Washington State has paid just shy of $10 million to settle a lawsuit with a mother-of-two whose cervical cancer became terminal while she was in prison after doctors there failed to diagnose and treat the disease.

Paula Gardner, 42, was serving time for drug and burglary offences and did not receive adequate medical care for over two years despite tests showing possible signs of cancer in that time before a scan revealed a growth inside her uterus, according to the lawsuit.

Ms Gardner’s case is the latest in a string of deadly and expensive health failures in state prisons. 

The complaint filed to Pierce County Superior Court in 2022 stated: ‘As a result of the negligent, reckless and grossly negligent conduct and medical malpractice of DOC [Department of Corrections]… Paula has, and will, endure incredible pain and suffering up to the time of her death.’

By the time her cancer was diagnosed at the Washington Corrections Center for Women in Gig Harbor, it was too late. 

Paula Gardner (pictured) was serving time for drug and burglary offences and did not receive adequate medical care for over two years

The 42-year-old will benefit from the $9.9 million payout along with her two sons – Jordan and Airon

Ms Gardner’s attorneys, Lincoln Beauregard and Marta O’Brien, added: ‘Because the cancer was left unchecked for this period of time, it became advanced when it was otherwise treatable.’

In a court filing before the December trial, a member of the Washington DOC legal team acknowledged prison health care had harmed the plaintiff and said the only issue for a jury to decide was a figure to award in the case.

The single $9.9m settlement exceeds total DOC-related payouts in each of the last six financial years according to reports by the state’s Office of Risk Management, and was reached on the first day of the civil trial with Washington State making the payout last month.

Ms O’Brien has since confirmed that her client was released following the eventual diagnosis and is receiving palliative care in Tacoma.

Ms Gardner had been in jail on and off for over a decade, according to her lawsuit, and five years ago, she began serving a 40-month sentence for burglary and possession of a controlled substance.

She had a history of abnormal Pap smears showing she had a carcinogenic type of the human papillomavirus, HPV, which meant she should have received specified regular screenings, according to legal documents.

In April 2019, an ultrasound found a 1.9-centimeter growth in her uterus and a radiologist recommended a follow-up ultrasound six weeks later as well as an MRI of her pelvis.

But, according to the lawsuit, Ms Gardner was never told about those findings or recommendations.

She spent some time in a Yakima County jail following crowding issues at the women’s prison, where no follow-up scans or treatment was done, and nor was it done belatedly on her return in 2020.

That May she was having ‘troubling symptoms’ and asked for a follow-up screening, but DOC staff delayed that for almost a year until March 2021 when an examination found lesions on her cervix, which biopsies confirmed were cancerous.

A medical expert hired by Ms Gardner’s lawyers declared such gaps in care led to her fatal diagnosis.

Ms O’Brien has also said she was particularly struck by the DOC’s failure to tell their prisoner about the potential cancerous growth that had appeared in the ultrasound – an omission only discovered via the lawsuit.

‘It’s just such a basic tenet of medical care that you inform the patient what is happening to them,’ O’Brien said.

Dr. Reed Paulson, the former chief medical officer at Oregon State Penitentiary, said in a report for the case that if Ms Gardner received a colposcopy and examinations of the cervix and vagina, in March 2020, ‘more probably than not, she would have survived her cervical cancer’. 

The settlement money will benefit Gardner for what remains of her life, as well as her two sons, Jordan and Airon, who were also plaintiffs in the case.

Chris Wright, a spokesperson for Washington’s DOC, said statement reported by the Seattle Times: ‘Our heart goes out to Ms. Gardner and her family.

‘In recent years, the agency has focused its attention on improving health care for our incarcerated patients.’

Mr Wright pointed to efforts including the hiring of a national expert in corrections health systems, a new review system for unexpected prisoner deaths and attempts to develop electronic health records, which would eliminate reliance on paper files.

The state must provide health care for those it incarcerates, both under state law and the constitutional ban on ‘cruel and unusual’ punishment. 

However, Washington’s DOC has struggled with medical issues. 

In 2019, the medical director at Monroe Correctional Complex was fired after an investigation found men imprisoned there had suffered and died as a result of negligent care.

In 2021, a state prison watchdog office issued a damning report detailing 11 cases of delayed cancer diagnosis and treatment leading to the deaths of some inmates. 

The same year, the state admitted negligence as it paid $3.25m to the family of a man who died at the Monroe prison of a festering abdominal wound that was not properly treated.

And two years ago, the state paid $3.75m in a settlement to the family of Kenny Williams, a man who died at the same prison after his cancer went untreated despite his increasingly desperate pleas.