Vannara Nhar was 22 years old and had near-perfect vision when a federal judge sent him to prison in 2011 for selling two stolen weapons to an undercover officer.
He left the Federal Medical Center at Butner two years later virtually blind, unable to see little more than shadowy shapes a foot in front of him, he said in a lawsuit filed last month.
The lawsuit references a series of polite but insistent pleas Nhar made over several months to Butner medical staff to get help. During that time, a rare but treatable disease destroyed his vision by causing the pressure within his eyes to build to the point that the optic nerves were permanently damaged.
Numerous medical staff noted Nhar’s repeated complaints of headaches and vision loss, but failed to provide him the specialized treatment he needed until it was too late, the lawsuit said.
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“I think that he was so nice that they just blew him off,” said Gregory Kash, a Raleigh attorney representing Nhar.
Today, Nhar, 26, is back home in Lowell, Massachusetts. His mother takes care of him as he learns how to get by without eyesight. He is in a job training program for the blind, and is taking a martial arts class that teaches him to use his other senses to fend off attackers, family members said.
“His eyes are gone,” said Malai Nhar, 48, a Cambodian native who immigrated to the United States in 1983 and raised Vannara and two other children as a single mom. “He cannot see, so it’s hard for me.”
Butner officials declined to comment on the lawsuit, referring all questions to the U.S. Bureau of Prisons, which oversees the prison hospital. The bureau did not respond to an email or a phone request seeking comment.
Damage to optic nerves
According to the lawsuit, prison medical staff knew Nhar has an eye disease called Vogt-Koyanagi-Harada syndrome, or VKHS. It is more likely to strike Asians, Native Americans and Hispanics, and can cause eye inflammation that triggers glaucoma – pressure within the eyes that damages the optic nerves.
Such harm can be avoided through early diagnosis and aggressive treatment, which includes the use of corticosteroids such as prednisone.
Kash said Nhar’s shoddy care is documented in emails he sent that are part of the medical record. In one typo-filled email that Nhar dictated to his cellmate, he told medical staff: “I am spose to go see the out side] eye doctor. My eyes are getting worst every day I wake up an I see less and less. Sometimes I can’t see my own hand. It’s getting really bad. I need to see the doctor ASAP. Please be for] I go blind. Please help me.”
The next day, medical staff emailed back that he was scheduled to see an ophthalmologist “soon.” But despite tests showing rapid vision loss, he wasn’t sent to the outside specialist until five weeks later. That doctor recommended an emergency “surgical intervention” to stem the vision loss, the lawsuit said.
Another two weeks passed before Nhar met the surgeon, who was so alarmed by Nhar’s declining vision that he scheduled surgery on both eyes the next day. Typically, surgery is performed on one eye at a time.
The doctor surgically placed small tubes in Nhar’s eyes to drain excess fluid and reduce the pressure within them. The procedure failed to halt the vision loss. Nhar’s eyes continued to deteriorate, and the headaches grew more intense.
The surgeon recommended follow-up surgery, but Butner staff never arranged it, the complaint said. Nhar left the prison legally blind on Oct. 23, 2013, unable to see beyond fingers held a foot in front of his face.
He filed a complaint against the prison with the Justice Department, but it was rejected.
North Carolina’s malpractice laws are intended to weed out frivolous cases. The state requires those claiming malpractice to have experts ready to testify to the poor care. That was a high hurdle for Nhar, who had limited legal knowledge and no money.
Kash found out about Nhar’s case through another lawyer. Kash revived the case a few weeks before a six-month window for an appeal was about to expire. He said he has lined up experts to back up Nhar’s claim of negligent care by three doctors and two physician’s assistants at Butner.
The lawsuit also asks a federal judge to waive another North Carolina law intended to limit the filing of malpractice suits, one that caps pain and suffering damages at $500,000. That law makes it harder for lawyers to make money taking such cases.
“Knowing there’s a limit on how much can be recovered for pain and suffering makes uncertain cases less attractive,” said Ralph Peeples, a Wake Forest University law professor. “You can no longer say if we win, we win really really big.”
Kash contends in the lawsuit that the cap is unconstitutional, but also cites an exception in North Carolina law for cases that involve gross negligence and cause permanent injury, such as the loss of vision.
Nhar’s lawsuit is the second in four years to claim medical staff at Butner exercised poor care in the treatment of someone’s vision.
Another inmate, William Daniel, received a settlement two years ago on his own. He said in court papers it was $23,000; a federal attorney didn’t dispute it. He alleged his eyesight deteriorated after the medical center twice failed to arrange for him to receive injections in a timely fashion, as an outside doctor had recommended, to treat his macular degeneration.
Like in Nhar’s case, federal attorneys sought to dismiss Daniel’s claim because he lacked an expert. But U.S. District Judge Terrence Boyle allowed the case to stand because Daniel was alleging negligence, which Boyle found wasn’t subject to the state’s malpractice rules.
Daniel, who said in court papers that he was terminally ill, was released from prison last year and could not be reached.