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Another month passed without his condition changing, while immigration officials continued, with Kafkaesque efficiency, to document his pain: “The lesion on his penis is draining clear, foul malodorous smell.” The “foreskin is bleeding at this time and the patient states his colon feels swollen.”

A new request for treatment authorization states that “the lesion now appears to be ‘exploding’ for lack of better words.” This request was approved, and in mid-July Castaneda was taken to the emergency room at Scripps Mercy hospital in Chula Vista.

At Scripps, emergency room doctor Juan Tovar documented the “fungating lesion” and made arrangements for Castaneda to be admitted to the hospital, where Tovar, like Walker, wanted to “rule out cancer, versus [an] infectious etiology.”

Next, Scripps urologist Dr. Daniel Hunting performed a brief exam but did not biopsy the lesion. Instead, Hunting “guessed that the problem was condyloma,” or genital warts. Documents reveal that Dr. Hunting did not ask about a family history of cancer and referred the patient back to his primary urologist, dismissing the symptoms as “not an urgent problem.” Castaneda was handcuffed and shackled and returned to Otay Mesa.

He Begged for Amoxicillin, but His Request Was Denied

In July, facing not only the complications of his medical condition but a complicated detainee health-care bureaucracy, Castaneda again saw Walker. Walker requested an early release to allow Castaneda to seek medical care on his own, but Castaneda was not released. A week later, David Lusche, a physician’s assistant at the Otay Mesa facility, wrote that he explained to Castaneda the following: “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.” Castaneda filed a grievance against Lusche, but that was denied. Officials still considered his surgery “elective” and therefore disallowable. Castaneda was characterized in this report as “conversational and calm, not confrontational.”

In August 2006, Castaneda was sent to see Dr. Masters, another outside urologist whose opinion he hoped would bolster that of Dr. Wilkinson. Dr. Masters recommended a biopsy and circumcision and said that he would arrange admission to a hospital, but again Castaneda did not receive treatment.

By fall, the pain was so bad that Castaneda couldn’t sleep at night. He was given antihistamines and trazodone, a strong sedative with antidepressant properties. The ibuprofen he took for pain, he said, had “no effect.” He told registered nurse Joanne Galano that at night he’d have a “white discharge” and the lesion was “getting bigger.” She noted “a whitish growth approximately 8 mm in diameter.” The nurse noted that 800 mg of ibuprofen was having no effect on his pain. He begged for amoxicillin, but his request was denied.

In October 2006, six months after his first medical evaluation at Otay Mesa, a prison guard noted that he “saw some dried blood on [Castaneda’s] boxers.” In early November, Castaneda told health officials that there was a “constant pinching pain, especially at night.” He said his rectum had swollen, which made his “bowel movements hard.”

If this weren’t enough, a second lesion appeared, on the underside of his penis. This lesion was moist, and Castaneda could not stand and urinate because the urine sprayed everywhere and he could not direct the stream. The treatment ordered: seven pairs of boxer shorts brought in weekly.

Also that fall, a Division of Immigration Health Services memo seems to acknowledge that officials knew Castaneda needed treatment and recognized it would be impossible for him to seek it himself. The memo states that Castaneda cannot “be released to seek further care due to mandatory hold and, according to Immigration and Customs Enforcement authorities, may be with this facility for quite a while.”

Equally damning is the charge that authorities may have tried to cover up their inadequate treatment by altering official government records. In July, physician’s assistant Lusche emailed a colleague that Castaneda’s grievance needed to be altered because federal auditors were coming to inspect Otay Mesa’s medical files. “We need to write something different,” Lusche wrote, “or make some amendment on the grievance for Francisco Castaneda.” The grievance stated that his case was “not resolved,” which would “attract all kinds of attention.” “Could you,” Lusche asked his colleague, “somehow ‘patch up’ that grievance with an amendment then put it in my box. I just want to avoid problems when the auditors show up.”

Mid-November, Castaneda was transferred to the San Pedro Service Processing Center, in Los Angeles. On his summary form, an immigration official said Castaneda had no “current medical problems.” According to an article in the Progressive magazine, Castaneda had been “forced to leave behind all his possessions, including his legal and medical papers.” Roused by a fellow inmate, he contacted the American Civil Liberties Union and explained his eight-month fight with immigration’s health officials. Attorney Tom Jawetz of the ACLU’s National Prison Project began writing letters in December on behalf of Castaneda. (One reason the ACLU and other prisoner-rights advocates take on such cases is that detainees, unlike criminal defendants, have no right to free counsel.) Jawetz wrote to ICE and Health Services Administration officials that Castaneda’s “long term health is being jeopardized by the lack of appropriate medical care he continues to receive in ICE custody.”

Jawetz’s letters had impact. On Thursday, December 14, Castaneda was taken off-site to see San Pedro urologist Lawrence Greenberg, who wrote that his penis was a “mess.” He required a circumcision. Greenberg’s exam noted that Castaneda was in “severe pain.”

