A Mississippi prison denied medical treatment to an incarcerated woman with breast cancer, allowing her condition to go undiagnosed for years until it spread to other parts of her body and became terminal, according to a lawsuit filed on Wednesday.
Susie Balfour, 62, alleges that Mississippi department of corrections (MDOC) medical officials were aware she might have cancer as early as May 2018, but did not conduct a biopsy until November 2021, one month before she was released from prison. It was not until January 2022, after she left an MDOC facility, that a University of Mississippi Medical Center doctor diagnosed her with stage four breast cancer, according to her federal complaint.
Her lawsuit and medical records paint a picture of a prison healthcare system that deliberately delayed life-saving healthcare and for years repeatedly failed to conduct follow-up appointments that the MDOC’s contracted clinicians recommended.
Advocates for incarcerated people in Mississippi say Balfour’s experience is common. Her lawyers allege there are at least 15 others incarcerated at the Central Mississippi Correctional Facility, her former prison, who have cancer and are not receiving necessary treatment.
“I want to hold them accountable for what they’ve done to me,” Balfour said in an interview last week from her home in Memphis. “Being alone in there, I feared I was going to die, because I’ve seen so many others dying from not being able to get the proper care they needed.”
Her suit alleges cruel and unusual punishment and was filed against a number of MDOC contractors, including Wexford Health Sources and Centurion Health, private healthcare firms that have faced controversies over their treatment of incarcerated patients in Mississippi.
Balfour’s concerns about potential breast cancer began when her prison gave her a mammogram in June 2011; her doctor said it showed “benign appearing … microcalcifications in both breasts” and recommended a one-year follow-up screening, records show.
But Wexford, the medical services contractor at her prison at the time, did not schedule another screening until January 2013, even as she frequently complained of pain, tenderness and “lumps” in her breasts, her complaint says. In 2013, her doctor wrote that the mammogram again showed “benign-appearing calcifications” and recommended additional testing to determine if there might be lesions, her files show.
Wexford, however, conducted no follow-up evaluation, and it wasn’t until January 2016, three years later, that she got another mammogram with Centurion now overseeing MDOC healthcare, her complaint says. This time, doctors reported the number of calcifications had increased and recommended a six-month follow-up, but she says she wasn’t seen again for more than two years.
During her subsequent mammograms in May 2018, November 2019 and March 2021, doctors continually noted increasing calcifications, but still deemed them “probably benign”. Balfour’s lawyers, however, say that the doctors’ billing records indicate they were providing services related to “malignant neoplasm in breast”, suggesting they may have already detected cancer. The doctors also repeatedly noted that their benign findings “should not discourage follow-up or biopsy”. It was not until November 2021 that she actually received a biopsy, which revealed cancer cells. A third firm, VitalCore Health Strategies, took over MDOC care in 2020.
After her release from prison, medical experts reviewed her records for her attorneys and reported that her earlier mammograms also showed signs of cancer, according to Andrew Tominello, one of her lawyers. Balfour said her cancer has spread to her lymph nodes, thoracic spine, bones and her liver.
The failure to diagnose and treat her cancer was part of a pattern of the MDOC and providers not believing incarcerated people, Balfour said: “They always think everybody is faking. How can you tell me something that is going on inside of my body is not happening?”
The repeated refusal to give her timely mammograms was indefensible, Tominello said: “They delayed over and over again, and they should not be able to get away with that.” He said if Balfour’s sister-in-law had not continually advocated on her behalf, “they would have probably tried to sweep it under the rug and hope that she passed away”.
The suit also alleges that Balfour and others were required to clean the prison with chemicals linked to cancer, including glyphosate, the weed-killing chemical. The incarcerated people lacked protective equipment while exposed to chemicals and when mixing raw chemicals in toxic combinations, the complaint says.
Pauline Rogers, co-founder of the Reaching and Educating for Community Hope (Rech) foundation, a Mississippi organization that helps women coming home from prison, said that deprivation behind bars erodes people’s health: “You have to fight for everything – for a toothbrush, for toilet paper, for a sanitary pad, for some decent water and your life is no different. You have to fight for a mammogram or something as simple as glasses.”
Wexford and Centurion have both been accused of allowing preventable deaths of incarcerated people through inadequate care. Tominello said they function like traditional insurance companies “except they can deny your claim and you’ve got no recourse. And so just like the traditional insurance model, the less they have to pay out on claims, the more they make – it’s the same model, but they have less oversight.”
Balfour was incarcerated for 33 years on a murder conviction that was eventually overturned, then resentenced to manslaughter. She said she wanted to bring the case in hopes it would help her friends who remain incarcerated and struggle to access basic care.
“I try to live every day like it’s my last,” she said. “And as long as I’m living, I’m going to fight.”
Katelyn Head, an MDOC spokesperson, said the department does not comment on pending litigation. Wexford, Centurion and VitalCore did not immediately respond to inquiries on Wednesday.
