Category: Medical Care

The Nueces County Sheriff’s Department in Corpus Christi, Texas, turned in a custodial death report regarding the death of 48-year-old Donald Oscar Cruz. Mr. Cruz had been incarcerated for five days when he died of natural causes on November 18, 2020.

The Texas Commission on Jail Standards (TCJS) sets the guidelines for the operations of county jails in Texas. Some of the rules are dedicated to inmate supervision. That portion of the Texas code includes the information below. In a jail inspection report dated November 15-17, 2021, a Texas county jail was found non-compliant with regard to inmate supervision.

Rule 275.1

This segment of the Texas code states that an appropriate number of jailers must be in each county facility 24 hours every day. Jails must have procedures in place for documenting face-to-face observation of inmates by jailers. In areas where inmates are knowingly mentally ill, potentially suicidal, or assaultive, observations must be made every 30 minutes.  Below are the findings of a TCJS inspector.

• Documentation at the jail revealed that some of the face-to-face inmate observations were performed by jailers between 90 and 144 minutes after the previous round was conducted. This area of non-compliance was in connection with the general population, where observations must be made every 60 minutes.

Learn more in this series, which is to be continued.

Implying that a person or Institution has been a participant in wrongdoing is never intended on this website. The purpose of each post is to help inmates in Texas county jails, whether they are current or former prisoners.

–Guest Contributor

There is a practice among some county jails in Texas, when an inmate becomes seriously ill, attempts suicide, ends up in a coma, or otherwise appears as if he or she will not live. Counties commonly release such inmates on PR bonds, dropping them at the local hospital. Counties do this to avoid paying medical expenses for the inmate.

Regardless, the United States Constitution requires Texas county jails to pay for reasonable medical care for inmates. Counties cannot shirk their responsibility to care for pretrial detainees in their care, simply by “releasing” them on a PR bond and sending or admitting them to a local hospital.

If a county chooses to release a detainee on a PR bond due to serious illness and or expected death, such release will not absolve the county of potential liability pursuant to the Constitution.

The 14th Amendment, as interpreted by courts, requires a county not to have policies, practices, and or customs which could harm an inmate. Likewise, Texas county jailers cannot be deliberately indifferent to and/or act objectively unreasonably regarding known medical needs of an inmate. If they do, and a person dies as a result, then there could be potential liability in a civil rights lawsuit brought by certain surviving family members.

The Jack County jail, in Jacksboro, Texas, failed an inspection with the Texas Commission on Jail Standards (TCJS). The Jack County Jail is now listed as being non-compliant with the TCJS.

The TCJS inspection occurred on November 9th, 2021. The TCJS inspector determined that jail staff failed to notify a magistrate within 12 hours as required by the Texas Code of Criminal Procedure on multiple occasions. The TCJS inspector noted that such was an area of technical assistance during the prior year 2021 annual inspection. The TCJS inspector found that the Jack County jail failed to comply with Section 273 of TCJS minimum standards. That section requires a jail to have and apply certain procedures for intake screening to identify inmates who are known to be or observed to be mentally disabled and/or potentially suicidal, as well as referrals to available mental health officials.

Our Texas civil rights law firm has handled an unfortunate number of jail suicide cases. It is extremely important that county jails in Texas comply with appropriate standards, and visibly monitor inmates, to assure that those with self-harm tendencies do not commit suicide and/or otherwise harm themselves. We do not have evidence indicating that such an occurrence happened in the Jack County jail. Hopefully, the Jack County jail will bring itself into compliance.

The Harris County Jail, in Houston, Texas, recently failed an inspection by the Texas Commission on Jail Standards (TCJS). The TCJS inspected the Harris County Jail from November 15, 2021 through November 17, 2021. The Harris County, Texas jail is now listed as being non-compliant with the TCJS.

