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A few months after two inmates in the downtown King County Jail committed suicide in 2005--one by overdosing on hoarded jail medications, the other by hanging himself with a TV cord--County Executive Ron Sims pronounced jail medical care "efficient and well-managed."
The deaths weren't made public at the time; they were revealed months later by Seattle Weekly. But Sims did publicize what he called a "prestigious" performance review his jail had received from a national correctional health care group, giving KCJ high marks for inmate care. By December 2006, jail health officials had reclassified their services as "medically sound," even though inmate complaints, medical errors, and deaths were on the rise.
Flash forward to two weeks ago, when U.S. Department of Justice investigators handed in their own performance review, determining that the two 2005 suicides—and at least three other deaths since then—were preventable. In a blistering report, the feds said King County Jail conditions had become so unsafe and abusive in the past three years that inmates' civil rights were being violated.
Asked last week how the jail could achieve a "prestigious" rating in 2005 and be "sound" in 2006, yet now be accused of deadly medical breakdowns and other failures dating back through those years, Sims would not comment. James Apa, a spokesperson for Public Health–Seattle & King County, says the county is still trying to decipher the medical significance of the new DOJ study. It "doesn't assess our performance against specified standards," claims Apa, "so we're going to be working with them in the upcoming months to understand their analyses."
The federal findings confirm a series of reports by the Weekly that revealed unreported jail deaths, disease outbreaks, and medical mistakes. The DOJ report cites the Weekly as one of the sources of its findings. (See "Dead-End Jail," Sept. 21, 2005, and "Contagion in the Jail," Dec. 7, 2005, among others).
After studying the new federal findings in private for nine days, county officials released the DOJ report on Nov. 21. While they conceded that there were problems that needed fixing, county leaders suggested the troubles were old news, in what seemed an echo of denials from previous years. As Sims appointees Reed Holtgeerts, director of Adult and Juvenile Corrections, and David Fleming, head of Public Health, put it in a joint statement, the federal review was critical of "past practices" in the jail, and many of those issues have since been resolved.
Except the "past" was barely a few months ago: It was just August when a DOJ inspection team made its second trip to the jail this year and found more of the harmful conditions the team discovered on an initial visit in March. Inspectors were so concerned with ongoing violations that, in August, they quietly issued an urgent notification to Sims that people were still unnecessarily dying in his jail.
Along with "preventable" deaths, DOJ inspectors found that inmate abuse was "routine" and overall jail operations had "serious" deficiencies. If remedial measures aren't made by Dec. 31, the DOJ says in its 27-page review, the county can expect to be taken to court by the federal government and forced to comply.
The jail made mistakes even while federal inspectors were in the building looking for them. In March, an inmate on suicide watch somehow obtained and swallowed multiple medications while the DOJ experts were on the same floor.
"Disturbingly," recounts Rena Comisac, acting head of the DOJ Civil Rights Division, "despite the unfolding emergency, security staff did not call for medical help for a crucial eight minutes after the inmate had swallowed the medications." It took another seven minutes before a nurse arrived with a medical crash cart, Comisac says in the new DOJ report, and it was 25 minutes after the suicide attempt that fire department medics arrived. Though the woman survived, Comisac calls it a "life-threatening example" of the jail's failure to provide adequate emergency care, leaving inmates at "grave risk of harm."
In August, an inmate suffering from shortness of breath and a lump on his neck had been misdiagnosed the day before the DOJ team's return. A subsequent "physical exam by our consultants," Comisac reports, "revealed that the inmate required urgent evaluation at an acute care hospital to rule out the risk of sudden death from obstruction in his trachea." The inmate wasn't alone. The contingent reviewed the medical records of seven prisoners and found six were wrongly classified and required prompt medical attention.
Abuse also was a major concern, the DOJ report found. Dangerous and painful inmate-controlling measures such as pepper spray and hair holds, for example, were sometimes employed on defenseless mentally ill or developmentally disabled prisoners. In one case, which the feds termed "inexplicable," a mentally distressed prisoner was restrained by a hair hold (yanking the hair forcefully to dominate the inmate) even though she was locked into a wheelchair by leg and waist restraints.
Noting that three custodial officers were accused (and later convicted) of having sex with inmates and that internal investigations had reached an "abnormally high" number, the feds said self-investigation techniques must be improved to assure inmates are safe from an "alarming" misconduct trend.
