When it comes to the mysteries of prison health care, they usually are.
Griswold was serving a three-year sentence for burglary. Although she lives in Kansas City, Afola spoke with him often by phone. Terrell didn't complain a lot, didn't volunteer much about his health, she says. She knew he was taking blood pressure medication, but she considered him in very good shape, and she was stunned when officials told her that he'd died of a heart condition that couldn't have been foreseen.
"Initially, they just told me that he died of an enlarged heart," Afola says. But over the past year she has tracked down medical records held by the private prison operator, Corrections Corporation of America, and the Colorado Department of Corrections; she's pored over the official autopsy report and pointed out inaccuracies to the medical examiner; and she's consulted with a private pathology group, which has reviewed the same records and issued a conflicting opinion regarding how Griswold died and the kind of medical care he received in the weeks leading up to his death.
It turns out that, in addition to an enlarged heart, Griswold also was suffering from obstructive uropathy -- a nodule in his prostate was blocking his urinary tract. He had a history of urinary tract infections and had been complaining of problems with urination dating back to 2007.
"Kidney problems can precipitate heart problems," notes Afola, who has worked as a medical assistant. "I know they [CCA] are responsible for my son's death. All they needed to do was get a catheter in him."
Medical records indicate that a week before his death, Griswold had complained of dizziness, abdominal pain, soaring blood pressure and other symptoms that he believed were related to prostate problems. A prison physician was notified by phone but didn't actually examine the patient; two days later, he wrote a prescription for antibiotics to treat a possible urinary tract infection.
Afola believes her son tried to get medical help more often than the prison's records indicate. "Inmates have told me that he was going to medical almost every day for two weeks before he died, and they would not see him," she says.
His cellmate told authorities that Griswold had been complaining of stomach pain and was frequently attempting to urinate. Hours before his death, he again went to medical, saying he'd been nauseous and vomiting. But the nurse who examined him concluded he was simply experiencing a bad reaction to the antibiotics prescribed for his infection. "He didn't show any outward signs of distress," reads one notation.
In response to information provided by Afola, Dr. Leon Kelly, the El Paso County pathologist who conducted the autopsy, took the unusual step of running additional lab work and amending his report six months later. Although Kelly is still convinced that the enlarged heart is the cause of death, Shawn Parcells, the outside expert whose firm Afola consulted, contends that "complications of obstructive uropathy" would be a more accurate finding.
Given the clinical history, he writes, "Terrell should have been taken to an urologist to have a complete and full workup.... I believe there is negligence in this case, which would be defined as the medical team providing care below the standard of care."
But Parcells is forensic pathologist assistant, not an MD, and medical opinions can vary widely about the causation of death when several contributing factors are involved.
At this writing CCA officials have not responded to a request for comment about Griswold's death; the company has been the target of frequent criticism from private prison opponents and is the defendant in a long-running lawsuit over the 2004 riot at its Crowley prison.
Afola says she has no legal standing to pursue a lawsuit over the alleged negligence. "My hands are pretty much tied for doing anything legally," she says. "But I want to expose these people. I'm just hoping I can make their actions public. I know that my son was not cared for. I know he should not be dead."
It's taken her more than a year, she says, to extract sick call slips that her son filled out, documents that CCA was reluctant to provide and that somehow disappeared and then reappeared in DOC files. She's written somewhere between fifty and 75 certified letters to corrections officials seeking additional information and investigation and has been gently urged to curb the practice.
Yes, Terrell Griswold was a convicted felon. But he was also her son. "These are still people," she says. "It's ridiculous, the kind of care they receive."
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