Eduardo Torres Colón was just weeks away from being released from the Ponce Correctional Complex when he sought medical attention for severe pain in his left hip.
Between January 11 and 13, 2021, doctors at the institution treated him several times, noting no abnormalities besides the hip pain in his medical records. However, on January 15, Torres Colón arrived at the prison’s emergency area in a wheelchair, complaining of chest pain and difficulty breathing, symptoms he had been experiencing since the previous day, according to a lawsuit filed in December 2022 against Physician Correctional, a company registered as Physician HMO Inc. and contracted by the Department of Corrections and Rehabilitation (DCR) to provide healthcare services to the inmate population.
After an electrocardiogram revealed that Torres Colón was suffering from tachycardia, a doctor arranged for his transfer to Hospital Damas in Ponce. There, according to the lawsuit, he tested positive for mycoplasma, and medical staff documented that, while in prison, he developed episodes of fatigue, fever, and severe chest pain that felt like “stabbing pain that was exacerbated by coughing and worsened by deep breathing for five days,” symptoms that did not appear in the prison complex’s medical records.
On January 16, hospital staff reported cardiac arrest, and a doctor intubated the patient. Hours later, at around 6:05 p.m. that day, Torres Colón died.
The lawsuit, filed by Torres Colón’s mother and his partner on behalf of their daughter, alleges that the prison’s medical staff did not properly evaluate him. The emergency doctor at the prison allegedly failed to perform a physical examination during one visit, and on another occasion, a doctor recorded an identical physical exam to a previous one in the medical file.
As in Torres Colón’s case, 59 lawsuits reviewed by the Centro de Periodismo Investigativo (CPI), mostly filed pro se by inmates without legal representation, describe a correctional health program administered by Physician Correctional that denies medical services, medications, and specialist care to inmates.
Of the lawsuits reviewed, 54 were filed in Puerto Rican courts, 26 of which were archived or dismissed. Many dismissals were due to inmates not exhausting administrative remedies before filing the legal action. Depending on its nature, Puerto Ricans can file lawsuits in San Juan Federal District Court.
Physician Correctional has managed prison healthcare services in Puerto Rico with little oversight since the DCR contracted the company in 2018, according to a CPI investigation.
In September 2023, after the DCR and Physician Correctional came under scrutiny following the death of inmate Shannel Colón Ponce, the agency hired UTICORP for $450,000 to audit the correctional healthcare provider’s performance. Colón Ponce, a mental health patient, died in 2022 at the Bayamón women’s prison. According to a Senate investigation, Physician Correctional lacked adequate staff to address her mental health issues. Her death was classified as a suicide.
Before UTICORP, the DCR had contracted Health Strategy Consulting, led by Ramón Alejandro Pabón, from 2017 to 2022 for $416,000 to audit the compliance of Correctional Health Services Corporation, the previous healthcare provider, and Physician Correctional. UTICORP received a larger contract for a shorter period, from 2023 to 2024.
According to DCR Secretary Ana Escobar Pabón, the contracts with Health Strategy Consulting and UTICORP have different purposes. However, Escobar Pabón could not specify the services for which Health Strategy Consulting was hired. According to the contracts, the company was hired to “evaluate compliance with the contract signed” between the DCR and the company providing medical services to the correctional population.
“UTICORP directly analyzes the medical files to verify compliance with health services, and organization of records. They mainly check administrative procedures regarding medical records. But the previous company’s contract was not aimed at the auditing process as UTICORP does,” Escobar Pabón said in a phone interview.
For several months, the DCR and Physician Correctional have been in the public eye again after the release of femicide perpetrator Hermes Ávila Vázquez, who, after being freed in 2023 for alleged health reasons, killed another woman.
Ávila Vázquez, who had been evaluated by Physician Correctional doctors and diagnosed with paraplegia, received an extended pass due to his alleged health condition under Act 25 of 1992, which grants freedom to terminally ill inmates.
In May, during a public hearing before the Senate Committee on Community Initiatives, Mental Health, and Addiction, Escobar Pabón said UTICORP’s audit revealed “inconsistencies in medical documentation, discrepancies in diagnoses, and a lack of medical evidence to confirm” the diagnoses. She added that one of the recurring findings in UTICORP’s audit was related to “the organization of the inmate’s medical file.”
