IF YOU'RE SICK and imprisoned in Oregon, Dr. Robert Snider might be one of your only lifelines.
Snider is the lone physician at the minimum-security Columbia River Correctional Institution in Northeast Portland. Charged with addressing the medical needs of more than 550 inmates—a population known to harbor its share of medical maladies—he's worked for the Oregon Department of Corrections (DOC) since 2006 and pulls in more than $185,000 a year.
But there are some convincing reasons to be concerned about the doctor's care of his captive audience.
At least twice, records show, Snider has faced the scrutiny of state licensing boards for alleged medical misdeeds. In 1999, his New York State medical license was suspended for two years. A decade later, Oregon authorities required Snider to complete a "pain and prescribing course" after an investigation into his practices. And in 2010, the state paid out thousands to an inmate who nearly died under the doctor's care.
Now, there are fresh claims about Snider's practices.
According to a lawsuit filed last month in US District Court, Snider—and others providing care to Oregon's more than 14,000 inmates—withheld a vital epilepsy drug from a Portland man serving time for a drunken driving conviction. Rather than pay for the medication, the filing claims DOC doctors experimented with cheaper alternatives as the man's condition spiraled out of control.
The suit paints a brutal picture of indifference to prisoner wellbeing at the DOC, and raises concerns somewhat similar to those the physician has faced before. Snider didn't respond to several requests for comment.
"What happened," says Portland attorney Lynn Walsh, who filed the suit on behalf of a man named Damieon Adams, "was atrocious."
Adams was sent to prison in December 2012, after court records indicate he violated terms of Multnomah County's DUII Intensive Supervision Program—a strict court for offenders with multiple drunk driving convictions.
When he entered the prison system, Adams was successfully using a regimen of two drugs to manage his epilepsy. He'd get a brief seizure once a day or so, but serious "grand mal" seizures were kept largely at bay, the suit says.
That changed quickly in prison. One of Adams' medications, Vimpat, isn't a substance the DOC routinely provides, the suit says. Plus, it runs about $1,000 a month. So DOC officials took Adams off the drug, allegedly in a manner experts warn against.
Both the US Food and Drug Administration (FDA) and its European counterpart, the European Medicines Agency, caution against abruptly stopping Vimpat. The FDA warns doing so "can cause serious problems."
Yet the suit claims Snider went against a neurologist's recommendation to taper the drug, instead simply removing it from Adams' drug regimen.
The prisoner began to suffer more seizures—along with their nasty side effects—so Snider allegedly experimented with other drugs. One of them, phenobarbital, is one of the oldest anti-seizure medications still in use. But the suit argues it's among the least desirable, saying it's used mainly in "third world countries" and "in dogs and cats."
Adams says he started hallucinating and had a dozen or more small seizures a day. He injured himself falling from his bunk, fought with other inmates out of confusion, and had numerous grand mal seizures, which had been exceedingly rare in recent years.
Adams' suffering continued until his release in September, the suit says. In October, he got a renewed prescription for Vimpat, and the seizures have dissipated. Adams alleges Snider and other DOC health officials were "deliberately indifferent" to his medical needs.
The DOC declined to comment substantively, though DOC Medical Director Steve Shelton, also a defendant, told the Mercury: "We disagree with the allegations."
Shelton also said the department reviewed Snider's medical record before hiring him. So officials were aware of a 1998 case in New York where the physician was charged with 34 specifications of professional misconduct—including gross negligence and gross incompetence.
The New York State Board for Professional Medical Conduct accused Snider of performing unneeded treatments to remove heavy metals from patients, lying to patients, and failing to develop appropriate treatment plans, along with infractions for inappropriately soliciting customers. Snider didn't contest the solicitation or failing to maintain records charges, and the board suspended his medical license for two years in early 1999, but agreed to withhold the suspension if he avoided further trouble.
Then, in 2009, the Oregon Medical Board issued a corrective action order against Snider. The circumstances aren't clear, but records show Snider was required to complete a "pain and prescribing course" and specifically prohibited from prescribing drugs to, or providing care for, "himself, or for any family member or significant other."
Less than two years later, the state was settling with Daniel Young, a former Columbia River Correctional Institution inmate who lost 30 pounds while he unsuccessfully begged Snider to address his gastrointestinal issues. Walsh also filed that suit.
"Plaintiff continued to waste away until he collapsed and was taken to the hospital," read Young's suit, which sought damages for Snider and others' "deliberate indifference."
The state gave him $100,000.