Russian-born US-citizen Robert
Daniels
with TB in hospital jail, denied rights, sues county
March 1 - Now — US Citizen Quarantined For Life (255+ comments) — Digg.com
March 2, 2007 — Man with 'extreme' TB may be jailed until death — Tucson Citizen
March 2, 2007 — Arizona’s Big Brother cracks down on “Citizen” Daniels — Burton’s View (blog)
March 29, 2007 — Confined TB patient says lawyer failed him — Arizona Republic
March 29, 2007 — Phoenix Man with TB in Lockdown — KJZZ Radio
Apr 2, 2007 — Man With Drug-Resistant TB Remains Locked Up — CBS4Denver.com (text, video 3 min.)
April 2, 2007 — Man with tuberculosis jailed for not wearing mask — Associated Press
April 6, 2007 — Is Sickness a Crime? Arizona Man With TB Locked Up Indefinitely in Solitary Confinement — Democracy Now.org
April 6, 2007 — TB: Public Health versus Personal Liberty — Voice of America
Download video/radio interviews with Robert and wife Alla, 2 attorneys and doctor. (16 minutes)
April 7, 2007 — AZ ACLU Takes on Robert Daniels Case — KJZZ Radio
April 7 - Now — Contagious disease: Should people with contagious diseases be locked up if they refuse to take precautions to avoid infecting others? — COE Express Polls
April 9-25, 2007 — Interviews with Russian-born Robert Danielov (Daniels) from jail-hospital
April 10, 2007 — "Up Front", Channel 12, NBC News, 4:30 pm & 10 pmNews — 12News
April 11, 2007 — Arpaio decides to return TV, phone to confined TB patient — Arizona Republic
April 11, 2007 — Man with tuberculosis jailed as threat to health — USA Today
April 13, 2007 — Phoenix, Daniels and XBR-TB — BioEthics Blog
April 15, 2007 — When's it OK to lock patients up? — National Review of Medicine
April 24, 2007 — Lawyers fight for TB patient's rights — 12News
April 23, 2007 — Considered a health risk, TB patient Robert Daniels has been confined for eight months — People Magazine
April 25, 2007 — Confined TB patient is unable to testify — Arizona Republic
May 3, 2007 — Virulent New Strain of TB Raising Fears of Pandemic — Washington Post, Page A1
May 8, 2007 — Russia Blog: Robert Daniels of Russia still in solitary confinement for Tuberculosis
May 30, 2007 — ACLU Sues County Officials Over Inhumane Confinement of TB Patient — American Civil Liberties Union (ACLU) of Arizona
May 30, 2007 — COMPLAINT 42 U.S.C. § 1983 Civil Action, Robert Daniles vs. Maricopa County; Dr. England, Dr. Kennedy, Dr. Moffitt; Sheriff Arpaio
May 30, 2007 — ACLU files lawsuit against county for treatment of TB patient — The Arizona Republic
May 31, 2007 — County violated rights, law, ACLU says — The Arizona Republic
May 31, 2007 — TB patient costing taxpayers ... $50,000 a month — Arizona Republic
June 1, 2007 — Mr. Contagious — Detail magazine
June 1, 2007 — 2 cases stirring TB fears — The Arizona Republic
Jun 1, 2007 —ACLU Brings Suit Against Arizona for Quarantine of Tuberculosis Patient: Robert Daniels Reportedly Strip Searched Regularly and Denied Visits with Family — Associated Content, Inc.
Jun 2, 2007 — Tuberculosis in the USA ! Hell for Poor; Celebrity for Rich!— WhippingCensorship, You Tube
June 2, 2007 — Held Captive By TB — And The State — CBS News
June 2, 2007 — ACLU Sues On Behalf Of Quarantined, Jailed TB Patient — North Country Gazette (New York)
June 3, 2007 — Jail sentence for 'crime' of being deathly sick with TB — Arizona Republic
Jul 13-31, 2007 — 5 TV news stories with video — 9NEWS.com (Denver) (text, video)
July 19, 2007 — 'Happy' TB inmate in town — Mountain News, Denver CO
July 20 - Sept 18, 2007 — 5 articles reach 50 million newspaper readers, 167 million TV viewers — National Jewish Medical and Research Center
July 20, 2007 — National Jewish Medical and Research Center Begins Treatment for Multi-drug-resistant TB Patient Robert Daniels — National Jewish Medical and Research Center
Jun. 24, 2007 — Money separates tuberculosis patient from prisoner — Arizona Republic
July 30, 2007 — TB patient readies for surgery to remove lung — 9NEWS.com, Denver
July 31, 2007 — Arizona TB Patient Robert Daniels to Undergo Surgery — National Jewish Medical and Research Center
Sept 18, 2007 — Drug-resistant Tuberculosis Patient Robert Daniels Discharged ... — National Jewish Medical and Research Center
Sept 18, 2007 — Tuberculosis Patient Headed Back To Phoenix — 9NEWS.com (Denver) (text, video)
Sept. 20, 2007 — TB patient back in Valley over legal fight — Arizona Republic
Sept. 22 2007 — Sheriff Joe Arpaio Silent On Robert Daniels Case — Burton’s View
Sept 27, 2007 — Fund set up to bring family of TB patient to Arizona — Arizona Republic
Oct 5, 2007 —TB Patient Back in AZ — by Rene Gutel for KJZZ Radio, Phoenix AZ
Oct 9, 2007 — TB patient who was quarantined in jail flees — Arizona Republic
Oct 9, 2007 — Former Ariz. TB Patient Leaves Country — Associated Press
Oct 9, 2007 — Hear what TB patient Robert Daniels says about Sheriff Arpaio (video) — 3TV phone interview from Moscow
Oct 9, 2007 — Special Reports: Robert Daniels (9 radio stories.) — KJZZ Radio, Phoenix AZ
Oct 9, 2007 — TB Patient Flees U.S. "Abuse" For Russia — CBS News
Oct 9, 2007 — TB patient flees country — 3TV, Afternoon news video, + 5 links
Oct 9, 2007 —TB patient who was quarantined in AZ flees country — ABC15.com Evening TV News video, text
Oct 9-10, 2007 —10 articles about Daniels going to Moscow — World News
Oct 10, 2007 —TB patient flees USA and escapes to Russia to avoid humiliation — Pravda.Ru
Oct 10, 2007 —Arizona may seek extradition of TB patient who fled to Russia — RIA Novosti
Oct 10, 2007 — TB Patient Escapes to Moscow — The Moscow Times
Oct 25, 2007 — Status Review Hearing: Case Dismissed, Minute Entry: Case PB 2006-002150, Superior Court of Arizona, Maricopa County
Mar. 24, 2008 — TB patient indicted as risk to public health — The Arizona Republic
Oct. 28, 2009 — Arpaio's Request for Summary Judgment in Robert Daniels Case Squashed in Federal Court — Phoenix New Times
Quarantine breach leaves TB patient locked in isolation
Man may serve life in hospital
By Dennis Wagner — The Arizona Republic — Mar. 1, 2007 — Page A1He is not allowed a TV, a radio, a cellphone, a shower or visitors. A video camera catches his every move. [Initially he had all this, but the staff took it all away!]
His floormates are criminals, including a suspect in the killing of a police officer.
He has been isolated here for eight months and is expected to remain much longer, perhaps until he dies.
But Robert Daniels [Russian surname: Danielov] is not charged with any crime. He has tuberculosis. And he is under court-ordered confinement because he violated the rules of voluntary quarantine, exposing others to a potentially deadly illness. [There is no evidence that anyone was harmed including his wife and child, and his former apartment and car were never quaranteined or disinfeted.]
Daniels is afflicted with a TB strain so dangerous* that he has never met his appointed lawyer, Robert Blecher, who describes the situation as "extremely unusual." [* "Dangerous" after one with weak immunity becomes infected which is not easy to do.]
"Mr. Daniels' problems occurred — and he understands this — because of his own actions," Blecher said. "It does come down to a health issue for the entire community. He did go out in the public. He was exposing people."
Blecher acknowledged that his client's living conditions are unusual: Daniels is housed in Station 41, a room where air flows only in, not out. He is on a hospital floor supervised by the Sheriff's Office. There is no other facility in the Valley for medical lockdown. [Daniels does not need "medical lockdown".]
Jack McIntyre, a sheriff's spokesman, said sympathetic nurses gave Daniels a computer, a phone and other items for a time, but those were confiscated for security reasons. "While he's there, we treat him as an incarcerated individual," McIntyre said. "It's a jail ward." [They violated his civil rights because he is not a "criminal".]
Daniels contracted TB while living in Russia, according to Superior Court filings. In July 2006, he was admitted to Scottsdale Healthcare Osborn hospital for respiratory illness. Lab tests revealed that he suffered from "extreme multi-drug-resistant tuberculosis," records show. [He was diagnosed after transfer to the Maricopa County Hospital. Medical staff before that neglectd to order a lab analysis.]
The disease is spread by airborne contact: If a patient coughs in public, others are endangered. [But that is no quarantee nearby people will get infected. People he may have come near were not quarantined and tested, nor did Monroe House staff wear masks.]
Robert England, Maricopa County tuberculosis control officer, said in court filings that Daniels was transferred from the hospital in July to Monroe House, an outpatient facility for indigent TB patients near downtown Phoenix. He was instructed to continue treatment and wear a mask whenever going out in public. England alleged that Daniels stopped taking his medication [not true] and went unprotected to a Jack in the Box, a Circle K and other stores [true]. Daniels understood the rules, England said in his affidavit, but "merely refuses to follow them."
Based on that, the Maricopa County Department of Public Health obtained a court order for "compulsory detention," a legal tool used only about once a year in Arizona and usually only for a short time. [Here's the legal problem, he's been locked up way too long. How much should the SCLU sue the county for?]
Daniels is a Russian-born 27-year-old with dual U.S. citizenship. During a hurried and rare phone conversation Tuesday, he admitted making a mistake eight months ago but said he did not understand the gravity of his disease at the time. [He was not fully diagnoses and staff neglected to explain the rules which staff did not follow.]
"I don't want to confuse people if I wear a mask," Daniels said, describing his thoughts. "What if they think I'm a robber? What if I get shot?
"Nobody talked to me about this thing. Nobody lectured me."
Daniels said face covers are not worn by tuberculosis patients in his homeland, which ranks 12th on the World Health Organization's list of most infected nations.
"In Moscow," he said, "when I went to clinics, even the doctors did not wear masks."
Russia, with 26,000 TB deaths annually, has more than 80 cases per 100,000 population, compared with five per 100,000 in Arizona.
Daniels said he has become depressed to the point of weeping.
"They're making a criminal out of me," he added. "I've been crying almost every day. ... I'm all alone. No showers. No sunlight. It's the silence that's pushing down on me. ... It's the worst you can get, even if you murdered somebody."
Daniels, who has an American [Russian] father and lived in the United States during the 1990s, was diagnosed with TB two years ago in Moscow. He was told drugs were difficult to obtain and too expensive for a poor laborer. Daniels said he came to Arizona in January 2006 looking for work and hoping to get treatment [and get his GED and bring his family here].
His wife, Alla, who is in Russia with their 5-year-old son, said in a phone interview that the imprisonment seems inhumane.
"I know he has a very dangerous form of the disease," she said. "But he was not arrested. His rights are being violated." [Neither Alla nor his son caught TB from Robert!.]
Daniels said hospital workers became so upset with his plight recently that a series of county Superior Court hearings were conducted. Last week, Commissioner Randy Ellexson ordered that the patient be moved to new quarters. He then reversed that decision during an emergency session, which Daniels said he was not allowed to monitor by phone.
Daniels said he has been a model patient at Station 41* and would not violate quarantine again. He claimed recent tests of sputum from his lungs were negative for TB. * Station 41 is an isolation room that only allows air to flow in to prevent spreading the disease via the airducts. HEPA filtration with high-energy ultra-violet light units kill the live bacteria and viruses trapped by the filter to protect careworkers who may enter the room. Air filters are burned to kill any trapped germs.
But prospects for freedom remain unclear. A medical assessment submitted to the court in August indicated the disease was still mutating* in Daniels and may require treatment for years. [* Not "mutating", he has 2 strains of TB, one strain responds to the drugs, the other is resistent.]
"There is certainly a high likelihood that the patient has developed additional drug resistant (sic) that may make cure impossible," the assessment said. "If this is the case, the patient must be detained in isolation until death or patient's own immune system contains it (50% chance of either possibility)."
A Feb. 20 entry in the file added that Daniels needs eight weeks of clear tests before he can be deemed non-infectious. Court records do not contain an updated prognosis, and medical authorities declined to comment. [They hope the public does not learn of their numerous errors or that they may lose their governmetn jobs.]
Robert Daniels (Danielov)
To contact Robert Daniels:
Cellphone: 602-754-9702
His laywer
Mr. Robert B Blecher
8930 E Raintree Dr Suite 100
Scottsdale, AZ 85260-0001
Telephone: 480-444-9988
Fax: 480-308-0015
8930 E Raintree Dr Suite 100
Scottsdale, AZ 85260-0001
Telephone: 480-444-9988
Fax: 480-308-0015
Facts about tuberculosis
What is TB?
