It is another day at FCI Thomson, a supposedly low-security institution within the federal Bureau of Prisons. Low-security prisons are meant for individuals with shorter, defined sentences; minimal criminal histories; and no recent history of violence or escape. However, Thomson is not operating as a low.
Thomson is a former high-security penitentiary that housed a special management unit (SMU), an 18-month program for “troublemakers.” And in many ways, it is still operating that way. It has maximum-security cells with all the trappings, such as locking steel doors with inmates locked inside from 9:15 p.m. to 6 a.m.. And the staff acts accordingly. When the steel doors are shut, it is a really bad time and a bad place to have a medical emergency. We’ve alerted staff on numerous occasions that the much reduced staffing of a low-security facility does not allow enough checks of older inmates when the doors are locked. Thus, a medical emergency while locked down is a really good way to end up dead.
Keystone cops
Such it was on January 6, 2026, when an inmate at “low-security” Thomson, awakened after the last roving check at 3 a.m. and before the doors opened at 6, with all the signs of a heart attack. The panic buttons located in the cells do not work. When the doors finally opened, he walked himself to the Health Services Department some 200 yards away in another building. He told the staff that he was having a heart attack. While one of the staff members hooked him up to an EKG, the other nurse told him to fill out a sick call form so that the prison could deduct $2 from his account to pay for his medical visit. After the nurse reviewed the EKG strip, she determined that he was correct and was in fact having a cardiac emergency. As has been widely accepted by mainstream medicine for decades, the :first hour after a heart attack is the golden hour.” After that, chances of survival drop dramatically. Shortly after the strip was analyzed, the facility’s primary medical provider (a migraine specialist by training) authorized the first of four nitro shots to help ease his symptoms. After almost an hour and a half, the ambulance finally arrived and he was driven to the nearest hospital some 20 miles away.
Upon arrival about 40 minutes later, the inmate and his escorts were advised that the hospital had no cardiologist on staff and no cardiac catheter lab. All the team there could do was check his enzyme levels and transfer him to a facility that could provide adequate care. He was placed on a nitro IV drip to try to alleviate his extreme chest and arm pain and was sent off. Five hours after the cardiac event began, the patient still had received no direct treatment.
A call to a sister hospital found no open beds. What a great area for a federal prison with hundreds of older and under-nourished inmates! Finally, an open bed was located that could treat his “cardiac event.” The patient was dispatched again for a 60-minute drive to a hospital in Sterling, IL.
Upon arrival the patient was immediately taken to a cardiac catheter lab for an angiogram. He then had seven stents inserted to restore stable heart function. At that time, it was about 12 hours after his heart attack.
A disaster that could have been prevented
FCI Thomson is located in rural western Illinois. The Thomson physician knew the closest hospital was not appropriate for a cardiac emergency, but sent the patient there anyway.That’s procedure, after all, I guess. However, the lost time could have killed this inmate. In fairness, the FCI Thomson medical staff did what they could within their limited ability. The fatal flaw is the BOP policy, which states that patients be taken to the nearest medical facility regardless of their capability to provide “adequate and timely” care. If anyone in the surrounding community went to a doctor who sent them to a facility that could not help, screams of malpractice would soon follow.
But there is more. A PET scan performed in December 2024 showed coronary artery calcifications and blockages in areas of the aorta that were ignored at that time. Readily available medications could have prevented the risk of death in the first place. This game of Russian roulette is played every day with the lives of thousands of inmates in U.S. custody.
It is my belief that the BOP and its providers intentionally understate medical conditions on inmate electronic medical records. Thus, many medical issues are hidden and go untreated. Thus, when inmates are referred to outside specialists, the physicians do not get a full and accurate picture of their health. Inmates normally do not have the expertise or the wherewithal to document and publicize these concerns. This story was only possible because this particular patient is a medical professional himself. He knows the proper and improper way to do things, but is still powerless to make the system work.
What’s needed is an ombudsman independent of the BOP that can and will hold the agency to account. But the Federal Prison Oversight Act remains unfunded. So ,no real accountability is possible until a body is lying on the morgue table. The act must be funded now. In addition, all immunity should be stripped from BOP medical staff so they are held accountable to the same standards of care as they would be in private practice. Finally, inmates must be allowed to file suit charging dereliction of duty by BOP medical providers — a right that has been chipped away by the Supreme Court..
inmates are humans, and deserve better than to be housed in a death trap.
