Patricia Hitch Ball was jailed for three months at J. Reuben Long Detention Center in Horry County for a charge that eventually was dropped. One month into her incarceration, she experienced a prolapsed rectum that caused her severe pain, rectal bleeding and the need to wear adult diapers in which she would soil herself.
By the end of her stay, she needed to use laxatives to pass stool and was completely unable to control her muscles, leading to multiple accidents a day, she said.
“She has blood dripping from her,” a correctional officer once noted.
The account of Ball’s time in jail shows the struggles people with serious medical issues may face at a pretrial facility.
Ball later was told that weakening of muscles in her digestive tract probably occurred over a long period of time, culminating in the complete prolapse she suffered at J. Reuben Long. During her incarceration, medical staff were unhelpful, she said, as Ball peppered them with questions about internal bleeding, possible infection and the possibility of colon cancer.
Her account was verified through several sources, including a copy of Ball’s jail medical records, medical records from immediately after her release and one of her cellmates. Much of the story also was confirmed by a person working inside the jail who The Sun News is not naming because of a policy that forbids speaking with reporters.
“Myself, the nursing staff and the correctional officers did everything we could do in our power to mitigate her discomfort. Scheduled med analgesia, which I rarely prescribe in the jail, extra hygienic pads to use, medications to help her bowel movements, surgical consultations to general and subsequently to a sub-specialist at MUSC was ordered,” wrote Joseph Papotto, the doctor who saw patients at the jail during Ball’s incarceration.
Marc Stern, an expert in correctional health care at the University of Washington and a former top doctor of that state’s prison system, said it was unclear if the jail shirked its duty in its care of Ball.
“It needs to be dealt with,” he said of the prolapse. “It depends, to some extent, on how much pain she was in, how much dysfunction she was in.”
Officials at J. Reuben Long said nursing staff are available 24 hours a day, and the jail followed the advice of doctors to whom Ball was referred during her incarceration. Melissa VanDuser, the health services administrator of the jail, said she had no comment on Ball’s situation.
Ball was arrested in December in North Myrtle Beach on one charge of knowing and willful exploitation of a vulnerable adult.
According to a case report from North Myrtle Beach, a man on Thick Branch Road told police that Ball helped a man named Robert Thomas steal a check from his dementia-ridden sister. Ball was a paid weekend caretaker in the home.
Thomas later tried to cash the $750 check at a Bank of America branch, according to the report. He left jail on a $1,000 bond the same day he was arrested — Nov. 23, 2016 — and has subsequently failed to appear for a court date, according to online court records.
Ball said she does not know Thomas.
“The only truth to this is that I did work there. I had nothing to do with the rest of it,” Ball said.
Ball believes officials used her past history of infractions against her.
She grew up and lived much of her life in Greenville County, and used drugs and alcohol intermittently starting when she was 18. Eventually getting hooked on crack cocaine, Ball was arrested for larceny, shoplifting, check forgery — “money crimes” to support her drug habits, she said.
She was on parole for one infraction when she was sent to J. Reuben.
“Once you get into making bad choices, the bad choice follows the bad choice follows the bad choice, and it becomes a habit,” she said.
But Ball said she left drugs behind in 2012.
“I felt like that they used my record kind of against me, you know, and I get that. I get that. I was the one in the home that had a record. Did I tell [the family] that I had a record? No. Did I lie to them? No, because they didn’t ask me,” Ball said.
By March 30, Horry County declined to prosecute Ball on the charge connected to the check theft. She said they never had proof that she was involved in the check cashing — just that she worked at the home.
Horry County Solicitor Jimmy Richardson said the circumstances allowed enough evidence to arrest Ball, but not enough to successfully prosecute her.
‘Pillar to post’
The Sun News spoke with Ball twice during her incarceration in J. Reuben Long earlier this year, in additional to multiple interviews after her release. She said that jail officials were dragging her “pillar to post” as she tried to wrangle medical care for the prolapse.
“It’s kind of like I’m a problem and I’ve been in their way,” Ball said in a March 8 jail visit.
“The more I kept asking for help, the more they would give me just a little bit, or just enough help to just kind of shut me up,” Ball said of her time in the detention center.
In the jail, inmates ask for medical care via a kiosk, a computer system used for all inmate requests. The Sun News obtained a copy of the kiosk interactions Ball had with jail staff for much of her time in detention — from her intake in December to Feb. 24.
