Amid three months of scrutiny from a local judge, Silverdale Detention Facilities is reworking its policies to ensure inmates get their prescribed medications more quickly.
Judge Tom Greenholtz continues to hear allegations that private medical providers, in some cases, take several weeks to verify new inmates' necessary prescriptions.
But Silverdale officials say they're correcting the problem.
"So you could have an inmate who is waiting on needed medication for as long as a week?" Greenholtz asked one official during a hearing on Oct. 31.
"Yes, sir," Veronica Winters said.
"Are those procedures under reconsideration to ensure that inmates have access to their needed medication more quickly?" Greenholtz asked.
"Yes, sir," Winters said. "We're working on a new operating procedure and making sure everything is done within 48 hours."
Greenholtz began digging into poor medical management allegations in August after a local inmate wrote that Silverdale wasn't treating his bone cancer or broken shoulder.
But medical concerns abound elsewhere, too.
A Chattanooga mother said her son, Unjolee Moore, was stabbed 37 times last month in a private facility near Nashville.
Unsure whether he was still alive, Annette Thompson called Trousdale Turner Correctional Center nine times only to be told the same thing: Officials couldn't share any medical information.
Trousdale, the state's largest prison, has been consistently understaffed and was fined in May by the Tennessee Department of Correction over problems counting inmates, according to news reports and a comptroller's audit released earlier this week.
CoreCivic manages that facility as well as Silverdale, and it largely doesn't keep accurate staffing information that would help monitor what's happening behind bars, the same audit said.
On her first day at Silverdale for a theft arrest Sept. 30, Krystle Giles said a group of inmates slammed her head into the floor and stabbed her in the ear with a pencil.
Giles, 33, reported her injuries to Silverdale, but officials found "no evidence" she was attacked, her Criminal Court records show. So she wrote Greenholtz a letter, and he arranged a hearing.
"[Silverdale] told me this morning there was no evidence that you'd been stabbed, and I just don't believe that," he said on Nov. 1. "Can you come closer for me and let me see?"
Giles walked to the bench and lifted her hair above her ear. "You can see where I been stabbed," she said.
She turned around. "And in the back of my head."
"OK, yes, I see it," Greenholtz said.
He released Giles so she could get her head checked at a local hospital, then sentenced her to four years behind bars for a separate forgery case when she returned the next week.
"It looks like CoreCivic has undergone a thorough review of its policies and procedures and are making needed changes," Greenholtz said Wednesday. "And we look forward to seeing how those procedures help out the interest of all involved."
Silverdale's trying to do better, but it's a complicated process to begin with, Winters said.
Providers cannot accept open prescription bottles because they can't verify what's inside, and they don't want inmates mixing strong medicine with equally strong contraband like methamphetamine, cocaine or heroin, officials said.
Other times, providers have to wait on the pharmacy to verify prescriptions, or seek approval for medicine they don't have, and an inmate's information sits in a queue until someone gets to it.
"How timely is that process, typically?" Greenholtz asked.
"It can take two days; it can take a week," Winters replied. "It just depends on how many are in the queue."
Providers also have to research whether someone's prescribed medication will negatively react with the amount of contraband that makes it behind bars.
"If we can get verification that [inmates] have been on those medicines, 99 percent of the time we continue them," Ujwal Siddamreddy, a doctor with Silverdale, said during a hearing in November. "That 1 percent is for the potential abuse of those prescriptions, like controlled substances, or substances which have interactions with other stimulants like methamphetamine or heroin or cocaine."
Combining certain prescribed medications with those "street drugs" could lead to death or brain damage or heart attacks, Siddamreddy said.
"Do we have a concern at Silverdale, then, that there may be interactions with those substances?" Greenholtz asked.
"Yes. Yes," Siddamreddy said.
For Thompson, she just wanted to know if her son was alive. "They ain't called me, they ain't told me nothing," she said.
Thompson's family saw a Facebook post on Oct. 12 claiming Moore had died at Trousdale after 17 men jumped him in the shower and stabbed him 37 times. Her worry grew when other women with sons at the facility reached out with the same story.
Thompson called the facility nine times hoping to learn what happened, she said. But a routine developed: If someone did pick up, they said they couldn't discuss medical information. Or they transferred her.
"If my child hadn't been on Facebook being nosy, I wouldn't have known," she said. "I don't get that."
Jonathan Burns, a spokesman for CoreCivic, said he couldn't discuss individual cases, adding that medical privacy laws apply whether someone's incarcerated or not. That's been Chris Jones' challenge as he represents Moore in a post-conviction relief for his 2013 life sentence. Jones asked a local judge to transfer Moore to Hamilton County since no one at Trousdale would answer his calls.
"Will I receive the medical information under (Health Insurance Portability and Accountability Act)? I doubt it because of their record of not responding to me," Jones said Wednesday. "So I had to get an order just to have a face-to-face? How much does that cost the taxpayers for him to be transferred?"
Thompson said her son called on Nov. 6, about three weeks later. The news was disturbing: The attack punctured one of his lungs, broke his left jaw in three places, and sent him into a coma for three days.
"He told me he doesn't expect to live - he'll probably be gone any day," Thompson said. "He hasn't been to a hospital. He said, 'They're keeping me in the infirmary.'"
Jones said Moore is supposed to arrive in Chattanooga next week. If he does, Thompson will finally be able to see him and put her mind at ease.
Contact staff writer Zack Peterson at firstname.lastname@example.org or 423-757-6347. Follow him on Twitter @zackpeterson918.
Contact staff writer Rosana Hughes at 423-757-6327 or rhughes@timesfreepress. com. Follow her on Twitter @hughesrosana.