TB is a respiratory ailment caused by Mycobacterium tuberculosis. The disease attacks the lungs and, in some cases, other organs.
It spreads when a carrier coughs or sneezes, expelling particles into the air that are inhaled by others. TB is less infectious than some other communicable illnesses, including the flu. Chances of transmission increase with greater exposure.
Does everyone who is infected get sick?
No. Only about 10 percent of those infected will develop active tuberculosis. Those with a latent form cannot spread the disease but should be treated to prevent development of active tuberculosis.
What is the likelihood of getting active TB?
Slim. More than 9 million U.S. residents are believed to be infected, but there were just 14,097 active cases in 2005, the nation's lowest number ever. In Arizona, there were 281 active cases, or 4.7 cases per 100,000 residents. More than half were in Maricopa County.
What are the symptoms?
Coughing, fever, weight loss and malaise.
What should I do if I think I've been exposed?
See your doctor for a TB skin test.
How is tuberculosis treated?
The most common strains are cured with regular antibiotics.
Are their different types of TB?
Yes. Some forms are more contagious than others. And some hybrids are resistant to antibiotics.
What is extensively drug-resistant tuberculosis?
This rare strain, known as XDR TB, resists most known treatments and is sometimes fatal. Because it is so pernicious and dangerous, treatment costs for a single patient may exceed $1 million.
Sources: Maricopa County Department of Public Health, Centers for Disease Control and Prevention and Dr. Robert England, Maricopa County tuberculosis control officer.
Read more about turberculosis in Russia.
Читай о туберкулёз в Россие.
Man with 'extreme' TB may be jailed until death
Tucson Citizen, from The Arizona RepublicRobert Daniels has not been charged with a crime, but the 27-year-old violated the rules of a voluntary quarantine, exposing others to a potentially deadly illness. Maricopa County public health officials got a court order to keep him locked up.
The TB strain Daniels has is so dangerous that he has never met his appointed lawyer, Robert Blecher, who describes the situation as "extremely unusual."
Daniels' hospital room is designed so that air flows in, never out, to prevent the bacterium from spreading.
Daniels, who has dual citizenship in the U.S. and Russia, contracted "extreme multidrug resistant tuberculosis" while living in Russia, court records show.
He was diagnosed two years ago in Russia, and said he came to Phoenix in January 2006 after being told drugs were hard to get and expensive.
Daniels went to a Phoenix hospital with respiratory problems in July 2006, and was sent to a Phoenix halfway house for indigent TB patients under a voluntary quarantine. He was ordered to continue treatment and wear a mask when he went out in public because the disease is spread by airborne contact.
Daniels stopped taking his medication and went unmasked to a restaurant, a convenience market and other stores, court records stated.
Robert England, Maricopa County's tuberculosis control officer, said in court filings that Daniels understands the rules, but "merely refuses to follow them."
England applied for and received a "compulsory detention" order for Daniels, a legal tool used about once a year in Arizona.
Daniels, who has a wife and child in Russia, said in a telephone interview with The Arizona Republic that he didn't want to confuse people by wearing a mask and that doctors at Russian clinics where he was treated didn't even wear masks.
The Centers for Disease Control and Prevention reported there were 14,097 cases of TB in the United States last year. Just 15 were of the rare strain Daniels has. Prospects for his release are unclear. A 2006 medical assessment indicated the disease was mutating in Daniels.
Robert Daniels (Danielov)
20+ Readers comments about this article
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Read 255+ comments at Digg.com:
US Citizen Quarantined For Life
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Arizona Man with TB
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Drug-resistant tuberculosis
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"Robert Daniels" tuberculosis OR TB
Confined TB patient says failed him
Dennis Wagner — The Arizona Republic — Mar. 29, 2007 — Page B1Robert Daniels, 27, is infected with a deadly form of TB that is extremely resistant to drugs. He has been housed under sheriff's guard since August, when a court ordered him confined because he endangered others by going out in public without a mask.
During the first six months of his confinement, Daniels was allowed to have a TV, clock radio and other amenities. However, in mid-February sheriff's employees seized his belongings and declared they were a security threat on the hospital's jail ward.
Since then, Daniels has been held in a padlocked room with covered windows, no access to showers, and limited contact with the outside. During a brief phone interview this week he said attorney Robert Blecher, appointed by the county as legal counsel, has failed to help him. [Blecher was trying the best he could, so the ACLU stepped in to help.]
"Always promises," Daniels said. "I don't really trust him."
Blecher could not be reached for comment.
Dan Pochoda, legal director for the ACLU in Arizona, said he understands why Daniels is in quarantine, but believes it is unlawful to subject a patient to punishment. "We are very concerned about this," he said. "I cannot imagine more punitive conditions than what has been described to me."
Daniels said he has not been allowed to participate by phone in court hearings. He added that the isolation has sent him into depression: "I am hanging on a thin piece of rope."
Daniels is a Russian-born U.S. citizen who spent years of his childhood living in Scottsdale with an American father. He contracted TB in Moscow, where he has a wife and child. After coming to the U.S. 15 months ago, he was hospitalized and then placed in residential care.
According to court records, Daniels willfully violated rules implemented to protect the community. He has said he ignored protocols because TB patients in Russia do not wear masks, and he did not comprehend the threat he posed.
Daniels has not been convicted of any crime. However, Maricopa County sheriff's spokesman Jack McIntyre said Daniels is being treated as an inmate because he is in the hospital's jail ward.
An August medical assessment submitted in county Superior Court said Daniels' disease could be fatal and may require treatment for years if he survives. On Monday, he said his most recent lab test remained positive for TB.
Robert Daniels (Danielov)
TB is not spread by
* shaking someone’s hand
* sharing food or drink
* touching bed linens or toilet seats
* sharing toothbrushes
* kissing
* smoking or sharing cigarettes
Drug-susceptible TB and MDR TB are spread the same way. TB germs are put into the air when a person with TB disease of the lungs or throat coughs, sneezes, speaks, or sings. These germs can float in the air for several hours, depending on the environment. Persons who breathe in the air containing these TB germs can become infected.
Questions and Answers About TB 2005
Phoenix Man with TB in Lockdown
By Rene Gutel — KJZZ Radio — Mar. 29, 2007| A Phoenix man with a
virulent strain of tuberculosis has been on a
lockdown wing of the Maricopa County Medical Center for eight months.
County health officials have gone to extreme measures to keep Robert
Daniels' illness from spreading. Some [doctors and laywers] say too extreme. Listen to the radio show as MP3 download. Coverage of the Robert Daniels Story, by KJZZ-FM PBS Radio, Tempe 7 text and audio stories online from March 29 to July 19, 2007 |
 Robert Daniels with his wife Alla and their son in Moscow, before he came to the US |
- Man with TB being held indefinitely as a health risk
- Authorities locked him up in July because he wouldn't wear mask
- Man held in cell with no TV, phone, radio or computer
- Hearing scheduled later this month
- Complete article at CNN.com
- Similiar article at Pravda.RU
- Complete
article
at Los Angeles Times
Robert Daniels (Danielov)
TB: Public Health versus Personal Liberty
By Rene Gutel, Voice of America, New York — April 6, 2007- Robert Daniels, Phoenix hospital jail
- Wife Alla Danielova, Moscow
- Attorney Dan Pochoda, legal director for the ACLU in Arizona
- Attorney Lawrence Gostin, Director of the Center for Law & the Public's Health at Johns Hopkins and Georgetown Universities.
- Dr. George Annas, professor of Health Law at the Boston
University School of Public Health
- Listen to the audio segment
- Watch/listen video stream in low/128k or high/256k resolution
- Read the entire show transcript
Attorney Pochoda: "... despite clear court cases, he's being held in an unconstitutional and punitive manner much worse than other persons in the hospital, ... like any other jail inmate. He is not a jail inmate... "
Dr Annas: "... if he doesn't go right up next to you and breathe in your mouth for a couple of hours, you're not going to get TB that way. .... unconstitutionality of locking people up with the disease."
AZ ACLU Takes on Robert Daniels Case
By Rene Gutel — KJZZ Radio — April 7, 2007| The American Civil
Liberties Union of Arizona says it is taking up the case of the
Phoenix
man quarantined for his rare type of tuberculosis. Since last July
Robert Daniels has been held in court ordered isolation because he went
out in public without a face mask. Listen to the radio show as MP3 download. |
Robert Daniels with his wife Alla and their son in Moscow, before he came to the US |
COE Express Polls: Results for April 11. To see current tally, click on "Results"
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See 100+ comments about this poll.
Interviews with Russian-born Robert Danielov (Daniels) in jail-hospital
by Andrei Conovaloff, for Russian Arizona NEWS — April 9-25, 2007I called the hospital and talked to 3 departments. I learned the Sheriff runs the jail ward, but the Sheriff's office did not return my call. The Arizona Republic reporter Wagner said he'd try to help. And I left a message with attorney Blecher, who returned my call ans said he would definitely help soon.
On April 9, I got a collect call from "INMATE PHONE 602-262-9814". It was Robert. The call cost $2.50 for 10 minutes and was such a big boost to Robert that I said he could call any time. We talked 3 times in 2 days. Then he got his cellphone and we chatted nearly every day. He invites anyone to also call him who is interested in being friendly or his medical or legal case.
Here are some of the errors and misconceptions that have appeared in the press and on the Interent, and some new information.
Robert Daniels, Russian surname Danielov, phoned me from his hostipal-jail, twice. He says these 10-minute collect calls are expensive. On April 12 and 13 he called again from his cellphone which he was given back due to al this news about his inhumane treatment. See article April 11, below. He also got his TV back, but not his computer.
He is surprized, but glad that Russians in Arizona are interested in him because he had few friends or family in America during his first 6 years here. Now his situation is much worse.
Robert welcomes anyone who wishes to get a collect call from him to call his lawyer (right) and ask that their phone number and name be passed on to him. Now you can call his cellphone.
He appears to have a little bit more hope now that his story is getting out into the national press, and international pree, even to Russia. The Arizona Republic, National Public Radio, and CNN interviewed him.
He says that reports about him not taking his medicine are incorrect. Robert says he has been taking very strong medicine since he was in Russia. The pills make him very sick at times and he falls to the floor with nausea.
The reports about this drug-ressitant type of TB being "very contagious" are also not correct. Robert lived with his wife and son for 6 years and they don't have the disease. Dr. Annas says a TB patient one must breathe directly into your mouth for hours before the average person can become infected. So Robert was really not a danger to society, as the judge ruled last year.
Robert's parents divorced when he was young in Moscow, and his father moved to Arizona and became a registered nurse. Robert did not get along well with his mother in Russia, so at age 11 his father invited him to live with him in Scottsdale where he finished grammar school and entered Arcadia High School.
As a teenager Robert was not really happy in Arizona. He was not a good student because his father worked a lot, and he was alone most of the time with no parent. He got into trouble and arguments with his father so his father offered to send Robert back to Russia because he got into too much trouble here and he missed Russia.
Before graduating high school, Robert moved back to Moscow at age 17. He worked in construction, married Alla and had a boy, Dmitri now 6, and caught turberculosis. He was being treated in Moscow, but decided to return to Arizona last year at age 26, to get his GED (finish high school), start college, and get better medical treatment here. He left Alla and Dmitri in Moscow, but talks with them by phone often, hoping to bring them as soon as he can afford it.
In Arizona Robert got a job and entered a residential treatment program which had about 10 patients all required to live in supervised apartments in Phoenix. Robert says that none of the staff wore masks around him, but he was told to wear a mask when he went out in public. Robert said he did not think to wear a mask in public was absolutely necessary and would scare people, so he would seek out to buy cigarettes and snacks, knowing he was breaking the house rules but also not thinking he wasn't doing anything really wrong. It's not easy to get TB unless your immunity is weak.
Robert says he did not know that he had the most dangerous form of TB, because no one told him and none of the staff treated him as if he was extremely dangerous or contagious. For the past 8 months, he has been sitting in a small room with no window and little communication besides collect phone calls. He got his cellphone back on April 10.
He said he did not think to make Russian friends when he returned to Arizona last year, because he wanted to be American. He was surprized that so many Russian social events are held and looks forward to anyone who may want to contact him.
Today (April 9) he got interviewed by CNN TV News, and that created interest in his case. The ACLU has offered legal help, and 2 Phoenix TV news programs — Channels 12 and 15 — covered his story. See stories below. Then the embarrased Sheriff ordered his TV and cellphone be returned, according to the Arizona Republic. See story below.
Call his cellphone: 602-754-9702
His laywers:
Mr.
Robert
B Blecher
8930 E Raintree Dr Suite 100
Scottsdale, AZ 85260-0001
Telephone: 480-444-9988
Fax: 480-308-0015
8930 E Raintree Dr Suite 100
Scottsdale, AZ 85260-0001
Telephone: 480-444-9988
Fax: 480-308-0015
TB is not spread by
* shaking someone’s hand
* sharing food or drink
* touching bed linens or toilet seats
* sharing toothbrushes
* kissing
* smoking or sharing cigarettes
Drug-susceptible TB and MDR TB are spread the same way. TB germs are put into the air when a person with TB disease of the lungs or throat coughs, sneezes, speaks, or sings. These germs can float in the air for several hours, depending on the environment. Persons who breathe in the air containing these TB germs can become infected.
Questions and Answers About TB 2005
Roberts Complaints:
1. I always took my medicine. Dr. Moffit says I did not. She's lying.
2. Medical staff never explained that I had a drug-resistant form of TB until after I was put in the jail ward
* 24 hours lights, they put up 3 lights to annoy me.
April 10, 2007 — "Up Front" 4:30 pm , Nightly News 10 pm — NBC Channel 12 News
Arpaio decides to return TV, phone to confined TB patient
By Dennis Wagner — The Arizona Republic, Valley & State, Page 1 — Apr. 10, 2007The Arizona Republic first reported last month that Robert Daniels was confined with criminals after failing to abide by quarantine rules. Daniels, who has extremely drug-resistant TB, has been in deprived isolation at Maricopa Medical Center since August.
Sheriff Joe Arpaio (above) said he had mistakenly allowed subordinates to handle the situation. Finally, he said, "I went over there. Even against the advice of my own staff, I decided to give him back his TV and cellphone. . . . He's in no man's land." [Sheriff]
A hearing on the quarantine is scheduled April 19.
When's it OK to lock patients up?
Ethics
of
forced confinement for noncompliant TB patientsBy Sam Solomon, National Review of Medicine, April 15, 2007, Volume 4, Number 7
"When he was transferred to Toronto he was already drug-resistant and continued to have difficulties complying fully with treatment," says Dr Rae. His ongoing noncompliance caused his disease to become more and more resistant to drugs, making him one of Canada's first XDR-TB cases and the first to be forcibly confined by public health officials.
THE XDR THREAT
The emergence over the past year of XDR-TB in South Africa and around the world, including several confirmed cases in Canada already, has prompted widespread fears of a pandemic. And emerging in parallel to the spread of XDR-TB has been a renewed focus on the ethical issues inherent in the forcible confinement of patients.
XDR-TB is an extremely dangerous type of multi-drug resistant TB (MDR-TB) that was only identified last year. It describes patients who have become resistant to the basic TB drug combination rifampicin and isoniazid as well as at least three of the six second-line TB drug classes as well. All but one of the 53 cases identified by the WHO in the rural town of Tugela Ferry, South Africa, last September have proved fatal. Patients can be treated aggressively with second-line antibiotics, should wear a mask and avoid human contact as much as possible — especially with susceptible people like the HIV positive. The treatment regimen is gruelling, but is it ethical to lock up sick patients? That depends on who you ask.
The Arizona Republic recently broke the story of a 27-year-old Russian-American man named Robert Daniels who has been quarantined in the detention ward of an Arizona hospital for almost nine months now — a state of affairs that could quite possibly last until he dies of XDR-TB, which he contracted in Russia two years ago. The court order was issued after he violated his voluntary quarantine when he stopped his medication [false allegation] and left, unmasked, to visit restaurants and stores in Phoenix. He argues he's being treated like a criminal; the wardens say that's exactly what he is, which is why they won't let him use the phone or have access to a computer or TV.
.... Read complete article...
Robert Daniels (Danielov)
Lawyers fight for TB patient's rights
April 24, 2007 — 12 NEWSOn Tuesday, April 24th about half-way down click on
Lawyers fight for TB patient's rights
Confined TB patient is unable to testify
By Dennis Wagner — The Arizona Republic, Valley & State, Page 1 — April 25, 2007Robert Daniels, who attended the Maricopa County Superior Court hearing by phone because of his contagious disease, erupted in anger after Court Commissioner Randy Ellexson refused to let him challenge testimony from a health worker.
"I didn't even get to say anything," Daniels blurted when reached by phone after the hearing. "It's an (expletive) lie. . . . I wish we didn't even have a hearing. I've been embarrassed in front of the whole nation."
Daniels, 27, a laborer who was born in the former Soviet Union to a Russian mother and American father, has dual citizenship and attended high school in Scottsdale. He has a wife and child in Moscow. After contracting extremely drug-resistant TB there, he returned to Arizona last year for treatment and to seek work.
According to court records, he refused to abide by medical rules while living at a sanitarium in Phoenix and has been a prisoner at the Maricopa Medical Center since August when he was declared a threat to public safety. Under the sheriff's guard, his lights have been on 24 hours a day and he is constantly monitored by video. For months, he was denied a phone, television set or other comforts. Those deprivations generated worldwide media coverage.
At Tuesday's hearing, Dan Pochoda, legal director of the American Civil Liberties Union, blasted the government for treating a sick man as a criminal.
"(This is) a continuing violation of Mr. Daniels' rights," he said. "He is being treated worse than felons in the Department of Corrections. . . . He has not seen the outside, your honor, in eight or nine months. He has not been allowed to have a shower in eight or nine months."
Ellexson declined to change Daniels' quarantine conditions and advised Pochoda to file a written motion if he wished to challenge them.
During the hearing, Dr. Maricela Moffitt, a Health Department TB specialist assigned to the case, spent more than an hour describing the medical history and portraying the patient as deceitful. She said he caused treatment problems by initially lying about his disease. Later, she said, he skipped medications and violated voluntary quarantine by going out in public. Because of the extremely drug-resistant form of TB, Moffitt added, that conduct was a severe danger to public health.
"It was clear that Mr. Daniels really could not be trusted," she said. "We were incredibly concerned that we had lost a chance to cure. . . . Robert really showed very poor judgment by going out because he knew he was ill. He was dying in front of our eyes."
Defense lawyer Robert Blecher asked if Daniels could give testimony refuting Moffitt's allegations, but Ellexson denied the request.
Daniels admitted leaving his quarters without a mask, but said he did not realize the gravity of his disease at the time or the danger to others. He said treatments involved five medications and injections, some of them taken several times daily. He said he overslept on occasion, but never intentionally skipped taking pills.
"This is so unfair," he said.
Robert Daniels has been a prisoner at the
Maricopa Medical Center since August when
he was declared a threat to public safety.
Hear his phone conversation with the reporter.
Click on "Play Video" on right side
Read 65+ comments about this article.
Tuberculosis Surveillance Report Arizona, 2005.
Arizona Department of Health Services, Bureau of Epidemiology and Disease Control, Office of Infectious Disease Services, June 2006
Virulent New Strain of TB Raising Fears of Pandemic
Bug Is Resistant to Most Available DrugsBy Peter Finn — Washington Post Foreign Service — May 3, 2007 — Page A1
Known formally as extensively drug-resistant TB, or XDR-TB, the strain has been detected in 37 countries. It arises when the bacterium that causes TB mutates because antibiotics used to combat it are carelessly administered by poorly trained doctors or patients don't take their full course of medication. Rather than being killed by the drugs, the microbe builds up resistance to them.
At least 50 percent of those who contract this strain of TB will die of it, according to medical experts. In trying to stop the spread of the disease, which can be transmitted through coughing, spitting or even speaking, health officials have imposed sometimes extreme controls on infected people.
Robert Daniels, a 27-year-old dual Russian-U.S. citizen, underwent months of treatment for TB in Russia, where he often led a homeless existence. [Not true according to Robert, maybe one month.] After telling people he was feeling better, he flew from Moscow to New York on Jan. 14 last year, then on to Phoenix.
In fact, his disease had not disappeared. The microbe causing it had mutated, apparently helped by his failure to complete a drug regimen in Russia. Weeks after arriving in Phoenix, Daniels was again coughing, feeling weak and losing weight.
Doctors in Phoenix diagnosed his illness as the new resistant strain of TB [not at first, but after he was in Maricopa County Hospital]. Daniels again failed to follow doctors' orders, authorities say. So health officials got a court order, and he was locked up in the prison wing of a Phoenix hospital, where he has spent the past nine months in hermetically sealed isolation.
"It's not right," Daniels said in a telephone interview. "I'm not a criminal."
Daniels has become a case study in the bleak choices society faces in dealing with the new strain and attempting to balance protection of individual rights with protection of the public.
Evidence of TB has been found in ancient skeletons and mummified remains. From the 17th century to the 20th, it was a major killer in the United States and Europe, taking the lives of such notable people as the poet John Keats, the composer Frédéric Chopin, the writer Stephen Crane and the actress Vivien Leigh.
Even in the antibiotics age, TB has remained a scourge in poorer countries and communities. Today, one in three people globally is estimated to be infected with dormant TB, according to the World Health Organization (WHO). Most will never get sick, but in one in 10 cases the bacterium becomes active when the host's immune system is compromised. Worldwide, an estimated 1.7 million people die every year of the disease.
Two events last year alerted the medical community to a frightening new version of the disease. The Centers for Disease Control and Prevention, drawing on a survey of TB labs on six continents, reported that the prevalence of the super strain of TB increased from 3 percent of patients to 11 percent between 2000 and 2004. It reached 15 percent in South Korea and 19 percent in Latvia. There are no statistics yet about the new strain in Russia, China or Africa, areas with major TB populations.
In the United States, 13,767 TB cases were recorded in 2006, the lowest rate of infection since reporting began in 1953. A retrospective analysis by the CDC found 49 cases of the new strain in the country since 1993.
The CDC survey was followed by a report from Yale University researchers that the superbug had raged through a rural hospital in South Africa in 2005 and early 2006, killing 52 of 53 who contracted it, including six health care workers. The victims, apparently infected by airborne transmission of the virus, died on average just 16 days after diagnosis; most of them also had HIV.
"We have to come to grips with this quickly," said Vladislav Yerokhin, director of the Central Tuberculosis Research Institute in Moscow. "This is not just a threat for TB patients. This is a serious threat for the general population."
Russia has become a petri dish for drug resistance.
After the fall of the Soviet Union in 1991, rising poverty and a disintegrating medical system unleashed a TB epidemic in Russia and other post-communist countries. In 2005, the number of newly diagnosed cases in Russia reached 119,226, and 32,148 people died of the disease, according to the Ministry of Health and Social Development [because the health conditions of the clinics are terrible].
Up to 70 percent of TB patients in Russia are homeless, unemployed, in prison, former prisoners or alcohol abusers [the typical Russian guy]; 30 percent or more of patients break off their treatment, boosting resistance to anti-TB drugs.
In addition, Russia has an estimated 1 million people who are HIV-positive. That is an explosive combination, according to Murray Feshbach, an expert on Russian demography at the Woodrow Wilson International Center for Scholars in Washington. "It's potentially catastrophic for Russia," he said.
Today, South Africa is also a major TB infection zone. "The pressure of TB is enormous in our setting, and the majority of AIDS-related deaths are due to TB," said Gilles van Cutsem, medical coordinator with Doctors Without Borders in Khayelitsha, a large township on the edge of Cape Town, South Africa.
"People are wary about transmission within the community, as well as within health structures, from patients to patients and from patients to staff," van Cutsem said. "Considering that a great proportion of the health staff is also HIV-positive, this is even more of a concern."
Active TB bacteria are treated with four standard drugs. In most cases, patients quickly become non-infectious and start to feel better, although they are considered cured only after a full course of treatment, lasting about six months.
By the 1980s, doctors had begun to notice that some patients were resistant to these first-line drugs, particularly the two most potent ones, isoniazid and rifampicin. Their condition was defined as multidrug-resistant TB.
When the first line of drugs fail, doctors fall back on more expensive ones that have toxic side effects but can cure the condition after being used for 18 to 24 months. However, it is extremely difficult to keep patients taking the drugs for such a long period.
The new strain, a step up in resistance from the multidrug-resistant variety, has appeared more recently. An estimated 22,000 Russians have TB that is resistant to drug therapy to some degree. An unknown number of them have the new super strain.
If it is not contained, it will almost certainly mutate again into a completely drug-resistant TB, according to Mario Raviglione, director of WHO's Stop TB Department.
Some experts believe that may have already happened. Doctors reported this year that a 49-year-old woman in Italy died after 625 days of hospital treatment; all the drugs they tried failed.
The world is facing a return to the era before antibiotics when the white plague, as TB was known, was often a death sentence, according to Raviglione. The only treatment option then involved risky surgery in which doctors collapsed or removed an infected lung or attempted to cut out diseased tissue.
"We will be left with surgery and prayers," Raviglione said. "It's a desperate situation."
New drugs are in the pipeline but still years away, and patient non-cooperation could quickly undermine their effectiveness. "Monitoring patients is not easy when you are talking about a man who drinks a half a liter of vodka a day, or has no home or no family or no job, or all of the above. Those are our TB patients, " said Sergei Borisov, deputy director of the Phthisio-Pulmonary Institute in Moscow.
Some doctors and medical ethicists have said that countries will have to consider forced isolation of uncooperative patients, a public health strategy that evokes the sanitariums of decades ago.
"We have to face the possibility that restrictive measures may be necessary to control what could become a global pandemic," said Ross Upshur, director of the Joint Center for Bioethics at the University of Toronto. "I'm not advocating detention as a first resort," he added. "But if voluntary measures fail, people do not have the right to infect others. At the same time, people should be treated humanely, and they should have access to counsel, and they shouldn't be placed in a prison setting."
Other experts say such an approach might merely drive the disease underground and is impractical in poor countries.
