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Dying In Jail
The Sad, Short Life of Jimmy Villanueva

By Dan Frosch
Santa Fe Reporter

On March 26, buried beneath headlines of bombs over Baghdad, the daily papers reported that the warden of Santa Fe County’s jail—as well as his second in command—had been fired.

The way the story went, Management and Training Corporation, the private company that runs the Santa Fe County Detention Center, had removed Warden Cody Graham and Major Greg Lee perhaps because of concerns about sanitary conditions recently raised by the county jail’s advisory committee.

What wasn’t mentioned, however, was that the same week as the firings, the county’s jail monitor, Greg Parrish, had met with lawyers from the federal Department of Justice’s Special Litigation Department.

Though neither Parrish nor the DOJ would comment on that meeting, it likely centered on a 34-page report issued early last month.

The report was the result of a six-day visit last spring, during which a Washington, DC, team talked to prisoners and staff and pored over records.

The report concluded that certain conditions at the jail violated inmates’ constitutional rights. More than half of the report focused on the health care provided at the jail, via a subcontract, by Physicians Network Association, and includes a frightening laundry list of cases in which inmates were put at risk.

PNA’s regional medical consultant, who worked out of the jail, could not be reached for comment. Her name is Katherine Graham, and she is the wife of Cody Graham. A nurse at the facility, contacted last week, said Katherine Graham also no longer worked there, but SFR was unable to confirm this prior to press time.

What has become clear, as the result of several months of interviews conducted by SFR with inmates at the jail, is that the quality of health service provided by PNA has become an increasing concern. Inmates Manuel Valencia, Jerry Freeman and Billy Ganó say inmates have to wait from a week to two weeks just to get into the jail’s medical facility.

Parrish, too, acknowledged he was “not satisfied” with the medical care, and said the majority of grievances from both inmates and their families focused on lack of access to both care and needed prescriptions.

One voice missing from the discussion and left out of the DOJ report is that of a man named Jimmy Villanueva.

Villanueva came through the doors of the Santa Fe jail after the DOJ team had already left. Nonetheless, Villanueva’s case exemplifies what the DOJ and others have characterized as a health system that puts inmates at serious risk.

It is these conditions that have left Villanueva’s sister, Priscilla Romero, determined to sue the jail. Sue them, she says, “for neglect, for premature death. For what they did to Jimmy.”

Some time during the daylight hours of Jan. 11, 2003, the 45-plus inmates of Santa Fe County Detention Center’s Delta 100 pod gathered in their communal area, joined hands in a semi-circle and began to pray.

The night before, one of their more popular cell mates, Jimmy Villanueva—Jimbo or Jim to his closest friends—had been rushed to St. Vincent Hospital’s emergency room after complaining of searing pain in his back.

Virtually everybody in D-100 knew Villanueva: A large man at 5’9” and close to 300 pounds, he’d been serving a six-month parole violation sentence since early July.

At 55, Jimmy had been in and out of jail more than five times over the past 30 years, mostly for drug possession charges. Like his cell mates, he’d been placed in a Delta pod because of the nonviolent nature of his crime.

Delta, the largest and least restrictive of the jail’s four cell blocks, had pods with two floors of dormitory-style bunk beds as opposed to the standard two-person cells; there were common toilets and showers on each floor.

This communal atmosphere meshed well with Villanueva’s personality. By all accounts, he was well-liked by inmates, guards and nurses. Lighthearted and quick-witted, he loved to draw, play cards and boasted about going fishing as soon as he got out.

He also was in a lot of pain.

“His back was always sore, always bothering him,” remembers Manuel Valencia, Villanueva’s closest friend in jail. “He knew something was wrong with him but he didn’t know what.”

According to Valencia, Villanueva had gone to the jail’s on-site medical facility numerous times and had been put on pain medications but nothing seemed to work.

By October, Villanueva’s pain had gotten so bad he could barely move off his bunk.

“People were getting his meals, heating his coffee, pretty much having other inmates get everything for him,” recalls Jerry Freeman, who lived in D-100 with Jimmy for more than three months. “He was that immobile.”

Villanueva was having trouble making it down the flight of stairs from his bed to get his medication off the “med line,” and safety restrictions prohibited the nurse from taking the medicine up to him, so several inmates would carry him down to get his pills.

“It would take him 15 minutes to get down those stairs and another 15 minutes to get back up,” says D-100 inmate Billy Ganó. “He missed his drugs a lot because he was getting to the point he just couldn’t move.”

During that second week of January, inmates said Villanueva’s pain had become so unbearable there was nearly a riot in Delta.
“We raised hell,” says Ganó. “We kept telling the nurse to bring the medicine to him! We were all yelling: He can’t take make it down the stairs! Take the medicine to him!”

Finally, said Ganó, a guard brought Villanueva’s medicine up to his bed, an unprecedented event.
As before, though, his painkillers did little.

“That last night he was in there, he was in so much pain, he was crawling around,” remembers Freeman. “To see a man that large crawling around was awful.”

According to Valencia, the night of Jan. 10, Villanueva told him he needed to be taken to a hospital or he was going to die in jail. Valencia says a nurse came in to see him and took his vital signs.

With Villanueva’s condition worsening, medical staff from the jail called an ambulance which whisked Villanueva to St. Vincent Hospital.

Recalls Valencia: “We had made plans to go kick back and go fishing because he was getting out soon. I knew deep down it would never happen. I knew when I saw them take him through those doors, I would never see him again.”

Jimmy Villanueva was not only Priscilla Romero’s closest brother—he was all she had left.

At one time there had been 11 of them, six brothers and five sisters, growing up hard and fast in small homes around old Santa Fe—back when West Alameda and Juanita Street were considered el barrio and St. Francis Drive was nothing but dirt.
But bad health, heartbreaking luck and violence haunted the Villanueva family over the years.

At 19, Jerry Villanueva died after being struck by a car. Julian was stabbed to death at 31. While also in their early 30s, Johnny suffered a heart attack, Ted choked in his sleep and Mikey froze after getting lost hiking in the hills.

But Jimmy, the most outgoing of the brothers, had managed to sidestep the Villanueva curse. He’d gotten mixed up with heroin at a young age and seemed to be in jail more than he was out, but he’d managed to make it longer than any of them, splitting time between Santa Fe, their mother’s trailer in Chimayó and the jail.

Romero and Villanueva were close, and she was happiest, of course, when her brother was not behind bars. By early 2003, Villanueva was set to be released and she looked forward to seeing him again.

But on Jan. 11, a St. Vincent nurse called Romero and told her Villanueva had been hospitalized, but that it would be difficult to see him because he was still considered incarcerated.

Three days later, Romero, growing more concerned, got another phone call. It was her brother.

“He said, ‘Sis, I’m here at the hospital. I need to talk with you. There’s something wrong with me,’” she says.

Villanueva told Romero that he’d been released from the jail to the care of the hospital and she could finally come visit him.

St. Vincent doctor Rebecca Bair had been treating Villanueva since the night he’d been brought in. Bair wouldn’t comment on his case due to patient confidentiality, but Villanueva’s medical records from the hospital, shared with SFR by his family, help show what happened to him once he reached St. Vincent.

During the initial examination, Villanueva described the pain in his ribs and back he’d had for months and said that he hadn’t been able to walk for a week without numbness in his lower body.

Bair immediately ordered an MRI of two places on Jimmy’s spine. She found lesions in both places and assessed them as metastatic cancer.

Bair described the cancer in her report as “poorly differentiated”—a bad sign. It meant, essentially, that the the tumors were aggressive and spreading rapidly.

On the day after Jimmy was admitted, Bair recommended “urgent radiation treatment,” which Villanueva began receiving daily. As a procedural measure, she’d ordered biopsies of the lesions on his spine and a mass spotted on the right side of his ribs. All confirmed cancer.

But Villanueva wasn’t responding to the radiation; the tumors were eating away at his insides too fast for any treatment. Doctors also had discovered that he was sick with Hepatitis C and cirrhosis of the liver, which had contributed to the rapid deterioration of his body.

Romero received the news that her brother was dying when she finally got to see him on Jan. 15.
“I go, ‘What do you mean?” she remembers. “‘You’re lying! You’re making it up.’”

Daniel Romero also remembers that day: “Jimmy broke down crying. He told us, ‘I don’t think I’m gonna beat this shit.’”
Shortly after the Romeros saw him, Villanueva began slipping in and out of a coma.

In the morning hours of Jan. 23, he woke up confused, disoriented and in unimaginable pain. “God help me!” he shouted and pounded on his bed tray.

Knowing he didn’t have long, the Romeros came to see Villanueva the following day.

