the suit was filed in Missoula District Court.

It says that over the course of nine days in jail last spring, Bethany Cajune, 25, experienced constant vomiting, diarrhea, rapid weight loss, dehydration and other symptoms, all “extremely dangerous” to her fetus.

Rather than receiving the necessary medical care, it says, she was instead placed in solitary confinement.

 

Jennifer Giuttari, staff attorney for ACLU of Montana, told the Missoulian Thursday that Cajune had developed an addiction to painkillers after undergoing two to three surgeries to remove a cyst from her tailbone. She was nearing a year of successful medical treatment for the opioid addiction, and was four to five months pregnant, when she reported to the Lake County Detention Facility to complete a 24-day sentence as a habitual traffic offender.

The lawsuit says Cajune’s counselor, Kathy Ross, spoke to Mathias eight days before Cajune was incarcerated and informed him that to avoid the serious harms withdrawal could trigger in Cajune and to her fetus, Cajune needed to continue receiving Suboxone, a medication that suppresses withdrawal symptoms, while in jail.

After repeated warnings to Irwin and his staff from the doctor who had prescribed the Suboxone – he also faxed letters to Larson about it – that withholding the medication could lead to the death of the fetus, the lawsuit says it took the intervention of a public defender to secure Cajune’s release from jail so she could go back on the Suboxone and receive medical care.

“Punishment is the deprivation of liberty, not unusual and cruel suffering,” Giuttari said Thursday. “Being forced to undergo abrupt withdrawal symptoms, and having to fear for the life of your baby, is not the punishment we’re supposed to hand out for traffic violations.”

The lawsuit says Lake County and its jail staff denied Cajune rights guaranteed her under the Eighth and 14th amendments to the U.S. Constitution, as well as rights guaranteed under Montana’s Constitution.

Cajune v. Lake County seeks unspecified damages.

Irwin was not in his office Thursday, and a number listed for his residence was not answered. Larson said he had not seen the lawsuit, and could not comment.

“Apparently, filing a press release is far more important than informing a defendant about a lawsuit,” Lake County Attorney Mitch Young said. “We haven’t been served, and obviously, I can’t comment on anything I haven’t had a chance to look at.”

***

The lawsuit is the first complaint filed through ACLU of Montana’s new Montana Prison Project, which Giuttari heads, and which seeks to ensure humane treatment of Montana’s jail and prison inmates, including that they be provided with necessary medical and mental health care.

It’s also a part of ACLU’s national Reproductive Freedom Project. The ACLU produced a video about the case that was posted Wednesday on the Internet.

In it, Cajune says she worried that, denied the Suboxone, her fetus wasn’t getting the vitamins and nutrients it needed as she got sicker and sicker.

“I was scared I was going to lose my baby,” she says, adding that at one point she fainted.

“I felt so drained, and so weak from being dehydrated,” Cajune says.

The lawsuit says that, after repeated attempts by Cajune and her treating physician to have the medication made available to her, Cajune submitted an inmate grievance four days into her sentence asking to speak to a judge about her concerns.

On that day or the next, the lawsuit alleges, Cajune was placed in solitary confinement, in a cell with “no windows, a dirty toilet, a sink, a mattress on a cement floor, and a bright light Ms. Cajune could not turn off at any time.”

“The jail had absolutely no basis, in law, in medicine, in humanity, in how you treat a human being, to put her through this,” Diana Kasdan of the Reproductive Freedom Project says in the video.

Asked what sort of traffic violations result in a 24-day jail sentence, Giuttari said Cajune had pleaded guilty to being a habitual traffic offender. They were mostly citations for speeding and driving without a license, Giutarri said, and that “nothing major” had jumped out at her, including any DUIs.

“But what I want to get across is, regardless of what the offense was, everyone deserves constitutional care, regardless of the crime,” Giuttari said.

***

Cajune pleaded guilty to the traffic charges in 2008, and began her sentence while pregnant with her fifth child. She served five days before experiencing early labor symptoms, and was released.

At some point after that child was born, Cajune began making arrangements to finish the remaining 19 days of her sentence. The lawsuit says she called the jail several times to see if a bed was available.

