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California inmate sterilizations violated informed consent rules: audit

By Sharon Bernstein

SACRAMENTO Calif. (Reuters) - California failed to follow its own rules for obtaining consent from female prison inmates who were sterilized by having their fallopian tubes tied, a state audit released Thursday shows.

The audit is the latest blow to the state's troubled prison system and comes as California is struggling to meet court-ordered demands to improve medical and mental healthcare in its overcrowded prisons.

The report "shocks the conscience," said State Senator Ted Lieu, a Democrat who represents part of suburban Los Angeles. "These systemic failures are unacceptable for a procedure that is life-changing and irreversible."

The report by the California State Auditor showed that of 144 tubal ligations performed between 2005 and 2011, errors were made in obtaining informed consent in 39 cases.

In 27 of those cases, a physician failed to sign the consent form as required, the audit showed. In 18 cases, there were potential violations of a mandated waiting period after women gave consent.

Prison rules make tubal ligation available to inmates as part of regular obstetrical care. But until the issue was brought to officials' attention in 2010 by an inmates rights group, proper authorization for the procedure was rarely obtained, the report said.

Carol Strickman, a prisoner rights lawyer, said, "This disturbing report shows that California is still a long way from meeting its duty to provide constitutionally adequate health care for prisoners."

Auditors criticize federal officials put in place to oversee care in the state's prisons in 2006.

The current official in charge, receiver J. Clark Kelso, was appointed in 2008, but did not learn about problems with tubal ligations until 2010, when the prison rights group Justice Now brought it to his attention, the audit said.

Just one procedure was performed after the concerns were brought to Kelso's attention and it was deemed medically necessary, the audit said.

"We are glad to see that our efforts to stop the practice have been successful and we look forward to working with auditors office to improve the process further," said Elizabeth Gransee, a spokeswoman for Kelso.

She said the receiver's office had undertaken several steps to address the problem, including appointing a women's healthcare executive to focus on health issues for female inmates.

In past years California prisons have struggled with crowding and concerns about the use of long-term solitary confinement for prisoners with suspected gang ties, which led to a hunger strike last summer.

The state has been under court orders to reduce crowding in the prisons since 2009.

(Reporting by Sharon Bernstein; Editing by Bill Trott)

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