First, the TCJS inspector determined, after reviewing documentation, that some face-to-face inmate observations were not performed by jailers at least once every 60 minutes as required. In some instances, such face-to-face inmate observations went between 90 minutes and 144 minutes between rounds. The TCJS standard which applied to this situation requires every county jail in Texas to have the appropriate number of jailers at the facility 24 hours each day. Facilities must have established procedures for documented face-to-face observation of all inmates by jailers, no less than once every 60 minutes. Likewise, the interval for observations is every 30 minutes if inmates are known to be assaultive, potentially suicidal, mentally ill, or those who have demonstrated bizarre behavior. Further, electronic sensors or cameras capable of recording require personal observations of inmates in high-risk cells or groups of cells had to be installed no later than August 31, 2020.

The TCJS inspector also found, when reviewing Harris County jail documentation, that while the 1:48 officer to inmate ratio was being met, the Harris County Jail used supervisors as well as other essential staff members in assigned duty posts to meet that requirement. Such a practice removed personnel from their assigned supervisory duties, as well as from auxiliary duties, such as intake and classification. The TCJS determined that there were times when there were not enough personnel to perform duties other than to meet the 1:48 requirement.

The TCJS inspector also determined, when in walking through Harris County Jail facilities, a lack of cleanliness in inmate housing areas. There were numerous burn marks throughout a majority of the housing units, which were direct results of inmates burning wicks. There were multiple cells at the 701 North San Jacinto facility with an unidentified black substance in and around the mop sink areas in the housing units. There was also excess clutter throughout all housing areas that led to an overall appearance of uncleanliness.

In an unusual manner to document an inspection, based on our Texas civil rights law firm’s review of such reports frequently, the inspectors wrote a note at the end of the inspection report. The inspectors wrote:

“It is the professional opinion of the members of the inspection team that the lack of sufficient staffing has contributed to the heightened level of tension and inmate hostility at the Harris County Jail system that was experienced during the course of this inspection. A review of serious incident reports reveals that inmate assaults have increased when comparing 2020 numbers to 2021 numbers. While this was a limited inspection to review specific areas, it was evident that while the administration strives to meet the one officer to 48 inmate ratio, it can only be accomplished by reducing the resources allocated to other ancillary but necessary and required services.”

The Harris County jail has had significant problems. In fact, its jailers even sued Harris County due to alleged working conditions at the jail. From a constitutional perspective, Harris County has an obligation to provide reasonable medical care and reasonable mental health care to its inmates. Hopefully, Harris County will bring itself into compliance with minimum jail standards and the United States Constitution.

Lambert Sabrsula was 45 years old when he died in the custody of Bexar County Jail in San Antonio, Texas, on November 28, 2020. He was booked into the jail on November 13, 2020. According to the custodial death report, which was filed by the Bexar County Sheriff’s Department, Mr. Sabrsula died of natural causes, including complications of mental health disorders.

The Texas Commission on Jail Standards (TCJS) requires jail staff members to be trained so that they can recognize, supervise, document, and handle inmates with mental disabilities as well as those who are possibly suicidal. Once an inmate has been identified as mentally ill or potentially suicidal, they are placed in housing where observations of inmates are more frequent than in the general population. Every 15 minutes, maximum, inmates must be observed in these areas.

During annual jail inspections, records are checked to determine whether requirements for inmate observations are in compliance. Oftentimes, they are not.

Texas Jail Inspection Report on Noncompliance Dated April 18, 2018

The TCJS inspector at a county jail in Texas reviewed and the face-to-face requirements for checking the general population, which is every 60 minutes, was exceeded on a continuous basis by 1 to 3 minutes. 

Learn more in Part 1 and Part 2 of this series.

On this website, there is never an intention to infer wrongdoing on the part of any person or institution.

Suggesting that a person or entity has been involved in wrongdoing is never intended on this website. Providing assistance to inmates in Texas county jails is the purpose of posts on this site.

–Guest Contributor

An inmate at Bexar County Jail in San Antonio, Texas, at the time, Lambert Sabrsula died on November 28, 2020. According to the custodial death report, Mr. Sabrsula died of natural causes, more specifically, cardiomegaly and complications of mental health disorders. He had been incarcerated for a total of 15 days when he died.

