25-064 - Recommendation 6

The BOP should reassess its policies, procedures, and training to provide better guidelines for medical staff conducting medical checks of inmates in restraints. As part of this reassessment, the BOP should consider, among other things, incorporating the following into its policies, procedures, or training: A requirement to video record medical checks; A requirement to photograph injuries observed during medical checks; Requiring greater detail regarding inmate injuries, toilet usage, and food and liquid consumption in the Health Services Restraint Review Form, and revising the Health Services Restraint Review Form to include larger spaces to allow for such detail to be included; A requirement to provide a detailed explanation when concurring with the continued use of restraints despite evidence of injury; Enhanced guidelines and training to medical staff on recognizing the existence of injuries that can lead to nerve and muscle damage and on when injuries resulting from restraints warrant action, such as removing restraints or seeking a higher level of medical care; and Enhanced guidelines or training to correctional staff to recognize signs of potential nerve or muscle damage that warrant seeking assistance from medical staff.