He reported minor symptoms to his jailers. Two weeks later, he was dead.
Alex Kuhnhausen
(Courtesy of Katie Kuhnhausen)
On April 21, 2024, Katie Kuhnhausen woke before dawn. She showered in the dark, dressed quickly, and jammed the day’s provisions into a backpack—snacks, a hairbrush, bottled water, lipstick. She planned to do her makeup in the car. The drive from her home in Vancouver to the Washington State Penitentiary in Walla Walla took about four hours, and she was running behind.
“I was feeling really nervous,” says Katie. “I hadn’t heard from my husband in eight days at that point.”
Katie’s husband, Alex Kuhnhausen, had fallen ill some weeks earlier. There was no formal diagnosis, but he presented alarming symptoms. On April 7, he told prison medical staff he had been coughing and sneezing up blood for three days and sleeping for most of the day for the past week, according to Department of Correction records reviewed by The Nation .
The following day, he told them again that he had been coughing up blood. The physician’s assistant wrote that it “could be a thrush,” and prescribed Alex an “oral wash.”
The care was subpar, but Katie says Alex shrugged it off. He didn’t think he would need to deal with prison medical staff again—his release date was four days away, and his wife planned to take him directly from the prison gates to a local ER.
But two days later, on April 10, he was placed in solitary confinement after guards allegedly caught him with drug paraphernalia. His release date was pushed back. On an assessment form, a licensed practical nurse checked off that Alex was “medically suitable” for solitary.
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In the hole, Alex’s condition deteriorated. He again requested medical attention.
On April 17, a physician’s assistant came to Alex’s cell and conducted a consultation with him. Although he remained in his cell throughout the encounter, her report states that he was able to get off and on an exam table.
She wrote in her notes that Alex was “not feeling well…. Hard to make himself drink fluids. Intermittent nausea with vomiting, worst when he gets out of bed. Sleeping all day and all night. Recently came to [solitary confinement] about 2 weeks ago, was injecting suboxone.”
But she dismissed the possibility of serious illness out of hand, concluding that his condition “appears to be more dehydration” than thrush and speculating that Alex was going through “suboxone/opioid withdrawal.”
It was a bizarre conclusion. Alex exhibited just one of the nine diagnostic criteria for opioid withdrawal—nausea and vomiting—and three or more must be present to satisfy the diagnostic threshold. Some of his symptoms, particularly his continual sleeping and inability to drink water, are antithetical to the symptoms of opioid withdrawal, which is characterized by lasting insomnia and fever.
Also, Alex continued to receive daily doses of suboxone, a synthetic opioid substitute that is used to tamp down withdrawal symptoms and stave off cravings, through the facility’s Medication Assisted Treatment program.
His symptoms did square neatly with those of another, much more sinister ailment: sepsis. Later, when he was properly evaluated, doctors immediately realized that this was the condition actually afflicting him. Untreated, it would only get worse.
Inside prisons and jails, Alex’s experience is an everyday occurrence. Doctors and nurses routinely ignore incarcerated people’s symptoms, even in dire situations.
David Fathi, director of the ACLU National Prison Project, says nurses and physicians working in prisons frequently question whether the people asking them for help are sick at all.
“There is, unfortunately, a pervasive belief among many prison staff that essentially all incarcerated people are liars,” Fathi says. “And if the patient happens to be someone with a history of drug use, as many incarcerated people [are], that presumption becomes almost irrebuttable. It becomes very, very hard to overcome.”
Medical staff tend to think incarcerated patients are feigning illness in pursuit of a free high, says Fathi. “This presumption that many prisoners are drug-seekers leads to really far-reaching, systemwide consequences.”
In some instances, healthcare staff assume prisoners have overdosed, despite evidence to the contrary. Their assumptions can “waste precious time” a dying patient doesn’t have to spare, Fathi says.
In 2024, at Stateville Correctional Center in Illinois, prison medical staff administered multiple doses of Narcan to Michael Broadway , who had fallen unconscious in his cell, even as prisoners called out that he had asthma and at least one repeatedly yelled that Broadway did not use drugs. Broadway was eventually taken to a nearby hospital, where doctors pronounced him dead.
Katie knew little of her husband’s circumstances as she drove across Washington to see him. But it had been more than a week since he last called her, a dramatic break from their routine of tal…
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