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Thursday, Jan. 19, 2012 04:56 pm

Despite malpractice payouts, sheriffs still use jail doctor

Dr. Stephen A Cullinan
More than $1 million has been paid out in Illinois since 2010 to settle lawsuits filed against Dr. Stephen A. Cullinan, a Peoria physician who has been sued dozens of times for substandard care in jails throughout the Midwest.

Despite a history of lawsuits and payouts, Cullinan’s company, called Health Professionals Limited, is still used by sheriffs throughout Illinois, some of whom have accepted campaign contributions from the firm. While the state is supposed to make public malpractice settlements involving physicians, at least one settlement is missing from an Illinois Department of Professional Regulation database that is supposed to keep consumers informed about physician discipline and malpractice cases.

The most recent settlement came Nov. 28, when Cullinan settled a case in Sangamon County for $737,500, according to figures recently made public by the Department of Professional Regulation. Although the department does not make public any details of settlements, the settlement timing corresponds with the resolution of a federal lawsuit filed by the family of Maurice Burris, who died in 2007 after a perforated ulcer went untreated in the Sangamon County jail.

Cullinan could not be reached for comment. Kathy Gallo, Health Professionals contact person listed on the company’s website, said that she doubted the company would have a comment but would forward a message to the firm’s legal department. Cullinan, who co-founded the firm, which is now a subsidiary of Correctional Healthcare Companies, is the company’s regional medical director.

It’s not clear whether Cullinan or an insurer paid the Burris settlement. Malpractice insurance isn’t mandatory in Illinois, and the state does not make public whether a doctor is insured.

Six months before Burris died, Jason Waggener, an inmate in the Macoupin County jail, was found sitting in a pool of blood with a compound fracture to his lower leg, which appeared gangrenous. He had broken his ankle and suffered a head injury three days earlier after suffering a seizure in the jail. Rather than send him to an orthopedic surgeon, as an emergency room physician recommended, authorities returned Waggener to the jail, where he became delusional, removed his splint and walked around, according to Waggener’s lawsuit against Cullinan and the county. His leg was ultimately amputated below the knee.

The Illinois County Risk Management Trust, Macoupin County’s insurer, paid $339,880 to settle the case, with the county paying a $5,000 deductible, according to records obtained through a formal request to the sheriff’s office and county board. In a December interview, Macoupin County sheriff Donald Albrecht had said that he did not know how much the county paid Waggener, who is now on parole for aggravated criminal sexual abuse. Similarly, officials at the county board last month said they could locate no records regarding the settlement memorialized in federal court records.

Albrecht, a Democrat, is one of at least four sheriffs in Illinois who have accepted campaign contributions from Health Professionals while contracting with the company to provide medical care for inmates. The company, which tends to back Republicans ranging from Aaron Schock to Ray LaHood, gave Albrecht $400 before Waggener lost his leg and an additional $1,100 after he sued. Albrecht could not be reached for comment this week, but he said last month that Cullinan still provides care for inmates and that he believes the doctor does a good job.

Counties throughout Illinois contribute to the risk-management trust that insures Macoupin County. It’s not clear how much Cullinan or his insurer paid Waggener, but state records show that the doctor settled a case for $130,000 at about the same time as the Macoupin County lawsuit was resolved in 2010.

If anything, records kept by the Illinois Department of Professional Regulation understate the seriousness of Cullinan’s record in settling malpractice cases. In Indiana, Cullinan last year told the state Professional Licensing Agency that he had settled a malpractice case in Oklahoma in 2009 for $17,500 after an inmate whose criminal charges were ultimately dismissed alleged that he had not gotten prescribed medication or proper treatment after he was injured when another inmate attacked him. Cullinan also told Indiana authorities that Health Professionals settled the Waggener case for $255,000.

Cullinan’s public file at the Illinois Department of Professional Regulation contains no mention of malpractice settlements of either $255,000 or $17,500. The department is supposed to make public any malpractice awards or settlements. Susan Hofer, department spokeswoman, said that the department’s public database went online in October.

