Arkansas jail sued over ivermectin treatments has alleged history of leaving ailing inmates "harmed and worse off"
When Walt Kelly was taken to Washington County Detention Center in Arkansas in November 2017 for two counts of delivering an ounce of marijuana, he was undergoing treatment for bipolar disorder. He had a notarized letter from his psychiatrist explaining his need to continue taking his medication – a cocktail of lithium, lamictal, seroquel and klonopin.
But when he arrived at the jail, he told CBS News, jail staff "basically" laughed at him.
"I was literally – I hate to sound so pathetic – but left to die in my own misery, in my mental health nightmare," Kelly told CBS News.
Kelly, 49, was only held at Washington County Detention Center (WCDC) for 24 hours before he was transferred to another facility. He says neither facility gave him his doctor-recommended treatment, and even just one day without his medicine took a toll on him, he said, impacting his ability to sleep, and quickly putting him in a manic state.
Missing doses of lithium, lamictal and seroquel, according to the National Alliance on Mental Illness, can increase risk for a relapse in bipolar disorder symptoms. Missing doses of klonopin after using for two or more weeks can cause withdrawal reactions.
Kelly's 24-hour stay at WCDC five years ago, he said, was the beginning of "the most traumatic experience of my life." Some others have expressed similar sentiments for years – many specifically related to the health care they received at the facility.
Last year, WCDC made headlines after it was revealed that the facility's medical provider, Dr. Robert Karas, was prescribing detainees the anti-parasite drug ivermectin to treat COVID-19, allegedly without their knowledge. Karas, who has admitted to administering the drug but said detainees were "not forced" to take it, is the same doctor that Kelly said refused to see him during his stay.
The ACLU of Arkansas filed a lawsuit against the facility and Karas last month on behalf of four inmates who said that when they had COVID last year, they were treated with ivermectin without their knowledge. Some of the inmates allegedly received several times the dosage amount of ivermectin than what is recommended for their weight and height.
Neither WCDC, Sheriff Helder, and Dr. Karas, nor their attorneys, have returned CBS News' request for comment.
The medication has not been approved by the Food and Drug Administration for COVID treatment and the CDC issued a health advisory warning people not to take the drug for COVID.
A fifth and sixth inmate, Thomas Fritch and Andre Lamont Williams, have also filed separate lawsuits against the same defendants, alleging they were misinformed about the medication. Karas has denied both Fritch's and Williams' claims and has requested a trial by jury, according to Karas' answers to the complaints, and Williams' case is still in discovery phase.
A seventh person who was detained around the same time as the other plaintiffs reached out to CBS News, alleging medical staff at the jail told detainees they were receiving vitamins and steroids rather than ivermectin.
Sarah Moore of the advocacy group Arkansas Justice Reform Coalition told CBS News that when it was revealed the physician was attempting to treat COVID-19 with ivermectin, it "didn't come as an incredible surprise."
For years, she said, people detained at the facility have claimed that medical staff refused to provide them adequate treatment, including some who say they were refused "life-saving" medication.
"There's been a lot of concern about medications and the lack of appropriate medications and the lack of access to needed life-saving medications," she said. "We've had individuals I've known, they're going into the facility and they've taken their meds with them and not been able to have access."
"They come out…worse off than when they arrived"
Karas has been contracted to work as a doctor at the detention center since 2016, court documents show. According to his 2021 contract, he has "sole authority" in determining "whether to continue, replace or discontinue a detainee's medications."
Karas' contract says he makes more than $1.3 million a year for providing medical services at the jail, and that he also receives copayments from detainees for his medical assistance. Detainees also have to pay for their care – $20 for provider and dental calls, $10 for sick calls, $10 for prescription medication, and $5 for over-the-counter medication.
Since Karas' arrival at the jail, at least 37 federal lawsuits have been filed against the doctor and/or WCDC about the quality of health care services at the facility, all but three of which have been dismissed. Several more lawsuits, dating back more than five years, have been filed against Washington County Sheriff Tim Helder and previous medical staff about the jail's conditions.
Thirty-four of the cases have been closed, and only one of those cases was settled and dismissed without prejudice. The remaining 33 closed cases were dismissed without prejudice, in many cases because the court was no longer able to get in touch with the plaintiff.
Moore told CBS News that Karas' history is "concerning," as many of those who end up detained at Washington County "come out of the facility harmed and worse off than when they arrived."
"We're renewing a contract when we've shown that there's been some harm, a tremendous harm that's come to our community members," Moore said.
Lawsuits depict inmates with "serious" medical conditions
Gary Wayne Guilliams sued the facility, the sheriff, and Karas in 2016 for allegedly denying him medical care. According to his complaint, Guilliams had injured his wrist the day before he was arrested for public intoxication and taken to the detention center. The day he was arrested, doctors confirmed Guilliams had fractured his arm and wrist and ordered him to wear a splint so he could heal. He was also urged to get surgery, but he testified that he was not able to do so because he was homeless and could not afford it.
But as cited in the judge's opinion, jail staff would not allow him to wear the splint during his multiple stays at the facility throughout the year.
Guilliams "made numerous requests for medical treatment for his fractured wrist using the 'kiosk' at the jail, including requests for pain medication, a splint, and to be seen by an outside orthopedic specialist," the complaint says, adding that all the requests were denied.
During court proceedings, Karas testified that his staff "couldn't 'fix' all the inmates medical problems and had to be judicious about what they treated," according to the judge's opinion. Karas testified that his staff considers how long someone will be incarcerated, whether they should address their issue post-incarceration, and "whether the patient would follow-up and take good care of themselves" when making that decision, the opinion states.
Ultimately, in 2017, a hand surgeon concluded Guilliams' injuries worsened because the bones were not able to heal, the judge's opinion shows.
"He should not have been denied orthopedic review in April or any of the early months following his injury," the surgeon said in an initial report. "These delays exacerbated his injury, deformity, arthritis, and more extensive considerations for later surgical management."
The defendants denied the majority of Guilliams' allegations. In regards to the allegation that his fractures and nerve damage "constituted an objectively serious medical condition requiring treatment," the defendants said the "medical records speak for themselves," and denied anything that's not strictly proven by those records.
After the judge issued an opinion saying "it is clear from the record that Plaintiff was suffering and that his condition was worsening," and held that the defendants were not entitled to qualified immunity, the case was set to go to trial. But it was dismissed without prejudice two months before its scheduled start.
Also in October 2016, Michael Turner filed a lawsuit against Karas and the sheriff, alleging they "did not provide much needed dental care for 51 days" when he was complaining of a bad cavity, and eventually, a broken tooth "just above the gum line."
According to case information laid out in a court order, Turner alleged that it took more than a month for him to receive dental care, and that when he was finally seen, "his gums were swollen, red, and infected."
While Turner was waiting, the facility gave him so much pain medicine, one doctor said if he had more than a week's worth more, it "could cause intestinal bleeding and increase cardiovascular risk." Later tests showed he did not ultimately suffer from these or other side effects from the prolonged use of the medication.
Court documents say Karas' contract makes a dentist available between 6 and 8 hours a month, and that according to Karas, the list of people needing dental treatment is "generally full" with "20 to 40 patients on it at a time."
"Emergency dental needs are treated immediately in the same way that … emergent medical needs are. However a broken or decayed tooth would not be considered an emergency dental need," Karas said, according to court documents.
In a written opinion, the judge said that the "defendants make no argument" Turner's toothache "did not constitute a serious medical need," and said that despite Turner's complaints, "no physical examination was performed until more than a month" after his initial request and nearly two months after he arrived at the facility.
Turner's claims against Helder and a sergeant at the jail were dismissed on summary judgment, but Karas' request for the judgment was denied. The case was set for jury trial, but was ultimately dismissed when Turner was released from custody and the court could not find his address.
In 2020, Michael Todd Bailey said that while he was detained, he had an infection on his forehead. Karas allegedly told him to put a bandage on it, and a week later, they had to "cut it open" because the infection got so bad. He claimed they told him the infection didn't warrant antibiotics.
"[They] wouldn't give me antibiotics early when it could have healed, now left with a scar after my eye swelled shut almost. Very painful," Bailey said in his complaint.
Karas and the other defendant denied all of Bailey's claims, and the case was dismissed two months later because he didn't pay a filing fee, which he was charged after being released from custody.
Moore told CBS News it's not uncommon for lawsuits from inmates to get dismissed.
"What happens is that folks file them and they don't have access to counsel, they're pro se," Moore said. "...Because of a lack of return of communication from the party, they end up a lot of times closing the cases out, but it's because the person is incarcerated and they get moved within the systems and they don't have any way to stay in contact with the court."
"A culture of acceptance"
Kelly has said he vividly remembers his experience at both WCDC and the state facilities "minute by minute." He said that after he arrived at the state's Southwest Arkansas Community Correction Center, he was immediately put in isolation, a move he said was part of the process for new inmates to "get you used to the rules."
Much of that time in isolation, he said, was spent without his bipolar disorder medication. Kelly said it took somewhere between two and six weeks to be given lithium, a drug that, according to the National Alliance on Mental Illness, "should be taken every day" to prevent relapses in stabilized mood symptoms.
When they did eventually offer him lithium, it was a once-daily dose of 150 mg, he said. As stated in the letter from his doctor that was obtained by CBS News, he had been taking 300 mg of lithium twice a day prior to his incarceration.
The drug is intended to be part of a long-term treatment plan, as Kelly had established with his psychiatrist before being jailed. Kelly said he started to feel the effects of not being able to take the medication "immediately," and that he was "basically losing my mind."
When he was released in May 2018 after six months, Kelly claims he didn't get his prescription medications back, or his $1,000 wedding band. He never filed a lawsuit against either of the facilities because he "was terrified of them."
"They took everything. … They changed my family's life forever. They changed my world. They were in charge. I was at the mercy of the conditions in those jails," he said. "...The place that I was sent to was just like a glorified 'we are going to reprogram these humans with their thinking errors and change their lives,' and it was highly unsuccessful."
When asked by CBS News for comment on Kelly's situation, a spokesperson for the Arkansas Department of Corrections told CBS News that "regular medical care was afforded to him by our contract medical provider."
The Arkansas facilities are not the only detention centers accused of providing inadequate care.
Correctional health care, according to the Prison Policy Initiative, is "low-quality and difficult to access." Ongoing lawsuits nationwide allegations of "tortuous" and "inexcusable" neglect in Washington state, and preventable infections going untreated in New Mexico. In 2021, a judge found the Arizona Department of Corrections in contempt for a statewide failure of health care service.
A 2020 Reuters investigation found that jails with private health care have higher death rates on average than those handled by government agencies.
"It is widespread. It is a culture of acceptance, of 'that is the way it is,'" Kelly said. "From the intake, to the jailers there at the jail, to the transporters from Washington County to this facility, to the people at this facility, it was a laugh-in-your-face ha ha ha."