That weekend, a lump appeared in Castaneda’s groin, and he filled out another sick-call slip. Castaneda’s surgical consult was forwarded to Asghar Askari, another urologist. It was not until 40 days later that Askari examined the fungating penile lesion on Castaneda and the lump in his groin; his assessment was “most likely penile cancer.” Askari ordered a biopsy, which was scheduled for early February 2007, almost a year after ICE officials had diagnosed Castaneda with a lesion on his penis.

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Comments

JacKim Dec. 10, 2008 @ 10:54 p.m.

I am just speechless. Had Castenada been a dog in the pound, he'd have gotten much faster and more humane treatment before dying an excruciating and needless death. I hope his daughter wins the case. Although it will not bring her father back, it will be ONE MORE nail in California's Prison Coffin. Sadly, there are many "Castenada's" in our California prisons. For those of you who wonder "why" our prisons are under Receivership, this case alone should answer that question. It has been found that one inmate dies needlessly or from negligence and medical incompetence every 6 days in our prisons. It is also reported that (at least) one inmate suicide per week occurs. I feel like ranting and raving and quoting study after study after report after report, but I won't. Let me just ask - where has our humanity gone? We pass laws to protect chickens - CHICKENS THAT WE ARE GOING TO KILL TO EAT ANYWAY! - yet "We the People" (yes, VOTERS - WE) allow this rampant and unspeakable type of horror to thrive in our prisons. This story makes me not just ashamed to be a Californian, it makes me ashamed to be human.

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Keith_Richard_Radford_Jr Dec. 11, 2008 @ 3:15 a.m.

As for passing laws for chickens by: Keith Richard Radford Jr

Chickens have not won in the request on their behalf by speakers for the silent fowl by foul lawmakers pushing agendas. The fact is that by changing the law for chickens space the adjustment effects the space an inmate has available to live in. Now many law suite have been set aside and people can be packed tighter for more revenue for them revenuers.

Speeking of tax dollars and the flimflam man, when voting on one side of an issue and it is all you see look closer cuz, cuse reading chicken lips is not possible, they have NoNe!

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dunitdevotroedell Dec. 11, 2008 @ 8:54 p.m.

I am sorry to say but I once worked at Corrections Corporation Of America in Otay Mesa. It was time someone exposed these inhumanities. What this article has stated is fact! 100 percent accurate. I understand inmates and detainees have broken the law but in that facility only 10 percent of those housed there are level III inmates, the majority are illegal aliens. These inmates have been violated to such extreme that I believe this facility should be closed and their ICE & USM contract revoked. Corrections Corporation of America is just there for the money. The lack of qualified officers and staff at that facility is lacking. Half if not more of the Detention Officers could not pass a Psychological evaluation. They are not even required to have a CORE Certification by the state of California, all they are require to have is a California Guard Card a monkey can get that. How can you be a first responder to an emergency if you do not have adequate training. There goes our tax dlls. As to the Castaneda Family my deepest apologies his death was not necessary nor warrented at least here in the United States

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blue Dec. 11, 2008 @ 9 p.m.

WOW!!!!!!!! that was a TRUELY biased rendition. but it is too common to point a finger and to find a culprit to blame for an otherwise unfortunate part of reality. PEOPLE GET SICK, PEOPLE DIE. Lack of health care, because of a positive financial situations or status in life is an everyday problem. Rich and prominent people have better healthcare and options than those less fortunate. Unfortunately people in jail are on the bottom of this totem pole. Not the very bottom however. At least there IS a 90+ MILLION dollar budget for them. What about our own law abiding, working class, but not insured citizens that cant even walk into a hospital without the badgering of an insurance card or no service. While it absolutely SUCKs about Mr. Castenada, this is happening all day everyday to our American families. WHO do u point the finger to there? WHAT do YOU do besides shake your head and look for someone ELSE to blame. this was just more self righteous propaganda!

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JacKim Dec. 11, 2008 @ 10:45 p.m.

Blue - based on your comments I can only guess that you did not read the entire article. And to clear up any misunderstanding you have about receiving health care: ANYONE, regardless of income, can walk into an emergency room and get immediate attention, whether they have insurance or not. A public hospital, BY LAW, can't turn anyone away. PERIOD. Mr. Castaneda continued to be denied proper and timely medical attention, and since he was in custody he didn't have the ability to "just go to the nearest ER".

I agree with you that health insurance is not something we all have and it's a problem for many. But we do have programs such as Medi-Cal, Medi-Care and Healthy Families for the truly desperate or needy. There are also insurance programs for the self-employed as well as programs that an individual can pay for themselves if they make too much money to qualify for either full Medi-Cal benefits, or co-pay Medi-Cal. But again, ANYONE (not in a prison or jail) can go to a public hospital's ER and get immediate medical attention.

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Fred Williams Dec. 12, 2008 @ 7:14 a.m.

