A Durham County report on the January death of an inmate recommends changes to treat and monitor inmates with complex, chronic illnesses.
The report is based on an investigation that followed the death of Matthew McCain, 29, who was found unresponsive in his Durham County jail cell at 5:30 a.m. Jan. 19. McCain was pronounced dead 38 minutes later.
Ashley Canady, McCain’s girlfriend, said after his death that McCain was epileptic and diabetic. She said he wrote and called often about receiving insufficient insulin treatments.
The Durham County Health Department investigation sought to identify any irregularities in the care provided, ensure the quality of care was acceptable and identify any areas in need of improvement.
The investigation concluded that McCain, who suffered from a seizure disorder, hypertension and diabetes, died as a result of “complications from a seizure disorder,” according to the county report.
The report recommended 14 changes to the jail’s medical unit to ensure health care meets national and local standards. Correct Care Solutions provides contract medical services at the jail.
Those changes include:
▪ Holding team meetings to discuss care and treatment for medically complex detainees.
▪ Restrict commissary purchases or retrieve a list of all commissary purchases made by detainees diagnosed with diabetes or other complex medical conditions.
▪ Implement a special housing unit plan for detainees with complicated chronic disease protocols, withdrawal protocols, and inmates who are wounded or wheelchair bound.
▪ Work with county agencies to develop screening tools to better identify detainees with mental health diagnoses, substance abuse histories and drug-related charges to identify at-risk detainees and create appropriate treatment plans.
The National Commission on Correctional Health Care, a nonprofit organization that implements a voluntary accreditation program, conducted a two-day review of the jail in December, about a month before McCain’s death.
The review found that the jail met 34 of the 38 applicable standards, according to the county health department’s report.
Accreditation was awarded contingent on the county taking four corrective actions that included improving continuity and coordination of inmates’ health care.
The review found providers don’t consistently review diagnostic tests with detainees in a timely manner.
“Patients are not consistently seen by a qualified health care professional upon their return from a hospitalization, urgent care, or emergency department visit to ensure proper implementation of the discharge orders and to arrange for appropriate follow up care,” the county report states. “In addition, the clinician does not review and act upon the recommendations of specialty consultations in a timely manner.”
The National Commission on Correctional Health Care also found that treatment plans do not routinely include appropriate elements, such as follow up frequency and monitoring condition and status. They also don’t include justifications of deviation from protocols.
“Providers do not consistently follow chronic disease protocols,” the county report states.
McCain was arrested in August on charges including assault of a female, assault with a deadly weapon, criminal trespassing, battery of an unborn child, and probation violation, according to public records. He reportedly had a seizure the day before he died.
The level of anti-seizure medication was within “typical therapeutic limits,” and the level of an anticonvulsant drug was “slightly below typical therapeutic levels,” a state autopsy report states. The report detected no signs of dehydration or hyperglycemia.
Earlier this month, Durham County Sheriff’s Office released a federal assessment of the jail that concluded it met or exceeded North Carolina standards. The report made 33 recommendations to improve the conditions for the about 510 inmates.
Sheriff Mike Andrews ordered the federal assessment after members of the community raised concerns about jail conditions.
The community-based, self-appointed Durham Jail Investigation Team has been protesting in front of the jail and demanding access to the facility and inmates to get more information on conditions, food, access to medical treatment and other issues.
The investigation team group grew out of the Inside-Outside Alliance, a group of family members and advocates, that have been protesting conditions at the jail for more than a year.