by David M. Reutter

After two North Carolina prisoners died in county jails, lawsuits filed by their families resulted in settlements. Under state law, the details of those agreements should have been public record; in fact, in the absence of accepted standards for jail health care or strong regulatory oversight, such information may provide the best measure of the quality of medical care provided to prisoners held in county jails.

Yet state court judges sealed the settlements in both cases.

North Carolina’s public records law allows an exception if a court finds “the presumption of openness is overcome by an overriding interest” that “cannot be protected by any measure short of sealing the settlement.” Yet Jonathan Jones with the North Carolina Open Government Coalition and Sunshine Center at Elon University called the decision to seal the settlements in the jail death cases “incredibly disappointing.”

“We’re talking about spending taxpayer dollars on claims of wrongdoing by the government, and often these are settled without an admission of guilt,” he said. “But even though there’s no admission of guilt or responsibility, there’s a transfer of funds, and citizens need to know whether or not their government bodies are being good stewards of their tax dollars.”

Jessica Lynn Martin, 20, died five days after her 2011 arrival at the Haywood County Detention Center in Waynesville. Arrested for a probation violation stemming from a misdemeanor charge of possession of drug paraphernalia, Martin told guards that she did not feel well. While in a courthouse holding cell awaiting release, she was found unconscious and struggling to breath. Martin was rushed to a hospital, where she died. An autopsy determined the cause of death was sepsis, after her immune system went into overdrive to fight acute bacterial pneumonia.

Kelly Anne Green, 28, died a day after she was booked into the Stanly County Detention Center in Albemarle, about 40 miles east of Charlotte, in 2010. Charged with a felony for obtaining property by false pretense, as well as misdemeanor traffic offenses, she told guards upon her arrival at the facility that she needed insulin to treat her diabetes. She requested a blood sugar test from staff employed by Southern Health Partners (SHP), the jail’s medical provider, which revealed a high level. Yet she was not given insulin. Green experienced a restless night and refused breakfast; the next morning she became unresponsive and was taken to a hospital, where she suffered cardiac arrest and died.

Martin’s estate filed suit for medical malpractice against Haywood County, while Green’s estate sued Stanly County. Both cases were settled in 2012 and both settlements were sealed – Martin’s by Judge Bradley Letts and Green’s by Judge Craig Croom.

Letts ruled that the section of the Haywood County jail where Martin was housed fit the definition of a “hospital facility,” which is exempt from disclosing settlements in medical malpractice cases. Croom’s order sealing the settlement agreement against Stanly County simply stated that “all parties consented.”

Over an 11-year period between 2006 and 2017, 309 people died in North Carolina jails. How many of those deaths resulted in lawsuits and settlements could not be determined. Requests to local sheriffs by the Raleigh News and Observer identified 21 settlements totaling more than $3 million, but about a third of the sheriffs did not respond.

Forsyth County, which includes the city of Winston-Salem, paid $180,000 in December 2017 to settle a complaint filed by the widow of Dino Vann Nixon, 55, who died after he was denied his prescription Xanax at the county jail. A doctor reportedly diagnosed him with alcohol withdrawal despite his lack of a history of alcohol abuse. Nixon’s August 5, 2013 death was one of five in the first five years after medical care was subcontracted to Correct Care Solutions (CCS), a for-profit firm based in Nashville, Tennessee.

According to a news report, CCS dropped its legal fight against releasing internal records related to Nixon’s death in March 2018; the company had unsuccessfully argued that under state law, the records were confidential and privileged. CCS settled the suit filed by Nixon’s widow in May 2018 under undisclosed terms.

A complaint filed after the September 2014 death of another prisoner, Jennifer Eileen McCormack Schuler, 31, also was settled by Forsyth County in late 2017, but according to John Vermitsky, an attorney for Schuler’s estate, the terms of the settlement were sealed. Schuler was three months pregnant at the time she died, and the suit named both CCS and Grand Prairie Healthcare Services, a CCS subsidiary, as defendants. [See: PLN, April 2018, p.52].

“The practice of having a medical malpractice lawsuit sealed, especially when they result in death in an otherwise county-run facility, is really problematic,” said Jones with the North Carolina Open Government Coalition.

At the same time it was entering into those settlements, Forsyth County officials approved a $13.2 million, three-year extension to its contract with CCS.

Sadly, the aforementioned deaths of prisoners due to poor medical care in county jails are part of a larger trend in North Carolina.

At the Craven County jail, about 100 miles southeast of Raleigh, Christopher Lee Wetherington overdosed in May 2015 on lithium, which he was prescribed to control his bipolar disorder. Arrested on charges of stealing a truck, the 33-year-old was eventually placed on suicide watch at the jail, where the rising levels of lithium in his blood were carefully recorded by medical staff from Southern Health Partners. Yet no further action was taken for the next four days, despite the fact that Wetherington “was seen stumbling around, wouldn’t keep his clothes on, [and was] eating his own feces,” according to his stepsister, Ashley Jones.

“They pretty much let him lay in there and die,” she added.

Found unresponsive in his isolation cell, Wetherington was rushed to a hospital where he died the next day. His family settled a wrongful death claim against Craven County for $50,000.

In Shelby, about 50 miles west of Charlotte, Archie McNeilly, Jr. died a week after he was booked into the Cleveland County Detention Center in May 2015, charged with breaking and entering, larceny and possessing stolen property. An autopsy determined that McNeilly, 40, died due to renal failure caused by an infection related to an undiagnosed kidney stone. His family filed a lawsuit claiming jail employees and SHP medical employees ignored his complaints of abdominal pain and in fact grew angry at his loss of bowel control.

