may v, 21y Page 9 Documentation with patient: TF Discharge summary (= Discharge overs FF other: peretumned wo any docs Vitale Intervie Assssemart Int clearee to return home aware of200 No further questions a concerns at this time Ss | submit uve pa for any new or worsening issues Iiveducated on mdeation noncompliance IM aware of POC and verbaled understanding The provider PA Rodriguez subsequently entered a note later on January 19. 2019 into cOMIS regarding his order to return Ms. IMM to the yard, while noting “[t]his gravida 4, schizophrenic patient has refused prenatal care. just recently allowed us to get an ultrasound.” Under “Plan” he wrote “None.” See Exhibit 3. According to her medical record, on January 22. 2019, an ICS was initiated after an officer discovered Ms. [I ad delivered her baby in her cell? Ms. I medical record shows no subsequent medical encounters between being sent back to her housing unit and the ICS on January 22. 2019. yeie2 | nursing Nurse - Return From Offsite Moya, Vonda F ‘SPC PV LUMLEY MDM 44:20 | Madical Records | EHR Record import yng, Brenda |ASPC-PV LUMLEY MOM 10:24 | Mantal Health | NH ~ Nen-Clnieal contaet Note Panels, Le ‘ASPC-PV WMLEY MOM. 02:25 | Nursing Nurse - ICS Response Smith, Shannen |ASPC-PV LUMLEY MOM, 17:95 | Madical Provider | Provider - Review Recriguez, Rumalde ‘ASPC-PV WMLEY MDM 1744 | nursing Nurse - Return From Offsite Moya, Vonda F |ASPC-PV LUMLEY MOM, 16:52 | Nursing Nurse ~ Return From Offsite Dirjs, Uliana ‘ASPC-PV LUMLEY MDM 14:20 | Madical Provider | Provider - Review Recriguez, Rumalde |ASPC-PV LUMLEY MOM, 14:00 | Nursing Turse ~ ICS Response eAdams, Amy ‘ASPC-PV LUMLEY MOM ‘Ms. IM told Plaintiffs” counsel that she was in her cell alone, as her cellmate works nights, and she felt herself going into labor. She told us that she started screaming and banging on her cell door, in hopes of getting the night officer’s attention, and that other women in cells 3 Despite our request prior to the tour for all Incident Reports from medical clinics, we did not receive the relevant IRs for this event.Mr. Tim Bojanowski RE: Parsons v. Ryan April 2018 Perryville Tour / ‘Notice of Noncompliance May 6, 2019 Page 10 around her started similarly screaming and banging on their doors to help her. She reported that she felt the baby start to come out, and was in excruciating pain and sat on the toilet, defecated, and delivered the baby into her hands and continued to scream for help. Both Ms. I 2s well as other people housed at the time near her, reported to us that it took approximately 10 to 15 minutes from the time she started yelling for help until an officer responded. The notes by the responding nurse also document that Ms. similarly reported that it had been about 20 minutes since she gave birth, and she had been knocking on the door for help. 'S_ Are interpreter services needed for this inmate: No NOTES: ICS initiated @ 0316 for Pt having delivered her baby in her coll. Pt seen in cell @ 0325. 911] requested by DOC. Pt reports she had the baby "about 20 minutes ago". Pt states she was feeling sick and was knocking on the door for help. ‘Ms. INI was transported by EMS to the hospital, where both she and the baby were found to be healthy. In our meeting with Dr. Ibrahim, he explained that the corrective action plan arising from this sentinel event is that in the future, if a woman is sent out in labor or because her water broke, and then is retumed to the prison from the hospital without delivering, that she would be housed in the special needs unit or infirmary where there is 24/7 nursing presence Lote it Ms. lelivered her baby on October 1, 2018, via an emergency C-section due to pre- eclampsia, She reported to us that a week prior to being sent out in maternal and fetal distress, she saw the OB/GYN and her blood pressuse was elevated. She saw Dr. Enciso on September 24, 2018 at 38-39 weeks gestation, and her blood pressure was elevated at 134/93. Despite the elevated reading. the plan did not include orders for daily or twice-daily blood pressure checks to monitor the possible onset of pre-eclampsia, which is the usual standard of care. See Exhibit 4 (Treatment Call and Appointments List). Oddly, eOMIS shows that she was not assessed for pre- eclampsia by Dr. Enciso until November 12. 2018, six weeks after she gave birth: