A medical examiner's report on the death of a 19-year-old Raleigh man due to a drug overdose raises more questions about the level of observation provided by Wake County jail staff in the hours after he was incarcerated.
The report released to The News & Observer this week represents the initial investigation by the state medical examiner's office into Ralph Madison Stockton IV's death. It says Stockton was last known to be alive at 11:30 p.m. Nov. 5. That is the same time he was evaluated by a jail nurse, according to a separate autopsy report.
This is significant because it suggests jail staff were not checking on him as often as required. He was then found unresponsive at 6:31 a.m. and pronounced dead less than an hour later. If the medical examiner's report is accurate, he would not have been properly checked for roughly seven hours before he was found unresponsive.
That information in the medical examiner's report was provided by Wake County sheriff's investigators, said Dr. Clay Nichols, a deputy medical examiner.
Last week, state officials said the jail had violated a regulation requiring that all inmates be observed at least twice an hour. That observation requirement means making sure they are alive and OK, according to Steven Lewis, the state Department of Health and Human Services official who oversees the jail regulations.
A state DHHS report found the jail staff had last seen Stockton, the grandson of a prominent Winston-Salem lawyer, at 5:29 a.m. - 62 minutes before he was found unresponsive.
Phyllis Stephens, a spokeswoman for Wake County Sheriff Donnie Harrison, who is in charge of the jail, said staff did not violate the observation standards. But she declined to provide documentation, saying it is not a public record for security reasons.
She also said the death is under an on-going internal investigation that includes "the actions of specific personnel regarding the supervision of the inmate."
Jim Jones, a DHHS spokesman, said the state investigation did not look into the entire time Stockton was in jail to determine whether the observation standard had been followed through the night.
The medical examiner's report and the autopsy also suggest that jail staff had indications that Stockton needed closer observation. The state regulation requires those who are suspected of being intoxicated to be observed four times an hour.
Both reports say numerous people observed Stockton to be intoxicated. Stephens said she could not confirm such observations because that would be protected "medical" information regarding Stockton.
The medical examiner's report also indicates that Stockton had been caught using "a number of illicit drugs" at his mother's home and that he had a history of depression and drug use.
Errors in the reports
The autopsy report contains one apparent error, and the medical examiner report contains two.
The autopsy report says that Stockton had been picked up Nov. 5 after being drunk and disorderly at a football game. Arrest reports indicate he had been picked up in his car on a misdemeanor marijuana possession charge, and subsequently charged with failure to appear on a prior underage drinking charge issued by police in Watauga County.
The medical examiner's report says Stockton was caught using drugs at his mother's home the night of Nov. 5, but Stockton had been in the jail since roughly 3 p.m. that day. It also says the death was reported to the medical examiner at 7:30 p.m. Nov. 6; it was actually reported at 9:30 a.m. Nichols said he has corrected that error.