Who'll Stop the Pain?

In the entrance bay to the Orange County Jail's Intake and Release Center (IRC) in Santa Ana, there is a pair of signs, the first things anyone who has just arrived behind bars will see. One sign, the more prominent one, warns prisoners they “must obey all directions of staff” and not “create a disturbance in the jail,” or else they risk “loss of privileges,” including use of recreational areas and access to telephones, as well as facing “disciplinary isolation.” Another sign on the side of the wall near a clerical desk, which apparently is meant to be facetious, is more blunt: “No Whining.”

It was about 9 in the morning on March 17, 2010, and a group of lawyers, inmate-rights activists and two newspaper reporters—the Weekly's R. Scott Moxley and myself—was assembled in the entrance area of the jail. For the Orange County Sheriff's Department (OCSD), which runs the county's detention facilities, the purpose of the gathering was to demonstrate how much conditions have improved since the most brutal murder behind bars in county history happened under its watch.

On Oct. 5, 2006, a Mission Viejo software engineer named John Chamberlain died at the hands of dozens of his fellow prisoners who suspected him of being a child molester. His slaying led to murder charges against nine inmates, as well as the firing of several deputies who had either been involved in the incident or who obstructed the homicide investigation and grand-jury probe that followed. Amid accusations of a cover-up by sheriff's officials, the grand jury released a thousands-pages-long report on April 7, 2008, that detailed how guards routinely used the various race-based jail gangs to enforce order, with vicious beatings being a daily occurrence.

By the day of the sheriff's department's “truth” tour, they wanted to dismiss that ugly episode as distant history. Mike Carona, who was sheriff at the time of Chamberlain's murder, was long gone, having resigned in a cloud of corruption that eventually led to his federal felony conviction for witness tampering. His replacement, Sandra Hutchens, immediately launched a top-to-bottom reform of the department, further purging the deputies and supervisors who let the horrific jailhouse beating take place. The tour was a grand opportunity for the agency to demonstrate its newfound transparency.

It began with a stroll through the IRC's so-called “loop,” where the department screens inmates for any illness or psychological conditions. The entrance had been cleared of inmates, with the exception of four bleary-eyed hipsters who offered embarrassed smiles while lounging behind a glass window in their holding cell. As the tour group moved farther down the loop, other holding cells contained more inmates who had been arrested within the past 12 hours, including an elderly bearded man who repeatedly banged his forehead on the glass. A larger cell housed roughly a dozen bald Latinos in wife-beater T-shirts and baggy cutoff shorts, all of whom sprang from their seats into menacing postures complete with narrowed, glaring eyes as the group passed by them.

A few minutes later, we observed a station where U.S. Immigration and Customs Enforcement (ICE) agents screen inmates suspected of being illegal immigrants. We saw the jail's medical ward (complete with a rubber room that housed a restraining bed), the rooftop recreational area where well-behaving prisoners can play handball for 90 minutes twice a week, and the protective-custody ward.

Eventually, the tour group passed through a long, hall-like observation deck with tinted glass that prevented inmates from seeing anything but their shadows. Most prisoners, including one who lay on his bunk reading a copy of The Rise and Fall of Nazi Germany, failed to notice us. However, one white inmate with a shaved head and bloodshot eyes smiled perversely at the shadows he perceived beyond the darkened glass and began to disrobe.

We moved on. Indeed, after being inside for this relatively short time, everyone seemed desperate to get back to the free world as quickly as possible.

While we wound through the jail, the same feeling of desperation must have plagued the mind of 42-year-old methamphetamine addict Michelle Gee. She'd been arrested the day before after admitting in court during a drug-diversion hearing that she had relapsed and was back on drugs. “She broke down and told them she needed help and couldn't do it by herself,” her mother, Karen Shue, says. “They said they'd get her help. They made arrangements to put her in the medical ward [of the jail] and treat her.”

Although Gee was placed in Module K, where inmates are supposedly under medical supervision, she, like all meth addicts who are arrested in Orange County, received no drugs to help her handle withdrawal symptoms. In addition, one of her feet was infected with a painful staph infection. Gee telephoned a family friend on the morning of March 17, after a tough night in jail, to say she still hadn't been given any medication.

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Around 4:15 that afternoon, about four hours after the jail tour ended, a registered nurse discovered Gee hanging from the top bunk of her two-person cell—she had no cellmate—and yelled for deputies to help cut her down. The sheet was too thick for guards to cut with their safety knives, according to an incident report on her death, so they untied the knot, laid her down on the floor and attempted to resuscitate her. Twelve minutes later, emergency workers with the Santa Ana Fire Department took over and, failing to revive her, pronounced her dead.

