Cases Show Medical Care Under Scrutiny At Federal Bureau Of Prisons

The Sudden Illness of John Dalaly

In mid-March 2024, John Dalaly began experiencing lower back pain—something he initially dismissed as a minor issue, possibly from work or exercise. However, serving a 28-month sentence at the satellite prison camp near USP Hazelton (WV) for bribery related to the Michigan Medical Marijuana Licensing Board, he soon realized the pain was worsening. As the weeks passed, his condition deteriorated. He repeatedly called his family, describing his worsening symptoms, and sought help from the prison’s medical staff. Despite his visits, Dalaly claimed the prison doctor misdiagnosed him with diabetes.

By mid-April, the pain had become unbearable. He was given a wheelchair but remained undiagnosed, relying on fellow inmates for basic tasks such as showering and using the restroom. Eventually, inmates took him to the front office of the prison, where they insisted that Dalaly was dying. An ambulance was called, and upon arrival at the hospital, a doctor immediately ordered a CT scan. Before the scan could be completed, Dalaly began losing consciousness and went into sepsis.

“I asked God to take me home,” he later recalled in an interview. “I was ready to die after five weeks of neglect in the camp.”

The CT scan revealed pockets of fluid and pus eroding his bones. He was rushed to a larger hospital for emergency surgery. “When I woke up,” Dalaly said, “the surgeon explained I had five screws and a ten-inch rod in my back due to the infection eating away at my bones.”

Dalaly believes the BOP is responsible for the inadequate care he received. Bedridden for five weeks after surgery, he was ultimately informed by his family that his compassionate release had been granted. “I couldn’t believe I was going home,” he said. “I cried the entire day, believing God had answered my prayers.”

Medical Care and Compassionate Release

Dalaly is not alone in his criticism of BOP healthcare. The Bureau operates 120 institutions, including seven federal medical centers (FMCs). While each facility offers medical care—often through community providers under contract—staffing shortages remain a persistent issue. A 2024 Office of Inspector General (OIG) report concluded that FMC Devens, for example, had “serious issues” in providing adequate healthcare to inmates.

Federal inmates may apply for compassionate release, historically reserved for those with terminal illnesses and a life expectancy of only months. However, courts have expanded its use in cases where the BOP cannot provide adequate care. The process begins with an administrative request by the inmate to the BOP, which, in most cases, is denied—just as it was in Dalaly’s case. Even with BOP support, only a federal judge can grant compassionate release, often the same judge who imposed the original sentence.

Bureau of Prisons Position On Inmate Healthcare

Courts often inquire whether the BOP can manage a defendant’s medical condition before sentencing. While judges may show leniency toward defendants with serious health issues, the BOP rarely, if ever, admits to being incapable of providing care. Former BOP Acting Director Hugh Hurwitz stated in an interview, “BOP is required to provide essential medical care in a manner consistent with accepted community standards. They are confident in the quality and ability of their medical care. Thus, I think it would be rare, if ever, that BOP would say they cannot handle a certain illness.”

Surrendering To Prison When Inmate Has Health Issues

Minimum-security inmates who self-surrender typically bring their prescribed medications as evidence of the drugs they are taking. However, during intake, BOP staff confiscate and discard all medications, citing efforts to prevent the introduction of illicit drugs. Instead, the BOP relies on its approved formulary—a limited list of medications it provides. If an inmate’s prescription is not on the formulary, BOP staff must obtain special approval to order it or they provide an alternative drug.

While substitutions are common, inmates are often wary of changing medications prescribed by their primary physicians or specialists when they get to prison. Delays, staff shortages, or bureaucratic errors frequently result in missed doses, which can lead to severe medical complications.

Being in prison is difficult but being in prison as a sick person is even more difficult. The mental stress as well as the physical stress to get well weigh heavy on inmates.

Compassionate Release of Nick Bovis

Nick Bovis, a former San Francisco restaurateur, pleaded guilty to Honest Services and Insurance Wire Fraud in a political corruption case. Judge William H. Orrick sentenced him to nine months in federal prison, and Bovis surrendered to FCI Florence’s minimum-security satellite camp on October 10, 2024. At the time, his only notable medical condition was high blood pressure.

Upon arrival, Bovis provided his prescription for 50 mg of Hydrochlorothiazide—an inexpensive, commonly available blood pressure medication included on the BOP formulary. However, prison staff failed to fill any of his prescriptions as written. Instead, his medication was arbitrarily reduced to 25% of the prescribed dosage. As a result, his blood pressure spiked dangerously. Seeking medical attention, he was prescribed Lisinopril, a different blood pressure medication that caused severe side effects, including dizziness, blurred vision, and a persistent cough.

On January 28, 2025, Bovis became disoriented and sought medical help but was initially denied treatment. His condition worsened to the point where he could no longer speak. A correctional officer, recognizing stroke-like symptoms, arranged for his transfer to a local hospital. Doctors diagnosed him with a Transient Ischemic Attack (TIA).

Less than a month later, on February 15, 2025, Bovis again experienced blurred vision, disorientation, and slurred speech before passing out. He was rushed to the hospital, where he was diagnosed with a seizure—a potentially life-threatening condition exacerbated by improper medication management.

Bovis filed for compassionate release, and Judge Orrick granted his request, writing:

“In sum, Bovis is a sentenced defendant who is now suffering from extreme high blood pressure and has been refused his prescribed medication. He has subsequently suffered two TIA episodes, on January 28, 2025, and on February 15, 2025, presumably as a result of BOP’s inexplicable refusal to follow his doctor’s orders. The refusal of the BOP to follow a simple prescription has resulted in two serious medical incidents in the relatively brief time he has been in custody.”

Judge Orrick ultimately ordered his release, emphasizing:

“A nine-month term should not become a life-threatening sentence. Continued detention raises constitutional concerns. The Eighth Amendment bars ‘cruel and unusual punishments,’ including deliberate indifference to unsafe, life-threatening conditions … The BOP’s medical treatment of Bovis is incomprehensible and very far below the standards that I expect for anyone held in custody. I am not happy to grant this request ”

Bovis was released.