The three deaths blamed in part on SHP – Green’s, Wetherington’s and McNeilly’s – were among claims raised in at least 43 lawsuits filed against the company in North Carolina within the past decade. With contracts at 30 facilities, Southern Health Partners is the largest jail medical contractor in the state. All three suits were settled for undisclosed amounts by SHP, as private companies are not covered by the state law requiring settlement disclosure.

In Greensboro, Ellin Beth Scott died at a hospital in 2015, two days after being found unresponsive at the Guilford County jail. Arrested for panhandling, the 57-year-old spent three days without her prescribed anti-seizure medication because a nurse at the facility claimed a doctor’s permission was required to dispense the meds. Scott’s death followed multiple seizures, where she was given only Tylenol.

Cecilia Sypka died at a Raleigh hospital in April 2015, a few hours after suffering a heart attack at the Wake County Detention Center. An autopsy determined the 44-year-old heroin addict, who was arrested for manufacturing methamphetamine, succumbed to withdrawal complications. Her family is suing the county, claiming medical staff at the jail should not have waited three days to send her to a hospital.

Jail health care costs in Wake County spiked to $7.8 million in 2014 from $6.4 million the year before after the state enacted legislation requiring jails to pay 70 percent of the actual cost for prisoner medical treatment or two times the Medicaid rate, whichever is less. Greg Kash, an attorney representing Sypka’s family, claimed that health care staff at the jail delayed providing treatment in an effort to avoid hospital costs.

But Allen Moran, the jail administrator for Dare County, said annual medical costs fell markedly after contracting with SHP in late 2015 – from $298,000 to $163,000. A large portion of the savings was achieved by monitoring bills with outside healthcare providers, he said, so the switch to SHP allowed his jail to “provide more service, and it costs less.”

In a case involving another private contractor, Corizon Health, the company was accused of denying care to a prisoner suffering from a perforated ulcer to “avoid the charges associated with hospitalization.” Fortunately Bryan O’Neil Simmons, 36, did not die. He was, however, left in a vegetative state after suffering a heart attack.

Simmons entered the Guilford County jail on September 4, 2012 to serve a 90-day sentence for a parole violation. In late November, he began to complain of severe stomach pain, prolonged constipation and bloody vomit.

Corizon nurses took blood work on November 22, and the results gave an “indication of intestinal bleeding and renal failure.” A doctor, however, did not review the results until December 4, 2012 – two days after Simmons suffered a heart attack.

On the same day that the blood was drawn, Simmons called his parents to inform them of his condition. A few days later he fell unconscious, bleeding on his clothing and the cell’s floor. He was not seen by a doctor or sent to a hospital. His medical records noted that he had vomited blood, had decreased urine output and no bowel movements for two weeks. The notes for November 30 reported that those symptoms continued and Simmons had complained of sharp abdominal pain and shortness of breath.

Then, on December 1, another prisoner called Simmons’ parents to tell them their son was too sick to come to the phone, had collapsed on the floor and urinated on himself overnight. He asked them to get help. When Simmons’ parents arrived at the jail, they were not allowed to see him. Additionally, a guard who claimed he was an EMT professed to have checked on Bryan and said he was fine.

Just a few hours later, however, Simmons was found with a bloody rag in his mouth and nurses and guards placed him on “suicide watch” because he expressed that he wanted to kill himself due to the extreme pain he was experiencing.

Surveillance video showed that Simmons continued to vomit, had a distended stomach, and told guards and nurses that he was “bleeding on the inside” and could feel his stomach churning. At one point, he began producing bloody foam from his mouth.

A Corizon nurse said the blood was “probably from gastric.” He then stated, “ulcer probably.” At about 1:00 p.m. on December 2, a guard moved Simmons in preparation for his release the next day. He collapsed several times and the guard pulled him to his feet by his handcuffs.

Just eight minutes later, while on his way to a cell in the medical unit, Simmons collapsed and went into cardiac arrest. He did not receive oxygen for 34 minutes, which caused a brain injury that left him in a permanent vegetative state. He is no longer able to move or speak.

Simmons’ wife and parents sued Corizon, Guilford County, the sheriff’s office and Sheriff B.J. Barnes. The suit was settled in May 2017 under confidential terms, with no admission of wrongdoing. The settlement was approved by the federal district court on May 26, 2017. Simmons was represented by the law firm of Devore Acton & Stafford, PA. See: Simmons v. Corizon Health, U.S.D.C. (M.D. NC), Case No. 1:14-cv-00730-TDS-LPA.

North Carolina’s Department of Health and Human Services has regulatory responsibility over county jails, but little authority. It requires jails to have a medical plan, for example, and can cite them for failure to do so – but it cannot force compliance with the regulation and cannot even make a determination of whether jail health care is negligent.

Dr. Marc Stern, the former medical director for Washington State’s prison system, said a lack of standards means there are no accepted metrics, such as a ratio of health care staff to prisoners.

“There’s not even any good national data or norms on how much you should be spending [on health care] per inmate each year,” he noted.

That’s why he believes a medical examiner’s report – which is public record in North Carolina – is the most important source the public has to determine whether the death of a jail detainee was caused by poor medical care.

“We simply don’t spend enough money on health care in jails until there are serious problems,” he said. “[Then] there’s a lawsuit and someone throws more money at it.”

And then, in many cases, the settlements in those lawsuits are sealed or confidential, shielding them from public scrutiny. 

Sources: News and Observer, Seattle Times, www.usnews.com, www.journalnow.com, www.courthousenews.com

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