"Forcing one uncooperative patient into isolation is fine, or even 10 patients or 100 patients," Borisov said. "But what about our situation in Russia, where 25 percent of the patients are uncooperative? Are we going to lock up thousands of patients? And where will we put them? Doctors cannot be prison guards."
Daniels, for instance, was often homeless when he was in Russia, according to him [damn that's a lie says Robert] and his wife, Alla Danielova, an English teacher. Daniels said he bounced among friends' houses, partying and trying to ignore the bloody sputum he was coughing up. "I knew I was going to have to treat it, but I had other plans at that time," he said. "I didn't think it was a big deal. Now I know better."
Daniels acknowledged that he had visited a fast-food restaurant and stores in Phoenix without a mask but denied that he had stopped taking his medicine there. "That's a nasty lie," he said.
He said his condition is now improving. He has petitioned the court to be moved out of the prison ward and, ultimately, released [not true, Robert just wanted to move next door to Station 42 with no guards, sunshine, a shower, hot water, and more humanity]. But last week a judge rejected his plea and ordered him to remain in medical confinement [actually a jail-ward].
Robert Daniels, with his son, now 5, has highly drug-resistant TB and is being held in court-ordered isolation in Phoenix after going out in public unmasked. (Courtesy of Alla Danielova)
See enlarged photo.
Super TB
The World Health Organization has found that a particularly virulent strain of tuberculosis that is highly resistant to drugs is present in 37 countries of 49 surveyed around the world.
XDR-TB, extensively drug-resistant turberculosis, is resistant to the two most powerful furst-line anti-TB drugs, isonaizid* and rifampicin, as well as to any flouroquinolone and a least one of three injectionable second-line drugs, capreormycin*, kanamycin and arnikacin.
* Robert thinks these are part of his current durgs
Click to enlarge.
From: Tuberculosis: In History & In McHenry County, page 25.
See CDC Fact Sheet:
Multidrug-Resistant Tuberculosis (MDR TB)
More photos from Robert:
Robert and Alla at Moscow Kremlin 2003
Wedding anniversary 2004
Metro Station Revolution Square, 2004
Dmitri 2005
April 23, 2007 : People.com
Considered a health risk, TB patient Robert Daniels has been confined for eight months
ACLU files lawsuit against county for treatment of TB patient
Dennis Wagner — The Arizona Republic — May. 30, 2007A federal lawsuit filed Wednesday by the American Civil Liberties Union alleges that Maricopa County officials have violated the rights of a quarantined tuberculosis patient for months by treating him as a criminal.
The U.S. District Court complaint on behalf of Robert Daniels alleges health officials and the Maricopa County Sheriff's Office have violated numerous constitutional rights and the Americans with Disabilities Act.
The suit asks that Daniels be housed in appropriate accommodations, rather than the severe and "inhumane" jail conditions.
"It's good news for me," Daniels said Wednesday evening. "I finally have a chance to get out of this black hole."
Robert England, the county's tuberculosis control officer, declined comment. Other county health officials were not immediately available.
Daniels, 27, has been isolated in a jail ward at Maricopa Medical Center for 10 months under court order, although he was not convicted or charged with any crime.
Linda Cosme, an attorney for Daniels, said her client has been victimized by constitutional violations. "Robert is helpless," she added. "And he's at the mercy of Sheriff Joe Arpaio. He needs as much support as possible, and the ACLU is supplying that support."
Arpaio said Daniels is confined under court order, and must abide by security measures. "I run a safe jail, and he's going to be treated like anyone else," he said.
Daniels, who holds dual United States and Russian citizenship, moved to Arizona in January 2006 after contracting extreme multi-drug-resistant (XDR) TB, in Moscow, where he has a wife and 5-year-old son.
Daniels, who spent his teen years in Scottsdale, said he returned to the United States in search of work and a college education. Months later, he became severely ill and was placed in a county sanitarium for indigent TB patients.
Dr. Maricela Moffitt, a county physician, has testified that Daniels willfully failed to take his medications, decreasing the likelihood that last-chance drugs would cure his deadly disease. Moreover, Moffitt alleged, Daniels endangered others by going out in public and entertaining visitors without wearing a mask.
Daniels has insisted that he did not understand the contagiousness or gravity of his condition, in part because TB patients in Russia do not wear masks. Daniels also has said he missed taking medications a few times because he overslept, not intentionally.
In August, a Maricopa County Superior Court commissioner ordered Daniels placed under involuntary quarantine. The jail ward at Maricopa Medical Center is considered the only Valley facility equipped for such confinement, so Daniels was housed under the supervision of sheriff's detention officers.
According to court records, Daniels has spent much of his time in custody without a phone, TV, radio, shower or hot water. Windows are screened. Video cameras monitor constantly. Lights remain on 24 hours.
Earlier this week Daniels said he was told that his TB bacteria may be developing resistance to all antibiotics, and a portion of his lungs might require surgical removal. He said he was advised to write letters to his child in Moscow so the boy would have communication before his father's death.
Cosme, the attorney, described Daniels as extremely depressed and fragile due to isolation and stress. She said the ACLU will soon file motions seeking an expedited hearing and an injunction to immediately improve Daniels' treatment.
According to county documents obtained by The Arizona Republic through a public records request, Daniels' confinement spawned a dispute among medical workers about the ethics and legality of his quarantine conditions.
In a Dec. 11 email, Inmate Health Services nurse Nancy Turco complained to Dr. Moffitt that the patient "really doesn't need to be in a detention unit (because) it is not the least restrictive setting appropriate," as required by state law.
Turco, who eventually quit her job and became an advocate for Daniels, followed up with a Jan. 3 email complaining about detention officers. "This patient is not arrested and has nothing to do with MCSO other than taking up a room in their ward," Turco wrote. "It is clear, Marci, that your job is to protect the public. However, depriving a person of basic rights is wrong."
Moffitt answered with a message that said: "The loss of liberty by our patients is not taken lightly by me. But you must realize that I also need to defend the citizens of Maricopa County. Unfortunately, this patient has lied repeatedly to me (and TB staff) and did ... threaten many innocent persons."
On Wednesday, Daniels said: "I'm slowly dying in this room. I didn't realize how serious this (TB) was, and I regret that, but nothing justifies the kind of treatment I've received in here. The solitary confinement starts to mess with your head and it has taken a serious toll on my body."
Also see The ACLU’s Views On Atlanta Man’s Quarantine Case (5/30/2007)
Download the lawsuit filed May 30, 2007:
COMPLAINT
42 U.S.C. § 1983 Civil Action
Robert Daniles
vs.
Maricopa County; Dr. England, Dr. Kennedy, Dr. Moffitt; Sheriff Arpaio
The lawsuit says that the defendants (county doctors and sheriff) failed to carry out their responsibilities in a professional, humane, and legal manner. ... have treated, and continue to treat Robert as if he were a criminal since August 2006. ... Daniels is entitled to “reasonable accommodations” at the county jail ward and the least restrictive means necessary ... Defendants violated the Americans with Disabilities Act and the Arizona Civil Rights Act, ...The defendants discriminated Daniels because other TB patients were not treated so bad .. .The country has no policy for caring for future cases or an epidemic....
County violated rights, law, ACLU says
Dennis Wagner — The Arizona Republic, Valley & State, Page B1 — May 31, 2007A federal lawsuit filed Wednesday by the American Civil Liberties Union claims that Maricopa County officials have violated the rights of a quarantined tuberculosis patient for months by treating him as a criminal.
The U.S. District Court complaint on behalf of Robert Daniels alleges that health officials and the Maricopa County Sheriff's Office have violated numerous constitutional rights and the Americans with Disabilities Act.
The suit asks that Daniels be housed in appropriate accommodations, rather than the severe and "inhumane" jail conditions.
"It's good news for me," Daniels said Wednesday evening. "I finally have a chance to get out of this black hole."
Robert England, the county's tuberculosis control officer, declined to comment. Other county health officials were not immediately available.
Daniels, 27, has been isolated in a jail ward at Maricopa Medical Center for 10 months under court order, although he was not convicted or charged with any crime.
Linda Cosme, an attorney for Daniels, said her client has been victimized by constitutional violations.
"Robert is helpless," she said. "And he's at the mercy of Sheriff Joe Arpaio. He needs as much support as possible, and the ACLU is supplying that support."
Arpaio said Daniels must abide by security measures. "I run a safe jail, and he's going to be treated like anyone else," he said.
Daniels, who holds dual United States and Russian citizenship, moved to Arizona in January 2006 after contracting extreme multi-drug-resistant (XDR) TB.
Daniels, who spent his teen years in Scottsdale, said he returned to the U.S. in search of work and a college education. Months later, he became severely ill and was placed in a county sanitarium for indigent TB patients.
Dr. Maricela Moffitt, a county physician, has testified that Daniels willfully failed to take his medications, decreasing the likelihood that last-chance drugs would cure his deadly disease. Moreover, Moffitt said, Daniels endangered others by going out in public and entertaining visitors without wearing a mask.
Arpaio said his office is reviewing possible criminal charges against Daniels.
Daniels has insisted that he did not understand the contagiousness or gravity of his condition, in part because TB patients in Russia do not wear masks. Daniels also has said he missed taking medications a few times because he overslept, not intentionally.
In August, a Maricopa County Superior Court commissioner ordered Daniels placed under involuntary quarantine. The jail ward at Maricopa Medical Center is considered the only Valley facility equipped for such confinement.
According to court records, Daniels has spent much of his time in custody without a phone, TV, radio, shower or hot water.
Earlier this week, Daniels said he was told that his TB bacteria may be developing resistance to all antibiotics, and a portion of his lungs might require surgical removal. He said he was advised to write letters to his child in Moscow so the boy would have communication before his father's death.
Cosme described Daniels as extremely depressed and fragile due to isolation and stress. She said the ACLU will soon file motions seeking an expedited hearing and an injunction to immediately improve Daniels' treatment.
According to county documents obtained by The Arizona Republic through a public records request, Daniels' confinement spawned a dispute among medical workers about the ethics and legality of his quarantine conditions.
In a Dec. 11 e-mail, Inmate Health Services nurse Nancy Turco complained to Moffitt that the patient "really doesn't need to be in a detention unit (because) it is not the least restrictive setting appropriate," as required by state law.
Turco, who eventually quit her job and became an advocate for Daniels, followed up with a Jan. 3 e-mail complaining about detention officers.
"This patient is not arrested and has nothing to do with MCSO other than taking up a room in their ward," Turco wrote. "It is clear, Marci, that your job is to protect the public. However, depriving a person of basic rights is wrong."
Moffitt answered with a message that said: "The loss of liberty by our patients is not taken lightly by me. But you must realize that I also need to defend the citizens of Maricopa County. Unfortunately, this patient has lied repeatedly to me (and TB staff) and did ... threaten many innocent persons."
In an ACLU news release, Daniels said, "I'm slowly dying in this room. I didn't realize how serious this (TB) was, and I regret that, but nothing justifies the kind of treatment I've received in here. The solitary confinement starts to mess with your head and it has taken a serious toll on my body."
TB patient costing taxpayers
Quarantined man's bills average $50,000 a month
Yvonne Wingett — The Arizona Republic, Valley & State, Page B3 — May. 31, 2007Maricopa County residents are paying hundreds of thousands of dollars in medical bills racked up by a tuberculosis patient who is under lockdown by health authorities at the county hospital.
Robert Daniels has spent nearly 10 months in a sealed room on the fourth-floor at Maricopa Medical Center's jail ward. The 27-year-old suffers from a dangerous TB strain that is drug-resistant and is under court-ordered confinement because he broke the rules of voluntary quarantine and exposed others to a potentially deadly illness. He is considered a patient of the county's public health department.
Daniels' hospital bills average about $50,000 monthly and include overnight stays in the sealed room, medicine and visits to doctors, said Mary Lee DeCoster, vice president of revenue cycle at Maricopa Integrated Health System. It runs the county hospital.
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From July 28, 2006, through March 31, 2007, the bills added up to about $510,000. Maricopa Medical Center gives a discounted rate to the county, which had to pay $389,293.69. Billing statements from April and May are on their way to county health officials.
"This is definitely an unusual situation," said Shawn Nau, director of the county's General Government Department. "Every once in a while, there's one of these cases that ends up costing a lot of money."
Maricopa County keeps a contingency fund to pay for these types of court-ordered quarantine cases, Nau said. Typically, the county pays out $100,000 or less a year to take care of such people, he said, on average about three or four people yearly.
Tuberculosis is spread by airborne contact and was among the leading causes of death in the first part of the 20th century. Daniels contracted the virus while living in Russia, according to Maricopa County Superior Court filings.
Mr. Contagious
Robert Daniels is a prisoner. His crime is tuberculosis, and it’s going to make him a celebrity if it doesn’t kill him first.By Jeff Gordinier; Photograph by Danielle Levitt — Detail magazine June 2007, with Daniels' comments in brackets []
Early this year, when life in the isolation chamber got really bad, Robert Daniels realized that he could no longer call up a mental picture of his own face.