RULE §273.2-Health Services Plan in Reference to Pregnant Inmates

(5) The Texas Commission on Jail Standards requires each Texas county jail to have procedures in place for inmates to have access to gynecological and obstetrical care and for inmates to have their mental, nutritional, and appropriate housing needs met and to have fitting work assignments. Documentation is required for the use of restraints during labor, delivery, and recovery for known pregnant prisoners. If there are any changes in policies and procedures with regard to the provision of medical care to pregnant inmates, the commission must be notified. 

(15) TCJS also requires staff members in the jails to be trained so that they may identify when a pregnant inmate is in labor. Access to appropriate care must be provided at these times. When an inmate states they are in labor or it is determined by a person at the level of emergency medical technician that an inmate is near to going into labor, she must promptly be transported to a local hospital.

Learn more in Part 1 and this ongoing series.

Suggesting that a person or entity has been involved in wrongdoing is never intended on this website. Providing assistance to inmates in Texas county jails is the purpose of posts on this site.

–Guest Contributor

Fifty-three-year-old Anne Elizabeth Murphy was booked into Harris County Jail in Houston, Texas, on November 8, 2021. On December 1, 2021, fellow inmates reported that she was in need of medical help. She received emergency aid and was transported to a nearby hospital but was pronounced dead that same day.

The Texas Commission on Jail Standards (TCJS) establishes the operational procedures for Texas county jails. TCJS has approved the use of restraint chairs.

Restraint Chairs Continued

Throughout the US, various watchdog groups have exposed data showing that restraint chairs are associated with many inmate deaths and a range of disturbing abuses. As a result of widespread findings such as these, many jurisdictions have outlawed the use of restraint chairs. 

Manufacturers include information about restraint chairs that is widely understood, and it has to do with the health of those strapped into the chairs. Namely, if a person is immobilized in a restraint chair after vigorous activity of any kind, the potential that a life-threatening blood clot will develop in their lungs is very real. On virtually every occasion in which a restraint chair is used, a strenuous struggle is involved in which law enforcement personnel secure the inmate in the chair.

In fact, one expose tells of a man who was strapped in a restraint chair for 16 hours and, upon his release, died from a pulmonary embolism or, in other words, a blood clot in his lungs.

Learn more in Part 1 and Part 2 of this series.

Inferring that individuals or entities have been engaged in wrongdoing is never intended on this website. The purpose of each post on this website is to provide helpful resources for county jail prisoners in Texas.

–Guest Contributor

Fifty-three-year-old Anne Elizabeth Murphy was booked into Harris County Jail in Houston, Texas, on November 8, 2021. On December 1, 2021, fellow inmates reported that she was in need of medical help. Ms. Murphy received emergency help and was transported to a nearby hospital but, tragically, was pronounced dead that same day.

Non-Compliance: §273.6 – Restraints continued

Rule 273.6  states that when restraints are used, they must be used in a humane manner. Restraints cannot be used as a form of punishment but can only be used to prevent injury. Jail staff members are required to observe inmates in restraints every 15 minutes, and that time cannot be exceeded. The blood circulation of inmates must be checked every quarter-hour to ensure that the extremities are not cut off from circulation.

The TCJS inspector found in restraint chair documentation that jail staff exceeded the required checks of no longer than 15 minutes between each observation. The violations were between 1 to 5 minutes in length, and they occurred on multiple occasions.

Restraint Chairs

Anytime restraints are used in jails, it is required to use the least restrictive type of restraint that will mitigate the danger. The last resort, when an inmate cannot be controlled by other types of restraints, is the restraint chair. An inmate in a restraint chair is immobilized. The ankles and wrists are held in place in the chair, and the chest and torso are restrained using straps.

Learn more in Part 1 and this ongoing series.

Making an implication that an individual or organization has been involved in wrongdoing is never intended on this website. Each post is intended as a helpful resource to benefit inmates now or previously incarcerated in a Texas county jail.

–Guest Contributor

The Dallas Police Department, in Dallas, Texas, filed a report regarding the custodial death of Chico Jesus Diaz. Mr. Diaz was only 29 years old at the time of his death. We provide in this post information we obtained from that publicly-filed report, and we make no allegation of any wrongdoing against anyone.

