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Nebraska prison watchdog says death of inmate might have been prevented with regular health exams

State lacks electronic monitoring of when inmates get routine medical exams like pap smears
Prison bars
Posted at 5:44 PM, Oct 11, 2022

LINCOLN, Neb. (Nebraska Examiner) — The death of Nebraska prison inmate Niccole Wetherell from cervical cancer might have been prevented if she had received regular, preventive health examinations, according to a state prison watchdog.

The Inspector General of the Nebraska Correctional System, in a report Tuesday, said the Nebraska Department of Corrections is out of compliance with a 2015 state law that requires the agency to establish an electronic health record system that would determine whether inmates got regular exams, such as pap smears.

Instead, the report said, the department mostly utilizes “a jumble” of paper records that include “handwritten nurses’ and physicians’ notes, which are often barely legible.”

Nine years between pap smears

Niccole Wetherell went nine years between pap smear tests before a 2019 exam that showed her cancer had spread to her brain, lungs, kidneys and liver and was deemed inoperable.

Wetherell, 40, died on Feb. 26, 2021, at the medical unit of the Nebraska Correctional Center for Women in York.

A spokeswoman for the Nebraska Department of Corrections said the agency was withholding comment about the report until Thursday, when a state legislative committee will be holding an interim hearing on health care issues within state prison.

But in formal responses to the report, Corrections stated that it would have an electronic monitoring system up and running by the end of the year that would track when inmates are due for “preventative and chronic care.”

Wetherell had been at the state women’s prison since 1998, after being sentenced to life in prison for first-degree murder for her part in the slaying of 19-year-old Scott Catenacci.

She was among a group of six people, ages 16-20, who attacked Catenacci in a Bellevue park, stabbing him at least 57 times.

A model prisoner

According to the Inspector General’s report, Wetherell had become a model prisoner, serving as a peer mentor as a “lifer” to give hope to fellow inmates in what may seem like a “hopeless situation.”

Her last documented pap smear was in September 2010, which indicated she was negative for cancer.

She suffered from irregular bleeding in 2015, then a recurrence in 2018, the report stated. After sending an inmate interview request to medical staff in June 2019, she underwent a pap smear in August of that year.

The exam and a follow-up exam by an obstetrician-gynecologist found that Wetherell was positive for squamous cell carcinoma, a type of skin cancer which is the most common form of cervical cancer.

‘Highly survivable’

That form of cancer, the Inspector General’s report said, is “highly survivable if detected early.”

A forensic pathologist who testified at the required grand jury investigation into her death said that “more frequent surveillance” might have prevented her death.

The federal Office on Women’s Health recommends that women ages 30-65 receive a pap test every three years, the report noted.

Why hadn’t such tests been given more frequently?

The nurse practitioner, who is the primary care provider at York women’s prison, told the Inspector General that “until recently, because of the department’s lack of electronic health records, the facility medical department had no method of tracking when patients were due for Pap smears and other preventive care.”

Nurse used Excel spreadsheet

As a result of the Wetherell case, the nurse practitioner said she began tracking patient visits with a Microsoft Excel spreadsheet.

According to the report, Corrections initially responded to the 2015 law requiring electronic medical records for inmates by seeking to hire a contractor to provide such a system. In 2017, the department was allocated $150,000 to hire a consultant to help implement such a system.

But in 2018, Corrections Director Scott Frakes testified in opposition to a bill that would have appropriated another $500,000 for the electronic medical records system, saying it was “premature.”

The department, Frakes said, was moving toward implementation in the summer of 2019.

In October 2018, the department received responses from 10 commercial vendors to a “request for information” about such electronic health tracking systems, and in 2019, the agency was allocated $1.3 million to move forward with the system.

But formal bids to provide the system were never sought, the Inspector General’s report stated, and instead, Corrections changed course and decided to create its own system in-house with the state Office of the Chief Information Officer.

A year ago, the department reported that the first components of its electronic monitoring system were launched on June 30, 2021, but they did not include features related to routine inmate medical care.

“It is unclear when the system will be fully implemented,“ the Inspector General’s report stated.

Nebraska Examiner is part of States Newsroom, a network of news bureaus supported by grants and a coalition of donors as a 501c(3) public charity. Nebraska Examiner maintains editorial independence. Contact Editor Cate Folsom for questions: Follow Nebraska Examiner on Facebook and Twitter.

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