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Why 1 in 4 inmate deaths happens in the same federal prison in North Carolina


A new NPR investigation has revealed a disturbing pattern.


Yeah. Of the 5,000 people who died in the past decade while in federal custody, 1 out of 4 died in the same prison.

MARTIN: NPR's Meg Anderson is with us now to explain what's behind those numbers. Meg, good morning.


MARTIN: So let me just clarify one thing. There are more than 120 federal prisons, and we are talking about just one. So tell us what's going on there.

ANDERSON: Yeah. So it is a prison in North Carolina. It's called the Butner Federal Medical Center. And to an extent, more death there makes total sense. It's a prison hospital, and it's the Bureau of Prisons' main cancer treatment facility. Cancer is one of the BOP's leading causes of death. So that explains a lot of it. But it doesn't explain all of it. When we started looking into the experiences of individual people, people who got really sick in prison, people who died in prison, we found stories of inmates all over the country going without needed medical care. And sometimes when they finally did end up at Butner for advanced care, it was too late to do much for them.

MARTIN: Tell us about some of the stories you found.

ANDERSON: Yeah. We found more than a dozen inmates who waited months, and some of them even years, for medical care. One inmate who ended up at Butner that we ended up focusing on, his name was Jeffrey Ramirez, and he found a lump in his testicle. He asked to see a doctor, but he didn't get an ultrasound until more than a year after he started complaining. He was eventually diagnosed with the final stage of testicular cancer. And when I interviewed him this year, he had been released from prison early, essentially to die at home. And he felt sure that it would have been different if he had been on the outside.

JEFFREY RAMIREZ: I know myself. That's the first place I would go. I'd go to the doctor. This would not happen. And I'm angry. I'm angry because it didn't have to get this far.

ANDERSON: Yeah. And he died just 11 days after he talked with me.

MARTIN: OK. But, Meg, Butner is a prison hospital. So are these men, women - I guess both - are they getting better care once they get there?

ANDERSON: Yeah. Just men, actually. And not necessarily. We found problems there, too. One man in prison there, Frank Carr, he waited more than a year for heart surgery. When I talked to him over the phone, he sounded panicky.

FRANK CARR: I do not want to die because I see so many people die in here. I witnessed people die, and I don't want to be one of the statistics.

ANDERSON: And he did end up getting his surgery. But another man we found waited five months for surgery to treat skin cancer. By then, it wasn't feasible anymore. Another inmate died after staff failed to give him his anti-epileptic medication. And last fall, two Butner inmates died in the night after they didn't get timely medical attention. And I should note that the BOP declined our request for an interview, but they said they are, quote, "committed to providing safe and effective health care."

MARTIN: Were you able to talk with anyone at the prison?

ANDERSON: So current and former staff at Butner told me that they think understaffing is the main reason for these delays in care. Of course, one way to fix that would be to hire more people. Another way would be to lower the prison population. But part of the problem is we just don't actually have that much insight into what happens inside prisons. That's according to Michele Deitch. She directs the Prison and Jail Innovation Lab at the University of Texas at Austin.

MICHELE DEITCH: There are so many things that we don't know about our prisons. How dangerous are they? How much violence is there? How well does the health care system work? - things that you would just assume we would know.

ANDERSON: So until there's independent oversight, it's hard for anyone to recommend concrete steps.

MARTIN: OK. That is NPR's Meg Anderson. Meg, thank you so much for this reporting.

ANDERSON: Thank you.

(SOUNDBITE OF KAFABINDUNYA'S "BINLERCE OZUR") Transcript provided by NPR, Copyright NPR.

NPR transcripts are created on a rush deadline by an NPR contractor. This text may not be in its final form and may be updated or revised in the future. Accuracy and availability may vary. The authoritative record of NPR’s programming is the audio record.

Michel Martin is the weekend host of All Things Considered, where she draws on her deep reporting and interviewing experience to dig in to the week's news. Outside the studio, she has also hosted "Michel Martin: Going There," an ambitious live event series in collaboration with Member Stations.
Meg Anderson is an editor on NPR's Investigations team, where she shapes the team's groundbreaking work for radio, digital and social platforms. She served as a producer on the Peabody Award-winning series Lost Mothers, which investigated the high rate of maternal mortality in the United States. She also does her own original reporting for the team, including the series Heat and Health in American Cities, which won multiple awards, and the story of a COVID-19 outbreak in a Black community and the systemic factors at play. She also completed a fellowship as a local reporter for WAMU, the public radio station for Washington, D.C. Before joining the Investigations team, she worked on NPR's politics desk, education desk and on Morning Edition. Her roots are in the Midwest, where she graduated with a Master's degree from Northwestern University's Medill School of Journalism.