The medical staff responsible for treating inmates behind bars in Orange County jails fear more deaths, mysterious and otherwise, are inevitable. For years, they have complained about poor morale and staffing shortages that have contributed to an unsafe atmosphere in the medical wards where inmates are being found dead on a semi-regular basis. Now, county supervisors are stuffing ICE detainees into the jails and expecting medical staff to oversee their health while not increasing resources. Worse still, pending legislation in Sacramento could soon send anyone sentenced to prison for three years or less straight to county jails.

Eight more jailhouse deaths have occurred since Gee's. Pending the district attorney's office's investigation, it's unclear if they committed suicide, were murdered, or died of natural causes. However, OCSD press releases and press reports indicate that some cases are suicides and others involve people, often being housed in the medical ward, who suddenly—sometimes inexplicably—die.

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Despite its purported policy of transparency, the OCSD didn't publicly announce Gee's death. But after the Weekly published a March 26 article on our Navel Gazing blog about Gee, noting it had happened within hours of the tour and quoting family and friends who bemoaned the fact she'd been left alone in a cell instead of being treated for her disease, sheriff's officials instituted a new policy of issuing press releases whenever an inmate dies in custody.

It wasn't until Oct. 7, 2010, that the DA's office wrapped up its investigation of Gee's death, ruling “it was not the result of a criminal conduct.” The DA's report provides few details beyond the discovery of her body and the attempts to revive her. However, it does quote an inmate whose name was blacked out in the report. The inmate, who says she was the last person to talk to Gee, claimed Gee was “emotionally bothered” and said “she can't do this” and “needed someone else in her cell because she did not want to be alone.”

Sheriff's officials acknowledge there has been a recent increase in the frequency of jail suicides, but insist that given the fact the agency houses roughly 5,000 prisoners at any given time, its track record on inmate safety makes Orange County's jail system among the nation's safest. Yet since Gee died, in a time span of a little less than a year, eight more inmates have perished inside the county's jail system.

Eleven days before Gee hanged herself, a deputy and a licensed vocational nurse were handing out medication at the Theo Lacy Jail when an inmate told them another inmate was dead. Ruben Maya Gallegos, 36, had just suffered a seizure but was still breathing, according to the incident report obtained by the Weekly. One deputy who arrived on the scene “tried to contact medical via telephone and was unable to reach any medical staff,” so another guard “used his handheld radio to inform medical we had a man down.”

However, paramedics didn't arrive until 15 minutes after the guard radioed his request. They performed CPR without success until he could be transported to UC Irvine Medical Center, where Gallegos was declared dead. A deputy wrote in his follow-up report that he asked the inmate's cellmate if Gallegos had any history of seizures.

“No, but he did go off compound earlier in the week because he told me he got beat up by the cops and he didn't feel right health-wise,” the cellmate said. “He told me he was walking down the street, and some cops jumped him and beat him up for no reason.” Gallegos' booking photo shows a nasty cut and bruises on his face, apparently sustained during his arrest. His autopsy report states he perished of “hypertensive cardiovascular disease.”

After Gee, the next inmate to perish in Orange County was Richard Wilson, who died of unknown causes on June 28. A month later, on July 22, Gregorio Torres passed away, and a week later, so did William Wedgeworth. Those cases are still under investigation, and neither OCSD nor the DA's office would comment on how they died.

The same goes for Taylor Lang Hart, 19, who'd been arrested for allegedly robbing a Nordstrom store in Mission Viejo and was found dead at the IRC on Aug. 13. “Hart was alone when deputies found him,” the Weekly's Matt Coker reported later that day on Navel Gazing. “An autopsy performed today determined Hart died of suicide, but the exact method he used is unclear.”

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Next to die was Stephen Clevenger, whose life ended for unknown reasons on Aug. 29. Keith Files, 28, was found dead in the IRC's medical ward on Nov. 30. “He was held in a single-person cell, and there was no obvious sign of foul play or the cause of his death,” states the OCSD press release. Finally, on Dec. 31, a day after she was arrested for heroin possession, Cynthia Kaye Drury, 46, was found dead in her single-person cell at the IRC; Drury's death is still under investigation and her exact manner of death remains a mystery.

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Assistant Chief Jay LeFlore of the OCSD is the highest-ranking person responsible for supervising the county jail system. An earnest man of medium height with dark hair and the requisite peace-officer mustache, LeFlore leans over his large desk in his well-appointed office on the second floor of the sheriff's administrative headquarters in Santa Ana and insists that one of his main priorities is preventing the unnatural death of any inmate—including suicides. “Believe me, one suicide is too many,” he says. “But our numbers, when you compare them to other mega-jails, our numbers are good.”