Blue, in addition to what JacKim wrote, you should me mindful that this was a case that amounted to death through torture and neglect.

How would you react to growing a tumorous mass on your genitals. Jabs of pain when you try to walk, going without liquids to avoid the razor blades ripping out your urethra when you pee. The daily horror of waking up to torn skin and blood soaking your underwear. It spreads to your rectum, you can feel the mass under your skin, growing larger and more painful as you sit in your cell, waiting and hoping they'll do something to help you.

Even the guard-card prison staff feels pity for you, wincing in sympathy as they see you groaning in pain. All they can give you is a few ibuprofin. They write in the log, day after day, describing your horrible symptoms, and it just gets worse.

Blue, do you think that is acceptable?

Yes, many of us have no health insurance. But at least we can stumble to a hospital and expect that they'll at the minimum attempt to do something about a situation as dire as what this man endured, month after month.

The prison choose to turn a blind eye to an unmistakable tragedy happening right before them. They allowed the torture to go on. And on. And on. In prison, where there is no escape.

Then, when he was past any hope of recovery, they dumped him on the street.

Blue, this does NOT happen every day to American families.

People DO get sick, yes. But they do not have to DIE...especially when it's detected and treated early. Castaneda DID detect it early. He tried his hardest to get any kind of treatment, and it was denied to him.

Why?

Was it scorn? "Hee, hee. Dude's got something growing on his dick. How funny!"

Was it prejudice? "Screw em. Wet backs in prison deserve what's coming to them."

Sorry, Blue. There's no reasonable excuse, no equivication, and no argument to be made that this is somehow normal or acceptable. When you imprison someone, you take responsibility for their care in detention.

Imprisoning someone and then allowing them to die is negligent homicide, manslaughter in the 2nd degree. Bringing this story to the attention of the public isn't propaganda, it's important journalism and one of our few safeguards against official abuse.

Now let's hope the doctors and officials who allowed this man to die through neglect are held accountable.

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JohnnyVegas Dec. 12, 2008 @ 12:38 p.m.

This case is still in court being litigated (it is a very well known case) and I have a feeling when it is over there will be a judgment in the 8 figure range-and there will be no accountability in governent, zero, none, nada, for those responsible.

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Sarcasm Dec. 16, 2008 @ 4:13 p.m.

I truly am sorry for the plight of Francisco Castaneda, however, HE himself is responsible for the decisions that put him in this situation. I'm sure all the bleeding heart posters here don't stop and consider the MANY legal citizens who were denied medical care in areas where illegals broke the system to the point where hospitals closed and medical aid was no longer available. Too bad - I hope the long-suffering tax payers don't get hit in the pocketbook for Francisco Castaneda, once again.

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babyblueye2142 Dec. 17, 2008 @ 10:01 a.m.

This case is very dificult. For one it does not matter what country a person is from! This is the United States of America the land of the FREE! NOT everyone can just walk into an ER and get immediate services. Before it is all sent into the prison or jail system, if you look at the "crime" itelf. if one is committed. If you are a suspect in any crime and you stroll into an ER they cannot touch you until the police show up and clear you. EMS rolls up on a scene before the police, they cannot treat you or even leave their vehicle until the police come to clear the scene. You could be shot and bleeding to death but the police do not come for 20-40 minutes later but the ambulance was there 5 minutes after the call. Is that considered neglect?? What about if you are an EMT or firefighter, paid or not if you witness an accident you are technically not allowed to leave the scene of that incident until cleared by police. If you do leave the scene before cleared and the victim dies, you can be charged with their death. I personally would not want that on my consience, sitting in the ambulance waiting for the police to show up while a person dies in front of my eyes.. I would much rather lose my job.

As for Castaneda's case, they could have passed it off at first but as it got worse, they should have taken the proper measures to take care of it. They thought with all the deaths and money they were saving by letting them all suffer then release them... well they thought they were coverin their oen arse.. GREEDY, GREEDY,GREEDY what would that mean if they spent a few million on health care?They would have less funds, but what did the funds go for anyhow? They were housing 3 people in a cell so it wasn't for construction of new cells.... Then I think the topper to this one is they had people wash the medical records clean, that tells you right there they KNEW they were guilty and proceeded through with it anyway. Must have paid that person off with the money they were saving huh?? I think that someone should come through and look through all the guards reports of observations unless they weren't even writing it down... this whole thing just sickens me. Anyone who has even had a wisdom tooth bother them knows that is makes the whole side of your face hurt from tour jaw to your ear to your head... Can you imagine having that pain CONTINUOSLY for MONTHS before getting it even looked at. After you take a medicine for so long your body becomes immune to it so it does not work anymore... How would that pain feel EVERYDAY ALL DAY??? That is just from a TOOTH!!!!! I cannot even imagine what Castaneda went through. I know it will not bring her father back but they took her father away and I hope they set Vanessa up financially for LIFE!!!

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