Parents say Vaughn Correctional health care was a 'death sentence' for their son
For years, as he sat in James T. Vaughn Correctional Center, Joey Murach begged for a colonoscopy, according to a lawsuit.
A longstanding intestinal disease would flare up, sometimes causing him to vomit bile and bleed from his rectum.
After three years, close to 100 medical requests and what the lawsuit describes as deliberate indifference on the part of state medical contractors responsible for caring for prisoners, doctors discovered Murach had colon cancer.
By then, it was too late. The cancer had spread. It killed him a little more than a year later, just after his 30th birthday.
"The whole thing is incomprehensible," said his mother, Laverne Murach. "Just because you are paying a debt to society, nobody has the right to hand you a death sentence."
In the federal lawsuit, Murach's family blames Connections Community Services Inc., the nonprofit that has the $60 million-per-year state contract to provide physical and mental health care to Delaware's prisoners.
Their lawsuit claims they spent years pressing prison medical officials to take their son's pleas for help more seriously. They say Connections not providing an annual colonoscopy that was recommended by an outside doctor, allowed the cancer inside their son to spread until he had no fighting chance.
"One of his last wishes was to get his story out ... to protect people under these circumstances," said his father, Joe Murach.
The Murachs tell a story of helplessness as their son struggled for help behind the walls and they tried to help from outside.
Their experiences parallel those found in other wrongful death and medical negligence lawsuits stacked against Connections. The state this week announced Connections' contract would end March 31, months before it was set to expire.
Joey Murach's struggle with his health started long before his incarceration. At 13, he was diagnosed with Crohn's disease, which causes chronic inflammation of the intestinal tract. The following year, he was diagnosed with Type 1 diabetes.
Through his youth, he became familiar with what his body needed, his father said. Weightlifting and athletics helped him control and find peace with his body, he said.
The then-Virginia resident enrolled in Wilmington University, but in 2011 found himself deep in trouble with the law.
That year, he pleaded guilty to assault, weapons and robbery charges for an attack on two people in a Newark parking lot as well as his role in a home-invasion robbery. The convictions landed him at Vaughn serving a decade sentence.
Joey Murach's father said his son was intent on paying his debt to society and bettering himself through programming.
The first prison hurdles with his Crohn’s disease articulated by the lawsuit filed by his family came in February 2013. He “urgently” sought medical care for rectal bleeding and loose stools. That began a series of trips to the emergency room and the prison infirmary over six months, according to the lawsuit.
In one instance, he was described as “violently ill” with bloody stool and fever and given only Tylenol, the lawsuit states. Records from that period show he was also not being given maintenance medicine for his Crohn’s disease for at least two months.
At times he was dehydrated. Over one month, he lost 30 pounds. During that time, a nurse recommended he receive a colonoscopy, the lawsuit states.
People with inflammatory bowel diseases like Crohn's are at an increased risk to develop cancer. The point of an annual colonoscopy is to catch such development early and to better understand how to medicate and maintain the disease, Joey's father said.
Joey Murach got his first colonoscopy in prison six months later, in October 2013. The procedure showed “active disease from the anus to the cecum" but no signs of cancer. The doctor said he should return in a year for annual colonoscopy checkups, the lawsuit states.
That didn't happen.
In 2014, the year Connections began providing medical services in the prison, a colonoscopy was scheduled with another doctor. Joey Murach questioned why another doctor was being used. The appointment never happened, and no other colonoscopy was scheduled for years, his family said.
Ron Poloqiun, the Murach's attorney, said Joey Murach reminded officials he needed the annual checkup.
"He expressed grave concerns," Poloquin said.
For years, Connections failed to give him the proper medication to maintain his Crohn's and sometimes he'd go three to five days without insulin for his diabetes, Laverne Murach said.
"He was left to manage it alone," she said.
Eventually, frustration set in, Joe Murach said.
"How much can a parent in Virginia crack the code when he is locked up as an inmate?" he said recalling persistent calls to the prison.
More than 300 doctors' visits
Frustration turned to fear late in 2016.
That's when the first of a series of more than seven trips to the emergency room described in the lawsuit occurred.
In some cases, he was vomiting bile. In some cases, a nurse or prison official denied him transportation to the emergency room, instead leaving him with nausea medication and Tylenol, according to the lawsuit.
In one instance, he "suffered in pain for several hours” until an on-call physician’s assistant pressured the prison administration to send him to the hospital, according to the lawsuit.
"On several occasions, the delay in emergency transportation caused Murach to experience severe pain to the point where he was bent over in bed or laid out on the floor," the lawsuit states.
Medical records from January 2017 state that he was receiving “no maintenance medications” for his disease. On multiple occasions, hospital scans showed a "stricture" in his colon. That would later be identified as a tumor, according to the lawsuit.
"Officials and doctors were aware of this but took no action that would have diagnosed the tumor and the cancer sooner," the lawsuit states.
Doctors again recommended a colonoscopy, but it didn't occur, the complaint states.
His trips to the hospital were replaced by trips to the infirmary where sometimes his IV bag would remain empty for hours, the lawsuit states.
