Under the Dome

Lawsuits blame lack of access to medicine in jail for inmate deaths

Two years ago, Amanda Hogan hung herself in a Carteret County jail cell and later died in a hospital. Her family is now suing Carteret Sheriff Asa Buck, the county, several jail employees and the jail's health care provider, Southern Health Partners.
Two years ago, Amanda Hogan hung herself in a Carteret County jail cell and later died in a hospital. Her family is now suing Carteret Sheriff Asa Buck, the county, several jail employees and the jail's health care provider, Southern Health Partners.

Amanda Hogan was among dozens of suspects arrested two years ago as part of a long-running drug sting run by the Carteret County Sheriff's Office.

Hogan, 28, had a history of opiate abuse, and she took prescription drugs for bipolar and personality disorders. She was also awaiting surgery on her right kidney, which had a stone and had become infected, causing throbbing lower back pain.

But the arrest pushed off the surgery, and jailers didn’t give her the prescribed medications for her mental illness, despite jail staff knowing she was a suicide risk, her mother said. After going a week without her medications, she used a bedsheet to hang herself in her cell. She later died at a hospital.

Her family is now suing Carteret Sheriff Asa Buck, the county, several jail employees and the jail's health care provider, Southern Health Partners, alleging deliberate indifference, reckless disregard and gross negligence in her daughter's care. The lawsuit is one of several across the state that have alleged inmates died after a lack of access to prescribed medications.

In Forsyth County , two inmate deaths have led to settlements related to claims they did not receive prescribed medications they needed to survive. Families of two other inmates at the jail who died have raised similar concerns to the media.

The county recently paid the estate of Dino Vann Nixon $180,000 to settle claims that jail staff and employees with Correct Care Solutions, another private medical contractor, caused his death by denying Xanax, a prescription medication commonly used for anxiety and panic disorder.

Nixon, 55, had long been prescribed a high dosage of the drug, and his estate alleged that removing it triggered a severe withdrawal that killed him on Aug. 5, 2013. The county did not admit responsibility in settling. The Nixon estate's case against Correct Care continues.


In the other lawsuit, Correct Care reached a settlement with the estate of Jennifer Eileen McCormack Schuler, who was pregnant when she entered the Forsyth jail in 2014. That lawsuit alleged that Schuler, 31, who was an opioid addict, was denied access to an anti-nausea medication, causing her to repeatedly vomit food, liquids and other medications. A medical examiner found she died of a lack of oxygen to the brain, with acute renal failure and dehydration contributing to her death.

As with other settlements with the companies that provide health care in jails, the terms were not disclosed. State law does not require settlements between private entities be made public, even if they involve services provided to a public entity, such as a county jail.

Correct Care officials declined to talk about both cases. Jim Cheney, a company spokesman, said in general, the “medications and dosages of an inmate are determined by a qualified medical professional with the required prescribing authority based upon clinical indication of such patient.” Forsyth Sheriff William Schatzman did not respond to interview requests.

Correct Care settled another death in Guilford County in 2015 that a medical examiner attributed to the inmate, Ellin Beth Schott, 57, not receiving anti-seizure medicine for three days. Schott suffered multiple seizures and later died in a hospital. Jail officials said Correct Care would increase its staffing to make sure needed prescriptions are provided.

Medical plan required

State regulations call for each jail to develop a medical plan that includes policies and procedures for the "(a)dministration, dispensing and control of prescription and non‑prescription medications," and jails are required to hear inmates’ medical requests on a daily basis. But the regulations do not specify how thoroughly inmates should be screened to determine whether they need medications, or how soon they should be provided.

Vicki Smith, executive director of Disability Rights NC, a nonprofit advocacy group, said her agency has received complaints from inmates and their families about withheld medications, though not as frequently today as more jails are recognizing the need to provide them to those with mental illness. The state is developing new regulations for the jails, and she sees it as an opportunity to address these concerns.

“This could easily be addressed by encouraging more specificity in the jail operation manual about screening, and what you do with medication when you get it and how it's administered,” she said. “There's nothing in the rules that would prohibit addressing this in the operations manual, but there's nothing addressing it specifically.”

Jamie Markham, a professor with UNC's School of Government, said while the regulations aren't detailed, jails have a constitutional requirement to avoid cruel and unusual punishment of inmates or act in "deliberate indifference" to inmates' medical needs. A knowing failure to provide needed prescriptions could trigger valid claims in the courts, he said.

The Pew Charitable Trusts recently reported that one study found smaller jails with less than 250 beds were less likely to offer treatment to those with serious mental health issues than larger facilities. Pew noted an unrelated survey from six years ago found roughly 60 percent of inmates with chronic conditions said they did not take prescription medicine while they were behind bars. The reasons varied – 30 percent, for example, thought they didn’t need to take them – but 36 percent said a doctor told them the medicine was unnecessary or would not be provided.

The Carteret jail’s medical plan at the time of Hogan’s death required jailers to confiscate prescription medications that inmates bring into the jail, until a medical professional could verify the inmate should have them. Jailers were supposed to “immediately” contact the jail’s medical provider for that verification. Since then, the jail has in place a new policy that states the jail doctor will ensure that inmates “admitted to the detention center continue to receive their current medications as previously prescribed, unless otherwise ordered by a qualified health care professional.”

Sheriff Buck declined comment on the Hogan family lawsuit, and Southern Health did not respond to an interview request.

Drug investigations

According to the lawsuit, Amanda Hogan had a traumatic childhood. She was abused at an early age, and when she disclosed it after she turned 15, her abuser committed suicide. The lawsuit does not say whether the abuse was sexual or physical.

“The trauma from these events caused Amanda severe emotional and mental issues for the rest of her short life,” the lawsuit said.

It also led her to “self-medicate,” first with marijuana, and years later with heroin in 2013. By then, she had been on prescription drugs to combat her mental illness, and had been twice involuntarily committed. One of those times, in 2014, a Carteret deputy had her committed.

That same year, and in 2015, Sheriff Buck launched two drug investigations that rounded up dozens of people. The lawsuit said those arrests overwhelmed the Carteret jail, which is designed to hold 116 inmates, but only 10 females. Hogan was arrested and jailed in both round-ups.

During her first incarceration in April 2015, nursing staff initially withheld her medication, and she began acting erratically and threatened to kill herself. She was placed on suicide watch, and was eventually allowed to take her medication.

She was released from jail, but then arrested in the second investigation. By then, she had been injured in a car accident, suffering back and rib fractures, and had developed renal failure. She needed kidney surgery, the lawsuit said, but doctors couldn’t operate until antibiotics had knocked out an infection.

When deputies booked Hogan into the jail on Nov. 24, 2015, her mother again delivered her medications, the lawsuit said. Kimberly Hogan said she told jail officials Amanda had surgery scheduled for Nov. 27; they told her to bail her daughter out. Hogan said in the lawsuit she couldn’t afford to make the $75,000 bail.

On Dec. 2, jail officials called Kimberly to report her daughter, a mother of two, had hanged herself in her cell. She had no brain function, and life support was turned off a few days later.

In an email last August, Kimberly Hogan said her daughter might be alive if jail staff had continued her prescribed medications and let her get the kidney care she needed.

"Amanda just wanted to get back to the hospital and unfortunately took extreme measures," Kimberly Hogan wrote.

Hogan’s death was among three in the Carteret jail over an 18-month period. In all three, state investigators found a lack of adequate supervision. Patrick O’Malley, 32, died a week after Hogan of a heart attack after being confined to a restraint chair for nine hours in violation of the jail’s restraint policy which limits use to no more than two hours in most cases.

Justin Allen Everett Carteret County Sheriff's Office

Justin Allen Everett, 28, hanged himself in the jail last June 2. State investigations found he and Hogan were suicide risks and weren’t checked at least four times an hour, as required by state regulations. Everett was also a drug addict who had been picked up in the same sting as Hogan.

The News & Observer reported the supervision problems with O’Malley and Hogan’s deaths in a five-part series, Jailed to Death, last August. They are among 51 deaths from 2012 to 2016 in which state investigations found supervision failures, or one out of every three deaths during that period.

Unaware of findings

O’Malley and Hogan’s families said they were unaware of the state findings until the N&O’s reporting, and that information has prompted lawsuits in both cases. Raleigh lawyer Eric Doggett is representing Hogan’s estate. He said he and the family could not speak in detail on the case after filing the lawsuit in December.

Dr. Marc Stern, a former medical director for Washington state’s prisons, said no inmate should be deprived of needed medication. There are no statistics for how many jail deaths are tied to prescription drug denials, but he said he believes most jails do a good job making sure proper medications are available. When there are problems it’s usually traced to poor screening procedures or a lack of qualified medical personnel to prescribe proper medication.

In those cases, the jails often are underfunded and lack the resources to provide proper care, he said.

“You can put all the requirements you want on the jail administrators, but if the county doesn’t give them enough money to do the job, it isn’t getting done,” he said.

State report on Harnett jail death

State Department of Health and Human Services officials say a young man who died last year after coming down with a paralyzing disorder while in the Harnett County jail received proper supervision from detention officers.

The DHHS’ Construction Section, which oversees jail regulations, visited the jail last month after The News & Observer reported the death of Apolinar ‘Hasen’ Perdomo, 27, who died April 21 after a series of events that began with a flu shot at a drug treatment facility in Raleigh several weeks earlier, medical records show.

Perdomo was taken to the jail for violating the terms of his release on a prior conviction. He was awaiting transfer to a state prison to serve a 90-day sentence when he began to lose feeling in his extremities. The medical records show he was sent to a local hospital that did not initially diagnose the problem, then spent another three days in the jail before a doctor there began to suspect he had contracted Guillain-Barre Syndrome, which can cause total paralysis if not treated.

Perdomo was sent to Cape Fear Valley Medical Center, where a doctor performed a tracheotomy, and then transferred to Kindred Hospital, a long-term care facility in Greensboro. It was there that he started bleeding from the tracheotomy site, and was resuscitated five times before dying.

State law requires inmate deaths be reported to the Construction Section, but Perdomo’s wasn’t because he did not die in the jail. Chris Wood, an investigator with the construction section, noted in his report that Perdomo was no longer in Harnett’s custody and therefore no notification was required.

His letter to the jail was short with the finding in one sentence: “This inspection found no deficiencies whereby no corrective action is necessary.”

While state law requires jails to have a medical plan for the care of inmates, the Construction Section does not investigate the quality of that care, said Steven Lewis, the section chief. It primarily investigates to see if detention officers made regular checks to make sure inmates are OK and that they have access to medical care.

He referred questions about the quality of care to Harnett County’s health department. The department’s director, John Rouse, could not be reached about the death.

Perdomo was one of 39 inmates in North Carolina jails who died last year either in the jail or after being released to a health care facility for treatment, state records show. That is one death shy of the 40 deaths in 2015, the highest number since the state began tracking them.