The state of Georgia has paid $1.5 million to the parents of a 43-year-old woman now in a vegetative state to settle their claims that their daughter was denied adequate medical care in prison.

The settlement is the state’s largest for a prison lawsuit in the last 10 years and ends a case that included video showing correctional officers accusing the inmate, Mollianne Fischer, of faking an illness and then forcibly moving her to an isolation cell.

The video, obtained by The Atlanta Journal-Constitution, shows the officers cuffing Fischer’s hands behind her back and loudly exhorting her to stand up. When she doesn’t comply, they cut away parts of her gown and pull her to her feet. When she collapses, they drag her onto a flat cart, put her face down and haul her across the prison yard.

Family photo of Mollianne Fischer shows her before she was stricken.

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Two days later, according to the lawsuit, Fischer was discovered lying in feces and had to be hospitalized for a variety of issues, including pneumonia, sepsis, renal failure and pancreatitis. During that hospital stay, she spent seven days in a coma.

“If we had gone to trial, we would have played (the video) over and over again,” said Michael Perez, one of the attorneys for Angela and James Fischer.

The settlement also points again to the issues surrounding Dr. Yvon Nazaire, the prison physician who was fired in 2015 after the AJC exposed how at least nine women had died under questionable circumstances while in his care. The state has now paid nearly $2.5 million to settle lawsuits citing the doctor for negligence since the first of the newspaper's stories appeared.

In their lawsuit, filed initially in Habersham County two years ago and later moved to federal court, the Fischers alleged that Nazaire and other prison personnel failed to take note when their daughter suffered a series of serious health problems. Ultimately, she had a pulmonary embolism that deprived her brain of oxygen, causing permanent injury.

When she was in Nazaire’s care at Pulaski State Prison, she had exhibited several of the risk factors for a pulmonary embolism, including obesity, a lack of mobility and a history of developing blood clots, yet nothing was done to deal with the situation, her parents’ suit claimed.

Others in the prison system were similarly negligent in dealing with Fischer before she got to Pulaski, and some branded her a malingerer even though her health was noticeably deteriorating, the suit alleged.

Dr. Yvon Nazaire was accused of failing to give Mollianne Fischer blood thinners to prevent clots after she was transferred to Pulaski State Prison to receive dialysis. There, she suffered a pulmonary embolism that left her permanently incapacitated, according to family attorneys.

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Since leaving the prison system as a result of a medical reprieve four years ago, Fischer has been bedridden in her parents’ home in Eastanollee. She cannot speak, receives nourishment through a feeding tube and wears a diaper that must be changed every few hours.

“There were so many signs (of trouble),” Angela Fischer told the AJC, discussing the prison system’s responsibility for her daughter’s condition. “They missed the boat every step of the way.”

Joan Heath, the director of public affairs for the Georgia Department of Corrections, did not respond to an email seeking comment on the settlement or the video.

`We don’t got a minute’

Fischer was sentenced to two years in prison in May 2014 for violating her probation in a case in which she misused an employer’s credit card, but she was in the system only six weeks before her health cratered to the point where she was eligible for a medical reprieve.

Her parents’ 87-page lawsuit described those weeks in painstaking detail, starting with several episodes at Lee Arrendale State Prison in Alto, where Mollianne was initially evaluated.

The video of her move to the prison’s isolation unit, obtained by the AJC from the Department of Corrections in response to an open records request, offers a dramatic look at how Fischer was treated.

“Wait a minute,” she pleads at one point as officers attempt to get her to stand.

“We don’t got a minute,” one of the guards responds. “We’ve been playing for three days, Fischer. Stand up.”

Finally, an officer can be heard saying, “Put her on the cart and drag her up there.”

Angela Fischer said the video is so compelling because it shows the officers resorting to heavy-handed tactics when her daughter clearly needed medical attention.

“Look at that video,” she said. “Look at her face. She was barely coherent.”

When Mollianne Fischer was unable to walk to an isolation cell, officers rolled her onto a flat cart and pulled her across the prison yard. This photo is from a prison video of the transfer.

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Only after her daughter was found lying in feces in the isolation cell was she examined by a physician, who diagnosed her as suffering from acute respiratory distress, the lawsuit stated.

After Fischer was hospitalized and her condition stabilized, she was transferred to Pulaski, where she would be able to undergo dialysis. There, she quickly went downhill again.

Thirteen days after arriving at the Hawkinsville facility, she went into cardiac arrest and ultimately was moved to Atlanta Medical Center, where, the suit said, doctors determined a pulmonary embolism had caused brain damage.

In July 2014, the Department of Corrections determined that Fischer was due a medical reprieve. The reprieve was granted after Angela Fischer, fearful that her daughter would be moved again, enlisted the services of an Atlanta attorney, Sid Weinstein, who obtained a temporary restraining order preventing the GDC from removing her from the hospital.

In a deposition, Nazaire acknowledged that Fischer was at risk for blood clots, but he said he never believed the situation called for blood thinners or other preventative measures.

“Yes, she was at high risk, but that doesn’t mean you’re going to put everyone with high risk on prophylaxis,” he testified in January.

At least four malpractice death claims involving Nazaire were filed in New York before he came to Georgia in 2006. Two asserted that he failed to properly diagnose symptoms of women who suffered from pulmonary embolisms.

A photo from a prison video shows officers trying to pull inmate Mollianne Fischer to her feet and get her to walk to an isolation cell. Her arms were handcuffed behind her back at the time.

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A Special Needs Trust

Perez said he and other attorneys agreed to settle the lawsuit because they believed that eliminating the expense of further discovery outweighed what might be gained by taking the case to trial.

“We felt that if we could get a substantial settlement when expenses were fairly reasonable, it would put more money in the Fischers’ pocket for Molli’s care,” he said.

Under terms of the settlement, finalized in July, $378,971 went to establishing a Special Needs Trust for her. Fischer’s parents also received $150,000 to reimburse them for past medical expenses. The couple’s lawyers took $675,000 in fees and $21,029 for expenses.

A database compiled by the AJC shows only five legal settlements paid by the state over the last decade equal or greater in value than the Fischer settlement. None of the other settlements involved the prison system.

Since the AJC began reporting on Nazaire, four lawsuits have been filed citing him for negligence, three of which have been settled. The previous settlements were $925,000 to the family of Bonnie Rocheleau, who died at Pulaski State Prison after suffering from COPD, and $30,000 to Kari Quinn, an inmate who left the prison with permanent vision loss in her right eye.

Angela Fischer, a school teacher who now devotes most of her time to caring for her daughter, has mixed feelings about the settlement in her case.

Mollianne is “like a 6-month-old, 160-pound baby,” she said, so the Special Needs Trust will be crucial for purchasing the diapers, formula and other supplies someone in that condition needs.

But she also knows no amount of money will restore her daughter to the life she once lived.

“It could have been $50 million,” she said. “It will not bring her back.”

Data specialist Jennifer Peebles contributed to this report.

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Nurses, a physician and other health care professionals who work in Georgia prisons have raised concerns that inmates are not receiving adequate medical care, AJC investigations have revealed. These are among the stories:

How much medical care has to be provided to prisoners? Read the AJC's explainer by clicking here.