While LeFlore acknowledges a recent rise in suicides inside his jails, he argues that this mirrors a similar rise of suicides in the county as a whole, a phenomenon that always pops up around holiday season. “Somebody that's not happy about being in the jail, anyways, and they have kids at home or something, they're going to miss Christmas,” he explains. “The numbers out in the field go up dramatically around the holidays.

“Every deputy who works inside Orange County's jails carries a card that lists several warning signs that an inmate might be suicidal,” LeFlore adds. As he says that, Captain Mike Krueger, a tall, soft-spoken man in glasses sitting in a chair nearby, opens his wallet and produces such a card. The warning signs include refusing to leave the cell, refusing to eat, having just arrived in jail, or having just returned from court after being sentenced to a lengthy prison stay.

“I can't think of a time when I haven't carried that [card] while working inside the jail system,” Krueger asserts. He quickly adds that he can't count the number of times he's dealt with inmates whom he or other guards suspected might be harboring suicidal tendencies. “We have this stuff all the time.”

Typically, an inmate will ask a guard to check out a cellmate who, for example, has refused to leave a cell for breakfast or is acting depressed. Or the guard will notice the behavior himself and talk to the prisoner in question. Depending on what the inmate says as well as the guard's gut instinct, the guard can call up a medical expert to perform a psychological examination on the prisoner, but that can often take a few days to arrange.

However, Krueger says, no amount of vigilance can prevent a truly determined inmate from trying killing him- or herself. Take the case of the prisoner who failed to get out of his bunk for the daily count. When a deputy ordered him to get up, he refused. “Well, he cut himself and was laying with a blanket over him, bleeding,” Krueger recalls. “We couldn't see it. Even the man's cellmate had no idea. 'Yeah, he's been depressed,' the cellmate said. But nothing indicating this was going to happen or anything even close to that.”

According to Krueger, the man (who survived) had cut himself with a razor—no easy task given that inmates only have access to extremely brittle safety razors. “But it is metal, and occasionally, they are able to get those and create cutting instruments with them. They usually don't go deep, but they can cut you.” Instead, most inmates try to kill themselves through asphyxiation. “One of the more popular ways is putting something around their neck,” Krueger says. “It can be their T-shirt, their boxer shorts . . .”

“Shoe strings,” LeFlore interjects, adding that at least one inmate hanged himself with those. “When we put inmates in areas where they are on suicide watch, we try to take away everything that they can hang themselves with, and we have these kind of tear-away jump suits, so they can't use those. But people are ingenious, and if they are hell-bent on suicide, they will find ingenious ways of doing it. We've had inmates over the years that have saved up bits of razors, and then swallowed them.”

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Even if Gee were determined to end her life behind bars, it's possible she wouldn't have reached that level of despair had she received swifter treatment. So why didn't that happen? On a recent evening, several exhausted health-care professionals who work inside the county jails gathered around a conference table at the headquarters of the Orange County Employees Association (OCEA) to answer that question. The meeting began late because several of the people at the table had just finished 12-hour shifts inside the jails. They insisted they not be identified by name, gender or job description, for fear of retaliation by their employer, the Orange County Healthcare Agency (HCA).

In the past three years, OCEA, which represents these anonymous medical staffers in contract negotiations, has bitterly fought HCA over working conditions inside the jails. The battle first surfaced shortly after Michael Patrick Lass, 28, was arrested on Oct. 11, 2007, for drinking in public. The day after his arrest, The Orange County Register later reported, “deputies used a Taser gun to subdue Lass when inmates said the man was banging his head against his cell bars.”

Upon being shocked with the Taser, Lass—who had a history of seizures—collapsed to the floor and was brought to a nursing station, where he soon died. After OCEA representatives revealed to the Register that no lifesaving equipment was on hand to rescue Lass and not one supervisor came to the scene, the Orange County grand jury investigated nursing care in the county jail system and eventually released a report titled, “Man Down!! Will he get up?” It severely criticized the standard of care at the jails.

Specifically, the grand jury reported that while inmates were receiving “excellent professional nursing care,” there were serious problems that needed to be fixed: short staffing, poor leadership, insufficient training and outdated equipment. In March 2009, the county Board of Supervisors ordered an audit of Correctional Medical Services (CMS), the branch of HCA that works inside the jails. The audit produced no fewer than 57 recommendations, highlighting several problems that hadn't been fixed since the grand-jury report.

