Let me preface this with the following: Read at your own risk. Remember, I'm just quoting. But for the squeamish amongst you -- especially you men -- maybe you should just skip this one. (By contrast, for a glimmer of the nature of the beast, you can just read the sentences I've underlined):
"Francisco Castaneda was imprisoned by the State of California following a December 6, 2005 criminal conviction and held in the custody of the California Department of Corrections (DOC) until his early release date, March 26, 2006. Several times during his approximately three-and-a-half-month incarceration, Castaneda met with DOC medical personnel regarding a white-and-yellow raised lesion, then measuring approximately two centimeters square, on the foreskin of his penis. Twice, in late December and late February, DOC medical providers recommended that Castaneda be referred to a urologist, and that he undergo a biopsy to rule out the possibility of squamous cell cancer. This referral never occurred during Castaneda’s detention by DOC, and on March 27, Castaneda was transferred to the custody of Immigration
and Customs Enforcement (ICE) at the San Diego Correctional Facility (SDCF).
Immediately upon his transfer, Castaneda brought his condition to the attention of the SDCF medical personnel, members of the Division of Immigration Health Services (DIHS). By this time, the lesion on his penis had become painful, growing in size, bleeding, and exuding discharge. Castaneda met with PHS physician’s assistant Lieutenant Anthony Walker, who recommended a urology consult and a biopsy
“ASAP,” noting both Castaneda’s history of genital warts and his family history of cancer (his mother died at age 39 of pancreatic cancer). That consultation with an outside urologist, John R. Wilkinson, M.D., did not occur until June 7, 2006. Dr. Wilkinson “agree[d] that” Castaneda’s symptoms “require[d] urgent urologic assessment of biopsy and definitive treatment,” citing the potential for “considerable morbidity from even benign lesions which are not promptly and appropriately treated.” Although Dr. Wilkinson’s notes indicate that he “offered to admit [Castaneda] for a urologic consultation and biopsy,” DIHS physicians indicated their “wish to pursue outpatient biopsy which would be more cost effective.” That biopsy, however, did not occur. Instead, Plaintiffs allege that DIHS officials deemed the biopsy, a standard diagnostic procedure to detect a life-threatening disease, to be an “elective outpatient procedure” and declined to approve it.
Castaneda’s symptoms grew worse and worse. On June 12, he filed a grievance report, asking for the surgery recommended by Dr. Wilkinson and stating that he was “in a considerable amount of pain and . . . in desperate need of medical attention.” On June 23, he reported to Lt. Walker that his lesion was emitting a foul odor, continued to leak pus, and had increased in size, pressing further on his penis and increasing his discomfort. He complained of increased swelling, bleeding from the foreskin, and difficulty in urination. On July 13, instead of scheduling a biopsy, ICE brought Castaneda to the emergency room at Scripps Mercy Chula Vista.
The emergency room physician noted the fungating lesion on Castaneda’s penis and referred Castaneda to urologist Daniel Hunting, M.D., who, following a brief examination, determined that the lesion was “probably condyloma,” or genital warts. Dr. Hunting referred Castaneda back to his “primary treating urologist” at DIHS. Four days later, Lt. Walker noted that the lesion continued to grow. On July 26, another physician’s assistant explained to Castaneda that “while a surgical procedure might be recommended long-term, that does not imply that the federal government is obligated to provide that surgery if the condition is not threatening to life, limb or eyesight.”
On August 22, Castaneda saw another urologist, Robert Masters, M.D. Dr. Masters concluded that Castaneda had genital warts and was in need of circumcision, which would both relieve the “ongoing medical side effects of the lesion including infection and bleeding” and provide a biopsy for further analysis. This treatment was again denied as “elective in nature.” The following month, Lt. Walker noticed “another condyloma type lesion [ ] forming and foul odor emitting from uncircumcised area with mushroomed wart.” On November 14, DIHS noted that Castaneda’s “symptoms have worsened. States he feels a constant pinching pain, especially at night. States he constantly has blood and discharge on his shorts . . . . Also complains of a swollen rectum which he
states makes bowel movements hard.” Castaneda was prescribed laxatives. The following day, Castaneda complained that the lesion was growing, that he could not stand and urinate because the urine “sprays everywhere,” and that the lesion continued to leak blood and pus, continually staining his sheets and underwear. DHIS responded by increasing Castaneda’s weekly allotment of boxer shorts. [!!] . . . .
Castaneda was sent to yet another urologist, Lawrence S. Greenberg, M.D, on December 14. Dr. Greenberg
described Castaneda’s penis as a “mess,” and stated that he required surgery. The ACLU continued to demand treatment, to no apparent avail. Forty-one days later, January 25, 2007, Castaneda was seen by Asghar Askari, M.D., who diagnosed a fungating penile lesion that was “most likely penile cancer” and, once again, ordered a biopsy. On February 5, rather than provide the biopsy prescribed by Doctors Wilkinson, Masters, Greenberg, and Askari, ICE instead released Castaneda, who then proceeded on his own to the emergency room of Harbor-UCLA Hospital in Los Angeles. He was scheduled for a biopsy on February 12, which confirmed that Castaneda was suffering from squamous cell carcinoma of the penis. On February 14, Castaneda’s penis was amputated, leaving only a two-centimeter stump.
The amputation did not occur in time to save Castaneda’s life. In addition to creating a 4.5 centimeter-deep tumor in his penis, the cancer had metastasized to his lymph nodes and throughout his body. Castaneda received chemotherapy throughout 2007, but the treatment was ultimately unsuccessful. Francisco Castaneda died February 16, 2008. He was thirty-six years old."
All I have to say is this: Wow.
