The inmate needed a wheelchair to get around. Doctor accused of taking it away

Fresno County Jail in downtown Fresno. The state medical board says a doctor at the jail gave negligent care to inmates.
Fresno County Jail in downtown Fresno. The state medical board says a doctor at the jail gave negligent care to inmates. Fresno Bee file

The California Medical Board has accused a doctor who provided care at the Fresno County Jail with repeated negligent acts, including denying a wheelchair to an inmate who could not walk.

The medical board investigation found Dr. Michelle A. Thomas negligent in the care of five patients she saw at the jail in 2014 and 2015. If the accusations are upheld, the board could reprimand Thomas, place her on probation or revoke her medical license.

In one case, Thomas is accused of deciding that an inmate could use a walker instead of a wheelchair. The board said she ordered the chair removed on July 25, 2014, before a physical therapy examination had been done to determine if the inmate could walk using a walker, and before he had been given instructions on how to transition from a wheelchair to a walker.

The wheelchair was removed on Aug. 27, 2014, the board said, and the inmate was not able to get around with the walker. He fell when he was taken from his cell for an appointment to have his eyeglasses repaired, the board said.

The inmate filed a grievance with the jail, requesting the return of his wheelchair, the board said. A camera was installed in his cell to observe whether he could walk, and after about a week, the wheelchair was returned to the inmate, the board said.

The medical board identified the patient only with his initials, D.T., but federal court records show a Daniel Trebas has filed a lawsuit for damages he alleges he suffered in the jail, including injuries caused by the removal of a wheelchair. The lawsuit is against Thomas; Corizon Healthcare, her employer at the time; Fresno County Sheriff Margaret Mims; Sgt. Betty Moreno; and the Fresno County Sheriff’s Office.

Trebas’ lawyer, Walter Riley of Oakland, confirmed his client is the D.T. in the medical board accusation. The accusations made by the medical board will be part of his lawsuit, Riley said.

The alleged removal of the wheelchair cited by the medical board occurred about a month after Fresno County, under fire in 2013 over the health care for inmates and the target of a federal lawsuit, turned jail medical services over to Corizon, a Tennessee-based inmate medical services company. The county had been accused of improperly diagnosing and meeting medical and psychiatric needs of jail inmates, which was chronicled in August 2013 by The Fresno Bee in its “Locked in Terror” watchdog report.

We provide health care services to an extremely litigious patient population and as such find it necessary to review litigation, grievances or complaints on a case-by-case basis.

Martha Harbin, spokeswoman for Corizon Health

David Pomaville, director of the Fresno County Department of Public Health, said he could not comment about the medical board’s investigation, but Thomas has not provided services at the jail or at the county’s juvenile justice campus since May 2015.

Thomas, reached by telephone, said she continues to work for Corizon. She referred questions about the medical board accusation to her lawyer, Matt Grigg of Walnut Creek, California. Grigg said in an email that he could not discuss the allegations due to the pending legal proceeding and patient privacy rights. But Grigg said: “We do anticipate Dr. Thomas will be fully exonerated.”

Corizon spokeswoman Martha Harbin said Thomas is not an employee, but has signed an agreement with the company as an independent contractor to do work on an as-needed basis. In August, at the time of the agreement, a review of the National Physician Database reported no actions against her license, Harbin said.

Harbin said Corizon cannot comment on the specific board findings, but will monitor the case. However, she said: “We provide health care services to an extremely litigious patient population and as such find it necessary to review litigation, grievances or complaints on a case-by-case basis.” Corizon also is confident Thomas will be exonerated, she said.

According to medical board records, Thomas graduated from the University of California at Davis School of Medicine in 1995.

Another charge

The medical board accusation against Thomas also includes alleged negligence in the care of a patient identified only as K.C., who could not swallow food or water and who had a gastric feeding tube that allowed him to be fed liquids directly into his stomach.

According to the accusation, the tract on the inmate’s feeding tube split and contents of his stomach spilled out. The inmate vomited and was in pain, the board said. A nurse told Thomas about the opening in the tube and Thomas told the nurse that the tube should be taped shut, the board said. The nurse taped the opening and told another nurse to use a catheter to change the tube. The right size catheter could not be found and the tube was not replaced. An on-call doctor had the inmate taken to a hospital to have the tube replaced, the board said. Thomas’ order to have the nurse to attempt to change the tube was an extreme departure from the standard of care, the board said.

Three of the patients Thomas saw in the jail were women who were pregnant.

In one case, the medical board said a nurse practitioner noted that an inmate, identified as C.S., had a history of high-risk pregnancy and blood clots. Thomas did not see the inmate when she was seen for the first time in the jail on March 24, 2015, and instead the inmate was seen by a nurse practitioner. The inmate was referred to an obstetrician outside of the jail, and the nurse practitioner continued to follow the inmate until she was released on May 20, 2015. The nurse practitioner made medication orders, ordered laboratory test and gave other care. Thomas did not sign any notes or orders, the board said.

A nurse practitioner needs additional obstetric training or needs to be a nurse-midwife to provide care to a pregnant patient, the board said. And a high-risk patient should be under the care of an obstetric specialist after 12 weeks gestation. The board said the inmate was 14 weeks pregnant when she was first seen at the jail.

Another inmate was six weeks pregnant when she was jailed on Oct. 24, 2014. The inmate had Rh-negative blood and problems can occur in pregnancy when a mother’s blood is Rh-negative and the baby has Rh- positive blood. An immunoglobulin injection at 28-weeks can prevent problems. In the inmate’s case, the board said when Thomas ordered the immunoglobulin she did not give an exact date for the shot to be given and she did not know the exact weeks of the pregnancy.

In the case of a third pregnant inmate, there was a note saying the inmate had syphilis and had completed four injections for treatment. However, there was no lab report showing a positive test for syphilis and no note regarding the shots, the board said.

In addition to gross negligence and repeated negligent acts, the board said Thomas is subject to disciplinary action for having inadequate and inaccurate medical records.

Barbara Anderson: 559-441-6310, @beehealthwriter