Photo | Puerto Rico Senate
In August, DCR Investigations Manager Alexis Rodríguez Rivera testified before the Senate committee and said Escobar Pabón ordered an evaluation of the contract between the agency and Physician Correctional, although he could not confirm if the Secretary issued a written order for this purpose.
According to a copy of the internal investigation report on Ávila Vázquez’s release obtained by the CPI, the killer claimed that a doctor guaranteed his release under Act 25 if he dropped more than a dozen lawsuits he had filed against Physician Correctional. The DCR has not made the document public.
Rodríguez Rivera revealed that the investigation recommended that Physician Correctional remove the doctors who comprised the medical panel that evaluated the femicide perpetrator, as it found “incongruities” in their actions. The report also suggests that the Department consider “reevaluating the continuity of the contract” with the company. However, the contract remains in effect.
Escobar Pabón told the CPI that, because of the Ávila Vázquez case, the Auxiliary Secretariat of Legal Affairs is in the process of identifying “which clauses of that contract we would need to amend if necessary.”
Secretary Escobar Pabón has stated that the areas that need modifications in Physician Correctional’s services are “purely administrative matters.” She added that “at this moment, we don’t have information that would lead us to cancel” the contract with Physician Correctional.
In an interview with the CPI, Escobar Pabón said, “If, at the end of all this, it is found that they have failed in those contract clauses or some additional clauses unrelated to this case, of course, I would cancel it.”
The CPI contacted Physician Correctional for an interview about the correctional health program, but the company declined to comment.
Photo | Puerto Rico Senate
In September and October 2021, Pablo Bermúdez de Jesús, an inmate at the Guayama Correctional Complex, requested medical services after experiencing dizziness, shortness of breath, and swelling on the right side of his abdomen. According to a lawsuit he filed pro se against Physician Correctional, a doctor saw him several times but never provided a diagnosis.
Bermúdez de Jesús began experiencing severe lumbar pain in March 2022 and requested medical services. However, the institution’s staff allegedly denied him medical attention, even when the pain was so intense that he could not walk or stand, according to the lawsuit.
The legal document shows that the man asked his sister to call the prison and intervene on his behalf, but when she did, the staff told her that her brother was “faking it. “
“I had to explain and swear to my sister through tears, sobs, and crying that this was not the case and reiterated that the pain was unbearable,” Bermúdez de Jesús recounted in the original 28-page handwritten lawsuit filed in 2023. This year, the legal document was amended by attorneys who took on the inmate’s case.
Eventually, after his sister’s insistence, one of the doctors referred Bermúdez de Jesús to the Río Piedras Medical Center, where a doctor ordered labs and imaging studies, and he was discharged on April 2, 2022.
But Bermúdez de Jesús’s pain persisted. The situation became so dire, according to the inmate, that other prisoners tried to intervene on his behalf to get him medical attention. Despite this, the medical staff allegedly did not provide adequate services, according to the legal document.
“I don’t think even a dog would be treated like this these days,” Bermúdez de Jesús expressed in the original lawsuit.
In May 2022, Bermúdez de Jesús returned to the Medical Center after a doctor at the penitentiary saw the inmate “screaming in agony” when correctional officers tried to place him in a wheelchair, the lawsuit details.
At the Medical Center, Bermúdez de Jesús learned that his medical records indicated that his X-ray studies showed osteomyelitis, a bone infection, since April 2, 2022, but apparently, the studies had not been reviewed at the time.
Bermúdez de Jesús was hospitalized at the Medical Center from May 8 until June 4, 2022. According to the lawsuit, the medical staff at the Guayama Correctional Complex did not provide the pain medication required as part of his treatment.
“The lack of humane treatment and good medical services in the island’s prisons is nothing new,” said Bermúdez de Jesús’s attorney, Laura E. Moreno Orama, who noted that when inmates lack legal representation, “it is very easy” for the State and Physician Correctional to defeat them in court through motions.
“This isn’t widely known precisely because of the obstacles inmates face when making claims, and if their cases don’t succeed, obviously, no one will hear about what’s happening,” she added.
The prison conditions described in the lawsuits align with the findings of a recent report by the American Civil Liberties Union (ACLU), which interviewed 50 prisoners, 21 former inmates, and their families between 2016 and 2021.
According to the report, those interviewed often mentioned that prison staff ignore “sick calls” or requests made by inmates for medical services. They also reported delays or interruptions in the delivery of prescribed medications and the lack of special diets for patients with diabetes or other conditions.
