Joe Nelson
San Bernardino County Sun, Calif.
SAN BERNARDINO COUNTY, Calif. — In the last three years, 30 people have died in San Bernardino County jails with 18 of those deaths, or 60 percent, being medical-related, according to Sheriff’s Department figures.
Last year, eight of 10 in-custody deaths, or 80 percent, were found to be medical-related while so far this year, four of eight in-custody deaths, or 50 percent, were determined to be medical-related, according to the Sheriff’s Department.
Attorneys representing the family of an Adelanto woman who died in custody in July, apparently from a drug-related medical emergency, say the problem has become so bad jail nurses are speaking out and fear losing their licenses, and at least one former nurse is pursuing legal action.
“We think somebody needs to be looking into these deaths and find out exactly what’s happening and put measures in place so they can be prevented,” said Victorville attorney Sharon Brunner, who along with attorney Jim Terrell are representing the family of Betty Lozano, who died shortly after 11 p.m. July 26 after she stopped breathing at the High Desert Detention Center in Adelanto and was hospitalized.
ALLEGATIONS DISPUTED
The Sheriff’s Department has long stood by the quality and quantity of medical care its inmates receive and denies any allegations of medical neglect or mistreatment of its prisoners.
“We refute claims that our inmates are not getting the care they need. Inmates today have access to kiosks within their housing units and can request medical attention at any time,” Lt. Sarkis Ohannessian said in an email. “Visiting a (doctor) in the jail today is faster than the attention you and I get from our personal healthcare providers. And, any patients requiring hospitalization are taken by ambulance to the hospital.”
He said significant improvements have been made in recent years to address concerns of ailing inmates and the growing jail population in the age of prison realignment.
“We continue to update our facilities and improving the level of care our medical staff provide in terms of preventative care,” Ohannessian said. “There are procedures in place to screen the 83,000 inmates who are booked each year into our facilities.”
He noted that in 2008, the San Bernardino County Board of Supervisors approved a $10.8 million contract with the state to expand a treatment program for mentally ill inmates at the West Valley Detention Center in Rancho Cucamonga that is tailored to restore mental competency to inmates so they can stand trial for the crimes in which they are accused.
“The state would not have entered into a contract with our agency if we were lacking in our ability to care for our inmate population,” Ohannessian said. “Our success rate in getting criminal defendants back in court to stand trial has been remarkable, to say the least.”
RECENT DEATHS
Lozano, 34, was arrested about 4:27 p.m. July 26 on suspicion of being under the influence of drugs. She began to suffer a medical emergency while in the back of a patrol car or upon arrival at the jail and was in a semi-conscious state, sheriff’s officials said.
According to claims filed with the county on Sept. 26 by members of Lozano’s family, Lozano was admitted to the jail in a wheelchair, nude from the waist down and in a semi-conscious state. Her feet were dragging along the ground as she was wheeled into the intake area of the jail, as the wheelchair had no footplates. She was “dumped” from the wheelchair onto the floor of a “sobering cell” and left there for hours without appropriate medical attention.
Lozano stopped breathing at 8:50 p.m. and was taken to Victor Valley Global Medical Center in Victorville, where she died at 11:11 p.m. the same night, Ohannessian said.
Brunner and Terrell said they plan on filing a federal lawsuit this week with more than a dozen causes of action including wrongful death, denial of medical care and civil rights violations.
Lozano’s death was followed by three more deaths at other county jails in September, with two of them occurring on the same day.
On Sept. 24, a deputy found 44-year-old inmate Albert Snell hanging by a sheet from the top bunk of his cell at 3:09 a.m. at the West Valley Detention Center in Rancho Cucamonga. The deputy cut the sheet and began CPR. Medical personnel summoned to the cell took over when they arrived, but it was too late. Snell was taken to the hospital, where he died at 4:02 a.m., according to the Sheriff’s Department.
Several hours later, at about 8:43 a.m., inmate Jacob Hoyo, 29, suffered a seizure at the jail. He was taken to the hospital, where he died at 10:12 a.m.
Prior to being into the jail, Hoyo had been involved in a traffic collision and was arrested for a DUI. He was treated at a hospital and medically cleared by doctors for booking at the jail, sheriff’s officials said.
About 9 p.m. on Sept. 29, a deputy at the sheriff’s Morongo Basin jail in Joshua Tree found inmate Henry Simmons, 60, of Joshua Tree, dead in his cell. Earlier in the day, at 12:51 p.m., he was arrested at the Hi-Desert Medical Center, in Joshua Tree, and booked into the jail on suspicion of being under the influence of a controlled substance, according to a Sheriff’s Department press release.
The Riverside County Coroner’s Office conducted the autopsy on Simmons, the results of which are pending.
Ohannessian said an in-custody death is “always tragic” and not something the Sheriff’s Department takes lightly.
“Our specialized detectives conduct a full investigation in every case and the results of those investigations are examined at the highest level in our department to ensure safety concerns of the inmates and staff are adequately addressed,” Ohannessian said in an email. “Within the last couple years, hundreds of camera systems have been installed in the jails as an added tool to monitor inmates. Deaths of incarcerated individuals will always be a concern for any agency, who all have their share of these types of cases. Whether they are medical in nature, suicides or other, we try our best to intercede and get them help.”
