Poor Health Care Underlines Array of Problems at Major Transit Point for Prisoners

One of the country’s busiest federal prisons, a transit point for 27,000 inmates a year, is buckling under a staggering array of problems, including substandard health care, crumbling facilities and harassment of employees by other staff, a Justice Department watchdog announced on Thursday.

Conditions at the medium-security prison in Lewisburg, Pa., mirror problems found at other lockups run by the Bureau of Prisons. But the magnitude of the dysfunction stunned investigators with the department’s inspector general’s office, which has made unannounced inspections to highlight shortcomings in funding, staffing and management.

Among the most alarming findings from an inspection in February: the unusual decision by the prison’s medical director to discontinue antidepressant medication for 15 inmates — without consulting or examining the patients. The omission violated bureau guidelines and put them at risk for depression and self-harm.

The medical staff also failed to provide inmates with basic care, tests and screening for colorectal cancer and diabetes, according to a report on the inspection’s findings.

Investigators also found that corrections staff acted in grossly inappropriate ways — hanging framed Nazi-themed art from prisoners on the walls of staff-only areas, and scrawling sexual slurs targeting fellow employees, the inspector general, Michael E. Horowitz, found.

“Our inspectors were very disturbed and surprised,” Mr. Horowitz said in an interview.

“The volume of inmates coming and going at Lewisburg poses extraordinary challenges for the institution’s leadership, and that’s exacerbated by the fact that they are substantially understaffed,” he added. “It just ripples through the institution — from the safety side, to the health care side.”