The summary portion of the report reads in its entirety:

“On May 9, 2021 at approximately 2:00 pm, Methodist Charlton Medical Center Police were dispatched to the emergency room #44 regarding the victim, Chico Jesus Diaz L/M/XX-XX-1991, starting a fire in the hospital room. The officers made contact with the victim and placed him under arrest for Arson. The victim had been arrested the day prior for a APPOW, after exhibiting mental/medical condition. As officers escorted the victim to the police car, the victim exhibited signs of medical duress. The victim was then placed in the police car for transport. The victim complained he was hot and began speaking in slurred speech. The victim then passed out and unconscious. The victim was taken by the police officer into the hospital where emergency medical staff treated and attempted to resuscitation the victim. The victim remained unresponsive and was pronounced deceased by Dr. Christopher Tallilerro at 4:34 p.m. Dallas Police were notified and responded to the location and investigated this incident, at the request of Methodist hospital police department.”

The “APPOW” reference relates to apprehension by peace officers without a warrant. Such apprehension is typically done pursuant to Chapter 573 of the Texas Health and Safety Code. Generally, that statute allows a police officer to take a person into custody if the police officer believes that the person has a mental illness, and because of that mental illness there’s a substantial risk of serious harm to that person or others unless the police officer immediately restrains the person. Police officers can take such a person into custody without a warrant. Since that was referenced regarding Mr. Diaz, we assume that he was having serious mental health issues, likely including and up to the fire he allegedly started in the emergency room.

The summary portion of the report does not provide a complete timeline. It is uncertain how long after the police officer saw Mr. Diaz exhibiting signs of medical duress, before he put Mr. Diaz into the police vehicle, until the police officer took Mr. Diaz back into the hospital for medical treatment. Hopefully, Mr. Diaz was not placed into the police vehicle for any extended period of time after the police officer saw that Mr. Diaz was exhibiting signs of medical distress.

The United States Constitution provides rights to those in police custody. Those rights, with regard to a person who has not been convicted, can arise under the 4^th Amendment and or the 14^th Amendment. The 4^th Amendment protects a person from use of unreasonable, or excessive, force. The 14^th Amendment provides certain guarantees, including the right to receive reasonable medical care. If a person does not receive reasonable medical care while in custody, and passes away as a result, then certain surviving family members may be able to file a lawsuit regarding constitutional violations.

On December 1, 2021, Anne Elizabeth Murphy was in a multiple occupancy cell in Harris County Jail, Houston, Texas, when fellow inmates reported that she was in medical distress. Life-saving measures quickly began and continued until paramedics with the Houston Fire Department arrived. Ms. Murphy, age 53, was transported to St. Joseph Hospital, where she was pronounced dead by a physician.

A Texas county jail had 21 custodial deaths in 2020 and possibly more, according to numerous news reports. Statistics from a study on deaths at the jail show that 1 in 185 inmates died in custody. Although Dallas County Jail has a much larger jail population, there were 8 custodial deaths in 2020. Questions are naturally raised regarding the high death count. For context, an investigative report reveals that in 2020, there was one in-custody death in Collin County. In recent history, the Collin County Sheriff fired seven employees after one controversial custodial death.

Many of the operational requirements for county jails in Texas are associated with such matters as suicide prevention and protection from hazardous health situations. During annual jail inspections, investigations sometimes reveal that jails are non-compliant in ways that can endanger inmates’ lives. Inspectors with the Texas Commission on Jail Standards (TCJS) conduct the inspections. An example follows, and further details will be revealed in this continuing series.

Non-Compliance: §273.6 – Restraints

In a jail inspection report dated October 7, 2021, an inspector reports that a rule pertaining to restraints has been violated. TCJS has approved various types of restraint systems for use when inmates behave in a manner that endangers themselves and/or others. 

Learn more in this ongoing series.

Suggesting that a person or entity is engaged in misdeeds is never intended on this website. The purpose of posts on this site is to help inmates currently or previously incarcerated at a Texas county jail.

–Guest Contributor