An inmate at the Fluvanna Correctional Center for Women who allegedly suffered from repeated life-threatening mismanagement of her medication has died.
Margie Ryder, 39, due to be released from the prison Oct. 15, died Monday at VCU Medical Center, said her father, Cecil Clark. Officials with the Virginia Department of Corrections confirmed she died at the hospital where she was admitted June 24.
“As is public knowledge following the lawsuit, she had a terminal illness,” said Lisa Kinney, spokeswoman for corrections. According to the medical examiner’s office, Ryder’s death was natural and caused by pulmonary hypertension due to end-stage lung disease.
Ryder suffered from terminal pulmonary arterial hypertension and was dependent upon the correct use of an expensive medication, Remodulin, which was continuously delivered to her heart with a pump.
Her lawyers with the Legal Aid Justice Center filed an emergency motion on her behalf. At a May hearing before U.S. District Judge Norman K. Moon in Charlottesville, her lawyers said that since Ryder arrived at Fluvanna in early 2018, she had had several emergency hospitalizations due to the prison staff’s failure to appropriately manage her Remodulin.
Shannon Ellis, who argued the case before Moon, said Wednesday, “Obviously, we are deeply saddened by Ms. Ryder’s death. We’re evaluating our options as far as what the next step in the motion dealing with her situation is.”
“I think that her death highlights the very real and ongoing need for continued oversight and monitoring of the ... problems at Fluvanna. We were very hopeful that Ms. Ryder was going to make it to her release date, which was only three months away,” Ellis said.
In a brief statement filed Wednesday, her lawyers notified the judge of Ryder’s death.
They wrote that her “death is especially devastating given her UVA physician’s testimony at the May 22, 2019, hearing in this matter that, although patients with Ms. Ryder’s condition generally only survive three to five years without treatment, modern treatment therapies have been introduced such that, with proper care, ‘that number has been extended out almost indefinitely.’”
Clark, Ryder’s father, said she had been at the hospital in Richmond for two weeks. He said he believed she was rushed there because of improper care at Fluvanna.
He said he visited with her Monday and was driving home to Natural Bridge Station in Rockbridge County when he was called shortly before 10 p.m. and told about her death.
“It’s kind of difficult,” he said, but he was grateful he got to visit with her.
Clark said that Ryder’s mother had the same disease and that he was qualified by the company that makes the medicine to administer it. His wife, Deborah Clark, died in 2010, he said.
Ryder was convicted of embezzlement in Fauquier County and sentenced to 10 years with eight years suspended.
Ryder testified at the May hearing, and she and Ellis said they were not concerned with the prison medical director’s handling of her case or of his efforts to improve health care at the prison.
But, Ryder testified, “the nurses on staff are not up to par.”
In an affidavit, Ryder said, “I live in fear every day that a nurse will make a mistake in my medication, or a piece of equipment will break without a backup available and it will kill me.”
A nurse at the University of Virginia hospital who cares for pulmonary hypertension patients and ensures the safety of patients prescribed Remodulin testified that she had cared for Ryder three times — first in April 2018 and most recently in February.
In an earlier affidavit, the nurse said that each time was a result of the failure of staff at Fluvanna to correctly administer her Remodulin. At the hearing, the nurse said, “I remember her telling me she thought she was going to die.”
She testified that after consulting with her hospital’s legal counsel, she called the Legal Aid Justice Center on Ryder’s behalf. Asked by Ellis why she called, the nurse said, “I felt our patient’s life was at risk.”
Moon ruled Jan. 2 that the Virginia Department of Corrections failed to live up to eight of 22 standards of health care established in a 2016 settlement agreement for inmates at Fluvanna.
The inmates’ lawyers argued that the department failed to hold the contractor providing medical staffing at the prison — Armor Correctional Health Services Inc. — accountable to provide an appropriate level of care established by the 2016 agreement.
Under the terms of the settlement, Ellis said Fluvanna is obligated to provide medications in a “timely, safe and sufficient manner.”
An emergency motion filed on Ryder’s behalf asked Moon to order the department to develop and implement a plan to safely administer Ryder’s medications and ensure appropriate nurse training and oversight.
It also asked to open communication at the prison between the medical staff and Ryder’s lawyers to ensure that future situations are addressed as quickly and cooperatively as possible.
A Roanoke lawyer representing corrections officials asked the judge to deny the emergency motion, arguing that there was no substantial threat of immediate harm to Ryder and the only question at issue under the settlement agreement was whether a medical emergency currently existed that posed a substantial threat of immediate harm.
At the hearing, Ellis said they appreciated efforts to improve care at Fluvanna, but a court order was the only way to ensure Ryder’s safety because the system has long had problems and had persistently failed her.
She said Wednesday that in the past three months, there have been three deaths at Fluvanna.
“All of this together raises a lot of concern,” Ellis said.
The Department of Corrections said earlier this week that Ashley Janette Carr, 27, died July 1 of a suspected overdose, although the cause of death has yet to be definitively determined by the medical examiner’s office.
Referring to the suspected overdose death, Ellis said that part of Fluvanna’s obligation to inmate health care is to have adequate emergency response procedures and equipment.
“While this is a very recent death, there needs to be an investigation of it,” Ellis said. She said the Legal Aid Justice Center will be investigating the deaths of both Ryder and Carr.
In their notification to the judge Wednesday, Ryder’s lawyers said they “have received concerning information regarding Ms. Ryder’s care at FCCW prior to her final hospitalization and are investigating and evaluating the situation.
“However, at the very least, Plaintiffs submit that in light of the recent series of fatalities — all of whom were women under the age of 40 — the systemic relief requested on Ms. Ryder’s behalf (including provisions for improved communication with FCCW’s Medical Director and medical personnel) remains urgently necessary.”