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There have been a bevy of recent reports of inmates escaping from hospitals -- by stealing a vehicle, rappelling down the side of a building, or simply walking out the front door.

Just this week, police in Marlborough, Massachusetts announced that they had recaptured 24-year-old Isaac Rivera, who escaped custody while undergoing a medical procedure over the weekend at UMass Marlborough Hospital, . At the time of his escape, Rivera was in custody for charges including domestic assault and battery, strangulation, assault and battery on a police officer, and illegal possession of a firearm.

Last Friday, authorities said that a man convicted of child sex crimes was back in custody after walking away from Mercy Hospital South in St. Louis, Missouri, where he had been taken for medical treatment, . Tommy Wayne Boyd, 45, is currently serving a 30-year sentence that was handed down in 2007, according to online court records.

Earlier this month, police said 44-year-old Yenchun Chen, who tied bed sheets together to rappel down the side of a New York City hospital, was back in custody, as reported by . Officials said Chen was arrested on July 31 for possession of a controlled substance, and had been taken to Mount Sinai Beth Israel in Gramercy Park to receive medical care prior to his escape.

Finally, new details shared by Oregon State Hospital provided insight into how 39-year-old Christopher Lee Pray, who had been taken to the hospital for medical care after a fight with another patient, seized on unattended keys to a transport van to enact his late August escape, . Pray, who was recaptured after being found in the van stuck in mud, was originally in custody for attempted aggravated murder.

Risk Factors

"Inmates get transferred to hospitals out of jails and prisons for treatment all the time," Jeffrey Keller, MD, who has long worked in correctional medicine and serves as president of the American College of Correctional Physicians, explained to 乌鸦传媒.

Inmates may need to have surgery for a condition such as appendicitis or an injury from a fall, he said, or they may need specialized treatment for a chronic disease like heart disease, cancer, or lupus.

"It's been happening forever, and it's something that all jails and correctional facilities plan for, but just by its nature, since inmates are going to a less secure place, the opportunities to escape are increased," Keller noted.

Accordingly, inmates are never supposed to know exactly when their outside appointments are, he said. Inmates may be told they're scheduled to see a cardiologist, but not when.

"There will be a correctional officer at the door to the hospital room," he added, "but that of course is not as secure as being in a prison cell with multiple layers."

Keller pointed to an incident in 2007, in which an inmate transferred to a Salt Lake City orthopedic clinic for an MRI stole a correctional officer's gun, .

The more recent spate of cases has also included the of 35-year-old Eric Abril, a suspect in a Northern California hostage-taking homicide and shootout with police, from a medical facility in Roseville, a suburb of Sacramento, as well as other escapees who are still at large.

Earlier this month, the Metropolitan Police Department in Washington, D.C. announced that a reward for information leading to the arrest of 30-year-old Christopher Haynes had . Haynes, who had been in custody related to an August shooting and murder, physically assaulted an officer and escaped after being transported to George Washington Hospital for treatment of a prior ankle injury, the police department said.

In addition, 21-year-old Naseem Roulack, who had been serving a 13-year sentence for a string of crimes, since walking out of Bon Secours St. Mary's Hospital in Henrico, Virginia last month.

Potential Remedies

To help reduce the number of transports of inmates for medical care, jails or prisons may turn to telemedicine, Keller said. However, nearly all jails and prisons are "underfunded and overcrowded," he noted. The challenges become where to put a telemedicine room, for instance, and how to pay for it.

In other instances, people who are in jail for a very limited time for a less serious reason and who need medical care may be bonded out or simply released, he said. In certain cases, those who are serving lengthy prison sentences and who are suffering from a terminal illness may be compassionately released, though this process is more difficult.

Furthermore, all inmates are assigned a security or risk level, Keller said, which is taken into account for every type of transport to a hospital or otherwise, such as to appearances in court. In addition to hand and feet shackles, high-risk inmates may be monitored by a pair of officers, one inside their hospital room and one outside.

"From a security standpoint, it would be better if the specialist came to the jail or prison, but very few are willing to do that," he explained. "Anything that can't be done inside the walls of a jail or prison has to go outside."

However, there are a few exceptions.

"If a prison system is large enough, they can have their own hospital ... Some jails that are big enough have jail wards within a hospital," Keller said. However, "most jails and prisons don't have anything like that."

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