The report also mentions that the lack of correctional officers and transportation in institutions — a responsibility of the DCR — appears to be one of the main reasons inmates miss their medical appointments or experience interruptions in prescribed treatments. In fact, in one of the lawsuits that the CPI reviewed, an inmate alleges that after undergoing two knee surgeries, he was not transported for the physical therapies prescribed by a doctor because “there was no transportation for the disabled.”
“Inmates too often complained that they were not receiving the necessary medical attention and that their treatments were denied or interrupted without justification,” says the report, published in 2024.
Concerns about healthcare in prisons have been ongoing for decades. In 1979, a group of inmates filed a class action lawsuit in federal court in San Juan, known as the Morales Feliciano case. The lawsuit denounced the inhumane conditions in Puerto Rican prisons, including healthcare services. The inmates won the case, and the stipulations remained in effect until 2016.
The case revealed “violations of the fundamental rights suffered by Puerto Rico’s prison population, including overcrowding, lack of adequate medical services, deterioration of physical facilities, lack of rehabilitation services, unsanitary conditions, illegal solitary confinement of minors, and illegal solitary confinement of psychiatric patients without supervision or treatment,” the ACLU report states.
As a result of this case, in the late 1990s, the federal court ordered the privatization of correctional healthcare services. Before Physician Correctional, Correctional Health Services Corporation provided healthcare services in prisons.
The DCR first contracted Physician Correctional in September 2018 and renewed the contract in September 2023 for nearly $74 million, a 37% increase over the previous $54 million contract. According to Escobar Pabón, Physician Correctional submitted the only proposal that met the necessary requirements.
In addition to the agreement to administer the correctional health program for the male, female, and juvenile populations, the DCR contracted Physician Correctional from 2020 to 2023 to provide mental health services in juvenile institutions and rehabilitation and treatment centers. These services were part of the current $74 million contract.
In 2018, the number of inmates ranged between 9,000 and 9,500. The current contract is based on a population of around 6,500 individuals, including the juvenile population. The average number of inmates in correctional institutions in Puerto Rico was 7,411 in July. The contract does not specify the funds allocated per inmate or the service rates.
Physician Correctional is owned by brothers Raúl and Javier Villalobos Díaz, who have donated more than $34,000 to New Progressive Party (PNP) candidates between 2016 and 2024, according to data from the Office of the Electoral Comptroller. Some politicians who have received donations from the brothers include former Senate President Thomas Rivera Schatz, Representative Jorge Navarro Suárez, Representative José “Memo” González Mercado, and Governor Pedro Pierluisi.
Rivera Schatz, who has received $8,155 in donations from the owners of Physician Correctional, was actively involved in the legislative hearings held in May regarding the erroneous release of Hermes Ávila Vázquez by personnel from that company.
Photo | Puerto Rico Senate
A previous CPI investigation found that other names associated with the company include Grupo de Empresas de Salud de San Juan Inc. GES – Grupo de Empresas de Salud-Clínica Dres. Villalobos Inc., Grupo de Empresas de Salud de Puerto Rico, Grupo de Empresas de Salud USA, Inc., Raúl Villalobos Professional and Health Services Inc., and GES Physician HMO Inc.
Before entering prison, José Luis Ortiz Roche underwent a cranioplasty, and as a result of the procedure he suffered from seizures, fainting, and symptoms similar to epilepsy, according to a lawsuit filed in federal court in 2023. The man’s condition, who was released from prison last March, worsened due to inadequate medical attention in prison, and he now suffers from balance, hearing, and speech difficulties.
Ortiz Roche claims that Physician Correctional ignored his requests to see a neurologist and did not adequately provide his medications. In its response to the lawsuit, the company argues that it has supplied the medicines and denied that Ortiz Roche requested medical attention for seizures, except on one occasion when he was referred to the Río Piedras Medical Center, where he allegedly refused to stay under observation.
Physician Correctional filed a motion to dismiss, arguing that Ortiz Roche did not exhaust administrative remedies before filing the lawsuit, but the court denied the company’s request. The company submitted documents to the court claiming it provided the medications. In her response, Ortiz Roche’s attorney noted that the documents provided have different initials and handwriting.
Physician Correctional submitted documents to the court with Ortiz Roche’s supposed initials certifying that he received the medications levetiracetam and gabapentin. However, the initials on some documents in the CPI’s possession appear as JOR, while others are JLOR in different handwriting.