On Jan. 20, Ball wrote for the first time that she needed an exam because something had started protruding from her body. Four days later, she saw Papotto, the doctor who visited the detention center for sick calls. Papotto diagnosed the prolapse and referred her to Aaron Epstein, a Conway-based surgeon, who saw Ball on Feb. 1, according to medical records.
In a copy of Ball’s records from that visit, Epstein wrote: “although this will need surgical repair at some point, at this moment in time it is not a life threatening problem. if it is desired to have it addressed now, i would send to dr george lagaris in charleston sc as he has expertise in this area (fellowship trained colorectal surgeon) [sic].”
Records of the visit say Ball reported rectal bleeding, sharp pain, bloody stool, difficulty passing stool and difficulty urinating.
Epstein declined to specifically discuss the details of Ball’s case, but said a rectal prolapse is not a time-sensitive situation.
“As a general rule, a rectal prolapse is never a surgical emergency,” Epstein said. “You just try to push it back in.”
Ball said one attempt to do that resulted in severe pain. She said that after that visit her medical condition continued to deteriorate, which her roommate, Brianna Morvillo, confirmed.
“She would constantly have accidents on herself, and couldn’t sit down for a long time or anything,” Morvillo said.
Ball’s roommate was a strong source of support during this period, helping her clean up when she soiled herself or the cell. But on Feb. 8, Morvillo bonded out of the jail. She was happy to leave the facility, but frustrated to leave Ball behind.
“I felt broken when I left,” Morvillo said. “I was excited when I was getting bonded out, but at the same time, [Ball] was like a mom to me, took care of me. We took care of each other. And then when I left, she really, she cried a lot and I asked all the other girls that were in there to look out for her and help take care of her and stuff while I wasn’t there.”
By late February, Ball’s condition had worsened. On Feb. 24, she wrote on the kiosk, “If it was your family, what would you do??? I know as long as I’m an incarcerated inmate, it’s the state responsibility to take care of me.”
VanDuser, the health services administrator of the jail, wrote back: “If you were in a state prison, then the state would be responsible for you. You are currently in a county facility who has contracted out their medical department. As long as you are a pretrial inmate, we do not pay for your medical bills.”
In an interview with The Sun News, VanDuser repeated the claim that the facility did not have to pay for outside medical treatment.
But Carter Elliott, a lawyer based in Georgetown, said that under existing law, the patient has to pay only if they demand a second opinion.
J. Reuben does charge patients $5 to see a doctor on sick call, but do not charge if patients do not have the money.
“If [inmates] have the ability to pay it and someone’s asking for it, I think they can try [to charge],” Elliott said.
Ball reported increased pain and bleeding to medical staff on Feb. 26 and 27, according to medical records from SHP. On 8 p.m. of the second day, a nurse wrote in medical records that she went to Ball’s cell to examine her after a correctional officer called and said “she has blood dripping from her.” The nurse noted she saw blood on the “adult brief” Ball was wearing and on another pair.
On Feb. 28, Papotto saw Ball during sick call and noted her increased bleeding and pain, saying he would call another outside referral in Georgetown County.
“I feel like they treat us differently because we are locked up,” Ball said during a jailhouse interview in early March.
In March, a new problem arose — a persistent, itchy rash that Ball was convinced was scabies, a highly contagious skin condition that is caused by tiny mites.
Papotto, in a March 14 note after examining Ball, termed the condition “institutional dermatitis.”
“I don’t think that actually exists, but that’s a name that doctors came up [with] for … dry skin, basically what it is from soap and water and the whole nine yards,” said Wayne Owens, the director of detention at the jail. “I don’t think institutionalized — whatever the word is — even exists.”
Papotto said he uses the term to explain a rash he saw in two to three of every 10 inmates.
“The symptoms included an itchy, scaly, bumpy rash on the torso and extremities,” he said. “The treatment was supportive with oral and topical medicines and sometimes we would go so far as to order water-washing of the inmates’ clothes to help alleviate symptoms.”
When Ball later visited the emergency room at South Strand Medical Center after her release, she was diagnosed with scabies. Her medical records from the visit confirmed the diagnosis.
When The Sun News told Owens about the diagnosis, he responded that he was “not aware of any medical reports or issues after Ms. Ball left JRLDC. Just to advise, she was transferred to another correctional facility after she was released from JRLDC.”
Papotto also said that Ball never presented with symptoms of scabies and “Just because the ER said she had scabies does not prove it.”
‘It costs them’
J. Reuben Long, named for the Horry County solicitor from 1938 to 1958, booked roughly 13,000 people in the past year. Its inmates are accused of wide-ranging offenses, from drug paraphernalia possession to murder.
