by David M. Reutter

Todd L. Caveness, 40, had a long history of bipolar disorder, anxiety attacks and paranoia when he was booked into North Carolina’s Wilson County Jail on attempted murder charges in early 2016. When he began to believe his food was poisoned and stopped eating, he lost 30 pounds over three weeks.

Upon his arrival at a hospital on February 3, 2016, he was suffering from malnutrition, dehydration and kidney malfunction. Hospital staff convinced him to start eating again, but a blood clot in his lungs caused his death two days later.

Because Caveness’ death did not occur at the jail, though, it was not reported to North Carolina’s Department of Health and Human Services (DHHS). When any of the state’s 24,000 prisoners held in its 113 jails dies, DHHS regulations require the death to be reported – but only if it occurred while in custody. Chris Wood, a DHHS investigator inquiring about Caveness’ death, was told a report was not made because he “was alive when he left the [jail] and the death was not related to a suicide.” Wood requested a full report anyway, stating it could note that Caveness did not die in custody.

Caveness was mentally ill, so he should have been checked every quarter hour, according to DHHS regulations. Guards were required to “directly supervise each inmate in person at least twice per hour at an irregular basis,” except when a prisoner is verbally abusive, attempts to harm a guard, is intoxicated, refuses to talk, threatens self-harm or displays erratic behavior – as Caveness did. In such cases, guards must provide direct observation “at least four times an hour.”

When he received the jail’s report, Wood found that during Caveness’ final week at the facility, required cell checks were missed 50 times. As a result, Caveness was counted as one of 69 prisoners who died without proper supervision in a North Carolina jail since DHHS began regularly investigating such deaths in 2012 – over one-third of the 189 jail deaths reported in the state during that time period.

An investigation by the News & Observer found that many of the deaths attributed to improper supervision were suicides; others were blamed on inadequate care by private jail medical providers. Correct Care Solutions (CCS), the medical contractor at the Forsyth County Jail (FCJ), faced lawsuits arising from the deaths of two prisoners.

Following the August 2013 death of Dino Vann Nixon, 55, a medical examiner ruled he had died due to withdrawal from benzodiazepine, which he had been prescribed for anxiety but not allowed to receive at the jail. In 2017, Forsyth County paid Nixon’s estate $180,000 to settle a wrongful death claim.

The second suit against CCS involved the September 2014 death of Jennifer Eileen McCormack Schuler, 31, a pregnant prisoner who was addicted to opioids. [See: PLN, March 2017, p.63]. The lawsuit, filed in August 2016, claimed she was not given anti-nausea medication, after which she vomited repeatedly. A medical examiner ruled her fatal heart attack was triggered by a lack of oxygen to the brain and acute renal failure, caused by dehydration.

“From all indications, there’s the concern of medical care,” Forsyth County Sheriff Chief Deputy Brad Stanley acknowledged.

As with Caveness’ death, Schuler’s was not investigated by DHHS for over a year because it occurred at a hospital and thus went unreported to the agency. CCS and another private medical provider at FCJ, Grand Prairie Healthcare Services, settled the suit filed by Schuler’s estate under confidential terms in December 2017.

“Our jail currently has medical positions that are open,” remarked Jerry Hufton, a registered nurse at FCJ. “Any for-profit medical company is going to have a high ratio of clients to nurses. They could not have adequate care.”

Hufton brought a sign to a “No More Jail Deaths” rally held in downtown Winston-Salem in June 2017 that read, “Correct Care Solutions = Negligent Care.”

Of the cases cited in the News & Observer’s five-part series, “Jailed to Death,” the majority involved suicides and incidents where guards failed to conduct routine cell checks.

When Emily Jean Call, 32, was arrested on April 16, 2012 for missing a court date, she told guards she was high on methamphetamine. Two weeks earlier she had cut her wrist. Her mother made several phone calls to the Wilkes County Jail.

“Please, I beg you, watch her,” she recalled saying.

After two days in jail, Call told guards she was sick, depressed and fatigued, and felt like she was going to have a nervous breakdown. Mental health services were not available at the facility; nonetheless, she should have been checked by staff every 15 minutes. She went unwatched for an hour, however, and hung herself with a bedsheet. Her estate reached a $105,000 settlement over her death.

At the Durham County jail, Terry Demetrius, 21, hanged himself in his cell in 2013 after he was not monitored for six hours. An investigation into the 2012 suicide of Matthew C. Reynolds, 29, in Dare County revealed he went nearly seven hours between cell checks.