Although HCA promised to solve those issues, as recently as May 2010, 95 percent of CMS employees signed a petition of no confidence in their employer. When the petition was signed, there were only two full-time physicians working inside the entire county jail system, effectively meaning that each doctor was responsible for the welfare of 2,500 patients. “If you have 2,500 patients per doctor, with the number of charts and people looking at them, the odds are that you will miss something because you don't have enough people to look at the charts carefully,” one worker notes. “That's just fact.”

Kathy Wild, HCA's deputy director for CMS, has only been on the job since October 2010. But eight years ago, she worked as a nurse inside the Orange County jails, so, she says, she understands the current concerns of the medical staff. “Early in 2010, there were some issues with filling positions,” she says. “But they have made tremendous progress in the past few months. Positions are being filled, and those caseloads are coming down.”

Yet while the medical staffers who spoke with the Weekly agree that progress is being made, they say the system is so overburdened that sometimes patients have to wait three days to see a doctor—a dangerously long time if the inmate is suffering from an illness or has run out of medication. “Because of the staffing shortage, patients are rolled over to the following days,” one of the staffers recalls. On one such occasion, a patient with a history of seizure disorder who had run out of medication waited five days to get his prescription refilled. “Somehow, the system broke down, and he had a seizure and ended up getting sent to the hospital.”

Typically, doctors see between 25 and 40 patients per day. The cases vary in complexity, says one staffer. “There could be 10 patients with heart disease, diabetes, a host of problems that aren't being controlled, and then you just have guys complaining of pain who want pain medication.” It's also common for doctors to treat patients who have either been injured in fights or beaten up by inmate gang enforcers.

“They don't come willingly,” the staffer says. “It's usually because a deputy saw something was wrong. And then they'll say they fell. I've seen them 'fall' with footprints on their backs, but they stick to their story.” Other inmates, who have been punished by gang enforcers by being forced to do hundreds of pushups or similar calisthenics, have to be carried into sick bay, their bodies slack and dehydrated. “They can't even walk,” the staffer explains. “It can be life-threatening.”

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The higher the jail population, logic dictates, the greater the likelihood of an inmate committing suicide, and the greater the chance a prisoner who is sick will die of preventable causes. And the jail population is growing steadily—and may soon explode. Orange County's jail system, made up of the Central Men's Jail complex in Santa Ana, Theo Lacy Jail in Orange and the James A. Musick Branch Jail in Irvine, houses roughly 7,000 beds; as recently as the late 1990s, it was filled to capacity with inmates. According to LeFlore, a variety of factors combined in recent years to drop the overall jail population to around 5,000.

-According to one of the medical staffers who spoke with the Weekly, one major impetus for their no-confidence petition was the fact they'd been complaining about staffing shortages and heavy workloads for years, and OCSD's looming contract with ICE was the final insult. “They were looking at bringing in 800 new patients and not adding additional staff,” one staffer explains. “We became so concerned about management's ability to address the issues that we felt compelled to ask the union to take up the issue and make it as public as possible.”

LeFlore denies the increased jail population has put a strain on his deputies or in any way affected inmate welfare. But he is far less sanguine about the California Community Corrections Enhancement Act of 2010, which would reduce the state's overcrowded prison system by 40,000 inmates by having anyone sentenced to three years or less in prison serve that time in county jails. “We don't like that idea,” he says, shaking his head with resignation. “People that I would argue should be in jails will not be in jails. There will be more cite-and-release, people released on parole. That's what's going to happen.”

The assistant chief, for his part, bemoans the fact that many people end up in his jail who probably belong in mental hospitals or, perhaps, drug-treatment centers. “We get these people, and it's a revolving door,” LeFlore observes. “That's just a darn shame. That's a statement on society. It's too darn bad. We get people in the jail system all the time [that] belong in the hospital. They don't belong in that jail.”

A report issued last year on the proposed bill by the Justice Policy Institute offers a solution to the crisis: stop putting drug addicts who aren't hurting anyone but themselves behind bars. “California incarcerates a large number of people with drug offenses who have no history of violence,” the report noted. “About a quarter (25.7 percent of men) of new felony admissions to the California prison system are for drug offenses. And about a third (32.7 percent) of people returning to prison from parole with a new conviction were sent back for a drug offense.”

One of those people who society sends to jail for all the wrong reasons was Michelle Gee. Shue recently retained a lawyer to sue OCSD over her daughter's death; neither she nor her attorney would comment for this story. But shortly after Gee's untimely death, Shue made that exact argument.

“There is no question that the cause of her being in there was drugs, and they assured me she was going to be treated,” Shue says. “Anybody who goes in a medical ward or who is in withdrawal for drugs needs help. They're sick and need something to come down with. I really feel that she called out for help and nobody helped her. I'm not going to lay dead on this. If there's one thing I do, it will be to make the system change.”