According to Ortiz Roche’s legal representation, the documents differ from those initially provided to the plaintiff as part of a subpoena, as the records originally supplied had incomplete initials.
“The documents provided by the plaintiff and the documents provided by the defendant raise a genuine dispute regarding the authenticity of the medical records, and for this reason alone, this lawsuit should not be dismissed,” says the legal document filed by Ortiz Roche’s attorney, Mayra Vicil Bernier.
Although federal judge Francisco Besosa did not address the controversy over Ortiz Roche’s initials, he upheld his decision to deny the company’s motion to dismiss.
The contract between Physician Correctional and the DCR includes mechanisms to monitor compliance, such as the submission of monthly reports by the company that include information on admission services, morbidity and mortality reports, and the use of outpatient services, among other data. The company must also submit an annual report on the operations of the health services and their compliance levels.
Physician Correctional must present the reports to the DCR Secretary and the medical liaison officer, a duly licensed doctor appointed by the DCR to serve as a link between the agency and the correctional healthcare provider. A Senate investigation concluded that, at least until last year, Physician Correctional had not submitted the required monthly reports.
The DCR Secretary told the CPI that the company has complied with submitting reports, but the CPI requested them and received no response.
In 2018, before the first contract between Physician Correctional and the DCR was signed, an audit by the Office of the Comptroller found that the position of Medical Liaison Office director had been vacant from July 1, 2014, to September 11, 2016. It also revealed that the Joint Oversight Committee did not meet in 36 of the 42 months evaluated, which, according to the Comptroller’s Office, hinders the oversight of the company’s contractual obligations.
Escobar Pabón acknowledged that the medical liaison position remains vacant and that a special assistant fulfills the role’s duties. “We are currently working on it,” the Secretary said.
However, she added that the Joint Committee, composed of representatives from the agency and the company, meets every two months.
Physician Correctional Fails to Address 28% of Inmates’ Clinical Requests
The DCR has provided the Puerto Rico Institute of Statistics with annual and monthly reports prepared by Physician Correctional. The most recent report posted on the Institute’s website dates to May 2023.
According to the company, between July and May of the fiscal year 2022-23, the correctional health program received 55,036 “sick call” requests, of which 94% were addressed. However, it acknowledges that 28% of requests for services in internal outpatient clinics, that is, in institutions that are part of the correctional system, and 34% of requests for service in external outpatient clinics were not addressed. The company was not available to explain what type of care it provides inmates when requesting a “sick call.”
According to the report, the main reason for not addressing service requests is the inmate’s “refusal/rejection.” UTICORP’s audit precisely highlights the high percentage of refusals for treatment “without evidence of forms signed by the patient and/or officer.” Physician Correctional’s report does not explain why inmates refuse treatment they have requested.
In 2023, the Senate Committee on Community Initiatives, Mental Health, and Addiction investigated Physician Correctional and concluded that the company had failed to submit the reports required in its contracts. The legislative body recommended that the DCR cancel and not renew the contract with Physician Correctional, determining that the company cannot guarantee the mental and physical well-being of the inmate population.
“The DCR has failed in its supervisory duty over Physician Correctional both in the absence of compliance with monthly reports and in the poor or nonexistent oversight of the invoices submitted by Physician Correctional, treating them as a pro forma process,” the Senate committee’s report concludes.
The committee, chaired by independent legislator José Vargas Vidot, along with the Committee on Legal and Economic Development, launched another investigation in May related to the services provided by Physician Correctional and the functionality of Act 25 following the release of Ávila Vázquez.
In June, the Senate committees concluded in a partial report on the investigation that there was “constant and repeated negligence” within the DCR’s and Physician Correctional’s administrative processes in releasing Ávila Vázquez.
“There has been an apparent intention to empty the correctional system looking for savings under a supposed austerity which has been enabled by the relaxation of regulations that no longer even relate to the spirit of the law,” states the report signed by Vargas Vidot and the president of the Committee on Legal and Economic Development, José Luis Dalmau Santiago.
Vargas Vidot emphasized that since his committee raised concerns following Colón Ponce’s death, Physician Correctional has been “persistently” negligent. He pointed out that the company’s records and reports are “vacuum” and “filled with generalities,” adding, “since there is no supervision from the contracting entity, they have done whatever they wanted.”
“This contract, easier than (private energy company) LUMA’s, could easily be dispensed with because the two audits conducted on these services highlight failures in practically all areas regulated by federal regulations,” Vargas Vidot said in a recent telephone interview.