The lawsuit says Ross spoke to Mathias about Cajune’s need to continue on Suboxone on March 10. On March 18, it says, Cajune self-reported to the jail with supplies of two medications she was on – the Suboxone, as well as Promethazine, which treats pregnancy-related nausea.

“Once in her cell on March 18, 2009, Plaintiff requested her medications, but jail staff refused her treatment,” the lawsuit alleges. “They informed her she needed to speak with a doctor before receiving any treatment.”

The next day, the document says, Cajune was given the Promethazine but denied the Suboxone.

On March 20, Cajune submitted a written medical complaint saying she was already feeling sick and would get worse without the Suboxone. The same day, the lawsuit says, Cajune’s doctor, Kenneth Cairns, called Irwin’s office twice. Both times he was only able to speak to Irwin’s nurse, but stressed to the nurse that without the Suboxone there was a substantial risk of both physical and emotional harm to Cajune, and that the health of the fetus was at risk.

Cairns followed up the phone calls with letters faxed to both Larson and Irwin, the lawsuit says.

“He … explicitly warned Defendants that the longer they withheld Ms. Cajune’s Suboxone, the greater the risk of causing permanent harm to the fetus, or even fetal death,” the lawsuit says.

On or about March 20, Irwin did see Cajune, the lawsuit says, but “did not ask her any questions about her condition, or provide a physical exam. He simply told her she could not have her Suboxone.”

Then came Cajune’s written grievance, and her being moved to solitary confinement.

***

Cajune was referred to the jail psychiatrist, the lawsuit says.

“She told the psychiatrist that she was suffering anxiety and continual waves of panic attacks,” according to the document, “and that she needed to go to a hospital.”

It alleges the psychiatrist did not prescribe any medical treatment to address her withdrawal symptoms and never visited her again.

On March 23, the lawsuit states, Cairns again called Irwin and this time spoke with him directly.

“He again explained to Dr. Irwin the medical necessity of continuing Ms. Cajune’s Suboxone prescription and that forced withdrawal was contraindicated (inadvisable) during pregnancy,” the lawsuit says. “Dr. Irwin was unwilling to consider this information and insisted he would continue to withhold Ms. Cajune’s Suboxone medication.”

The lawsuit alleges that Irwin saw Cajune again that day. “Despite having been informed multiple times by Dr. Cairns of the substantial health risks to Ms. Cajune and her fetus, and despite Ms. Cajune’s obvious pain, suffering and signs of withdrawal,” Irwin again refused Cajune the Suboxone.

Cairns visited Cajune at the jail on March 25, and said she “appeared visibly sick and underweight, and visibly suffering from the effects of withdrawal, including muscular pain, nausea, vomiting, diarrhea, dehydration and anxiety – all extremely dangerous during pregnancy.”

On March 26, Cairns again phoned Irwin to express concerns that Cajune’s condition could lead to a miscarriage, and faxed another letter to Larson indicating likewise. Cajune, her wrists and legs shackled, was taken to St. Joseph Hospital in Polson that day for an ultrasound, which dated her pregnancy at 16 weeks and five days, and showed her amniotic fluid measured in the lower limits of the normal range.

The next day the public defender filed his motion, and that evening the Lake County Justice Court ordered Cajune’s release because of medical complications.

On the video, Kasdan says when a pregnant woman is incarcerated, “she of course has the right to continue that pregnancy, and of course has the right to the medical care she needs to have a safe pregnancy.”

“You kind of feel like you’re being labeled, you’re an awful mother for taking this medication,” Cajune says on the video. “That’s kind of what they made me feel like. So then you feel worse about it, on top of being sick.”

Cajune gave birth to the baby, a girl, earlier this fall. The baby is shown in the video. The lawsuit does not mention any issues with the baby’s health.

Reporter Vince Devlin can be reached at (406) 319-2117 or at vdevlin@missoulian.com.

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  1. November 23, 2009 at 2:58 pm

    I saw this article last week too and was equally appalled. Ugh. I just wish there was some universal standard (that was adhered to) for women in this situation. We’ll just keep working at it, I suppose!! Thanks for posting this!

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