He hadn’t seen it for months. He didn’t have a mirror in his hospital room, and because the guards were afraid that the slightest wisp of his breath could infect the adjacent hallway, and the other floors of the hospital, and the city beyond that, and maybe even the whole country beyond that, he was never allowed to leave. The door to his room stayed locked. He couldn’t take a shower. His entire world, night and day—although at this point it was getting hard to tell the difference between night and day—consisted of the contents of Room 15 on Ward 41 of the Maricopa Medical Center in Phoenix, Arizona, a room whose décor could only be described as spartan.
White brick walls. A linoleum floor. A hospital bed with an array of buttons and gears on it. A side table where the nurses laid out his heap of pills. And a shiny metallic bathroom that made him think of a giant ashtray.
Daniels, a 27-year-old man who was diagnosed last year with a rare strain of tuberculosis, and who was known in legal documents as “the afflicted,” was living in a void. Although he was an American citizen, he’d spent most of his life in Russia, where he was born, and his wife and son were still there. But he hadn’t heard their voices in months. There was no working phone in the void. No television, no radio, no computer, no newspapers, no view of the surrounding Arizona landscape, no fresh air.
He could lie in bed. He could pace around the room dragging his IV apparatus behind him. He could wait for the nurse to come and give him his meds. He could clean off his skin with wet wipes, and when he was lucky, he could get down on his knees and hold his head above the shiny toilet, and the nurse would bring in some warm water so that he could pour it over his scalp to wash his hair. Then the nurse would leave, and a little bit of air from beyond the void would come whooshing into his room. The room was equipped with reverse-airflow vents and filters that prevented even a particle of his contaminated breath from floating outside the membrane of his chamber. A surveillance camera watched him; a light in the room never went out. He could protest the conditions only to the masked medical attendants who puttered into the void to dose him with toxic antibiotics. After they left, the meds that went storming through his guts gave him a diarrhea so wet and fast that if he didn’t keep his ass perched right on the edge of the shiny metallic ashtray, he’d soil his hospital gown. Sometimes he would sit on the bed for hours, “crying,” he says, “like a pussy.”
Sometimes, between the visits, Daniels would walk over to a window that had been frosted over with industrial paint. He’d stand next to it listening to the pigeons scraping and cooing on the ledge outside. He couldn’t see the pigeons—just their silhouettes, which bobbled around like Balinese shadow puppets behind the scrim of paint.
He had been in the void since July. Back then, the bug had shriveled him down to 108 pounds, but being cooped up in the void and brined in drugs had made his face puffy and sallow. I was a pretty beautiful guy, he thought. Handsome. I knew myself. I knew my face.
He wondered, of course, when he would be able to leave. But it wasn’t a good idea to think about that in the void, because there was a chance—slight, yes, but still plausible—that the answer was never. There was a chance that Daniels would be locked up in the void for the rest of his life.
Even though Ward 41 is on the fourth floor of a hospital, it is not, jurisdictionally speaking, part of the hospital. It is an area set aside for inmates—including murderers, rapists, drug dealers—who happen to be sick. Ward 41 is subject to the strict rules and regulations of Sheriff Joe Arpaio, a man who has put a great deal of time and energy into branding himself as “America’s Toughest Sheriff.”
All of which means that even though Daniels hadn’t been charged with a crime, he was in jail.
In the middle of his locked door was a square glass porthole through which Daniels could see the guards, the nurses, and the cleanup crews passing by the void, going about their lives, waving to him, speaking in muffled voices. If he peered across the hallway, he could see other inmates, the criminal ones, drifting around or lying in their beds. Those inmates had it easy. They knew when they might be getting out of jail. Daniels did not know, and as far as he could tell, he could escape from Ward 41 only by accomplishing one of two things: Either he would rid his body of a bug that had proved resistant to some of the strongest drugs in the medical arsenal, or he would die.
Ever since his family had come to the United States, during the Gorbachev years, he had seen America as a place of plenitude and freedom. So it was hard to grasp how he’d wound up in a place like the void, and he had a number of gnawing concerns. First was the concern, as the days and nights blurred by, that he just might be losing his mind. And second was the question of why he, “the afflicted,” an American citizen who’d had the misfortune of catching a deadly disease, was being treated like a prisoner of war.
Dr. Bob England is the director of the Department of Public Health in Maricopa County, Arizona. He is the man who signed the court order to confine and isolate Robert Daniels. He does not, when you meet him, give off the impression of a sadistic gulag master. He is gracious and calm—a western hippie in repose. He’s lean and fit from riding his bike to the office. He wears his hair in a graying ponytail.
He says that tuberculosis is not easy to catch, regardless of whether it’s a rare strain or a garden-variety one. “It is not wildly infectious,” he says. “You can swallow TB germs and it won’t make you sick.” To come down with TB, it helps to be tragically unlucky. You generally need to land yourself in a small, enclosed space—preferably for a sustained period of time—where TB sufferers have been coughing for a while. Time allows the particles to break away from the sputum in smaller clusters, which subsequently gives them a chance to lodge deep enough in your air sac that they can roost. Even when they do, you still might have only a 10 percent chance of getting sick.
The problem is that if you do get sick, you’re getting sick with a gargoyle of a bug. You’re getting sick with something that can easily mutate, if it’s not treated correctly, into an illness that’s a bitch to cure. There is normal tuberculosis, which is bad enough, but then there is multi-drug-resistant TB, or MDR-TB, which has mutated into a strain that can be eradicated only by the kind of drugs that turn your liver into oatmeal. Even worse is XDR, the extensively drug-resistant form of TB. If you get XDR and you have a compromised immune system, you will probably die.
Daniels does not have that strain, though early, hysterical news reports suggested that he did. Daniels has MDR. The catch is that if MDR is not treated properly, with a ruthless barrage of antibiotics, the bacteria will have a chance to evolve, and when they evolve far enough, they could become XDR. And XDR is something we’re not supposed to have here in the United States. Dr. England has a vision of an America that is free of such contagions—free of the mutant and untreatable globo-bugs that could destabilize a society. “It’s crucial that we not let multi-drug-resistant TB spread,” he says, “or we will lose our control over the disease, and we will slip back to the battle days. And much of the world is already there.”
England is barred from talking specifically about the Daniels case, but he can say a few general things about why a person might need to be isolated and confined for being sick. “We very rarely need to use any kind of legal authority,” he says. Normally, a patient has to be diligent about taking his medication and he has to wear a mask over his face in public. If he doesn’t do this, officials from the Health Department will talk to the patient. If he still doesn’t comply, then the patient will be warned in writing. “And if it all doesn’t work,” England says, “then it is Public Health’s absolute responsibility to protect other people.”
[Not entirely true. They put me here because I was a bad case. They never said they'd put me in jail, just "quarantine". They never told me my punishement was no shower, window, or visitors, ... like the vacant room just outside the jail ward. They can only justify their punishment by saying that I will runaway.]
The patient in question was born Robert Danielov, in Moscow, in August 1979. His father, Igor, moved to the United States in 1990, when the Soviet empire was falling apart and Russians finally had a chance to leave. Robert’s parents had split up, so the boy stayed in Russia with his mother. One year later Igor, then living in Arizona, sent for his son, so Robert and his aunt Irena and his cousin Eugene boarded a plane to Washington, D.C.
It was the Fourth of July. Since they didn’t have much money, they took a Greyhound bus all the way to Phoenix. Robert would later remember small things about the trip. He’d remember how he and Eugene dashed off to hug the first palm tree they saw, how they marveled over a soda vending machine, and how he grabbed a handful of sugar packets when the three of them went to a rest stop for lunch. He thought he was stealing the sugar. Somebody later told him that it was free. This was how he saw America: a place where you could have all the sugar you wanted.
Nevertheless, his teenage years were a bummer. Daniels says he was an outcast at Arcadia High School in Scottsdale. He ditched class. He smoked pot. To this day he has a mixed accent: It’s half Russian and half desert-rat dudespeak. In Scottsdale he felt shut out by the socially prominent people on campus. He was either suspended or expelled, he says—he can’t remember. He had a falling-out with his father. Eventually, when he was 17, he moved back to Russia.
Daniels has, it seems, the Russian talent for inebriation, and once, when he was locked out of his flat in Moscow, he decided to get back in by throwing down a rope and lowering himself into a window from the roof. “So I wouldn’t be afraid I drank a little vodka, obviously,” he says. “You know, Russian-style. And I drank so much that we didn’t even give a fuck: rope, no rope. It just snapped and I remember flying down on the asphalt. The doctor said I was really lucky. Thank God I was drunk.”
He kicked around in Moscow and in Kursk, a city east of Chernobyl, and at one point in Kursk, late in 2000, he made the absentminded mistake, he says, of putting a small amount of marijuana, “1.6 grams or something,” into his pocket. He was arrested and imprisoned for this—three months, at first, for the charge, and then another nine months in a penal colony because he failed to report to the probation authorities and piss into a cup. He has unsavory memories of his bunkmates. “Underneath me—you won’t believe this, but this is true—underneath me the guy who was sleeping had a case of cannibalism,” he says. “The guy ate his wife. I was freaked out. I wasn’t sleeping a couple of weeks because I was afraid.”
It was in one of these claustrophobic, cockroach-infested cells in Russia that Daniels most likely caught tuberculosis.
In January 2006, Daniels returned to the United States. By now he was a husband and a father. He’d met his future wife, Alla, when he was at the height of his adolescent-hooligan phase in Moscow and she was a graduate student in linguistics. “We met by chance in the street,” Alla remembers over the phone from Moscow. “I was carrying a heavy bag and he offered his help. At that time I didn’t think that he would have serious intentions because he was 18 and I was 25.” They got married in Russia in 2001, after Daniels got out of jail, but the years that followed didn’t allow for much of a honeymoon. Daniels bounced from job to job; he got coughing fits; in late 2000 a doctor diagnosed him with TB; his illness intensified; there were squabbles with his stepfather about the ownership of a flat in Moscow. Since he was running out of ways to support Alla and their son, Dimitry, he decided to make use of his American passport.
He returned to the land of palm trees and free sugar. He flew from Moscow to New York to Phoenix. He got a construction job, but within a couple of weeks he realized that his luck was getting worse. He was wasting away. He was exhausted. He had no appetite. His lungs were all shot up with a hacking cough. Later, his aunt Irena noticed that when he spoke, his voice sounded like a whistle. Daniels checked himself into an emergency room in Scottsdale, and it was shortly after that visit, according to legal documents, that he learned that he had a multi-drug-resistant strain of tuberculosis. Daniels disputes this. He knew he had TB, yes, but he insists that the doctors didn’t tell him that he had MDR until after he’d been locked down in the void.
The Department of Public Health placed him in the Monroe House, a row of quarantine barracks in a seedy section of downtown Phoenix. Monroe House is a kind of way station for poor people with TB. The doctors hammered home a simple directive: Daniels had to wear a mask. Anytime he passed through the chain-link fence and went for a stroll to the nearby stores, he was supposed to use an N95 particulate respirator mask to cover his mouth. He did not do this.
“The real thin guy? Did he die?”
Pat Sheikh is the manager at the 99-Cent Super Center up the street from the Monroe House, between the Jalopy Jungle and the adult-video store. She’s blunt and sixtyish and world-weary, and she’s happy to talk about Robert Daniels. Last year, before he was locked up, he’d come in here every day to buy cigarettes and phone cards so that he could call his wife in Russia. “Oh, he’s a nice kid,” she says. “I used to chat with him all the time. Funny—a sense of humor. Skinny. Oh my lord, he was a stick.”
The dime store is teeming with people. Mexican families, mostly. A lot of kids. Did the Russian guy ever wear a mask?
“No,” Sheikh says, “I never saw him in a face mask.”
Daniels was worried that people would mistake him for a robber. “Can you imagine standing outside of a store, especially in a dangerous neighborhood, and I would put a mask on before walking into the store?” he says. “The people down by the counter would get a hold of a rifle and shoot my ass. Anybody would do the same thing—a normal guy, not a wimp or a pussy. I’m serious. Nobody would put on the stupid mask.”
One day last summer, Daniels was summoned to the hospital. He was told not to bring his car; the Public Health people sent a taxi for him. That was strange. When he got to the hospital, he waited alone in a room for a long time. Eventually, masked attendants came in and put him on a stretcher. They hauled the stretcher into an ambulance that had all its windows open, and they zoomed through the streets of Phoenix with a police car as an escort. Not long after the ambulance arrived at the Maricopa Medical Center, Daniels was brought up to Ward 41, and there he entered the void. Why are officers going by the door? Why is there bars on the window? he wondered. And then, after a few days had passed: Where the fuck am I?
Ever since he was first elected, in 1992, Sheriff Joe Arpaio—everybody just calls him Sheriff Joe, and there’s no point in resisting it—has been keeping himself in the national media spotlight by punishing crime with a series of strange and Draconian innovations. He has brought back chain gangs. He houses many of his inmates outside, in tent cities—even when the desert heat is blistering past 120 degrees. He makes the inmates wear pink socks and underwear, and he feeds them two 15-cent meals a day, the most notorious of which is known as “green bologna.” Inmates have died in custody, too, but not even the prospect of having to pay out millions of dollars after an ugly lawsuit is enough to get Sheriff Joe to rescind his vow of toughness. Tough is what he does, and he’s not about to stop.
