Suit says civilly committed man denied medical care

VERNON FERREIRA, JR. was 27 years old with a baby on the way when he decided it was time to finally kick the drug addiction that had plagued him for years.

Ferreira was living with his father at his grandfather’s house in Carver, working with his dad in construction, and fixing and selling cars.

“He wanted to be clean, and he wanted to have a life with his girlfriend and his baby,” said his aunt, Stephanie McKeown.

With Ferreira’s support, McKeown petitioned a Wareham District Court judge to have Ferreira civilly committed under Section 35, the state law that lets someone be involuntarily committed to treatment if they pose a danger to themselves or others due to substance use. In fiscal 2018, there were around 6,000 people held under Section 35.

Ferreira was sent to Massachusetts Substance Abuse Center, or MASAC, in Plymouth, one of three centers for involuntary treatment for men in the state and the only one run by the state Department of Correction.

Ferreira died six months later, never seeing his baby son.

A lawsuit filed by Ferreira’s father on January 2 in Plymouth Superior Court alleges that the Department of Correction and its medical provider Wellpath violated Ferreira’s civil rights under federal and state law by failing to provide him with adequate medical care.

The lawsuit comes amid heightened scrutiny of the care provided to people in the Department of Correction’s custody. It also raises continuing questions about the propriety of holding men who are civilly committed because they pose a danger to themselves or others due to substance use – and who are not incarcerated for committing any crime – in a facility run by the state Department of Correction rather than by public health officials.

“People have complicated medical histories, many of them,” said Elizabeth Matos, executive director of Prisoners’ Legal Services of Massachusetts, which brought a separate lawsuit last year challenging the practice of holding civilly committed men in correctional facilities. “The prison setting is not a place where they’re going to get the kind of care they should get.”

According to Ferreira’s lawsuit, his son entered MASAC on January 5, 2019, with an injury to his knee and hip.

Ferreira Jr. had a history of overdoses and four prior civil commitments, according to a mental health evaluation included in a court filing.

Intake documents say Ferreira was addicted to alcohol and cocaine. He left stove burners on while dozing from substance use, burned holes in his aunt’s couch and carpet, and, according to a court report, became verbally abusive and threatening and made suicidal statements while using drugs. He was facing criminal charges after he stole his father’s car and was arrested for operating under the influence of drugs, drug possession, and driving on a suspended license.

The suit alleges that despite his severe pain, the Department of Correction and Wellpath, formerly called Correct Care Solutions, did not provide Ferreira with adequate medical care for three weeks.

According to the lawsuit, medical documents show that Ferreira entered MASAC with severe hip pain as the result of a fall. During an intake exam, a Wellpath case manager wrote that he was in a great deal of pain. Jail officials gave him ibuprofen and a cane.

For three weeks, Ferreira continued to tell jail staff that he was in pain, and they gave him ibuprofen and Tylenol. On January 8, 2019, he received a hip x-ray, and the radiologist recommended a follow-up CT scan, which was never performed. By January 14, Ferreira could not sleep and could not walk from his cell to the medical unit. By January 24, Ferreira could not walk at all, so jail officials gave him crutches.

Jail officials began treating his hip, with an injection and topical cream, on January 26. The following day, he spiked a fever and was hospitalized. He was diagnosed with septic arthritis — an infection of the joint — and osteomyelitis, an infection of the bone. Doctors said his hip was not salvageable, and he underwent emergency surgery at Beth Israel Deaconess Medical Center. He would require a full hip replacement.

The lawsuit alleges that jail officials’ refusal to provide basic medical care to Ferreira for three weeks caused him to suffer and “likely increased, if not caused,” the need for Ferreira to undergo emergency surgery.

Ferreira’s father and aunt said Ferreira told them that jail officials belittled his pain. “They would just be like ‘you’re an addict, of course you’re in pain,’” McKeown said.

Ferreira died July 4 of cardiac arrest, said his father, Vernon Ferreira, Sr.

