In 2024, at Stateville Correctional Center in Illinois, prison medical staff administered multiple doses of Narcan to Michael Broadway, who had fallen unconscious in his cell, even as prisoners called out that he had asthma and at least one repeatedly yelled that Broadway did not use drugs. Broadway was eventually taken to a nearby hospital, where doctors pronounced him dead.

Katie knew little of her husband’s circumstances as she drove across Washington to see him. But it had been more than a week since he last called her, a dramatic break from their routine of talking multiple times each day.

“I called 16 times and left messages,” she says. “Nobody called me back.”

She arrived at Washington State Penitentiary at 10:30 am. Sick with anxiety, she went through the elaborate screening process all visitors are subjected to—taking off her shoes, stepping through a metal detector, being pat-searched by a female guard—and was directed to a long corridor with small visiting booths lining one side.

Her assigned booth was divided in half by a sheet of plexiglas that separated visitors from their incarcerated loved ones. A black telephone receiver with a metal-reinforced cord was mounted on the wall.

Off in the distance, she could hear the muffled thud of heavy mechanical doors sliding open and banging shut. “I kept thinking he was coming,” Katie says. “Every time I heard a door I thought it would be him. He never came.”

After about 30 or 40 minutes, a mental health counselor and a guard came to see her.

“They said he’s not physically able to come,” she says. “They found him severely dehydrated and incoherent. I got really angry and I was yelling at them that I had been calling the prison begging them to check on him. I wanted to know what was going on. They said they can’t say anything else.”

Katie says the counselor told her that there was no Release of Information form, known as an ROI, on file designating her as someone to whom prison staff could give medical information. She asked the counselor to take a form to Alex and have him complete it then and there. The counselor said that he was too weak. The counselor’s notes state that Katie did not think there was an ROI on file and that the counselor “agreed to ask him to sign an ROI and if he did that I would call to update her.”

“She promised me she would have him fill out an ROI the next day,” says Katie. “I left crying. I was devastated. I felt scared. I didn’t know what was going on. They shut me out.”

It is not uncommon for prison administrators to stonewall, mislead, or flat out lie to the family of an incarcerated person when their loved one is in a medical crisis.

After 22-year-old Air Force veteran Maxwell Aguirre hanged himself at the Los Angeles County Jail in 2023, a nurse at the facility allegedly told his parents that he was in “stable condition,” and refused to provide further information, in spite of the family’s being listed on a signed ROI form. According to a wrongful-death suit filed by the Aguirre family, Maxwell’s parents arrived at the hospital days later to find their son had been in a coma all along.

There was nothing for Katie to do. She went home. To calm herself, she called a friend.

“I told her ‘I think my husband is dying.’ But I thought I was being dramatic,” she says.

Other responsibilities called. Katie took her son to soccer practice. She made dinner and put her children to bed. Her kids asked how Alex was doing. “I didn’t have answers to their questions,” she says.

Katie was terrified to fall asleep and miss a call from the prison, but there was no cause for worry. “They never called.”

Meanwhile, guards and medical personnel went into Alex’s cell. He was still in solitary confinement. They discovered a man near death. Weakness confined Alex to his bunk. His speech was slurred. He could not hold a cup and had not drunk water or eaten in several days.

Alex was “flopping/tilting his head backwards, and [his] eyes [were] rolling back/closing,” the counselor who had spoken to Katie wrote in her report. He asked the counselor to tell his wife he loved her.

But this was not enough to dissolve the skepticism of medical staff. A nurse theorized that Alex’s symptoms were the product of an unspecified psychiatric condition. He told the counselor that he was requesting Alex receive a mental health assessment.

Guards loaded Alex into a golf cart and took him to the infirmary. He lacked the strength to raise his arm for a blood pressure cuff to be attached.

After his labs came back, he was finally sent to the hospital—more than five hours since he was taken to the infirmary. At the time, his white cell count was 23,000, which can indicate an infection. His resting heart rate registered at 122. His mucous membranes were dry, his lips cracked. He had a fever of between 100 and 102.