So while it was unfortunate that Daniels came down with drug-resistant TB, it was a cosmic stroke of bad luck that he came down with it in Maricopa County. Ward 41 belongs to Sheriff Joe, and these days Sheriff Joe is not feeling inclined to treat Daniels with an abundance of sympathy. Somewhere in the middle of Daniels’ incarceration, concerned nurses [not nurses, but my case manager] on Ward 41 did manage to bring a computer, a TV, a cell phone, and a boom box [a little clock radio] into Room 15, along with a few CDs by Air, the French electronica duo—Daniels says he likes to listen to “weird music.” There was even a hearing in February to discuss whether Daniels should be moved to a less restrictive room in the hospital, but after another emergency hearing three days later, the patient’s media gear was deemed a security threat and whisked away. In the middle of April, by the time CNN and Good Morning America were calling and the ACLU had stepped in to fight for the afflicted’s constitutional rights, Sheriff Joe decided to bend his rules and let Daniels have a TV and a cell phone. [It's my TV and phone.]
At this point he just wants Daniels to stop whining.
“He’s got good food!” Sheriff Joe says at his desk on the 19th floor of the Wells Fargo building. His book, America’s Toughest Sheriff, is perched on a little stand behind him. Sheriff Joe speaks in a slow, hammy voice that sounds like John Wayne taping an Olive Garden commercial. “He’s got his TV back that nobody has! His cell phone that nobody has! He’s got personal sponge baths. He’s got his own big room. So what’s the guy complaining about?” [What does he consider bad food?]
He goes on. “I think he should be very thankful. Because he’s getting good medical treatment, free of charge, and I don’t think he should be complaining about a little TV or a cell phone or computer.” His cell phone goes off. The ringtone is Frank Sinatra’s “My Way.” [I don't have my computer or radio back yet.]
I ask Sheriff Joe whether Daniels lost his gadgets after the emergency hearing because he was threatening to contact the media. “I don’t punish people for contacting the media,” the sheriff says. “Fact, I should give him an extra bologna sandwich, especially if they blast me. Because every time they blast me, my polls go up. And I don’t care about the ACLU. I love it when they sue me. Because my polls go up. I’m not the typical politician that squirms and is scared when people blast me. Let ’em blast me.”
But the case has kicked up an unusual amount of drama . . .
“Might be more,” Sheriff Joe says ominously. “Might charge him. We’re looking into it.”
Charge him? With what? “Eh . . . endangerment,” he says. “You endanger the public—we’re lookin’ into it. Then I’ll take his TV back.” [That's how this guy is. That's how this idiot says he's going to save the world. He's old school. The harder he hits, he thinks is better.]
If it’s possible to take an even harder line on Daniels, that line is taken—with unabashed red-state vigor—by Jack MacIntyre, one of the sheriff’s deputy chiefs. Looming over the end of a conference table, MacIntyre tells me that there’s only one person to blame for the afflicted’s sad state of affairs, and that is Daniels himself.
“Would you feel any more great empathy if he were carrying bubonic plague or avian flu and decided that he wanted to go out and socialize, or attend Little League games, or go into the movies and cough—knowing that that’s all it takes for him to spread the infection?” the deputy says. “What a cavalier attitude that is. Nobody asked him a great deal other than to cover up if he had to go out. He didn’t care enough to do that. He didn’t care enough about running into somebody who may have a complete loss of immune system—a person that he could kill with this. A person that he could kill rapidly and readily. Quite honestly, I don’t know why he hasn’t been charged with something criminal. If we had a basis for extraditing him, I would move to extradite him in a heartbeat.” [I'd love to go back to Russia. Just give me the medication and I'll get the fuck out of here.]
Sheriff Joe is the one who gave Daniels his TV back. Deputy MacIntyre didn’t want to. “I’ve never seen any published opinion from any court,” he says, “that says access to television is a constitutional right.”
Before I leave the Wells Fargo building, Sheriff Joe gives me a copy of his videotape, Sheriff Joe Arpaio Does It “HIS WAY.” He also gives me two 8-by-11 portraits of himself. He also asks for the names of my kids, and then he autographs some crime never pays posters for them, and then he tosses a rubber band across his desk so that I can roll up the posters for the flight home to New York. Sheriff Joe autographs a poster for me, too, and when I get back to my rental car I take a look. It’s a picture of him standing with a clenched fist and a wagging finger in front of one of his infamous tent cities. “To Jeff,” he’s written along the top. “Robert Daniels should be happy he’s not in these tents.” [Bastard!]
The guy might be a publicity hound, but people in Maricopa County just love their Sheriff Joe. They talk about him the way you might talk about a comically deranged member of your family. Support for America’s Toughest Sheriff crops up where you least expect it. Irena Peart, the aunt who traveled across the country with Daniels back in 1991, sits on a leather couch in suburban Phoenix showing me old photos of her nephew. Her son, Eugene, watches ESPN on a massive TV. Eugene’s 23 now and has grown into a handsome, all-American management trainee at Chase. Irena dumps a few snapshots out of an envelope. In the first one Robert Daniels is 11 years old and he’s holding a giant bag of popcorn. He’s got a look on his face that says, Can you believe this freakin’ country?! “That’s the first week,” Irena says, “when we just arrived in United States.” As I flip through the snapshots, a picture of Sheriff Joe pops out. An autographed picture. It turns out that Irena met Sheriff Joe at the airport recently. She’s crazy about him. “This is the guy who put Robert in jail cell,” she says coyly. “I have great respect for him. I didn’t even tell him that Robert is my nephew, because it’s embarrassing. The point is Sheriff Joe is trying to clean up Arizona. I support that. I support that he has some rules, and I like his rules. I don’t like when people can just walk through the border and do drugs. Maybe Robert is not a criminal, but he broke the rule. You break the rule, you have to be responsible.”
“I was just thinking: You’re nobody,” Daniels is saying, thinking back to his worst stretch in the void. “I felt like a person that is going on electric chair. I am going through mental destruction. I guess you can say that. Because this is almost impossible to bear.”
In spite of the existential horror of what Daniels has been through, the more you talk to him, the more you realize that he’s not precisely the innocent victim of a Kafka-esque bureaucracy that the early media glare made him out to be. When the doctors started dosing him up at the Monroe House, he and another TB patient broke the rules and shared a bottle of red wine, which can interfere with the meds. “I’m a Russian guy,” he says. “After three months of not drinking, I kind of missed it.” In April the guards on Ward 41 issued him a reprimand. Apparently a female prisoner had been dancing naked outside his porthole, and Daniels stood there watching, gesturing, egging her on. “You can imagine myself going months without any porn magazines or anything like that,” he says. “I mean, obviously I’m going to be watching. It’s, like, normal.”
To punish him, guards covered his porthole with a portrait of Sheriff Joe. “They’re really pissed,” Daniels says. “They’re just looking for revenge. They’re pissed because they’re losing. It’s like a war for them. So they’re going to start doing some crap. I can feel it.” Even though he knows he’s up against one of the most inflexible law-enforcement regimes in America, Daniels doesn’t give any indication that he’s planning to scale back his acts of defiance. “I mean, right now I know Sheriff Joe is very angry at me because this all started and he was shown as a jackass on TV. He showed his bad side on television. He knows that, so he’s probably looking for something to get me somehow. But he won’t find anything.” People have told Daniels that it might make sense just to, you know, say something nice about the big man who holds the keys to the void. Thanks for the TV, for instance. “But I really don’t want to say that,” Daniels says. “I don’t want to be a dual-faced motherfucker like everybody else. I’d rather suffer, but I’ll say the truth, dude.” [I'm not going to be a pussy like everyone else here! Most important if a guy is in trouble, then you should do something, like a few people here who are not afraid of losing their licenses and stick up for what's right.]
The question is not whether Daniels should be isolated. Almost everyone involved in the case—even the guy’s own wife and lawyers from the ACLU—concedes that he probably should. “You don’t want the plague in town,” says Dan Pochoda, the legal director of ACLU of Arizona. [But after having TB for 6 years in Russia, my wife and son did not catch this from me with no mask. They did not even tell me not to go on the plane.]
It’s a little-known fact that the government is legally entitled to lock up people who pose a bacterial threat to the public. Right now in Texas, for example, nine people with tuberculosis are cooling their heels in isolation because a court determined that they were contagious enough to be dangerous. The conundrum is: Since Daniels has never been charged with a crime, does he deserve to be subjected to the same conditions as an inmate? Does a man who is not a criminal, even a sick man who rather moronically refused to wear a mask in public, deserve the void? “You can’t keep that person in a punitive manner,” says Pochoda, a Harvard Law grad who made his bones, in the seventies, working on high-profile cases that came out of the Attica prison riots. “There aren’t people in jails who aren’t charged with crimes. That’s illegal.”
In April, after learning that there was a hearing coming up in Maricopa County to hash out the Daniels case, the ACLU stepped in temporarily to represent Daniels as co-counsel. Daniels has a court-appointed lawyer, a preppy, pint-size suburbanite named Bob Blecher, but Daniels openly gripes that Blecher has been less than aggressive in his defense. “He got this case only because he thought he was going to get money by not doing anything,” Daniels says. “He took the case, and he really didn’t represent me when there was a court order or something. He was just quiet. He was just doing shit.” It’s worth pointing out that Blecher is getting paid a base fee of $200 for his labors. “He’s frustrated,” Blecher says with delicate, barely suppressed snippiness when asked about his ornery star client. “There are times when you just let him ramble. He doesn’t really understand the process. He also doesn’t understand that things don’t happen overnight. It’s frustrating for him. He’s the one sitting in there.”
Tuberculosis is by no means the only disease that’s grown eerily resistant to traditional antibiotics. With other monster bugs on the rise, isolating sick Americans could become more common in the 21st century. According to Pochoda, the courts need to set clear standards about which practices are constitutional and which are not. Pochoda says the afflicted has a right to receive mail that hasn’t been ripped open, to goof off without being given a reprimand, to look out a window, to take a shower.
And if a place like Maricopa County says it just doesn’t have a nicer, safer, less restrictive place to put the guy? “Not an acceptable answer,” Pochoda says. “It’s their responsibility to house him. They have to get a facility.” [Sure there are better places. I was supposed to go to Colorado. But that bitch Moffit is keeping me here, in jail.]
Old, shabby, utilitarian, and ringed by a neighborhood of sad bungalows, the Maricopa Medical Center would not look out of place in Vladivostok during the Brezhnev years. On a warm, cloudless afternoon in April, I take an elevator to the fourth floor, where a surprisingly cute female guard, identified as Sergeant Metzler, ushers me through a barred gate. We walk a couple of steps down the hallway and there he is: Through the porthole of his door I see the afflicted lying on his bed in the bluish light of the void.
Sergeant Metzler lets him know he has a visitor. He rolls slowly out of bed and drags his IV gear across the linoleum floor. He’s got bags under his eyes and stubble on his face, his hair is flopping around in a lopsided shag [I haven't had a haircut in almost a year.], and he’s wearing his hospital robe backwards and open at the chest, like a kimono. He looks like Kurt Cobain starring in an off-Broadway production of One Flew Over the Cuckoo’s Nest.
He’s loopy on painkillers and he makes no attempt to hide how thrilled he is to get a drop-by from the winsome Sergeant Metzler. “When she passes by, everything is blooming and it’s sunshine again,” he tells me. His pale, stubbly face breaks into a smile. He jokes—loudly, and well within range of the guards—about orchestrating a jailbreak. “If you can,” he tells me, “send me a cake with something inside. A loaf of bread with a chainsaw inside. Like in the cartoons.”
“You’re having too much fun,” someone calls at him from down the hall. “He is,” says Sergeant Metzler.
So, yes, life in the void was grim and sad, and Robert Daniels reached a point at which he could no longer identify his own face. But life in the void gave him a new face, and as the days wore on, and as the ACLU fought for his constitutional rights, and as the TV producers called his new Cricket cell phone with that lilt of understanding in their voices, well, Daniels got to a place where he didn’t mind his new face all that much. You couldn’t help but marvel at the way that an American—any American, even a shiftless dude in jail for being sick—could find redemption by becoming a celebrity.
He still didn’t know when he would leave the void. Late in April his captors held another hearing to talk about whether he should be moved to a less restrictive room [down the hall just outside the bars]. A doctor named Maricela Moffitt spoke for over an hour, saying that Daniels couldn’t be trusted and that his test results wouldn’t be available until at least July. She also suggested that Daniels had been spotty about taking his meds at the Monroe House, a charge that Daniels has vehemently denied, but the afflicted was barred from testifying over the phone. “I didn’t even get to say anything,” he complained to the Arizona Republic. “I’ve been embarrassed in front of the whole nation.”
The truth was that Daniels had finally got what he’d first yearned for when he rode across the land of free sugar. This was America, and he had a future.
