[WestMALocals] Fwd: [AriseAction] Another death at the Ludlow jail

[Owen Broadhurst]

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From: Michaelann Bewsee <michaelannb at hotmail.com>
Date: May 22, 2006 5:38 PM
Subject: [AriseAction] Another death at the Ludlow jail
To: AriseBoard at yahoogroups.com, AriseAction at yahoogroups.com



Inmate's death puts detox in spotlight
Monday, May 22, 2006
By PATRICK JOHNSON and DAVID REID
Staff writers

LUDLOW - As many as six of every 10 inmates arriving at Hampden County House
of Correction, either to await trial or to begin a sentence, are addicted to
drugs or alcohol and need immediate detoxification, jail officials said.

In the past year alone, the jail has had to sort out about 3,800 of the
6,392 inmates entering the gates of the county facility in order to give
them immediate detoxification treatment, or detox, according to official
estimates.

Those inmates are given medications, mostly tranquilizers, to help them cope
with the physical symptoms, such as vomiting, nausea, lethargy and
confusion, resulting from going cold turkey in the hands of law enforcement,
officials said.

One of those detoxing inmates, said jail superintendent Jay Ashe, was
Cynthia Brace.

Brace, a 41-year-old Holyoke woman and longtime heroin user, died Aug. 20,
one day after she was sent to the Ludlow facility following her arrest on
drug charges.

"Was that a detox case? Yeah. Yeah. It's not that hard to guess with these
numbers," said Jay Ashe, the brother of Hampden County Sheriff Michael J.
Ashe, during a recent interview. "Unfortunately, she died during the
treatment."

Brace's lawyer, Shawn P. Allyn of Holyoke, said her death was more than
unfortunate, it was unnecessary.

"This death could have and should have been prevented," said Allyn, who also
represents Brace's husband, Cecil, who is awaiting trial in Hampden Superior
Court on drug and other charges.

Allyn said he has asked the state attorney general to investigate Brace's
death, and charged jail officials with failing to provide proper care while
she detoxed. He said that was, in effect, cruel and unusual punishment and a
violation of his client's constitutional rights.

Allyn, who represents Brace's estate, said he intends to file a wrongful
death suit against the county facility, the Hampden County Sheriff's
Department and the Massachusetts Department of Corrections.

"Requiring an inmate to go 'cold turkey' clearly demonstrates a deliberate
indifference to the serious health risk and potential of medical harm this
may have on a given inmate," Allyn said.

The state medical examiner ruled Brace's death was the result of natural
causes, and District Attorney William M. Bennett told The Republican there
is no indication of foul play.

So far, jail and county officials have not provided The Republican with the
autopsy reports or detailed records of her treatment, citing laws relating
to inmate privacy.

Prior to an April hearing on Beacon Hill about inmates with mental illness,
Sheriff Ashe said the jail could not have done anything differently in
Brace's case.

Jay Ashe said her death was investigated internally, by the Massachusetts
State Police and by the Hampden County district attorney, and Ashe expressed
confidence that jail staff followed all proper procedures.

"We're very comfortable with it," he said of the jail's response.

Brace was arrested by Holyoke police on Aug. 18 in connection with drug
charges and allegations of elderly abuse of a city man.

Two days later she was dead.

Brace was brought to the jail on a Friday afternoon after a Holyoke District
Court judge ordered her held without bail.

According to a timeline issued by the jail shortly after Brace's death, she
was seen twice by medical staff on the first day and put through the
standard orientation procedure.

According to a heavily redacted, eight-page account of Brace's stay at the
jail - released recently only after The Republican filed a public records
request with Sheriff Ashe - jail officials, nurses and other medical staff
had numerous, regular contacts with Brace.

The report, released by lawyers representing the sheriff, detailed regular
15-minute checks throughout the night and the following morning, although
all medical references were blacked out. Brace reportedly was alert and
conversant between periods of sleep, was given two showers and her
bedclothes were changed several times.

The last contact between Brace and medical staff was noted at 10:55 a.m. on
Aug. 19, shortly after she was given medication and placed on a stretcher in
a hallway near the nurse's station, according to the report. At about 11:20
a.m., a registered nurse noticed that Brace "was on her left side but that
her head was turned awkwardly."

Emergency life-saving steps were taken after the nurse found that "she
wasn't breathing" and that "she didn't have a pulse, no respiration."

Earlier, officials said Brace had been vomiting and was brought to the
jail's medical unit for treatment.

At 11:55 a.m., the report states, she was taken by ambulance to Baystate
Medical Center in Springfield, where she was pronounced dead at 11:59 a.m.

Lawyer Edward J. McDonough Jr., who represents the sheriff, stressed that
all references to Brace's specific medical condition were blacked out in the
report because Allyn refused to waive privacy protections for Brace.

McDonough denied the newspaper's request for the results of an internal
investigation into Brace's death, citing they are the purview of "medical
peer review proceedings" and specifically exempt from public disclosure.

He also refused to provide internal communications about Brace's condition,
saying public disclosure of such materials "would so prejudice the
possibility of effective law enforcement that such disclosure would not be
in the public interest."

The district attorney and the medical examiner's offices used similar
language in declining to provide similar requests for interoffice
correspondence regarding Brace's death.

The Republican is considering appealing those decisions, particularly
regarding the internal review of Brace's death, since the public is entitled
to know how a person in state or county custody is cared for.

Allyn, who received a copy of the autopsy report, said it shows that neither
Medical Examiner Dr. Joann Richmond nor consulting cardiac specialist, Dr.
David L. Gang of Baystate Pathology Associates in Springfield, could
definitively conclude why Brace died.

