Clifford Farrar collapsed after seeking care last year. His death exposes the health crisis in Washington state prisons.
On a cold December day in 2021, the echoes of an emergency code cut through the bustling sounds of the Stafford Creek corrections center in Aberdeen, Washington.
The alarm could mean there had been a scuffle at the poker table, an officer was having a bad day, or a new lockdown due to yet another Covid outbreak was being imposed.
This time around, though, word spread across the facility that Clifford Farrar, an incarcerated resident, had collapsed in a common area.
Farrar, a 51-year-old with type 1 diabetes, had been insulin dependent since age 15. On the day he died, his medical records show, his blood sugar was dangerously low. When staff gave him glucagon to raise his levels, the records say, his blood sugar shot up, at which point he had a seizure and heart attack and died. The coroner said Farrar’s cause of death was “natural”, due to heart disease and diabetes.
But Farrar’s family believes the prison neglected his health throughout his detention, including by denying him access to life-saving supplies. A state committee found that staff responding to his collapse lacked proper training and that the medical devices they used had malfunctioned.
Farrar’s death, advocates argue, was a tragic but predictable consequence of the inadequate medical care within the Washington department of corrections (DOC), which has experienced repeated public health crises and scandals in recent years.
Even in a state considered one of the most progressive in the US, where the Democratic governor has pledged to make prisons “safer and more humane”, claims of systemic medical neglect have persisted, advocates point out, and in the last year, problems have escalated.
“They let him die. They killed my brother,” said Mary Farrar-McQueen, the sister of Farrar, who also leaves behind a wife and nine children. “My brother was not ‘sick’. He was only a diabetic like millions. He had a long life ahead of him. He died a senseless death, a preventable death.”
Deadly delays
Poor healthcare behind bars is a chronic problem across the US, where 2 million people are imprisoned; thousands die while locked up each year and incarceration has been shown to significantly reduce life expectancy.
“People in prison have a constitutional right to have serious medical needs taken care of,” said Hank Balson, an attorney who has advocated for prisoners’ healthcare in Washington. “But healthcare providers in the system often look at them as ‘offenders’ or ‘inmates’ and not as ‘patients’, and that can make it harder to recognize somebody’s pain as real or to feel compassion for their suffering.”
For years, families have complained that DOC has prioritized cost-cutting in prison healthcare, and investigations and lawsuits have exposed significant deficiencies. A prison medical director was fired in 2019 after an inquiry found that six incarcerated patients had suffered due to her inadequate care, including four who died, one due to an infected surgical wound and another who had a degenerative lung condition but did not see a specialist; the doctor has defended her care, saying the prison infirmary was a “problematic place to care for sick people”.
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A recent state office of the corrections ombuds investigation uncovered significant and deadly delays in cancer diagnoses and treatments across DOC, which partially blamed the lack of electronic health records but also pledged to make its processes more efficient. In a 2020 report, Crosscut, a non-profit news organization, found that a third of people who die in DOC are younger than 55, many suffering from untreated or poorly treated illnesses, with the prison healthcare system frequently deciding that treatments for common and debilitating ailments are not “medically necessary”.
“It feels like if it’s not life-threatening in that moment or in the next 24 hours, then they put it off and tell you to drink water and take ibuprofen,” said Tonya Wilson, who was released from DOC in 2018 and is now an advocate with Freedom Project, a Washington-based group. “When people get out, they find that they have serious health problems that could have been addressed and mitigated while they were inside.”