Texas jails under fire for inadequate medical care

Texas jails under fire for inadequate medical care

April 15
09:24 2014

Caitlyn Jones // Staff Writer

Teresa Castillo didn’t know what to do. Her brother, David Rea, had been arrested, but he wasn’t at the Denton County jail. Instead, he was being transported to a local hospital after suffering a heart attack.

Castillo wasn’t allowed to know where her brother was being transported for security reasons, the guards informed her.

“They told me, ‘We’ll call the family if he dies,’” she said. “I just couldn’t believe it.”

In the wake of the health care debate, most of the discussion has been focused on individual insurance, but Texas jails are under scrutiny from inmates and their families for a lack of adequate medical care and unsanitary conditions.

According to the 2013 Annual Report from the Texas Commission on Jail Standards (TCJS), the agency received 1,428 inmate complaints last year, with 242 complaints concerning medical services. Out of the 1,428 complaints, 454 required a written response by county officials and 56 percent of those responses were for medical service complaints.

Emergency Care Woes

Rea was arrested on March 1 at his home in The Colony and was charged with deadly intent. He was taken to The Colony Police Department and transferred to the Denton County jail six or seven hours later, he said.

Rea, 55, was previously diagnosed with sleep apnea and is also diabetic. He had a heart attack two weeks before his arrest. He wasn’t given any medication upon his arrival at the Denton County jail and suffered another heart attack on his first day there.

After three days in an undisclosed hospital, Rea’s condition was stable but he still experienced chest pains. He returned to the emergency room but doctors turned him away, he said.

“They said, ‘That’s all we can do for you,’ and sent me back to the jail,” Rea said. “You just don’t know what’s going to happen.”

The TCJS sets forth an administrative code for all jails in Texas to follow. Under Title 37, Part 9, Chapter 273 of the Texas Administrative Code, each jail implements a written health plan that must be approved by the TCJS, including procedures for efficient care during emergency situations.

The plan that Denton County implements includes employing trained personnel in emergency first response and advanced emergency response including advanced cardiac life support, said Sandi Brackeen, public relations officer for the Denton County Sheriff’s Department.

When there is a medical emergency, the department activates community emergency medical services, she continued.

All jails are inspected yearly by TCJS. Four inspectors are tasked with inspecting all 244 jails in Texas and filing reports on whether the facilities meet the minimum requirements.

Denton County has not been inspected for 2014 but was last inspected in March 2013. The jail passed inspection but needed technical assistance with administrative issues.

“If it’s not life safety, the inspector can provide information to correct the problem on site,” said Brandon Wood, executive director of TCJS. “Technical assistance can range from logging exercise hours to a leaking toilet.”

Sanitation Concerns

When Rea was brought back to Denton County, he was put in a medical unit. While there, he said he saw black scum on the toilet seats, mold in the showers as well as on the ceiling, and urine on the floors.

“I’ve been in horse stalls that were cleaner than that,” Rea said.

He also said that trustees, unpaid inmates who work in the jail, clean the facility with dirty towels and limited supplies.

According to the Texas Administrative Code, while inmates are allowed to clean the jail, it is ultimately the corrections officers who have the responsibility for keeping the facility clean and making regular sanitation inspections.

The sheriff’s department declined to comment on the situation.

“This is the first we’ve heard about this and no complaint has been filed,” Brackeen said. “There is a grievance form online that this person should fill out if he feels he has a problem, so it can be investigated.”

Brackeen also added that 19 agencies, including the American Heart Association, Center for Disease Control and Prevention, American Medical Association and Texas State Health Services have some sort of regulatory authority or influence over standards of care and operational standards for jail medical.

Medication Mishaps

During his 11 days under the supervision of Denton County, Rea said he was unable to receive his pain medication and anti-anxiety medications that he took before being arrested. Instead, he was given blood pressure medication, aspirin and nitroglycerin.

His sister Teresa, a registered nurse, said that jailers wouldn’t accept Rea’s medical records or medical history.

“I saw him during visitation the Tuesday after he had the heart attack and he looked like death warmed up,” she said. “He was sweating and had visibly lost weight. He was in terrible shape.”

The Administrative Code states that jails should provide procedures for the distribution of prescriptions in accordance with written instructions from a physician by an appropriate person designated by the sheriff/operator.

However, the physician refers to a physician within the jail and all directions from the jail physician must be followed, according to the Administrative Code.

“Guards pass along information and don’t tell you anything,” Rea said. “They medicate you until you don’t care.”

Other Health Incidents

Denton County isn’t the only jail receiving complaints regarding medication. David Conis Jr., a Type 1 diabetic placed in the Henderson County jail, said in a January article in The Texas Tribune that he was denied his own insulin medication because it wasn’t marked with a prescription label. He was forced to take another type which caused his blood sugar levels to fluctuate.

Henderson County state district Judge Carter Tarrance sent Conis to a clinic and ordered jail officials to follow instructions from the doctor at the clinic. However, jail officials refused and hired a lawyer, Robert Davis, to prepare for pending legal action.

“[Tarrance] has absolutely no business trying to be a doctor from the bench,” Davis said in the article.

Inadquate medical care has the potential for fatal consequences. The Denton County Sheriff’s Department has reported eight deaths of individuals who were in the care of the jail since 2005, according to custodial death reports from the attorney general.

Although it is unclear whether or not deaths in county jails are related to medical care, the death toll at Denton County is much less than those of neighboring counties, like Tarrant County with 32 deaths and Dallas County with 82. The Harris County Sheriff’s Office tops the list with 140 deaths.

However, the population of Denton County is much lower than the other county jails mentioned. Currently, Denton County holds 1,037 inmates while Tarrant County holds 3,185, Dallas County holds 6,101, and Harris County holds 8,511.

Solving the Problem

Administration within Denton County is taking steps to better health care in the jail.

The 2013-2014 county budget allocated $717,103 to jail health, pushing the total jail health budget to $4,418,180.

Still, progress across the state is slow.

Diane Wilson, Krishnaveni Gundu and Diane Claitor began an organization called the Texas Jail Project in 2006 and is helping inmates of county jails and their families by answering questions, assisting in filing complaints or litigation, and dealing with jails directly. The group also speaks to legislators in an effort to reform jail standards.

Claitor said the majority of the complaints the organization receives are about medical conditions and that Denton County ranks in the top ten of “most complained about” jails.

“There’s a lack of medical care and Denton County won’t talk to family members,” she said. “The biggest complaint is requesting medications from the outside.”

Claitor also pointed out that more than half of the inmates in county jails have not been convicted of any crime and should still be treated with respect.

Even though David Rea was released on March 11 after posting $5,000, he still feels he was treated unfairly.

“We were treated like cattle and I was rubber-stamped ‘guilty,’” he said. “To treat everyone equally is difficult.”

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