Someome posted Marcia Powel's autopsy which revealed the medication she had in her body. I lost it when I saw what medications she was on:

Cogentin for side effects of neuroleptics. It is an old medication which comes with a huge warning not to get overheated as it causes decreased sweating. Cogentin is a very dangerous drug to give in the desert. Where the hell are the doctors and nurses?

Haldol which is usually not a first choice for a psychotic or manic patient it is also used to sedate agitated patients and is another bad choice for the desert as people die from heatstroke if precautions are not taken. It should only be used for the patients in which alternative, equally effective, but potentially less harmful treatments are not available or appropriate. Caution should be used in bipolar disorder as it can cause depression and suicide. It is know as a chemical restraint. It's the drug the government illegally uses on people they are deporting who have no mental illnesses. It should not be used like handcuffs, it is a last resort drug. It is also very old and has a side effect called tardive dyskinesia, a syndrome consisting of potentially irreversible, involuntary, dyskinetic movements which can be permanent. They can give injections for "non-compliant" patients. The question is if she was given the Haldol because she was agitated that day or is it a regular med. It is most likely a regular med because the Cogentin would be given for side effects of Haldol generally for long term use.

This medication is used in prisons all over the country because it sedates inmates to the point of being in a stupor and saves them money. It is often given as a monthly injection in prisons because it cuts down on work and cost. So, this would make them more likely to choose it. Of course we do not know what her behavior is like or what medications have been tried in the past or even if she had a psychosis. The only mental illness I found mentioned was bipolar disorder. In a prison they go for the cheapest and easiest. It is more important to them for the medication to be convenient for the staff rather than appropriate for the patient. Someone screwed up big time putting a woman on these medications out in the sun like that. They should all be prosecuted including what ever medical or nursing staff was responsible to make sure the sadistic guards did what they were suppose to do to keep her from getting heat stroke. I would imagine  the main problem is the idiots running the prison system, just like here in Alaska. Then there are the legislators who pass laws because they get paid off by prison corporations who know more prisoners mean more money. Then the legislators don't fund enough money to run the prisons. There also are not enough competent doctors and nurses. Then there are the citizens of this country who do nothing about it. They tell stories about how unfair it is prisoners get healthcare when it is so bad it kills people and medical concerns are ignored.

Precautions for Haldol:

This medicine will often make you sweat less, causing your body temperature to increase. Use extra care not to become overheated during exercise or hot weather while you are taking this medicine, since overheating may result in heat stroke . Also, hot baths or saunas may make you feel dizzy or faint while you are taking this medicine.

Haloperidol may cause your skin to be more sensitive to sunlight than it is normally. Exposure to sunlight, even for brief periods of time, may cause a skin rash, itching, redness or other discoloration of the skin, or a severe sunburn. When you begin taking this medicine:

Stay out of direct sunlight, especially between the hours of 10:00 a.m. and 3:00 p.m., if possible.

Wear protective clothing, including a hat. Also, wear sunglasses.

Apply a sun block product that has a skin protection factor (SPF) of at least 15.

Some patients may require a product with a higher SPF number, especially if they have a fair complexion. If you have any questions about this, check with your health care professional(unless you are in a US prison.

Apply a sun block lipstick that has an SPF of at least 15 to protect your lips.

Do not use a sunlamp or tanning bed or booth.

As far as medicine and nursing goes this is pretty basic stuff. No inmate on the meds she was on should ever go out in the sun, especially in a state like Arizona without sun block, long sleeves, sun glasses and a hat. For a nurse or doctor to not know that they would have to be pretty incompetent, because even if they don’t know it they should look it up. A medication is never given unless the nurse, doctor or mid-level is familiar with it. The question is whose responsibility is it to make sure these precautions were taken? When working with psychiatric patients you never take them outside without checking to see everyone has what they need to protect them from the sun and if the outing is more than a few minutes water needs to be brought along. It is common knowledge if it is hot outside be very cautious and you might want to keep certain people inside in cooler conditions.

Valproic Acid is a seizure medication also used as a mood stabilizer. It is probably given for her bipolar disorder. It can cause liver or pancreatic damage and requires close monitoring and lab work must be checked.

She also had Lidocaine on board that would be from resusitation efforts. Haldol also causes heart arrhythmias, but this cardiac arrest was from the heatstroke.

They also did a toxicology screen for drugs. This may be routine, but since amphetamines or cocaine could have contributed they may have hoped to find a positive result.



Cause of Death: Complications of hyperthermia due to environmental heat exposure
Manner: Accident
Coroner Dr. Mark Fischione

A. dehydration, electrolyte pattern

B. Core body temperature 108 degree Fahrenheit (That was as high as the thermometer would go)

C. Metabolic acidosis with coagulopathy

D. Rhabdomyolysis and acute renal failure

E. Numerous first and second degree thermal burns of face, trunk, and extremities

He reported no evidence of trauma. She had about six areas of first and second degree burns with blistering. Rhabdomyolysis is the destruction of skeletal muscle resulting in leakage into the urine of the protein myoglobin from the breakdown of the muscle tissue due to heat. It is a major cause of renal failure. Coagulopathy is a very simple way of stating the multiple problems heatstroke can cause with blood clotting. She had pulmonary edema which is another sign of heatstroke.

Some of the Signs and Symptoms of Heatstroke:

Physical manifestations of heatstroke include hot and dry skin. Signs of central nervous system dysfunction such as irritability, ataxia(uncoordinated walking), and confusion are essential to the diagnosis of heatstroke. Coma and seizures may develop. Coagulopathies may manifest in bleeding from intravenous sites or in epistaxis (nose bleed), and endothelial(skin) damage may present as peripheral or pulmonary edema(extra fluid in the lungs). The heart muscle damage can cause cardiac arrest. Heatstroke is multisystem failure. But, that didnot happen until she begged for help and a drink of water for a long period of time. I wasn't there and have no information, but I can tell you they ignored her  made fun of her, and laughed at her, no doubt.

The coroner says her death is due to “complications of hyperthermia.” Gee, I guess she just got a little too warm. Really what is going on here is classic heatstroke aka nonexertional heatstroke. I guess that is the “complication” he is referring to. It is neuroleptic potentiated heatstroke. Why does the coroner not say this? Because the prison doctor may be his buddy. Marcia died from both the sadistic treatment of the prison guards and malpractice.

The mentally ill are not given adequate or minimal treatment in prisons. Well, why would they, no one in prison gets proper treatment. The doctors and mid-levels (nurse practitioners and physician’s assistants) are often not the best in their fields, although there are some altruistic individuals who dedicate their lives to helping inmates who are excellent. A great deal of medical and nursing decisions are made by corrections officers who generally have a few weeks of training. Even if they had more training they are not qualified to make the decisions about the health of inmates. To put mentally ill inmates who are on powerfully sedating medications which have severe side effects that require not only monitoring, but the knowledge level to interpret any symptoms they have in the hands of those with no medical or nursing degrees is unconscionable.

Here in Alaska there is not much danger of problems from medications because they rarely give them in any form and even if they are ordered there is a nurse at Wildwood who withholds them just to be cruel. They don't have that problem at Hiland Mountain because they just abruptly stop everyone's medication when they arrive. If they give the mentally ill psychotropic medications I would not trust the nurses I came in contact with in the prison system to have the skill to evaluate an inmate’s status under any circumstance(except one). Most of them also could care less about the inmates. Outside of the mental health unit the corrections officers did most of the decision making about the inmates. Their responses were usually very inappropriate and abusive.

I am willing to bet that the only treatment she got was to sedate her with Haldol, without any knowledge of her history. She had a mental illness and did not have the ability to make good decisions in her life. She needed help early on and not knowing her history I do not know if she got any. What I do know is many get little or no help at all. Our mentally ill often end up in prisons where they are abused and neglected. If they do get out of the prison they are worse than when they went in. They are then back on the streets in a high number of cases with little or no support. Many of them drink or use drugs to medicate their symptoms which causes many in our society to look down on them all the more. Marcia went in and out of prison and lived on the streets in between.

She is labeled as a prostitute.A prostitute is a woman who only harms herself.  She was in prison for it when she was killed. I don't judge any woman who is a prostitute because I have not lived their lives and have not gone through what they have. Marcia was apparently severely mentally ill and had difficulty making good judgments. She needed help not prison. The mentally ill should be in hospitals or some other appropriate setting. In this country the industrial-prison complex is being allowed to use the mentally ill for profit while treating their lives as worthless. The legislators who were bought off to pass all the harsh laws we have so the prisons would fill up for the profit of companies like Corrections Corporation of America and Wackenhut Corporation should all be given Haldol and put in that same cage Marcia was in for four hours with no water. We have some in Alaska I guess we'll send them down to Arizona for that because we don't have enough heat here.

I worked for a short time in two prisons in Washington through a nursing agency. They treat inmates better than most states even with some of the juvenile corrections officers they have. I did physicals and drew lab work on the women as they came into one prison. This is something Alaska does not do, but if you ask the higher ups they say all the inmates are seen by a medical professional within a short time of arriving at the prison. This consist of a nurse asking a few questions and that is it. I guess the DOC doesn't know the difference between medical personnel and nursing personnel. I had several of the inmates tell me they came back to the prison on purpose because it was the nicest place they had ever lived. At the time I thought that was the saddest thing I would ever hear. After my experiences with the prison system in Alaska which caused my research to begin about the American system of gulags I have found not just sadder stories, but horror stories.

"If one considers the observation that the worth and dignity of a civilization is judged by the way it treats its weakest members, we cannot help but look back in shame at our past." - Social Justice Yesterday - Today - Tomorrow, A Critical Reflection, By Rudolf Rickes

1 comment:

Anonymous said...

Celia thanks for this...she should of never been put outside in that heat, no matter what!
I hope you can write to people or agencies and let us know where to write to change this!
I am very sensitive to the heat and take anti-depressent meds. Infact I am a zyprexa victim.
God I hate to hear this shit and they are getting away with it!