TACOMA, Wash. — The Washington State Department of Corrections (DOC) has settled a lawsuit for $9.9 million with a woman who was formerly incarcerated after the DOC failed to treat her cancer before it became terminal.
A lawsuit filed on behalf of Paula Gardner and her sons alleges that the DOC's cancer screening practices fell below the standard of care, and the department failed to act on multiple opportunities to diagnose her with cancer before it became untreatable. The DOC did not dispute that its failure to provide medical care led to Gardner's terminal diagnosis.
Gardner was incarcerated for the better part of a decade and had a history of medical results indicating she was either at high risk of developing cervical cancer or in the early stages of the disease. A test that Gardner took while out of incarceration as far back as 2011 came back with two different warning signs for cancer, showing abnormal cells identified during a Pap smear and a type of HPV that is more likely to turn into cancer than other genotypes.
Gardner received her next Pap smear in DOC custody in 2014, and the cytology, a type of test used to screen for cancer, came back normal. However, no HPV test was administered despite the DOC's knowledge of Gardner's previous concerning test results.
Gardner asked about a Pap smear in 2015 but was notified that the guidelines did not require yearly testing. In 2016, she received a Pap smear and another HPV test, which returned negative for cancer, but still indicated that she was living with high-risk HPV.
Gardner was out of DOC custody for a period of time between 2017 and 2019. She was incarcerated again in March of 2019. A co-test performed that month came back positive for high-risk HPV. A provider recommended she be tested again within one year.
In April of that same year, Gardner received an ultrasound which identified a 1.9-centimeter growth in her lower uterus that required monitoring. The provider recommended that she receive a follow-up ultrasound in six weeks and an MRI of her pelvis. Gardner was not told about the results of her ultrasound. The DOC failed to coordinate any of the follow-up screenings recommended by medical providers.
Gardner was not made aware of the results of her medical tests.
She then developed "troubling symptoms" in May of 2020 and asked the DOC about performing a test, but they did not. It was incorrectly noted that she was to be examined every three years instead of annually.
Gardner would not receive any type of cancer screening between 2019 and 2021.
When a screening was finally performed in March of 2021, there were "obvious lesions on the surface of her cervix," and biopsies confirmed that they were cancerous. At that time she was diagnosed with Stage IV cervical cancer which had spread to her lymph nodes. It was untreatable.
The lawsuit filed on her behalf notes that Gardner "has, and will, endure incredible pain and suffering up to the time of her death," due to the DOC's actions.
"The lapses in care Paula experienced at the Department of Corrections are inexcusable and she was denied the information she needed to advocate for her own care," read a statement from Connelly Law Offices, PLLC, the firm that handled Gardner's complaint. "Paula hopes that her experience will help educate others about the current state of women’s healthcare at the Department of Corrections and bring about meaningful changes to the system."
The DOC has a documented history of failing to screen or treat inmates for cancer before it becomes terminal as outlined in a 2021 ombudsman report. The report identifies 11 cases where the DOC mishandled cancer diagnoses or treatment of inmates.
In a statement, the DOC said it is working on improving healthcare for incarcerated patients and contracted with a nationally recognized leader in correctional healthcare systems. The department launched a Patient Centered Medical Home in 2022 with a focus on prevention. The department said it is also working to improve electronic access to inmate health records so providers have access to relevant medical history. The department convened an Unexpected Fatality Review committee in 2021 which has made multiple recommendations that have been adopted by the DOC to improve patient outcomes.
