This article emphasizes what Sharif and others have told us about the lack of medical care and the experiences with unconcerned jailers such as Abell and Lewis.

Complaints of poor care at jail continue
Inmates describe negligence even after scathing report

By JAMES M. O'NEILL / The Dallas Morning News
E-mail joneill@dallasnews.com
12:02 PM CDT on Monday, July 11, 2005
http://www.dallasnews.com/sharedcontent/dws/news/city/dallas/stories/070905dnmetjailhealth.892741a4.html
dallasnews.com
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Inmates who enter the Dallas County Jail with physical or medical problems risk losing more than their freedom, say inmates, family members and health-care advocates.

One inmate said he lost sight in one eye because of poor care in jail. And a recent lawsuit filed by the family of an inmate who died in custody contends he was denied medications for serious health ailments including congestive heart failure.

Bruce McDonald got into a fight in the county jail, and his left eye was hurt. He says delays caused the need for surgery. 

Five months after county commissioners received a scathing report on medical care at the jail, inmates with serious physical illnesses still wait weeks to see a doctor or receive proper care, according to accounts by inmates and their families, staff members and health-care advocates.

And many mentally ill inmates continue to languish for a week or more without receiving the medications that keep them stable, they say.

"People should be up in arms about this, but until it hits them personally, the public just doesn't seem to care," said Vivian Lawrence of the Mental Health Association of Dallas.

After receiving a highly critical report about jail medical care in February, which noted a serious shortage of staff and other problems, Dallas County commissioners created a committee to fix things. The committee met once, in April, but has not met since, as it waits for medical experts to propose specific improvements.

Advocates, however, are growing weary of the wait and say little has changed since the report was completed.

Lawrence Priddy of Advocacy Inc., which monitors mentally ill inmates, said the group learns about new cases every week. Medications are often started once the group looks into a case, but he said at least 10 cases remain open.

"The complaints are all about inmates not getting to see doctors and delays of over a week before mentally ill inmates get their medications," Mr. Priddy said. "They still haven't fixed that problem.

"I'm quite disappointed the commissioners' committee has not met again," he said. "Meanwhile, what happens to the folks with these problems?"

Commissioners Court administrator Allen Clemson said smaller groups have met to discuss the issue every week.

The county's jail system, which houses about 7,000 inmates, is the seventh-largest in the nation.

Federal lawsuits against the county over the issue continue to be filed. Among them:

•James Leroy Johnson, 60, was booked on Oct. 24 on theft and parole violation charges. He suffered from congestive heart failure, diabetes and other ailments. He and his sister, Barbara Stephens, told jail officials about his medical needs at book-in, according to a lawsuit filed in May.

The suit says Mr. Johnson phoned Ms. Stephens repeatedly to say he was not getting his medication, that he was scared and that his body was beginning to swell. Ms. Stephens contacted the jail, and Mr. Johnson submitted requests for treatment. The suit says that after 15 days, he was sent to Parkland Memorial Hospital, where he died on Nov. 13.

•Kendrick Deshun Baines, 19, was booked on July 11, 2003. A lawsuit filed last month says that other inmates alerted jail guards on July 23 that Mr. Baines was trying to kill himself.

He was identified as a suicide risk and was supposed to be placed on suicide watch. But the suit says "jail personnel never actually placed Baines on suicide watch." The suit says "he was not promptly seen by a doctor or any other mental health professional." The next day, Mr. Baines was found dead in his cell, a suicide.

Steve Simons says he spent a night in agony in the Dallas County Jail with a fractured ankle. He says he was forced to walk on the injured ankle.

•Bryan Posey was arrested Dec. 9, 2002, after his mother complained of verbal abuse. In an affidavit, a Dallas police officer who arrested Mr. Posey noted his "irrational emotional state."

Lawyer Tom Carse, who filed suit on behalf of Mr. Posey's family, obtained a video of Mr. Posey's book-in. During book-in, jail staff are supposed to screen inmates for mental illness or suicide risk by asking a detailed set of questions. In the video and transcript, it appears that the staff never asked Mr. Posey the questions. He was put in a holding cell and soon after was found dead, with the cord of the cell's pay phone around his neck.

No medical training

The February jail study noted the danger of having jail guards with no medical training screen inmates, since they can easily miss symptoms of illness. The University of Texas Medical Branch, which oversees the jail's medical care, proposes having medical staff handle screening.

Peter Harlan of the district attorney's office, who is representing the county in the Johnson, Baines and Posey cases, would not comment on the suits.

Since the February report, inmates and their families continue to describe serious problems with the jail's medical care:

•Bruce McDonald, in an interview, said another inmate hit him in the left eye on April 28, and a few days later his vision started to blur. Despite diagnosis of a torn retina, medical staff comments about the urgent need for surgery, several trips to Parkland and his own requests for medical help, Mr. McDonald did not receive corrective surgery until June 14 – over a month and a half later. He said doctors told him he could be blind in the eye forever. A U.S. Institutes of Health Web site notes that "if not promptly treated, retinal detachment can cause permanent vision loss."

