California's medical board and Department of Public Health have been asked to investigate 17 doctors and eight hospitals involved in dozens of illegal sterilizations of female prison inmates, based on a critical state audit released Thursday.
The auditor's office recommended that authorities investigate 39 cases where sterilizations were performed without inmates' lawful consent. The issue surfaced after the Center for Investigative Reporting found that doctors sterilized the nearly 150 female inmates without proper state approval over five years.
The 39 cases were among 144 between 2006 and last year in which inmates had tubal ligations or other procedures for the sole purpose of sterilizing them. Another 650 inmates had other medical procedures that could have resulted in sterilization.
Auditors found that nearly 30 percent of the tubal ligations and other sterilization procedures were performed without lawful consent.
In 27 cases, the inmate's doctor did not sign a required consent form saying the patient appeared mentally competent, understood the permanent effect and had waited at least 30 days and no more than 180 days to give the patient time to reconsider.
Margarita Fernandez, a spokeswoman for the California State Auditor, said the sterilizations were performed by private doctors at hospitals outside the prisons. Surgeries on prison inmates are typically performed at outside facilities.
State Sen. Hannah-Beth Jackson said she found it shocking that nearly 30 percent of the procedures were performed without obtaining proper consent. Jackson is the author of legislation which would bar the state's prisons and jails from sterilizing inmates for the purpose of birth control. It passed the Senate last month, 36-0, and is awaiting consideration in the Assembly.
Jackson fears that inmates may feel pressure to have the sterilizations, a topic that was not part of the auditor's review.
"The experience in and of itself is extraordinarily coercive," Jackson said of obtaining health care behind bars. "It's very difficult for a woman to exercise her free will under those circumstances."
The federal receiver's office previously said new procedures to limit sterilizations were put in place in 2010, but the state auditor recommended that the office adopt better procedures to monitor its own medical staff and medical providers who work under contract with the state. That includes improving medical record-keeping and making sure inmates give their informed consent to medical procedures.
The receiver's office failed to make sure its own staff obtained necessary approvals from inmates and from two medical procedure review committees before inmates were sterilized, the audit found.