After suffering a heart attack in city custody last year, Tyrone Greene received a pair of stents, a medical clearance that prevents him from being pepper sprayed, and a prescription for a blood thinner. The medication required him to receive a daily check of his heart rate and blood pressure, a routine procedure for many survivors of cardiac arrest.

But Greene, who is awaiting trial on a weapons charge, said he is frequently denied access to those appointments by correction officers, who are either unavailable or unwilling to escort him to his appointments. The mismanagement of his health condition has convinced the 47-year-old that he “will not make it out of here alive,” according to his attorneys.

Greene is one of hundreds of detainees on Rikers Island who allege they are being deprived of basic medical care – and who may soon receive compensation if the city Department of Correction cannot show compliance with a court-ordered mandate to expand health care access.

While the city claims that increased staffing has improved conditions on Rikers Island, recent data suggests the number of missed appointments is only growing. In April, there were 11,789 missed appointments, a 67% jump compared to December, when Bronx Supreme Court Judge Elizabeth Taylor ordered the city to guarantee access to medical appointments.

In March, the city reported 10,000 missed appointments for the first time since last summer, when dysfunction on Rikers Island became so severe that Governor Kathy Hochul declared a state of emergency within the jails.

In the months since Louis Molina took over as the city’s jails commissioner, he has pledged to work with the federal monitor on a series of reforms, averting, for now, a federal takeover of Rikers. But attorneys and jail watchdogs say progress has been uneven. Last month, Judge Taylor found the Department of Correction in contempt for failing to follow the order.

The city has until June 17th to demonstrate compliance or face a $100 fine for each missed medical appointment from December and January – amounting to roughly $200,000 in payments to those affected, on top of attorneys fees and costs.

The department keeps saying they’re just about to turn things around, the improvements are just around the corner ... but the numbers are getting worse.
Veronica Vela, a supervising attorney at the Legal Aid Society

Veronica Vela, a supervising attorney at the Legal Aid Society, one of the groups that brought the petition, said she has little confidence in the city’s ability to reverse the trend.

“The department keeps saying they’re just about to turn things around, the improvements are just around the corner,” Vela said. “But the numbers are getting worse. It seems to me that at the very least there’s a lack of urgency.”

A spokesperson for the Department of Correction did not respond to questions about what accounted for the increase in missed appointments or whether the city would meet the judge’s deadline.

“We are committed to ensuring that everyone in our custody has access to quality medical care,” the spokesperson, Jason Kersten, wrote in an email. “Non-production of clinic appointments varies from month to month, depending in large part on individuals in custody who have the right to refuse treatment and appointments.”

Public defenders dispute that reasoning, arguing that the city’s method of tracking the reasons for a missed appointment is confusing, if not outright misleading. A spokesperson for the Legal Aid Society said the agency often claims a detainee has “refused” an appointment, despite never alerting them to the appointment.

By contrast, when the department is unable to escort a detainee to a scheduled medical visit, the missed appointment is filed in an “other” category that includes a variety of explanations, such as a conflict with religious worship or a work assignment. In December, when the Legal Aid Society asked the court for a more specific breakdown, the city acknowledged that 1,061 of the 1,231 missed appointments marked “other” were due to the lack of escort.

According to families and advocates of incarcerated individuals, the lack of basic medical care has contributed to a rising death toll in city jails. Since the start of last year, 22 people have died in city custody, city records show, with at least five of those victims believed to have taken their own lives.

At a briefing last month, Mayor Eric Adams said he was confident his administration could restore order to the jail system, adding that a proposed federal takeover would send the wrong message to the city.

“It says we can’t do our job,” he told reporters. “I’m not surrendering this city to anyone who believes we can’t do our job.”

This story was updated with the correct spelling for Veronica Vela.