'A hiccup'

Mr. Clemson said Mr. McDonald had frequent contact with the medical staff.

"There was a hiccup in that a pre-operative appointment was not kept, and we don't know why," Mr. Clemson said. "But he was getting care. It's not like he was being ignored.

"I'm not saying we're perfect," Mr. Clemson added. "It needs some work. We're fixing it, but the jail medical care is much better than this might indicate it is."

Roy Taylor Jr. says he didn't get proper care for an infected thumb and was later told he needed 80 percent of it removed.

•Inmate Roy Taylor Jr. said in an interview that before his June 7 book-in, he had cleaned up a shattered light bulb and got a shard of glass stuck in his thumb, causing a severe infection. After book-in, medical staff examined him and noted that his finger was still infected. He requested help for the thumb. He said that a week later a doctor told him he needed to go to Parkland to have the tip of the thumb amputated. He went to the nurse each day to clean the finger but was never sent for surgery.

Finally, on June 24, he asked to see the doctor again. Surprised that the thumb hadn't been addressed, the doctor sent Mr. Taylor to Parkland, where the finger was lanced. Mr. Taylor said he was told he now needed 80 percent of the thumb removed. But on July 1, when The Dallas Morning News interviewed Mr. Taylor in jail, he had not had the surgery. He removed his bandage to show the deteriorated tip of the finger, with the exposed bone. "The bone is turning black. The pain is excruciating," he said. "The care here is almost nonexistent."

Mr. Clemson said Friday that Mr. Taylor arrived at the jail with the bone already exposed, that it had already been lanced at Baylor Hospital, that it was lanced again at Parkland on jail staff orders and that he is being given antibiotics in the jail that seem to be helping.

Families upset

Families of some mentally ill inmates have also described problems. Evelyn Allen said her son, Ronald Combs, an inmate with mental illness, waited for weeks in March to get medication. In the meantime, she said, Mr. Combs received a burn on his chest when another inmate poured hot water on him. He was supposed to get the dressing changed three times a day, she said, but it wasn't even changed every other day.

Robert Perry, 42, an inmate with bipolar disorder, said he did not receive any medications for weeks during a month-long jail stay in April. Finally, he got his meds for a few days before release. But he was released without a treatment plan or medication and later was arrested on a theft charge during a bipolar episode. He found himself back in jail on May 3.

He said in an interview in mid-June that he had not received medication since his arrival, despite asking jail staff repeatedly. Later, in a letter, he said that soon after The News interview he started receiving some medication, though he hadn't seen a doctor and one of the meds was thorazine, which he had never taken before.

"It's so repetitive," Mr. Perry said wearily of his revolving-door experience at the jail. "I don't want to excuse what I've done. But it's difficult when you can't get the help you need. I'm sick and tired of this."

Mr. Clemson said on Friday that officials still were investigating the Allen and Perry cases and had no immediate response to their charges.

"I don't like that this is still happening," said Commissioner Kenneth Mayfield, who chairs the county's jail health committee. "I know we will have to increase staff to some extent, but that's not the only issue." He declined to comment on the pending suits.

Sgt. Don Peritz, the sheriff's department spokesman, said Sheriff Lupe Valdez and the department "are extremely concerned about the health and mental health care that inmates receive" and are working with the commissioners and UTMB to "improve and upgrade care."

Hard to fill

Last December, UTMB said it needed at least 50 more staff and more recently increased the estimate to more than 60. The county must pay for and approve any increase. The current staff is 147.

Even existing positions are hard to fill. The mental health unit has three vacant nurse slots. UTMB confirmed that last week no nurse was available for the jail's West Tower, which houses about 1,400, during one night shift. Nurses are able to act immediately on a doctor's verbal order to give medication, so a lack of nurses slows response time.

John Allen, UTMB's executive director for operations, said medication is sometimes sent to an inmate's location, but by then the inmate has been moved to another part of the jail. The inmate then needs to be located, delaying distribution of the medication.

When mentally ill inmates are denied medication, lawyers often seek competency hearings to determine whether they are able to stand trial. Until recently, Dallas County jail inmates found to be incompetent were routinely sent to Terrell State Hospital for treatment.

But often, after Terrell staff restored mentally ill inmates and sent them back to the Dallas County jail, the inmates returned to Terrell in bad shape, saying they hadn't received medication in jail, said Dr. Mitchell Dunne, a Terrell staff psychiatrist.

That required the Terrell staff to go through the process of restoring the inmate all over again, he said.

"We'd send them back to the jail with two weeks of medicine so they could start on it right away, but we were told the jail would put the medications with the inmates' private possessions that were stored away for them until release," Dr. Dunne said. "It happened frequently enough that sheriff's people told one of our nurses, 'Why are you bothering to give them these meds – they're not going to get them in the jail.' It was pretty concerning."

E-mail joneill@dallasnews.com