He again lost weight. He was prescribed medicine for his Crohn's, but the prescriptions were not refilled in a timely manner, according to the lawsuit.
Eventually, his pain grew and it was a doctor at Kent General that sounded the alarm.
The surgeon wrote that he was “shocked” by Joey Murach's care so far, according to the lawsuit. The doctor said his intestines were so “badly damaged” that the scar tissue had narrowed his bowels to the point where emergency surgery was required.
Days later, he diagnosed Joey Murach with stage 3 colon cancer. That began a push to get Joey Murach out of prison for specialty care.
The doctor said he had "ethical concerns" sending Murach back into the care of the prison system. He wrote that “all the above issues would have been avoided if (the medical providers) had conducted standard medical tests, annual colonoscopies and given Murach proper medications,” the lawsuit states.
A doctor for corrections testified that Murach could not receive the care he needed in prison. Lt. Gov. Bethany Hall-Long stepped in to advocate for his release.
In May 2017, his sentence was modified to send him home. It was too late. Testing revealed that the cancer had spread to his liver.
After Joey Murach received his medical records, he learned that the doctor that evaluated him in 2013 described what the Murach's believed was Crohn's disease was more likely colitis, a similar bowel disease. Neither Joey Murach nor his family were told about the possible misdiagnosis until they received his medical records years later.
Each illness puts people at greater risk to develop cancer, and in Joey's case, he should have received an annual colonoscopy either way, his father said.
His family said there were good times on the outside after his release. There was the time he came in second place in a volleyball tournament and the time he belted softballs beyond the outfield fence further than even his healthy teammates.
But much of his time outside Vaughn was a fight.
"It wasn't quality time," Joe Murach said.
Between June 2017 and December 2018, Joey Murach had more than 300 medical appointments in a frantic war against the cancer, his family said.
Half his liver was removed. His entire colon was removed. Lesions were burned from his liver. He had 16 chemo treatments, and at times, he was taking six chemo pills a day, according to the lawsuit.
Chemo had to be paused for the surgeries. Each time, the cancer would surge, Joe Murach said.
"He wanted to come out of prison, get married, have a family, move on with his life, get a job, watch his sister get married, you know, be an uncle," his father said.
Joey Murach died in December 2018.
Months after their son's death, the Murachs received a medical bill for a 2016 doctors visit that Connections never paid. The bill was in collections and was meant for Connections.
"It was horrible, unfathomable," Laverne Murach said describing receiving the bill. "It was surreal."
They don't have certainty as to why their son's colonoscopy was put off, but they say the failure of care amounts to a death sentence.
"The negligence of Connections addressing his medical needs or timely evaluations or timely medications, I firmly believe led to him developing the cancer or it not getting caught early enough," Joe Murach said.
The Murachs filed suit in March 2018. Last year, Bayhealth Medical Center and the corrections officials named as defendants settled with the family, Poloquin said.
Each had denied wrongdoing to the court.
Connections is now the lone defendant. Officials for the nonprofit denied comment.
The Murachs are seeking compensatory and punitive damages.
Their lawsuit is one of several that have piled onto Connections during their six years working in the state's prisons.
There's the ongoing lawsuit by the family of a man who died in prison of a stomach ulcer. There's a similar lawsuit by the family of a former inmate who claim Connections allowed the inmate's cancer to fester until it was too late. They settled with Connections after cancer killed him.
News broke this week that Bayhealth was suing Connections, claiming the nonprofit owes the hospital more than $6 million in medical bills for care to inmates within Delaware prisons over a five-year period.
Connections is also being sued by numerous former employees who filed whistleblower lawsuits about Connections' practices and policies, including lack of treatment to a dying inmate and the firing of two employees when they voiced concerns about overbilling.
Collectively, their stories raise questions over whether financial problems with the embattled nonprofit led to substandard care for Murach and other prisoners who claimed to have been maimed by neglect.
Depositions in Murachs' lawsuits have uncovered further financial problems, Poloquin said before the announcement of Connections' early departure from the state prison contract.
"Outside medical providers were refusing to treat connections patients because of financial issues and that affected overall care," Poloquin said. "It is an underlying element of this case."
Claire DeMatteis, commissioner of the Delaware Department of Correction, declined to comment on the specifics of the Murachs' lawsuit, but said she's seen no evidence that financial considerations affected the decisions of medical professionals in the prison.
"It offends medical professionals," she said. "They would not do that. That is not who they are."
She said lawsuits against the nonprofit did not weigh on the "mutual decision" to terminate Connections' contract early and that officials for the nonprofit did not communicate anything about financial problems in the discussions that led to the end of their work.
She also said pointing to individual lawsuits against the organization paints an "inaccurate picture" and that the lawsuits are not indicative of a bigger problem with Connections.
In her view, they derive from a litigious area of law and a litigious group of people in prison.
"When offenders come into our facilities, they get terrific care. They expect to get care they'd never get on the outside," DeMatteis said. "That is not how it works. There is an unreal expectation by offenders that fuels some of these lawsuits."