Each doctor offered cardiac arrhythmia, or an irregular heartbeat, as a
possible cause of death. Allyn said he doubts those determinations because,
although she was a longtime drug user, Brace had "no prior heart problems to
this degree."

The report also notes Brace had bruising on her wrists, Allyn said.

Brace is the 25th person to die in jail custody in the last 25 years, a
period spanning an estimated 55,000 inmates, according to jail statistics.

Eighteen of the deaths were of inmates being held in custody, and the rest
were people who died while in day-reporting or work release programs.

Eight of the deaths were attributed to AIDS-related illnesses. Four were
considered suicides, and the remainder were from a variety of medical
conditions, including brain hemhorrage, stroke, liver disease, lung cancer,
heart disease and sleep apnea.

Six other inmates, like Brace, died within the first two weeks of custody.
Three of them were suicides.

Jail officials, speaking generally about detox procedures and not the Brace
case specifically, said the volume of new inmates needing detox is just one
part of the bigger issue involving chronic health and mental health issues
at the jail.

"They're big. That's what we're dealing with," Jay Ashe said of the medical
concerns. "No one has any idea, (and) no one wants to know. The medical
issues are huge, aside from the detox."

Nationally, since the declaration of the War on Drugs in the mid-1980s,
county jails have seen between 60 and 70 percent of new inmates needing
detox, said Dr. Scott Chavez, vice president of the National Commission on
Correctional Health Care.

"Jails are at the front lines of (the war) on drug addition," he said.

Sheriffs throughout the state recently went to Beacon Hill to lobby for an
additional $9 million to assist with treatment of mentally ill inmates.

As social service agencies have seen budget cuts in the last few years,
county jails have been left to treat inmates arriving with mental, medical
and addiction issues, said James F. Walsh, executive director of the
Massachusetts Sheriff's Association.

The estimated number needing treatment at the Ludlow facility is comparable
with other county jails across the state, Walsh said.

There has been no official study but the sense is that the problem has only
gotten worse over the last decade, he said.

Officials with the Ludlow facility said roughly half of all inmates have
historically needed some kind of detox, but as the jail population has grown
in recent years, the number of detox cases has grown proportionately.

For the first time since the Ludlow facility opened 14 years ago, jail
officials have recently begun describing the facility with a word not used
since the days of the old York Street jail: overcrowded.

At the beginning of April, the jail had a record 1,642 inmates inside a
facility designed to hold 962, or 171 percent above the planned capacity,
according to jail officials.

The pretrial population of 814 inmates, following an increase of 17 percent
over the previous three months, is now just below the sentenced population
of 828.

Overcrowding complicates every aspect of running the facility, jail
officials say.

Jay Ashe agreed the jails are being forced to pick up the slack on detoxing
as community-based programs that specialize in addictions are losing
resources.

"We have become the detox center," he said. "There are very few resources
until you hit rock bottom."

As Sheriff Ashe notes, "Jails are a reservoir of illness, and no less so
than in terms of the illness of addictions."

With many inmates, the addiction masks an underlying health concern that
also needs to be addressed, officials said.

Terri Theroux, director of health care at the Ludlow jail, said that in
addition to seeing patients in varying stages of addiction, the medical
staff has to treat people suffering from illnesses such as asthma, chronic
illness, hypertension and hepatitis.

"Generally, there are very sick people, and (the illness) could be
exacerbated by the detoxification of one substance or another," she said.

Theroux said the detox treatments vary from inmate to inmate, depending on
the substance, how long the person has been addicted and the last amount
taken.

Men and women are kept separated from each other at the jail, but the detox
procedures are exactly the same, she said.

The jail has no infirmary with bed space for inmates needing treatment.
Instead its medical unit is run like a clinic, and inmates receive treatment
and return to their cell. Those needing more serious care are transferred to
local hospitals.

The Ludlow jail was given full accreditation last year by the National
Commission on Correctional Health Care, and was named its facility of the
year in 1998.

Chavez, who has toured the Ludlow facility, said its health care services
are highly regarded, and are seen as a model for more than a dozen jails
nationwide.

The jail's approach is to contract doctors from area health clinics and
assign inmates to doctors based on proximity to the community where the
inmate resides, he said.

This encourages inmates to continue going to the area health clinic after
release, he said.

Medical staff check in with detox inmates daily, but it is up to corrections
officers to keep an eye on them, Theroux said. A person who has been an
addict for a longer period has a rougher time coming clean than a new user,
she said.

Sometimes, Theroux said, inmates arrive in rough shape because they've been
held in a police lockup for a day or more without a fix and with no medical
assistance. "Detoxification may take several days for a person to rid him or
herself of the substance," said Theroux. The jail's procedures seek only to
"ease the detoxification process."

Jay Ashe said the initial detox treatments seek only to minimize the
physical symptoms of withdrawal. The psychological reasons for addiction are
addressed later in counseling, he said.

The jail does not treat inmates with methadone, a synthetic narcotic used to
treat heroin addicts, but its use has been under consideration for the past
year, he said.

Detoxing inmates are given medications used as various forms of "mild
tranquilizers," such as Librium, a short-term medication used for treating
anxiety associated with types of withdrawal, Jay Ashe said.

"We're trying to calm them down and deal with the detox issue," he said.

Patrick Johnson can be reached at pjohnson at repub.com

David Reid can be reached at dreid at repub.com

�2006 The Republican
the tiny ants of spring are out to play






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-- 
Owen R. Broadhurst
Candidate for State Representative
Third Hampden District
http://www.owenbroadhurst.org