He took to musing on the bizarre predicament of becoming a celebrity germ carrier: “A guy with deadly tuberculosis can’t be famous, you know? CNN said, ‘We’re gonna come over and do an interview that you’re a hero, that you survived this fuckin’ TB, and wow!’ And I thought, Here we go again. I think that there’s going to be two stories. One that I’m dying, and one that I survived.” Daniels had been thinking of moving to New York—maybe he’d save up enough money to bring over Alla and Dimitry. They were healthy, after all; they had tested negative for TB. Then again, maybe he’d sock away some money and buy a condo back in Russia. “Moscow is like a real free city,” he said. “It’s more free than America.” He was considering writing a book. A friend had told him there might be a movie deal in this thing. People were offering him money. It was all so amazing! For the first moment in a very long time, Robert Daniels had plans. “I’ve got a lot to do,” he said. “I’m still alive.” Someone had once told him something when he was a little kid from Russia, and it had turned out to be true: That American sugar? It was free for the taking.
[It's pretty good. He's the first reporter who wrote what I said. He didn't mix it up.]
2 cases stirring TB fears
Health officials, U.S. public question national readiness
Robert Anglen — The Arizona Republic, Page 1 — Jun. 1, 2007In Phoenix, a man sits in a hospital isolation unit, terrified he is about to die.
In Denver, the first person in the United States to face a federal quarantine order since 1963 might need portions of his lungs removed.
The two men have one thing in common: a virulent strain of drug-resistant tuberculosis that has sent waves of alarm across the country about the risk of contracting the disease and the government's ability to stop it.
The cases have heightened worries among health officials, left airline passengers voicing concerns over international travel and sparked worldwide news coverage. Tuberculosis was thought to be a plague of the past here, a threat only in developing countries.
The cases of Robert Daniels of Phoenix and Andrew Speaker of Atlanta are shifting that view.
But the real threat of extensively drug-resistant (XDR) TB in the United States is not an immediate pandemic.
What worries health officials more is the emergence of a disease that over the next few decades could render drugs useless and push the country back into the bitter past, when isolation, containment and quarantine were the only ways to thwart its spread.
"If TB is less under control . . . it is much more likely for (extremely drug-resistant) strains to develop," said Bob England, director of Maricopa County Department of Public Health. "When that becomes the norm, it will be like going back to the days when we didn't have drugs."
In the short term, some people are uneasy, and others mad.
In Phoenix, public-health officialssay they were outraged when they say Daniels, 27, violated rules of voluntary quarantine by not taking his medicine and going to local stores without wearing a mask. Daniels, who denies not wearing a mask, was ordered by a judge into an isolated jail ward at the Maricopa Medical Center, where he has been for 10 months.
Elsewhere, airline travelers are angry that Speaker, a 31-year-old personal-injury lawyer from Atlanta, flew to Canada and then drove into the United States knowing he was infected with virulent TB. He had ignored warnings from doctors not to return to the U.S. from his European honeymoon.
When the Centers for Disease Control and Prevention discovered he was back in the country, it ordered Speaker quarantined, transported him to a hospital in Denver and began searching for passengers who were on his flights.
So far, public health authorities have not identified any additional victims, and there is a very good chance that nobody else was infected.
The reassurances haven't erased the worries, especially among travelers.
"It definitely concerns me," said Christine Rice, a 23-year-old sales consultant with the Christmas Light Company in Phoenix who travels as part of her job. "It's not something I would have thought about before. But now . . . I'm not even sure how you could beef up security to stop it."
According to the CDC, there have only been 49 cases of the XDR reported in the United States since 1993, not including the two newest cases. Of those, 17 were reported between 2000 and 2006.
Despite the low numbers, the CDC in October issued a health bulletin that described XDR-TB as a potentially untreatable future epidemic. The bulletin said patients in the United States with XDR were 64 percent more likely to die during treatment than patients who contracted multi-drug resistant strains.
In Arizona, about 300 new cases of tuberculosis are reported each year. In Maricopa County, the number is about 170. Only about one person a year in the state is forced into court-ordered isolation or placed in a specialized ward away from the public.
Ken Komatsu, state epidemiologist for the Arizona Department of Health Services, said the vast majority of patients are concerned that they might expose others and voluntarily take precautions to limit exposure.
He said drug-resistant forms of TB, while rare, are becoming more common, especially in developing countries, where treatments are incomplete.
"Inadequate treatment leads to the disease," he said, explaining that the drug mutates when treatment isn't followed up or the right medicines aren't given.
Komatsu said Russia is an area of risk because of its failing infrastructure. He said medicines once used to successfully treat the disease in Russia now are being given without proper follow-up, allowing the disease to spread.
Daniels, the Phoenix patient, said that he contracted the disease in Russia, where he is also a citizen. He says he moved from Russia to Arizona in 2006 to find work and became severely ill. He was placed in a county sanitarium for indigent TB patients.
In the Speaker case, passengers who sat next to the Atlanta attorney on several flights, said they had no idea their fellow traveler was infected and expressed outrage that he may have put their health at risk.
"It's still very scary," Laney Wiggins, 21, one of more than two dozen University of South Carolina-Aiken students who are getting skin tests for TB, told the Associated Press. "That is an outrageous number of people that he was very reckless with their health. It's not fair. It's selfish."
Health experts said the likelihood of a transmission was low, partly because Speaker has a small amount of TB bacteria.
England said tuberculosis is slow-spreading and not nearly as infectious as even the flu virus.
That hasn't stopped callers from contacting airlines and questioning them about the safety of flying.
"There certainly has been an increase in calls," said Phil Gee, a spokesman for U.S. Airways in Phoenix.
He said most callers want assurances that the airline has procedures in place to deal with a communicable disease. Gee said the airline will almost always turn decisions over to the CDC or other health officials when a situation arises, as it did two months ago when a passenger in North Carolina falsely claimed to have smallpox.
"We sequestered the plane for a couple of hours," he said. "We had on the air conditioner. We brought in food and water (for passengers)."
In that case, the passenger was suffering from mental illness.
"It is occasionally one of those issues that arises," he said.
Jail sentence for 'crime' of being deathly sick with TB
E. J. Montini column — Arizona Republic — Page B1 — Jun. 3, 2007Robert Daniels isn't in the jail ward at Maricopa Medical Center because he has a drug-resistant strain of tuberculosis. He's there because we don't trust him. [A county doctor didn't trust him.]
He may be the first
person in Arizona history to receive a sentence of life in prison
without ever being convicted of a crime. The offense that landed him in
jail isn't being sick, but being irresponsible. At least that is what a
court commissioner decided.
[Daniels was not allowed to testify. He was denied his civil rights to
defend himself and refute false testimony.]Sheriff Joe Arpaio goes one step further. He said that his office has opened a criminal investigation into Daniels' behavior from before he was quarantined: "We want to get to the bottom of what led him to get placed in that jail. I'm not going to say what he was doing, but I'm looking into it." [The Sheriff needs to cover for his staff who mistreated a patient, by harasing him.]
Daniels was born in the Soviet Union to a Russian mother and an American father. [Russian father who immigrated to the US, then invited his sister, her son, and his son Robert to come.] He went to high school in Scottsdale and has dual citizenship. He contracted the drug-resistant TB while living in Russia and decided to return to the States, where treatment is better.
Initially, county officials sent Daniels to an out-treatment facility for indigent TB patients. [They failed to properly diagnose him.] Later, they said that Daniels didn't take his medication [Lie!] and that he went out in public without a mask, among other things. Dr. Robert England, medical director of the county's Department of Public Health, told the court that Daniels understood the rules but had refused to follow them. [Nobody told him they would put him in jail and take away his hot water, bathroom, phone, TV and computer. Half of the staff wore a mask. He got mixed messages, and the county has to protect itself by making Daniels the scape goat for their mistakes.]
So we locked him up. [Didn't have to. There is a regualr hospital room with negative air on the same floor near Daniels. He's have a shower, hot water and not be on the news and there'd be no lawsuits.]
Last week, the American Civil Liberties Union of Arizona filed a lawsuit on Daniels' behalf, calling his confinement "inhumane and unconstitutional." However, according to Executive Director Alessandra Soler Meetze, that doesn't mean that the ACLU wants Daniels released.
"We are not challenging the quarantine," she said. "But once the county made that very serious decision, they have an obligation to treat him in a humane manner, and that does not mean treat him like a criminal."
Ironically, the county official who helped to land Daniels in jail feels the same way.
"My only interest is to keep a person's germs from getting to someone else," said the county's Dr. England. "I would hope that it could be done as comfortably and as humanely as possible."
But what happens when we have a patient who doesn't cooperate, as is alleged of Daniels? Or one who, like the lawyer from Atlanta, takes commercial flights knowing that he is putting other passengers at risk? Even Arpaio wonders about how we treat such individuals.
"We should have some type of alternative plan to take care of these people," he said. "It should not be the jail. Maybe this will make the health profession start looking into this and say, 'What are we going to do with these people?' "
Strangely, the ACLU, which named Arpaio in its lawsuit, feels the same way.
"The county should have made some sort of plan for this," said Alessandra Soler Meetze. "In the lawsuit, we attempt to get the county to start addressing this issue."
Most people who contract TB, even the worst form of it, cooperate with authorities and pose no serious threat. Someone like Daniels, however, can be jailed. Luckily, for now, his particular form of TB is rare in the United States.
What happens when the illness is much more prevalent and easily spread, like a virulent form of the flu? Would there be enough hospital space, or prison space, to hold hundreds, even thousands of untrustworthy patients? [There are only 3 (three!) negative air rooms at county hospital! Two are in the 4th floor jail area, and one is on the same floor just outside the bars. The county cannot handle 4 such patients.]
In the meantime, treatment for Daniels (which may or may not save his life) is costing taxpayers $50,000 a month, through which we hope to protect the public from a lone man wielding an extremely deadly weapon: A cough.
[It may have been cheaper to have sent him to Denver immediately, because all his spit tests and diagnostics are sent to Denver for analysis anyway. There'd be no news and no lawsuits. But the county needs to justify their 2 negative air-flow jail cells which are rarely used. Daniels being in jail allows the county to say they need the these 2 rooms in their the annual budget report. There is one other room on the same floor outside the bars that has a regular bath, with shower, that Daniels is not allowed to use. Why? That's what the nursing staff has been complaining about. Why not put him next door in the single empty regular room with negative air-flow? Somehow it will take a court order to do this simple task of moving him 20-30 feet.]
Reach Montini at (602) 444-8978 or ed.montini@arizonarepublic.com. Read his blog at montiniblog.azcentral.com.
Money separates tuberculosis patient from prisoner
E. J. Montini column — Arizona Republic — Jun. 24, 2007If the lawyers working for Robert Daniels are correct, then just about the only difference between a TB patient and a TB prisoner is money. That can't be good news for those of us who don't have bags of cash stashed away in a closet and who, sooner or later, might contract a dangerously contagious disease.
Daniels has a drug-resistant form of TB, as does the Atlanta lawyer Andrew Speaker, who made national news a few weeks back while traveling the globe. What the two men don't share are similar bankbooks.
Daniels went to high school in Scottsdale but was born and lived in Russia. He has dual citizenship. He contracted TB in Russia, where he said people, including doctors, didn't treat the disease with such alarm.
When he got ill in Arizona, he was sent to a county sanitarium for indigent TB patients. But doctors said that he endangered people by not following his drug regimen and by meeting friends and going out in public without a mask.
So we locked him up in the county jail's hospital ward at Maricopa Medical Center, the only secure place in Maricopa County with the proper ventilation system.
Meantime, Atlanta lawyer Andrew Speaker found out while he was in Rome on his honeymoon that his TB was drug-resistant. After being asked not to take commercial flights, Speaker and his wife flew from Rome to Prague, then to Montreal, where they rented a car and drove across the border to New York. Speaker's plan was to make it to the National Jewish Medical and Research Center in Denver, the premiere hospital for TB treatment. And he did.
He now has a nice room, gets to visit with his family and, according to recent news reports, is doing work for his law clients.
Robert Daniels' room at the county hospital is a cell. The windows are frosted so that he can't see outside. The lights are on 24 hours a day so that he can be monitored by a security camera.
Dan Pochoda, legal director of the American Civil Liberties Union of Arizona, along with cooperating attorney Linda Cosme, have been working to get Daniels better treatment.
His story made the news a while back, but we've moved on. Daniels hasn't.
"The conditions that Robert is living in are worse than those we impose on the majority of people in our state prisons," Pochoda said.
The ACLU filed a lawsuit against the county to improve Daniels' situation and expects as well to seek a court injunction.
"We're not disputing the decision to quarantine," Pochoda said. "But if you choose to do so, there is a legal obligation to do so in the least restrictive manner. The county hasn't planned for this, and it should have."
It's possible at some point that we'll send Daniels to Denver for treatment, perhaps to their county hospital.
His lawyers have heard rumors but can't confirm them. And officials at the county health department aren't saying.
There also have been complaints about the cost of treating Daniels. It runs in the tens of thousands of dollars.
But we don't do it out of the goodness of our hearts. We do it because it's cheaper than having him infect the rest of us.
If Daniels were a poor man with a non-contagious disease, he'd probably be dead by now.
At some point, there may be others like him. Daniels' lawyers not only want the county to find a better place for their client, but to establish a secure place that is not a prison for other sick people we may have to quarantine. Drug-resistant TB frightens us enough to lock away some patients, but that doesn't make them criminals.