“We are in the process of going through older cases to add this type of information to the site,” Hofer wrote in an email message.

Cullinan was ordered to appear before the Indiana Medical Licensing Board in 2009 after he failed to disclose a $10,000 fine levied earlier that year by authorities in Michigan who found that he had withheld prescribed psychotropic drugs from mentally ill patients without examining them or their charts or notifying the prescribing physician. Cullinan was supposed to disclose any discipline taken by another state as part of a license renewal process. The Indiana board in a 3-2 vote renewed Cullinan’s license after a lawyer for Health Professionals’ parent company testified that Cullinan’s staff filled out the renewal form and that the doctor had not tried to deceive the board.

In a written explanation about the Michigan matter, Cullinan told Indiana authorities that Health Professionals had implemented procedures to “ensure continuity of medications” when someone with a prescription gets arrested. But Cullinan and his company have failed to provide prescribed drugs to inmates in Illinois and elsewhere, before and after Michigan fined the doctor, according to lawsuits filed against Cullinan and his company.

Cullinan and his company last year settled a lawsuit filed by the mother of Roy Wireman, Jr., who suffered seizures and died in an Indiana jail in 2009 after failing to receive prescribed Xanax. It’s not clear why the Illinois Department of Professional Regulation public database contains no record of the Wireman settlement that court records show was reached in September.

In Illinois, Cullinan and his firm are defendants in a federal lawsuit filed last fall by the family of Robert Awalt, an epileptic who died in the Grundy County jail in 2010 after he was denied anti-seizure medication that had been prescribed.

During a 2004 meeting called by judges and others concerned that inmates in La Crosse County, Wis., weren’t getting prescribed medication, a Health Professionals physician acknowledged giving inmates “drug holidays” to see if they could go without prescriptions. Three months later, a La Crosse County judge ordered jailers to take an inmate out of the jail to a county mental health clinic each day because a Health Professionals doctor refused to provide a prescribed psychotropic drug commonly used to treat schizophrenia.

Michael Goldberg, a Chicago lawyer who represents physicians accused of malpractice, said that the Department of Professional Regulation can discipline doctors for gross negligence if the department can show either a single egregious mistake – amputating the wrong limb, for instance – or if a doctor keeps repeating the same mistake. Repeated failure to provide drugs could qualify, Goldberg said.

Cullinan has, presumably, already been investigated by the Department of Professional Regulation, given that malpractice settlements and discipline levied in other states are supposed to trigger investigations in Illinois where, until recently, Health Professionals held state contracts worth millions of dollars.

Since 2007, the state has paid more than $96.5 million to Cullinan’s company for health care provided to the Department of Juvenile Justice and the Department of Corrections, which until last summer contracted with Health Professionals for medical care in four prisons, including Vandalia Correctional Center, Southwestern Illinois Correctional Center, Centralia Correctional Center and Taylorville Correctional Center. The Department of Corrections re-bid the contract in August and no longer uses Health Professionals. Stacey Solano, corrections spokeswoman, said that the department had no dissatisfaction with the company.

An unattributed quote on the website of Correctional Healthcare Companies, the parent firm of Health Professionals, touts Cullinan’s company as a money-saver for jail administrators:

“We look at HPL as preventative. What we pay is a fraction of what you’d pay with a lawsuit.”

In Sangamon County, which is self-insured, taxpayers paid $60,000 to Burris and nearly $300,000 to attorneys who handled the lawsuit filed by his family. The county terminated its contract with Health Professionals nine months after Burris died and one month after Sheriff Neil Williamson received a report from a consultant who concluded that health care was still lacking in the jail, despite Burris’ death.

“The report was influential, I would say,” Williamson said. “We lost faith, and we were wanting to go in a different direction.”

Contact Bruce Rushton at brushton@illinoistimes.com.


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