PRACTICE & POLICY
Despite the Sheriff’s Department’s firm stance that inmates at its jails receive appropriate and expeditious medical care as needed, it counters hundreds of inmate complaints that have poured into attorney offices in recent years alleging the exact opposite, including Brunner’s and Terrell’s offices and the Berkely-based Prison Law Office, a prisoner advocacy nonprofit.
In February 2016, the Prison Law Office filed a class action lawsuit against the county alleging drastically deficient medical and mental health inmate care as well as other civil rights violations at San Bernardino County jails.
“Jail medical, mental health and dental care is so deficient that it is harming the people it aims to serve,” according to the lawsuit, filed in U.S. District Court in Riverside
Terrell, one of the Victorville attorneys representing the family of Lozano, said, “We receive countless letters (from inmates) each month, and they’re all about medical abuse. Eighty or 90 percent are about just total neglect.”
Data from the U.S. Department of Justice’s Bureau of Justice Statistics underscore the importance of adequate medical and treatment for prisoners.
In 2011–2012, an estimated 40 percent of state and federal prisoners and jail inmates reported having a current chronic medical condition while about half reported ever having a chronic medical condition. Additionally, 21 percent of prisoners and 14 percent of jail inmates reported ever having tuberculosis, hepatitis B or C, or other STDs (excluding HIV or AIDS). Female prisoners and jail inmates were more likely than males to report ever having a chronic condition according to BJS numbers.
Prison Law Office Executive Director Donald Specter said protocol calls for inmates to be interviewed by a nurse during intake, and if the inmate appears to suffer from an urgent medical condition, they’re supposed to be referred to a doctor. A special protocol is also supposed to be in place for treating inmates going through drug withdrawal, he said.
“If it’s an emergency, then they’re not supposed to be admitted to the jail, but taken to a hospital,” Specter said. “If it’s something that can be taken care of within the jail, they’re supposed to be referred to a clinician who has the authority and training to treat them.”
Specter said he visited the High Desert Detention Center in Adelanto about a month after Lozano’s death and noticed a problem with how inmates were being medically screened during intake.
“The nurses were not doing the (medical) evaluations,” said Specter, adding that the medical evaluations were being done by sheriff’s deputies and that the evaluations were not being done in private.
“That’s what I learned while I was there – the deputies are doing the medical and mental health intake and are completing the forms,” Specter said.
Specter said the Prison Law Office is in settlement negotiations with the county regarding its class-action lawsuit, and one of the things the Sheriff’s Department has agreed to do is implement sweeping reforms including a revamping of its inmate intake procedures. That includes, among other things, videoconferencing capabilities that allow clinical staff at other facilities to participate in intake procedures, implementation of a tuberculosis screening protocol that conforms to Centers for Disease Control guidelines and adopting withdrawal assessment and treatment protocols.
MOVING FORWARD
Ohannessian said the Sheriff’s Department has been working cooperatively with the Prison Law Office for more than a year to address its claims, and that all county jails are inspected by the California Board of State and Community Corrections (BSCC) to ensure they meet the requirements set by the state.
Still, the impact prison realignment has had on county jails cannot be ignored, sheriff’s officials maintain.
Prison realignment, or AB109 (the Assembly Bill for which the law is based), took effect in California in October 2011, shifting many prisoners serving longer sentences into county jails instead of state prison and resulting in sharp increases in both inmate-on-inmate violence and violent confrontations between inmates and deputies.
Additionally, arrestees suffering from drug abuse and chronic medical conditions such as cancer, HIV, dialysis, and mental health issues require substantially more resources for ongoing treatment, Ohannessian said.
The demand for increased medical and mental health care and resources for inmates has grown by leaps and bounds in the last several years.
In 2012, physician clinics at county jails averaged 2,100 patients per month. Today, the clinics average 5,200 patients per month, Ohannessian said.
In 2012, jail nursing clinics averaged 4,500 patients per month, and today they average 7,200 patients a month. Offsite specialty clinic referrals averaged 120 patients per month in 2010 and had increased steadily, with the average now at 220 patients per month, Ohannessian said.
Referrals for mental health care at county jails averaged 900 patients per month in 2012. That average is now 1,400 patients per month. Out of the approximately 6,000 inmates now in custody, 1,100 have been identified with a history of mental health issues and are receiving medications and/or therapy, Ohannessian said.
As the Sheriff’s Department continues grappling with the issues surrounding inmate monitoring, medical and mental health care, its harshest critics continue to ask: Why are inmates still dying at such alarming rates?
“It’s a problem that has to be addressed because more people are going to die,” said Woodland Hills attorney Dale K. Galipo, who is partnering with Brunner and Terrell on the Lozano case.
Citing the recent deaths at the jails, Galipo said the county has a long way to go before the ideal is met.
“I think that, clearly, there’s a lot of work to be done to get to the bottom of it, to compensate the victims and to find out what the current policies are and how it needs to change to ensure this doesn’t happen in the future,” he said.
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©2017 the San Bernardino County Sun (San Bernardino, Calif.)