Nevada has agreed to pay $250,000 to settle a threatened lawsuit by a man who did not receive a recommended colonoscopy while incarcerated and was later diagnosed with Stage IV colon cancer.

The settlement was unanimously approved Tuesday with no discussion by the state Board of Examiners, a panel made up of the governor, attorney general and secretary of state that reviews major contracts and state spending decisions.

It's at least the 12th time that Nevada has agreed to a settlement with a formerly incarcerated person or their family in the past three years. These agreements have cost the state more than $16 million. 

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The man, Alfred Lajes, reported blood in his stool in May 2021 while incarcerated at Northern Nevada Correctional Center, according to a tort claim recommendation submitted to the Board of Examiners in June. He was approved to see a gastroenterologist, but the appointment did not occur until 10 months later.

In March 2022, the gastroenterologist recommended that Lajes receive a colonoscopy. The procedure was never completed "for unknown reasons," according to the Nevada Attorney General's Office recommendation. 

After his release from prison, Lajes received a colonoscopy through the Oncology Institute. Doctors found a 25-centimeter mass in his colon, and he was later diagnosed with Stage IV colon cancer, according to the state document. 

The attorney general's office said the allegations were confirmed through medical reporting and recommended settling the claim before a lawsuit was filed.

The recommendation states that if litigation proceeds, attorneys for Lajes would argue that the delay between the recommended colonoscopy and his diagnosis amounted to deliberate indifference, a legal standard used in claims involving inadequate medical care for incarcerated patients. 

The agreement provides a full and final release of further claims. The state will pay $250,000 total, with $249,500 coming from the state's Tort Claim Fund and $500 paid by the Nevada Department of Corrections (NDOC). An attorney representing Lajes did not return a request for comment.

NDOC also receives staffing shortage designation

The Board of Examiners also approved a separate request from NDOC for a critical labor shortage designation covering several positions across the department.

The designation allows NDOC to hire certain retired public employees to fill positions that have been deemed difficult to staff, providing the department another option to address vacancies that in some cases have remained open for years. 

In its request, NDOC said it was struggling to fill positions throughout its facilities, including correctional officers, doctors, psychiatrists and counselors. It added that the staffing shortage was leading to more overtime, which was leading to heightened security risks. 

Here is a breakdown of NDOC's critical vacancies at the time of the request:

• Of 1,528 authorized correctional officer positions, 273 were vacant.
• Of 15 authorized senior physician positions, 12 were vacant.
• Of eight rural correctional counselors, six were vacant.

NDOC reported that the correctional officer and correctional counselor vacancies have existed for as long as six years, while senior psychiatrists vacancies have existed for as long as seven.

The department attributed the challenges to a limited, qualified applicant pool, competition from higher-paying employers, the demands of working in a correctional environment and housing challenges in rural areas.