The lawsuit, which asks for at least $25,000 in damages, does not blame correction officials for Ferreira’s death, but his family has lingering questions.

From his family’s perspective, Ferreira entered MASAC with a treatable injury and left with a dangerous infection and a hip that doctors described as not medically “salvageable.” He had no known heart problems.

“He didn’t get medical attention for 27 days,” Ferreira Sr. said in an interview. “I could be wrong. I’m not a doctor. But I do believe if he had got medical attention, my son would be alive today.”

McKeown struggles with guilt for petitioning to have her nephew committed. “I could kill myself just knowing that I signed that paper,” she said. “If I could turn back the hands of time right now, I wouldn’t have done it. I would have taken him to a hospital.”

The Department of Correction does not comment on pending litigation, but DOC spokeswoman Cara Savelli said, “The Department of Correction is committed to the timely health care and well-being of those in our custody and we work with our medical contractor, Wellpath, to ensure that this goal is met.”

Ferreira Sr. said he brought the lawsuit to provide for Ferreira Jr.’s baby son.

Ferreira’s attorney, Adam Gutbezahl, said other people who are held at MASAC could be facing similar denials of basic medical care. “Our client’s here to hold the Commonwealth to account and ensure no one ever faces this situation,” he said.

The Department of Correction has had other problems providing inmates with timely medical care. Massachusetts Auditor Suzanne Bump on January 9 released an audit criticizing the department for not reviewing sick call requests and not getting medical appointments for prison inmates quickly enough. While the audit only looked at criminal offenders, not people who were civilly committed, the corrections department uses the same contracted health care provider for both populations.

The audit covered the period from July 1, 2016, through June 30, 2018. The department switched its contracted health care provider on July 1, 2018 from Massachusetts Partnership for Correctional Healthcare to Wellpath.

Ferreira is not the only man civilly committed at MASAC to have had problems with medical care before and after Wellpath took over.

The lawsuit filed by Prisoners’ Legal Services in March 2019 in Suffolk Superior Court, challenging the practice of confining civilly committed men in correctional facilities, cites a lack of mental health services for civilly committed men at MASAC. It says patients with serious mental illness faced long delays receiving psychiatric medication and were put on medication that was ineffective in the past.

That lawsuit says men detoxed in the prison’s medical wing, which prisoners described as “filthy and stinking of the vomit, urine, and excrement of patients in the throes of cold-turkey withdrawal, who are required to clean up their own bodily waste.”

In an interview, Matos said her organization, which advocates on prisoners’ behalf, had been involved with several cases of allegations of substandard medical care of civilly committed men at MASAC between 2017 and 2019. Among them:

• A man with pancreatitis who was handcuffed to his hospital bed.
• A man with liver issues who had an operation, after which MASAC did not give him his follow-up prescriptions.
• A man who was denied an inhaler for asthma and medication for severe back pain after surgery.

The Department of Correction says it monitors Wellpath with regular meetings and audits.

In 2016, after a lawsuit spurred legislative action, Gov. Charlie Baker signed a bill ending the practice of treating civilly committed women in correctional facilities. The state now treats those women in in facilities run by the state departments of public health or mental health.

Legislation sponsored by Sen. Cindy Friedman of Arlington and Rep. Ruth Balser of Newton would end the practice for men as well. Men were not included in the initial lawsuit, so they were also left out of the legislation that Baker signed.

Today, civilly committed men are split between facilities run by the Department of Public Health, the Department of Correction and, in western Massachusetts, the Hampden County sheriff’s office.

Both Friedman and Balser said they were unaware of specific concerns about medical care at MASAC, but their bills attempt to address the larger issue of whether addiction should be treated as a disease or as a crime. Friedman called it “the criminalization of an illness” to confine people for substance-use treatment in a jail setting.

Balser agrees. “Addiction is a medical problem, and people with addiction are being sent for so-called treatment at a facility that’s run by correctional professionals, not health care professionals,” she said.