As Pochoda told me, "You can't sacrifice constitutional rights because of inconvenience."
TB patient back in Valley over legal fight
Man held in confinement by Maricopa County returns from Colo. over 'agreement'Ryan Kost — The Arizona Republic — Page B1, Sept. 20, 2007
When Robert Daniels answers the phone in his Phoenix motel room, all he offers is a labored "hello."
He's not impolite. He's not warm, either. He's just exhausted. It may be from the recent surgery that left the tuberculosis patient with only one lung. But more likely, it's the yearlong legal back and forth that on Tuesday tore him away from Colorado and deposited him in a state he had hoped to leave behind.
More than a year ago, Daniels was diagnosed with a rare, multidrug-resistant form of tuberculosis. Daniels had just returned to Arizona from Russia and was so contagious that he was told to wear a mask. Maricopa County officials said that he didn't comply and was not taking his medication.
His actions, the county said, were such a danger to the public that he was put in solitary confinement for a year.
His case became a study in how the government must balance personal freedoms and public safety and made headlines nationwide.
"Man with 'extreme' TB may be jailed until death," read one headline in the Tucson Citizen.
"Drug-proof TB strain poses ethical bind," said another on MSNBC.com.
Along the way he fought his confinement. The ACLU helped file a federal lawsuit in May, requesting Daniels be moved out of his "inhumane" jail conditions. For much of the confinement, court records show, Daniels was without a phone, TV, radio, shower or hot water. He says the lawsuit gave him back his life.
In July, he was sent to a hospital in Colorado that specializes in treating TB. There, he gave up his lung to the disease, and doctors found him to no longer be contagious, he says. "I was great. I felt good."
He thought things had finally turned around, that soon he'd be a free man, but on Tuesday, Daniels was on a plane bound for Phoenix.
Maricopa County health officials won't say why he had to return to the Valley. They won't even confirm he's a patient. But Daniels' lawyers say it was an agreement he signed with the county that pulled him back to Arizona. The agreement, they say, was presented to Daniels as an ultimatum: You sign it, or you don't go to Colorado for treatment.
County officials have also filed a petition to put Daniels in an ankle-tracking bracelet, his lawyer Burt Rosenblatt said.
In an e-mail, he called the move "completely unnecessary and inhumane," and one they would fight. He added that they'll continue to push for Daniels' freedom and for a lawsuit Daniels filed against the county and certain employees.
For the time being, Daniels is resting in the hotel room the county provides for him. He talks with his family back in Russia, where he also holds citizenship, almost daily.
He can leave, he says. He could probably go look for work, too. But a side effect of his TB medication means his feet are in constant pain. He'll have to deal with it until he can stop taking the drugs two years from now.
Daniels said he understands the government has to balance the public's safety and his own rights, but he doesn't understand what the problem is now that he's not longer contagious.
"I still consider myself very American," Daniels says, "but what America is doing to me is just unbelievable."
[On September 23, Daniels admitted himself to the hospital because he was feeling very sick, "probably from the side effect of the drugs" he said. In Denver the doctors were more experienced and did a "drug holiday" several times when the titre in his blood was too high, or the side-effects miserable. In Phoenix, the doctor is not very skilled which is the main reason for his mistreatment and the $10 million lawsuit.]
Lawsuit:
$10 million lawsuit filed against Maricopa Couty, 3 dcotors and the sheriff may be settled out of court to provide funds for Daniels to return to Moscow, and compensate for abusive treatment. The county laywers want to protect the doctors' and sheriff staff jobs while the Daniels' lawyers want to be paid for his civil rights violations and misery. On September 27, judge Vatz ruled that Daniels did not have to wear a radio tracking device.- See his court docket: PB2006-002150
- See the judges decisions (minutes) by entering this case number: PB2006002150
- Judge's
order
on 9/27/2007
Fund set up to bring family of TB patient to Arizona
Ryan Kost — News Update: Arizona Republic — Sept 27, 2007. Page B1
A fund has been set up to hep recovering tuberculosis patient Robert Danils bring his family to Arizona from Russia.
Daniles, who had his lung removed is no longer contagious, recently returned to the Valley.
He had been held for a year in involuntary quarantine by Maricopa County because the county says he endangered the public by not wearing a mask or taking his meication after he was diagnosed with a drug-resistant strain of the disease.
Donate to Account 707173 at any Arizona Federal Credit Union branch.
Robert Daniels self photo by cellphone,
Phoenix. Sept 27, 2007.
Robert Daniels self photo by cellphone,
Phoenix. Sept 29, 2007.
Daniels with nurse Nancy Turko who "blew the whistle" on his mistreatment to the news and started this whole mess. She was fired from her job at county hospital for complaining about and helping Robert too much. When Robert returned to Phoenix she bought him these new clothes because nobody else cared for him. We need more nurses like Nancy.
TB patient who was quarantined in jail flees
A tuberculosis patient who was quarantined in a Phoenix hospital jail ward for nearly a year fled the country on Sunday.
He apparently wanted to escape possible prosecution by the Maricopa County Sheriff's Office and to reunite with his family in Russia.
[And to avoid the sickening side-effects of the medicine which Maricopa County doctors did not know how to dose, or care to dose properly. Daniles said he reported medical mistreatment to the Denver clinic that saved his life several times, and they called Dr. Moffit, Daniels' Primary Care Physician, to advise that he needs more frequent "drug holidays", days off meds. Dr. Moffit was "furious" according to Daniels for him complaining to the national specialists. The county doctors testified that they treated him the cheapest way possible to save money.]
Robert Daniels, who was ruled no longer contagious after lung surgery last month, had been living in a Valley motel under monitoring by Maricopa County Public Health officials for the past few weeks.
His attorney, Linda Cosme, said he sent her an email from Moscow after arriving there on a flight Sunday.
"He apologized," Cosme said. "Essentially, he could not take the abuse from the county. He felt threatened (by Sheriff Joe Arpaio). He just couldn't take it any more."
Daniels, who was born in Moscow to an American father and Russian mother, holds dual citizenship and spent some of his childhood in Scottsdale. He was treated for drug-resistant TB early last year after moving from Moscow to Arizona in search of work. He left his wife, Alla, and a son in Russia.
A call to the family's residence at 3 a.m. Moscow time was answered by Alla, who declined to put her husband on the phone, saying, "He's asleep."
In Phoenix, the 28-year-old Daniels was placed in solitary confinement last Augustin the jail ward at Maricopa Medical Center. A judge had ruled that he recklessly exposed others to his illness by going out in public without a mask. The Sheriff's Office treated Daniels as an inmate while in custody, confining him in isolation and under video surveillance for most of the time with no phone, shower, television or other comforts.
Daniels fought a losing battle in Superior Court to improve his living conditions. That case has been sealed, and litigants recently were placed under a gag order.
Meanwhile, the American Civil Liberties Union filed a federal lawsuit this summer, but proceedings were suspended when county health officials agreed to send Daniels to National Jewish Medical and Research Center in Denver. While at the hospital, Daniels had a lung removed. Doctors there also determined that he is no longer contagious, and that he never had extreme drug-resistant TB, the deadly diagnosis given by health experts in Arizona. Instead, he had a less serious strain, multi-drug-resistant TB.
Nevertheless, Daniels was returned to Phoenix in September and ordered to submit to monitoring by the county for at least 18 months. Authorities at one point sought to require that he wear a tracking device on his ankle. "I still consider myself very American," Daniels said at the time, "but what America is doing to me is just unbelievable."
Arpaio, who was stung by negative news accounts of Daniels' treatment, said Monday he intended to have the man arrested for reckless endangerment, but was stymied because investigators have been unable to get medical files as evidence. [Why didn't the doctors report Daniels to the police to have him arrested? Because they are afraid their mistakes will get reported to the tax payers and lose their jobs. Arpaio is protecting his job and "tough cop" image by independently saying he wants to arrest Daniels to get himself in the news.]
Arpaio said he believes Daniels was under court order not to leave the country.
"Maybe now they (the public) will understand this guy is untrustworthy," added Arpaio. "He lies . . . and he skipped. What, did the heat get too much for him? He had to run to Russia?"
Cosme said Daniels was traumatized by his year in sheriff's custody and "terrified" when he was forced to return to Phoenix.
Former Ariz. TB Patient Leaves Country
New York Times, Associated Press — October 9, 2007PHOENIX (AP) — A man with a drug-resistant form of tuberculosis who had been confined to a hospital jail unit for nearly a year has left the country, his attorney said.
Doctors ruled that Robert Daniels was no longer contagious after he underwent lung surgery last month in Colorado. He had been living in a Phoenix-area motel under monitoring by Maricopa County Public Health officials for the past few weeks.
Attorney Linda Cosme said Daniels sent her an e-mail from Moscow after arriving there on a flight Sunday. ''He just couldn't take it any more,'' Cosme said.
Daniels, who holds both Russian and American citizenships, moved to Arizona last year and was treated for drug-resistant TB. Last August, the 28-year-old Daniels was placed in solitary confinement in the jail ward.
A judge had ruled Daniels recklessly exposed others to his illness by going out in public without a mask. While in custody, he was treated as an inmate, confined in isolation and kept under video surveillance most of the time. Daniels was not given a phone, shower, television or other comforts.
Atlanta attorney Andrew Speaker, who caused an international health scare in May after he flew to Europe knowing he had a drug-resistant form of tuberculosis, was treated at the same Denver hospital where Daniels underwent surgery.
Status Review Hearing: Case Dismissed
Minute Entry: Case PB 2006-002150
Superior Court of Arizona, Maricopa County
"The Court is advised that the Patient is no longer in the country and is obtaining the same treatment in Russia that he was getting in the United States. Linda Cosme advises the Court that information was received from the Center of Disease Control (CDC) and discussion is held between the parties regarding that information. The parties agree that there are sufficient facts to show there is no jurisdiction of this Court to continue monitoring the Patient and that this matter should be dismissed without prejudice. ... IT IS ORDERED dismissing this matter without prejudice, as this Court no longer has jurisdiction over this matter."
The lawsuit continues in District Court for abuse and damages.
YOUR WORLD
TB patient returns to Russia
A turburculosis patient who was quarantined in a Phoenix hospital jail ward for nearly a year has left the U.S. and returned to Russia. Robert Daniles told his attorney that he felt threatened by Maricopa County Sheriff Joe Arpaio. "He just couldn't take it anymore," Linda Cosme said. Daniles, 28, was placed in solitary confinment in August 2006 after a judge had ruled that he recklessly esposed others to his illness by going out in public without a mask. Valley & State, B8
Robert Daniels. a tuberculosis patient who was quarantined in a Phoenix hospital jail ward for nearly a year fled the country on Sunday, Oct. 7, 2007.
Daniels happy to be at the airport Sunday morning on the way home to a wife and son, and asylum from Sheriff Joe.
Download the lawsuit filed May 30, 2007:
COMPLAINT
42 U.S.C. § 1983 Civil Action
Robert Daniles
vs.
Maricopa County; Dr. England, Dr. Kennedy, Dr. Moffitt; Sheriff Arpaio
The lawsuit in District Court says that the defendants (county doctors and sheriff) failed to carry out their responsibilities in a professional, humane, and legal manner. ... have treated, and continue to treat Robert as if he were a criminal since August 2006. ... Daniels is entitled to “reasonable accommodations” at the county jail ward and the least restrictive means necessary ... Defendants violated the Americans with Disabilities Act and the Arizona Civil Rights Act, ...The defendants discriminated Daniels because other TB patients were not treated so bad .. .The country has no policy for caring for future cases or an epidemic....
Also Daniles was not acurately diagnosed until AFTER he was placed in the County Hospital, then he was mistreated, including strip searched regularly and denied visits with family for nearly a year, until he went to Denver. He received a hearing test shortly after arriving in Denver because the powerful antibiotics he has been receiving can cause hearing loss. He he also got a X-ray, a CAT scan, blood tests and a examination of his heart, lungs, kidneys, and liver function. Many of these medical proceedures were neglected in Arizona. He was negative on the saliva test, hence not contagious and "poses no threat to National Jewish patients or the Denver community". After he was healed arrangements were made for him to stay in Denver, BUT NO-Oo, Maricopa county who botched his diagnosis and treatment forced him to return to Phoenix to try to pyschologially break him with intimidation to get out of the lawsuit.
If this case goes to trial, more civil and medical violations and mistreatment will be revealed. Maricopa County attorneys will most likely settle out of court to protect their county emloyees, hide embarassing facts from the tax payers, and save millions of dollars that a jury will most likely award. He did take his meds and was denied time to testify about that at his first hearing, a violation of his civil rights. If the Denver specialists testify, they will show that Maricopa doctors did not measure the medicine in his blood to check if he was over or under medicated, or if he needed to be off-meds for a few days. When Daniles testifies he will say that Maricopa helath workers (a) lied that he did not take his meds, and (b) did not always wear masks when they came in contact with him.
- Irony 1 — Maricopa county doctors
testified that they treated him the way they did because it was the
cheapest way possible to save money,
when they could have done it right from the beginning, and we'd never
be talking about this mess, and Robert would just be another guy trying
to earn a living.
- Irony 2 — He is seeking asylum in
Russia from presecution in America!