“There were no rounds made the entire day,” a report into Reynolds’ death stated. “It is clear that there was a gross failure to properly supervise inmates.”

“It’s my understanding they were just standing behind the desk and not going out to actually walk around and do the rounds,” said Capt. Allen Moran, the jail administrator hired after Reynolds died. The county paid a $25,000 settlement to Reynolds’ estate.

The medical examiner who conducted the autopsy of Ellin Beth Schott, 57, ruled that her August 2015 death at the Guilford County Jail in Greensboro was due to “complications from prolonged seizure activity.” The medical examiner noted that Schott told jail staff she “had seizures, nerve damage, and was disabled.”

On her second day at the facility, Schott was observed shaking and trembling under her blanket. She told a CCS nurse that she was on medication. The nurse said she would have to see a doctor, and gave her Tylenol.

At a 2017 hearing before state lawmakers, DHHS section chief Steven Lewis testified that recent jail deaths totaled among the highest in the 20 years since the state began tracking them – reflecting a pattern found in many other states as the opioid crisis has resulted in increases in both the number of addicted prisoners and overdose deaths.

“We are trending the same way that it is across the nation,” Lewis stated.

Calling jail “a very expensive place for them to be,” DHHS Secretary Mandy Cohen said prisoners with mental illnesses and drug addictions need “stable treatment” during their incarceration.

While emphasizing that the causes of jail deaths range from suicides to overdoses, Lewis admitted that lack of supervision is “one thing that does kind of run through a lot [of] the deaths.”

“It was obvious that [Jennifer Schuler] wasn’t given the care that she needed,” observed state Senator Joyce Krawiec.

When asked whether a prisoner’s death should be reported to DHHS even when it occurs at a hospital, Krawiec responded, “It absolutely should. No question about that.”

In Carteret County, Sheriff Asa Buck and jail healthcare provider Southern Health Partners were named as defendants in a wrongful death suit filed by the family of prisoner Amanda Hogan, 28. Her 2015 death was one of three at the county jail in an 18-month period. In each case, DHHS investigators discovered inadequate supervision.

Hogan, a mother of two, was an opioid abuser on medication for bipolar and personality disorders. Denied her medication in jail for a week, she hanged herself and later died at a hospital.

Patrick O’Malley, 32, had a fatal heart attack the week following Hogan’s death, after he spent nine hours in a restraint chair – seven hours longer than permitted by jail policy.

Another Carteret County prisoner, Justin Allen Everett, 28, hanged himself in his cell in 2015. He was an opioid addict arrested in the same sting that nabbed Hogan.

According to the Pew Charitable Trusts, jails with fewer than 250 beds are less likely than larger facilities to provide treatment to detainees with serious mental health problems. The organization found that many prisoners with chronic conditions do not take prescription medicine, but over a third of those didn’t even have the chance because their meds were denied by jail medical staff.

A professor with UNC’s School of Government, Jamie Markham, said jails are constitutionally prohibited from being deliberately indifferent to prisoners’ medical needs – which could include the failure to provide necessary prescriptions.

Although she still receives complaints from prisoners about medications being withheld, Vicki Smith, executive director of Disability Rights NC, noted the number of complaints was dropping as more North Carolina jails develop policies to address the problem.

After publication of the News & Observer series, more jails in the state have started reporting deaths that occur at a hospital, according to Lewis with DHHS, perhaps accounting for some of the increase in jail deaths reported during 2017. Two of those deaths occurred in Davidson County.

In July 2017, prisoner Ricky Vanhoy, 30, threatened to harm himself. While he should have been monitored at least four times an hour, surveillance video showed he was checked just twice at the jail in the nearly two hours before he died. Autopsy results revealed he had ingested a bag of narcotics which leaked into his stomach, Sheriff David Grice said.

Six weeks later, James Ross Curry, 59, was found in distress in his cell and later died. The cause of death was not released, but an examination of electronic supervision logs by DHHS investigators found no cell checks in Curry’s unit or in four others – with a combined total of 196 beds – for over an hour before another prisoner alerted guards to Curry’s condition.

It is apparent that in addition to inadequate medical care, the failure of jail staff to conduct regular checks – that is, to do their job – has contributed to prisoner deaths that otherwise would have been preventable.

Sources: www.newsobserver.com, www.triad-city-beat.com, www.abc11.com, www.scalawagmagazine.org, www.usanews.com, www.wilsontimes.com, Associated Press

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