The average daily population sits at 780 on any given day. Though the average length of stay from January to May was roughly 20 days, Owens said. Ball stayed in the jail for 103 days, unable to pay the 10 percent of a surety bond set at $5,000.
Because she was in the custody of the state, they were required to pay for her care, said Elliott.
“Whenever they send people out, it costs them. So that’s another reason why they don’t send people to hospitals, because they’d have to pay for it,” Elliott said.
Many detention facilities use private health providers as contractors. The contractor at J. Reuben Long during Ball’s incarceration, Chattanooga, Tennessee-based Southern Health Partners, provided care for an annual rate of about $1.8 million, with 18 full-time employees.
Jennifer Hairsine, the president of SHP, could not be reached by phone or email.
Going under the knife
On March 16, Ball was taken by J. Reuben Long staff to see another outside doctor, who told her she needed a colonoscopy before a potential surgery.
The entry noting that appointment is the last one in her file of jail medical records. Ball said she continually asked when she would have her next appointment, and said she didn’t receive many answers.
“They didn’t say anything else about it,” Ball said. “And then the next thing you know I got a phone call, and the officer handed me the phone and she said ‘It’s your attorney.’ So I said ‘Yes, ma’am,’ and she said ‘The solicitor’s [personal recognizance] bonding you out.’ And I said, ‘Really? Why?’ and she said ‘Just take it for what it is.’ ”
On March 27, Ball left the jail after the conditions of her bond were changed.
“They wanted me out of there, because it was costing them too much to take care of me,” Ball said.
Detention center officials could have asked to have her bond changed to avoid the cost of her medical care, Solicitor Richardson said.
“What does happen all the time is they will call and say ‘Look, this person has got more serious issues and things than we can deal with,’ ” Richardson said. “If they’re not dangerous, then yeah, we will address — we usually go to the defense attorney and whoever’s around and say ‘Look, here’s what’s happening, so let’s get them out of jail.’ And everybody’s good with that.”
“I can almost assure you that’s what happened with this one,” he added.
Elliott, the attorney, said many jails will adjust the bond of seriously ill patients because their care is too costly.
And, as Richardson said of J. Reuben’s medical department, “They’ve got a budget, too.”
After her release, Ball was transferred to a facility in Kershaw County, because she was on parole that stipulated she could not get arrested. A case to determine whether she violated the parole is still pending.
Ball left the Kershaw facility March 28. Two days later, the bleeding worsened, and she checked into South Strand Medical Center’s emergency room. On the same day, the Solicitor’s office declined to prosecute the charge that landed her in jail.
Ball thought the ER visit would be quick, but doctors began immediately prepping her for surgery and took vials of blood to do tests. She was taken by ambulance to Grand Strand Medical Center, where doctors were waiting to operate.
She was ready to go under the knife — until a new surgeon at the 82nd Parkway campus, Jason Sciarretta, suddenly stopped the process. Results of the blood work showed that Ball could be facing other issues, and Sciarretta decided to first order a colonoscopy.
A spokeswoman for Grand Strand Medical Center said Sciaretta would not be able to comment.
After weeks of follow-up appointments, including the colonoscopy, Ball finally underwent a surgery in May that removed a significant portion of her intestinal tract. Today, the scars have almost healed.
Ball does not have insurance to cover her medical costs. The ambulance ride, colonoscopy, emergency room visit and anesthesia already have topped $5,000.
While she’s waiting for the final bill for her surgery and other services, a pre-intake form estimated that it could cost over $11,000 in total. She created an online fundraising page on GoFundMe, but hasn’t received many donations.
After months of living with an unaddressed medical issue, Ball said she’s just happy the process is over.
“I just really believe everything’s going to be okay,” she said.
As for the jail, officials believe they did everything in their power to address Ball’s issues.
“We transported her to different doctor appointments while she was here,” Owens, the director of detention at the jail, said. “As far as what the doctors thought or didn’t think, I don’t know. We did everything the doctors recommended we do … but I don’t have any comment on why she feels her process wasn’t fast enough.”
Elliott, the Georgetown-based lawyer, said many county detention centers have issues with medical care.
“All these county facilities have a duty to provide 24-hour health care, in the same way a hospital would,” said Elliott, who is currently litigating a suit that alleges J. Reuben Long and others are culpable in a 2015 inmate death. “It’s very difficult, and they don’t do a good job of doing it, if at all.”