Narinder K. Saini says refusal to change inmate's diagnosis cost him his job
Bill Lueders on Thursday 05/22/2008
A veteran state psychiatrist testified in court last year that he was asked to change the diagnosis of a state prison inmate and fired because he refused.
Narinder K. Saini, a state employee since 1990, dropped this bombshell in a Dodge County courtroom last July at the sentencing hearing of former Lodi resident Brian Locke. He stated that in mid-2004, he was asked by his boss, Dr. Kevin Kallas, to agree that Locke did not have a bipolar disorder, a serious mental illness, "so he could be sent successfully to Boscobel."
At the time, Saini was in his 10th year of employment with the state Department of Corrections, then under a court order not to use the supermaximum security prison at Boscobel for patients with serious mental illness.
"[Kallas] asked me to change the diagnosis because they knew if I will not change the diagnosis, [Locke] cannot go to Supermax," Saini testified. "I refused to do that."
Saini knew Locke from previous contacts and felt he had been correctly diagnosed with bipolar disorder. He said Kallas was "not happy with my clinical diagnosis" and overruled him, sending Locke to Boscobel, but that another doctor who also knew Locke's medical history ordered his return. Shortly thereafter, "I was terminated by the DOC...for mishandling the case, not cooperating with them."
The DOC, Saini added, cut Locke off medications that had proved effective in the past. Why would it do this? he was asked. "Save money," he replied.
Saini said he tried restoring these medications but "was not allowed to."
The DOC wanted to send Locke to Boscobel because he had assaulted a guard, the incident for which he was being sentenced. At the hearing, Saini suggested the assault owed at least in part to Locke being taken off his medication.
Dodge County Judge Andrew Bissonette, in sentencing Locke to an additional five years in prison, noted that he had, prior to this incident, been "complaining to staff that he was being deprived of the meds he needed." The judge called Saini's testimony "kind of damning to the DOC," adding that the agency "has a responsibility to provide care to all of its inmates so we don't have incidents like this where staff are injured."
DOC spokesman John Dipko calls Saini's testimony "inaccurate on nearly every count. The Department of Corrections does not withhold necessary medication from inmates because of cost, and the department does not fabricate documentation to send inmates to [Boscobel]."
Brian Locke, now 50 and incarcerated at the Columbia Correctional Institution in Portage, could be a poster boy for the dangers of using prisons to deal with people with serious mental illness.
His attack on the guard after his medications were yanked was his first felony conviction. His prior convictions were all misdemeanors, although he did draw a multi-year sentence in 2002 on multiple misdemeanor counts.
In a letter to Isthmus, Locke says this incident — an attack on medical personnel transporting him to a hospital — owed to a mix-up involving medications: "I was still responsible for my actions, but not the intent."
Locke later sued his Madison defense attorney, David Stokes, for malpractice; the case was dismissed last fall but is now being appealed. Armed with records he obtained through discovery, Locke has also alleged that Stokes defrauded the State Public Defender's Office through overbilling. He initiated a John Doe proceeding against Stokes in Dane County court.
Sounds nuts, right? But this February, around the time when the Legislature nearly passed a bill to bar inmates from bringing such actions, Dane County Judge Sarah O'Brien found probable cause that Stokes repeatedly submitted "false and fraudulent" records. David Feiss, an assistant district attorney in Milwaukee County, has been named special prosecutor. He says no charges have yet been filed and Stokes is presumed innocent.
In 2000, inmates at the Boscobel prison filed a class-action lawsuit alleging that conditions there constituted cruel and unusual punishment. A settlement agreement reached in 2002 mandated some policy changes and prohibited the DOC from using the prison for mentally ill inmates.
Carlos Pabellon, an attorney with the office of Ed Garvey, which represented the inmates, came to suspect the DOC was "manipulating" diagnoses to sidestep this ban.
"What we discovered," says Pabellon, "is that a number of these inmates had on one day an MH-2 classification" [meaning they could not be sent to Boscobel] and after the next visit an MH-1 classification [meaning they could be and were]." He believes the DOC was under pressure to "fill the empty beds at Boscobel, and, unfortunately, it appeared to us that they were doing it at the expense of the mental health of these inmates."
Federal Judge Barbara Crabb tapped a Medical College psychiatrist to monitor whether seriously mentally ill inmates were going to Boscobel. This appointment ended earlier this month, as did the court order against using Boscobel for seriously mentally ill inmates.
DOC spokesman Dipko says "the screening process" that was developed in response to the lawsuit remains in place. But others say the Locke case underscores that the DOC cannot be trusted.
"They're still putting mentally ill prisoners into [Boscobel]," says Frank Vanden Bosch, an inmate rights activist who lives near the prison. "They're really not concerned with the prisoners. They're concerned about keeping the prison full. It makes a mockery of what the courts have decided."
Dr. Kallas, in a recent interview with Wisconsin Public Radio, admitted he sometimes overrules diagnoses made by colleagues. But he claimed it is on the other end of the spectrum.
"While the psychologist may be technically correct in saying there's not serious mental illness, I err on the side of caution and say, 'Let's not send this person,'" Kallas maintained. "I've just taken a more conservative stance and in many cases have decided that I don't want certain inmates there even though they may technically under the court criteria qualify."
The transcript of the July 2007 hearing was not completed until late October. In January of this year, Locke filed a complaint against Dr. Kallas with the state Department of Regulation and Licensing, arguing that he committed "medical malpractice" and violated Judge Crabb's order. That complaint is pending.
Locke has also asked the 7th Circuit Court of Appeals to intervene, saying, "It is time to put the DOC in check and punish them for this behavior." This is also pending.
Dr. Saini himself briefly agitated against his termination. His Madison attorney, Richard Bolton, sent a letter dated Dec. 30, 2004, to Matthew Frank, then DOC secretary. It says Saini worked at the agency for 10 years "without serious criticism of his performance" and occasional commendations, only to be fired in August 2004, shortly after "failing to cooperate" with the DOC's attempt to "manipulate" Locke's diagnosis so he could be sent to Boscobel.
Saini, who is now working at the Mendota Mental Health Institute, declined opportunities to comment. Bolton says the DOC denied there was any connection between Saini's termination and the Locke matter. Saini did not pursue legal action.