“I went to work and came back. I hadn’t been there for 10 minutes, when I noticed his breathing was strange,” Priscilla Romero remembers, her voice choked with feeling. “I said, ‘Jimmy what are you trying to tell me?’ Then I realized he was taking his last breaths.”

At 6:54 pm, Dr. Daniel Kovnat pronounced Jimmy Villanueva dead.

Nurses called his mother who rushed down from Chimayó. The family stayed in the hospital room until his body was removed at close to 2 am.

Shortly thereafter, Jimmy Villanueva’s family began asking for his medical records from the jail.
“He told me the jail knew he was sick and that they didn’t do anything,” says Romero, who adds that her brother was furious and said he wanted to hire a lawyer as soon as possible. “He told me that he’d had a checkup in October but the jail was ignoring him…”

“We have a well-qualified staff of nurses and doctors. Experts the prisons and jails can rely upon,” says Dr. Vernon Farthing as he sits down for lunch at the San Marcos Cafe, in the shadows of the Santa Fe County Detention Center.

A middle-aged man, with a neatly trimmed red beard, slightly receding hair line and pinkish complexion, Farthing extends his o’s and smooths his u’s with the honey-sweet twang of a well-educated Texan.

A waitress brings him a steaming plate of huevos rancheros, his favorite. “Thank you,” he smiles politely.

Ten years ago, at the urging of a judge from Lubbock County, Texas, Farthing—an internal medicine doctor by trade—formed Physicians Network Association to provide medical care for Lubbock’s inmates. Since that time, Farthing’s baby has blossomed into a successful private health care corporation that provides on-site medical services for county, state and federal correctional institutions in Florida, Texas and New Mexico.

In all, PNA holds 14 contracts. Here in New Mexico, PNA works at the Gallup County Jail and the Santa Fe County Detention Center.

“We have never solicited one contract. People solicit us because of our expertise,” Farthing states confidently in between bites.

MTC contracted PNA in October 2001. Since then, Farthing has driven or flown the corporate jet to Santa Fe a few times a month to check on patients and oversee operations.

It was during one such visit to Santa Fe that Farthing met Jimmy Villanueva.

In fact, it was Farthing who referred Villanueva for X-rays following his complaints of rib pain—the October checkup Romero referred to.

Those X-rays occurred Oct. 3 at Santa Fe Radiology, and were taken of Villanueva’s chest and the right side of his ribs by Dr. Jonathan Lehman.

Lehman noted that Villanueva’s lungs did not look like they were in great shape, and, according to doctors with whom SFRspoke, that could be attributed to many different reasons, for instance his smoking.

He’d spotted something on Villanueva’s ribs though—an “expansile abnormality”—that Lehman assessed as either an infection or what he called a “neoplasm.”

Neoplasm literally means “new growth.” In medical terms, it has another, more ominous implication: cancer. Lehman recommended further evaluation, specifically of Jimmy’s ribs. He also suggested a CAT scan.

SFR showed or read Lehman’s initial report to three New Mexico doctors: Arlene Brown, an Albuquerque doctor who sits on the board of the American College of Family Practitioners, Cynthia Cathcart, an oncologist at the University of New Mexico Cancer Research and Treatment Center, and Sandra Penn, the medical director for the Penitentiary of New Mexico.

SFR has no way of knowing if different treatment for Villanueva would have made any difference in his prognosis, but all three doctors (none of whom specifically knew Villanueva’s case) all agreed that, at the very least, Villanueva’s ribs should have been checked again and a CAT scan ordered.

“The report on his rib was not equivocal,” said Penn emphatically. “The specialist clearly stated there was a problem. I would have sent him to get a CAT scan. I would have scheduled a biopsy. I would have had him in a doctor’s office for a follow-up within 48 hours.”

But Farthing and Dr. Arturo Calderon, PNA’s on-site doctor who also saw and treated Villanueva (and who could not be reached for comment), apparently did neither. (Villanueva’s family is still trying to get his medical records from the jail.)
Instead, Farthing says PNA performed numerous physical examinations and bloods tests on Villanueva and concluded that his history of chronic back pain was causing the problem. They placed him on painkillers.

Then, nearly a month and a half later, just to be sure, Farthing sent Villanueva back to Santa Fe Radiology for another X-ray.

But Farthing ordered an X-ray on Villanueva’s chest, not his ribs.

Dr. Christopher Kosir performed the X-ray and reported that Villanueva’s lungs looked worse but that the situation remained unclear. Kosir’s analysis didn’t mention the possible cancer in Villanueva’s ribs, the more pressing problem. In fact, the word rib is not mentioned.

“This was a follow-up to both,” Farthing responds to the question of whether he’d ignored Lehman’s opinion. (The DOJ report specifically criticizes PNA for not following specialists’ recommendations). “Every radiologist that X-rays a person’s chest, by law, has to look at the ribs. The radiologist did not discuss ribs, because there were no significant findings.”

SFR e-mailed Dr. David Lynch, a professor of radiology at the University of Colorado Health Sciences Center, and asked whether a chest X-ray would provide as accurate a picture of a person’s ribs as a rib X-ray. Lynch replied: “No. The rib films are to show the ribs. The chest is to show the chest.”

Farthing, however, insists that given the information he and his staff had, PNA acted appropriately and that the pain medication was what they felt Villanueva needed.

Nonetheless, Villanueva apparently remained in pain.

“I remember seeing him in medical,” said one nurse employed by PNA at the jail, who asked to be kept anonymous. “The other nurses kept telling the doctor that there was something wrong,” she said.

Just over three months after the initial X-ray, Villanueva was sent to St. Vincent. “The fact that the disease was diagnosed was a direct result of our clinical activity,” Farthing said. “We sent him to the hospital and he was diagnosed upon our action.”

Further, says Farthing, it’s impossible to judge PNA’s treatment of Villanueva by two X-ray reports.“That’s like taking two pieces out of a puzzle,” he said.

Farthing acknowledges Villanueva died of cancer he appeared to have back in October.

He agrees that, in retrospect, he “would have liked to have done a CAT scan.”

He agrees that PNA’s diagnosis of Villanueva—essentially as a guy with serious, chronic back pain—was wrong.
He also insists that Jimmy Villanueva received the best care possible.

“We are not a callous, uncaring, hateful organization,” he says. “Our outcomes prove that.”

The DOJ report, however, reached a different conclusion, stating that inmates at the Santa Fe County Jail suffered “serious harm” from, among other things, inadequate health care.

Attempts by the county to improve conditions at the jail have been numerous. Two years ago, it contracted the Salt Lake City-based MTC to re-place the much criticized Cornell Companies Inc.

Former FBI agent Greg Parrish was hired to monitor and report weekly on jail conditions.

The volunteer Corrections Advisory Committee was created to monitor and issue an annual report on the jail.

Still, says County Commissioner Paul Duran (who was unfamiliar with Villanueva’s case), “Some of the violations that have taken place at the jail and that have continued to take place are atrocious. We need to get more involved or we’re going to expose the county to considerable risk and the potential of human rights violations.”

Neither Parrish, nor committee member Dr. Steve Spencer (who served as medical director for the New Mexico Corrections Department from 1985 and 1993) would comment on the DOJ report. But both said they believed PNA had improved since the DOJ investigation ended in May.

They also agreed important problems remain.

Spencer noted that PNA’s staffing of one medical doctor, on site once a week, serving an average of 650 inmates was problematic and said the the American Correctional Association recommends that a doctor spend a minimum of 21 hours a week on site at a facility of Santa Fe’s size.

Farthing did not return phone calls seeking comment on the DOJ report (which SFR obtained following its interview with him).
As for MTC, its e-mailed response to questions about the DOJ report only said that it remained “confident in the medical service” provided by PNA and would work with the latter to resolve “any issues as they may arise.”

Ophelia Padilla lives in a tiny trailer at the end of a dirt road in Chimayó. Her home is warm from the heat she likes to turn up high. Spanish soap operas play quietly from a television in the corner. Pictures of Jesus and her 11 children cover the walls.

Last month, Padilla turned 80. A few daughters and grandchildren gathered from Santa Fe and Española to celebrate with her. Once, a long time ago, Padilla had six sons. Now she has none.

Padilla says she spends most of her days thinking and crying about the death of her last son, Jimmy Villanueva.

She’s not the only one mourning his death. Villanueva’s old cellmates from Delta 100 made him a get well card they never got to deliver. Instead, they asked it be given to his family.

Among the 26 letters and signatures, one reads: “Jimbo, I can’t begin to understand the pain you and your family are going through right now but I felt it cause I went through it with you in here. Stay strong for us all homie and may God bless you and you family in this time of need. Get well soon.”

Dan Frosch
Additional reporting by Rob Jenkins.

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