NASHVILLE — Last fall, Wayne Ruby was two years into his sentence for robbing a Nashville dry cleaning business, and he was ready to get out of prison.
The 51-year-old had completed a Release for Success program and, with luck, would be paroled in less than a year.
But on Sept. 27, Ruby suddenly became violently ill.
He made his way to the Bledsoe County Correctional Complex clinic about 2 p.m., where he sat, then lay, on the floor, doubled over in pain and vomiting.
But Ruby's illness was not taken seriously, according to an account written by fellow inmate Horace Gaddis in a letter to The Associated Press and corroborated by other inmates who witnessed the events. A guard accused Ruby of faking illness to get pain medication, Gaddis said.
Ruby then cursed at the guard and a nurse, according to Gaddis and a prison disciplinary report that cited Ruby for disrespect. Gaddis was told to take Ruby back to his cell in a wheelchair.
Less than two days later, Ruby was dead.
The state Department of Correction says Ruby's medical records are confidential and has not released them even to his family. They are not subject to the state's open-records law, even after death.
Tennessee Department of Correction spokeswoman Dorinda Carter said a review showed Ruby "received appropriate access to treatment" but would not comment further about the case.
Gaddis wrote in his letter that as he wheeled Ruby back to his cell, he was pale and sweating, bent over in the wheelchair and vomiting into a plastic tub.
"I asked Wayne what was wrong with him and his exact words were 'Gaddis I think I have appendicitis and these people are going to let me die,'" Gaddis wrote.
Ruby died at 3:58 a.m. Sept. 29, although not of appendicitis. According to the medical examiner's report, Ruby suffered from cholecystitis, or an inflamed gall bladder, and pancreatitis, a severe inflammation of the pancreas likely caused by gall stones. The pancreatitis also caused his kidneys to shut down.
It is unclear exactly what happened to Ruby from the time he was taken back to his cell to the time of his death, but it appears from the medical examiner's report that he was not taken directly to the nearest emergency room, about 15 miles away. Instead he was driven from Pikeville to Nashville, about 135 miles away, and admitted to the Lois DeBerry Special Needs Facility, a prison for inmates with serious medical problems.
The report shows Ruby was then transferred sometime Friday to Nashville General Hospital, where his "condition continued to decline until death was pronounced" before dawn Saturday.
Ruby's sister, Linda Post, said she suffered from pancreatitis 20 years ago. She called the pain excruciating and said she didn't blame her brother for cursing the guard and nurse who sent him back to his cell.
"If they did that to me ... I don't swear. I'm a church secretary. But I might have done that too," she said.
In a phone interview from her home in North Carolina, Post described her brother as loving and generous but troubled by addiction. Before he went to prison, he worked as a cook and always gave the leftovers to homeless people, she said.
Post acknowledged that her brother committed a crime. "But he paid his time," she said. "He was not given a death sentence."
Although the Department of Correction has not released any details of Ruby's medical treatment, annual reports show the agency has been concerned with bringing down the cost of hospitalizing prisoners. Inmate hospital admissions decreased by 41 percent in the four years between fiscal year 2008 and 2012, according the reports. One report credits "extensive inpatient utilization management" for the decline. Last fiscal year, there were 746 admissions, compared with 811 the previous year. A report said the drop saved the department more than $1 million.
Medical examiner Thomas Deering said in a phone interview that no autopsy was performed on Ruby's body. Deering said he reviewed the medical records and signed Ruby's death certificate. He said he could not comment on the quality of Ruby's medical care because he had no knowledge of it, nor could he say how quickly Ruby's illness progressed.