At the hospital, a comprehensive diagnosis was at last completed: septic embolism, acute bacterial endocarditis, acute renal failure, anemia, and pleural effusion. Alex, the ER doctor wrote in his notes, “very clearly is septic.”

The next day, April 22, he was flown to Sacred Heart Medical Center in Spokane.

By April 23, two days after her botched attempt to see her husband in person, Katie was done waiting on prison bureaucrats. “I took the day off work,” she says. “I was going to drive to the capitol and talk to whoever, legislators, anybody. I was going to tell them what was going on and get somebody to listen.”

As she readied to leave, a Department of Corrections official called with an update on Alex. She does not recall the administrator’s name, but says he told her Alex had developed sepsis as a result of an untreated ulcer.

A few minutes later, while she was still catching her breath, her phone rang again. It was Washington State Penitentiary Superintendent Rob Jackson. Her husband was in critical condition, he said, and if she wanted to see him she should drive to Spokane right away.

“I still didn’t think my husband would die,” she says. “I said, ‘OK. He’s at Sacred Heart. It’s a good hospital. People go to the hospital to get better.’”

Katie called Alex’s aunt Jacqueline, and they drove together from Vancouver to Spokane. Along the way, the two received updates from an office assistant at the penitentiary whom Superintendent Jackson had assigned to them as a liaison. These updates were less than helpful, Katie says.

“She didn’t understand medical terms, but that’s who was given to me,” Katie says. “She kept using the phrase ‘latest and greatest.’ Like, ‘You want to hear the latest and greatest about your husband?’”

The calls left Katie deeply agitated. She says the office assistant “absolutely blamed Alex” for his illness, emphasizing his prior drug use and insisting that he had refused to take antibiotics he was never prescribed. “She said Alex wasn’t septic and he would be fine,” Katie says. “She made me feel like I overreacted.”

Katie and Jacqueline arrived at Sacred Heart around seven that night. The person at the front desk told them Alex was not a patient. “No one knew who we were supposed to talk to or where we were supposed to go,” Katie says.

Finally, security came down and they were escorted to the ICU.

During a hospital visit, families of incarcerated people hoping to comfort a loved one or to have a final, peaceful goodbye can instead find themselves in tense and stressful settings. Families are often stunned to see their loved one shackled to a hospital bed with armed guards standing nearby.

The guards posted in Alex’s hospital room were expecting Katie and Jacqueline. In the hallway, they listed a host of rules—among other restrictions, there would be limited physical contact, the Kuhnhausens could not sleep in the room, and Alex could not take any food from them. Finally, they were allowed to enter.

“I walked into the room, and my heart just sank,” says Katie. “He looked gray. He looked like he was dying. I went over and kissed his forehead, and I asked him if he knew I was coming. He said he did.”

Katie says Alex’s legs were swollen and he couldn’t move the left side of his body, which appeared to be paralyzed. He was shackled to the bed.

Alex was afraid of flying and had never been on a plane. To lighten the mood, Katie asked about his flight to Spokane.

“I said, ‘I heard you got to ride on a helicopter.’ He said, ‘It was so scary… When I think about those last days, that’s what I think about. He was so scared, and he was alone. No one would help him.”

She asked whether the counselor who had promised to bring Alex a Release of Information form had done so. Alex said she had not. (Her report states that Alex agreed to sign the form, but there’s no indication she ever gave it to him.)

They sat together for a couple of hours, holding hands and chatting. When it became obvious Alex needed to sleep, Katie and Jacqueline said good night.

“I told him how much I loved him and that I’d be back in the morning,” says Katie. “I remember I looked back when I was leaving and he tried to smile. He saw the look on my face, and he said, ‘Don’t worry, baby. I’m coming home with you.’”

On her way out of the hospital, Katie pulled aside her husband’s doctor and asked if Alex was going to die. The doctor said Alex was “very sick,” and needed heart surgery, but was too weak to survive it.

Hospital staff, who Katie remembers as exceptionally kind, found a room for her and Jacqueline at a nearby hotel. It was well past midnight by the time they got to bed. Katie woke in a panic after four or five hours of sleep, as she had the day before, fearing she had missed a critical update on Alex’s condition.

