In August 2002, the Seattle Post-Intelligencer reported on long-standing issues in Washington's prison health care system, including incomplete or inaccurate patient records, lack of proper staff training, missed diagnoses, poor handling of emergencies, and severe medical staff shortages. At the time, Washington prisons had more than 15,000 inmates, but only five full-time staff doctors, and prison wardens instead of doctors held final authority in medical administration. A report in 2002 concluded that the prison health care system lacked standards and accountability, ultimately due to Washington not having a prison medical director with the proper medical knowledge and the authority to enforce change.

In this image, inmate Pierre Parent has his blood pressure checked by physician assistant Carl Nelson at the Monroe Correctional Complex.

Caption information source: "Failings in the system go back many years - medical warnings pile up, but few fixes made," by Angela Galloway, Seattle Post-Intelligencer, August 21, 2002, page A1.