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The 55-year-old inmate with a family history of lung cancer was coughing up blood the day he arrived at the medium security Illinois River prison in November 2012.

A nurse sent him away with a container to spit in and told him to report back if it worsened. In a series of visits to the Peoria-area prison’s medical facility, doctors and nurses continued to miss the inmate’s classic signs of lung cancer.

By the time the inmate was finally diagnosed correctly and offered treatment in June 2013, it was too late. He died nine days later.

The details of the inmate’s potentially preventable death was just one example in a scathing 405-page expert report filed in federal court late Tuesday that alleged sweeping problems in medical care at the state’s prisons ranging from unqualified and incompetent physicians and nurses to woeful record-keeping and poor sanitation.

The report was compiled by a team of medical experts after both sides in a proposed class-action lawsuit gave the go-ahead to the independent assessment in hopes it could help settle the case without a trial.

The experts found “significant lapses in care” in 60 percent of the cases they reviewed in which prisoners died of natural causes from January 2013 through May 2014.

The report also ripped prison physicians for failing to properly treat even ordinary illnesses. In one case, a patient at downstate Menard Correctional Center being treated for Type 1 diabetes had his insulin treatment discontinued by a doctor after his blood sugar levels were found to be normal while he was on the insulin. This error, the report noted, reflected “a lack of understanding of the basic pathophysiology of this common disease.”

Other examples included an inmate’s foot being amputated due to a “grossly mismanaged” ulcer and another inmate who was not sent to a hospital for two weeks despite a “rapidly progressive paralysis of the lower half of his body” and is now permanently forced to rely on a wheelchair.

“This report confirms that people incarcerated in Illinois state prisons receive grossly inadequate medical care that endangers their lives and in some cases leads to their deaths,” said Benjamin Wolf, the associate legal director of the American Civil Liberties Union of Illinois, which joined the suit after it was filed by the Uptown People’s Law Center and the Seyfarth Shaw law firm. “From start to finish, the system is broken.”

The Illinois Department of Corrections said Tuesday that the report is based on reviews of only eight of 25 correctional facilities statewide and “uses a broad brush to paint an incomplete picture.”

“While the IDOC agrees with certain recommendations contained in the report and has already taken steps to improve its delivery of services, we believe many of the conclusions in the report are flawed and disagree with a number of the criticisms presented,” the Corrections Department statement said.

Wolf said that both sides have been negotiating a potential settlement since the report was finalized in December, but talks have broken down and the case now appears headed to trial.

Dr. Ronald Shanksy, a nationally recognized expert on inmate care who led the study, and his team visited facilities around the state and reviewed hundreds of thousands of pages of medical records involving inmates of all ages and backgrounds, from convicted murderers to nonviolent offenders.

In the 63 inmate deaths reviewed by the team, a number of “significant deviations from the standard of care” occurred, Shanksy said in his report. These deviations vary from delays in testing and care to lack of follow-up and failures to refer patients to specialists.

The report also noted many state correctional facilities have vacancies in medical staff that often include key leadership positions and that many medical professionals are not trained to deal with specific problems that confront the prison population. The problem is “compounded by a lack of oversight and peer review,” which causes problems to fester and grow, according to the report.

Medical care for the state’s approximately 50,000 inmates is administered by Wexford Health Sources Inc., a for-profit company that was given a 10-year, $1.36 billion contract in 2011. Since the contract was announced, the Pittsburgh-based company has been sued dozens of times in federal court in Chicago by inmates alleging substandard care, records show.

Representatives of Wexford did not respond to calls or emails seeking comment.

In its statement, the Corrections Department said it already has taken steps to alleviate some of the conditions described in the report, among them increasing staffing “in certain areas” and working to properly equip clinic space and improve record-keeping. The department also is seeking national accreditation from the auditing body that sets correctional health care standards.

Wolf said both the Corrections Department and Wexford have so far been unwilling or unable to deal with caring for a prison population that has quintupled over the past few decades, with thousands of new prisoners coming into the system every year.

“It is fiscally and humanly irresponsible,” Wolf said. “These inmates were not sentenced to death. Many of them are there for a short time, and they shouldn’t receive substandard care.”

jmeisner@tribpub.com

Twitter @jmetr22b