She called the lieutenant overseeing Alex’s security detail. There were no updates, he said. Katie and Jacqueline decided to have a quick breakfast before going back to the hospital.

While the two were on their way to the hotel’s dining room, Katie’s phone rang. It was the hospital chaplain. “He said we needed to get there right away.”

When Katie and Jacqueline arrived, doctors and nurses were huddled over Alex’s bed. A pair of prison guards stood off to the side. A physician Katie hadn’t seen before was performing chest compressions on Alex. Katie fell to her knees.

She pleaded with Alex. “I told him to keep fighting.”

Then everything stopped. Medical staff backed away. The blinking machines surrounding Alex were shut off without ceremony. The doctor declared the time of death—7:18 am.

“I didn’t know what to do. How long do I stay?” she says. “I just sat there for a long time. I didn’t want him to be alone.”

It was Wednesday, April 24, 2024. Just over two weeks after Alex first reported his illness—at the time a relatively minor infection—to medical staff at the Washington State Penitentiary, asking for help.

It’s unknown how many people die in America’s prisons each year.

In December of 2014, Congress passed the Death in Custody Reporting Act (DCRA), which requires states to report every death of a person in custody to the Department of Justice (DOJ.) However, the agency’s data collection efforts have been plagued by inaccurate and incomplete reporting by states.

Based on a 2022 report by the US attorney general on the DCRA, The appeal found that, since 2019, the agency had failed to record at least 18 percent of deaths in state prisons, 39 percent of deaths in jails, and roughly two-thirds of deaths that occur in police custody, which amounts to more than 5,000 deaths.

According to an investigation conducted by University of North Carolina researchers, as of 2022, only 15 states required prison systems to notify courts or prosecutors when someone in their custody dies. In Washington state, the DOC must send reports on “unexpected” deaths to the state legislature, but those reports tend to be short on details, and the legislature leaves the DOC to decide which deaths qualify as unexpected.

After her husband’s death, Katie says a doctor at Sacred Heart told her emergency measures had begun hours earlier, at around four in the morning. Katie asked why she hadn’t been notified. The doctor told her he had asked a guard about calling his patient’s wife, but the guard warned him not to, saying it was “against policy.”

A guard who had come on shift after lifesaving efforts had started told Katie that family notifications had to go through prison administrators.

“He showed me his phone and he had tried to call the administration at Airway Heights [the local prison from which the guards in Alex’s room were deployed] seven times,” she says. “No one answered. He said he was sorry.”

The Department of Corrections held Alex’s body for several weeks. Katie waited, assuming someone would contact her.

“I don’t know what I thought the prison would do,” she says. “I don’t know why I thought they would call and apologize. And of course they didn’t.”

Finally, she called Superintendent Jackson to ask for Alex’s remains.

“He said ‘Oh I thought that happened already.’ He was so nonchalant, like my world wasn’t destroyed,” she says. “I sat on the phone just crying. Then I hung up.”

Alex’s ashes arrived by mail in May of 2024.

“I picked him up from the mailman,” she says. “He handed Alex to me in a cardboard box. It wasn’t how it was supposed to be. But I was happy to have him home.”

In a postmortem investigation conducted by a team that included several DOC employees, the state agency cleared itself of all wrongdoing.

Unlike most democratic countries, there is no independent oversight of the United States prison system, says the ACLU’s Fathi: “You literally get the agency investigating and exonerating itself.”

Almost a year ago, Katie and her attorney put the state on notice—they intend to file a wrongful-death suit against the Washington Department of Corrections. When asked for comment on Alex’s death, a DOC spokesperson told The Nation in an e-mail, “Pending litigation and medical privacy laws prevent us from commenting.”

“They looked at Alex like he was just a drug addict,” Katie says. “He doesn’t feel good because he’s using drugs. If they would have checked on him, they would have seen that he was dying. They just guessed at what was wrong with him. And here we are.”

Katie says she hopes the lawsuit will mean the DOC is finally held accountable for Alex’s death. “This isn’t about anything else except that my husband’s life matters,” Katie says. “He matters. My husband was 25 years old. We’ll never know who Alex could have been. But I’ll never let them forget about him.”