Category: Medical Care

After being booked into Live Oak County Jail in George West, Texas, at 11:16 pm on November 7, 2021, 54-year-old Johnny Ray Ximenez was placed in a cell in the booking area. Less than 24 hours later–at 9:44 pm on November 8–Mr. Ximenez was declared dead in his cell.

The Texas Juvenile Justice Department provides guidelines for juveniles who are incarcerated. Under the rule cited below, details are provided specifically about restraint chairs and the rules that govern their use. 

RULE §351.46-Restraint Chair

The following are details about this rule under (a) Requirements:

• The chairs used as restraint chairs must be professionally manufactured and approved by the juvenile board.
• A resident must only be placed in a restraint chair if he or she is displaying extremely disruptive or aggressive behavior that could cause harm to the resident or others and other approved techniques for restraint are either ineffective or inappropriate for controlling the resident’s behavior.
• Only a detention officer or juvenile probation officer who has been trained in the proper use of a restraint chair is authorized to place a resident in the restraint chair and provide ongoing supervision.
• Every 10 minutes, the resident must be checked by a detention officer or juvenile probation officer to ensure that blood circulation has not been restricted by the restraint device. 
• Every 10 minutes, the resident must be considered for removal from the restraint chair.

Learn more in Part 1 and Part 2 of this three-part series.

There is no intention to imply that a person or organization has been a participant in wrongdoing. The posts on this website are added for the purpose of helping inmates now or previously incarcerated in a Texas county jail. 

–Guest Contributor

On November 8, 2021, Johnny Ray Ximenez died in Live Oak County Jail in George West, Texas. He was 54 years old. The cause of death is still unknown, but some information on the custodial death report is helpful, such as that Mr. Ximenez was not in restraints prior to his death.

Restraint Chairs 

The Texas Commission on Jail Standards (TCJS) sets forth the rules for county jail operations. The guidelines for utilizing restraint chairs are included. Requirements for using restraint chairs are detailed under the chapter on health services. Medical personnel and supervisors are the only individuals, for example, who are supposed to authorize placing an inmate in one of these restrictive devices.

In the portion of the rules for county jails housing adults, mandatory steps related to restraint chairs are no different than for all of the other types of restraint systems. 

RULE §273.6–Restraints

Part (2) of this rule states that the type of restraint system used on an inmate must be one that restricts the inmates’ movements only to the extent necessary to get him or her under control. The rule even states that padded or soft types of restraints should be used whenever it is feasible. Another requirement is that no one should be restrained in a manner or position that would worsen any physical ailments that the inmate may be suffering from.

Learn more in Part 1 of this continuing series.

It is never an intention on this website to make an implication of wrongdoing having occurred on the part of individuals or institutions. In providing posts on this site, the hope is to provide helpful resources benefiting inmates in Texas county jails.

–Guest Contributor

Johnny Ray Ximenez was 54 years old when he was booked into Live Oak County Jail in George West, Texas, at 11:16 pm on November 7, 2021. Less than 24 hours later, Mr. Ximenez died at 9:44 pm the following day. His cause of death is pending autopsy results.

When inmates behave in a way that threatens their own safety or endangers the lives of others, an option that county jail staff members have for getting them under control is to use restraints. The Texas Commission on Jail Standards (TCJS) has approved various types of restraints. Although restraint chairs are highly controversial and banned in various jurisdictions throughout the U.S., they are among the restraint systems approved for use in county jails in Texas.

Why are Restraint Chairs Controversial?

Custodial deaths linked to restraint chairs have occurred on far too many occasions, research shows. Watchdog groups have studied this issue and released various reports, none of which are encouraging to people who are concerned about inmate rights and safety.

News reports about restraint chairs used in county jails indicate that abuses are often linked to cycles of behavior among jail staff members. For instance, in one jail outside of Texas, multiple inmates were allegedly restrained in a restraint chair or five days or more. It was not uncommon for the inmates to urinate and defecate on themselves due to the lack of opportunity to take restroom breaks.

Learn more in this continuing series.

The posts on this website are never meant to implicate persons or entities in Acts of wrongdoing. The purpose of the posts is to provide county jail inmates in Texas with helpful resources.

–Guest Contributor

On November 22, 2021, the Bexar County Sheriff’s Office in San Antonio, Texas, filed a custodial death report on Richard Altamirano. The report states that the inmate had refused a diabetic check at some point during incarceration. At age 58, Mr. Altamirano died in Bexar County Jail’s custody on November 8, 2021. 

The afore-referenced article about Texas county jails focused, in part, on one jail in particular. A new sheriff responsible for the jail ultimately spoke out about his concerns related to inmate medical care. He said that he had not been there long before he became concerned about medical care, and he investigated the complaints. Among his discoveries was that it may take six weeks for an inmate’s request to see a physician to be reviewed.

The sheriff detailed one incident in which an inmate stated during the booking process on a Friday that he needed daily insulin to treat his diabetes. At that point, the inmate was informed that until he could see a doctor the following Wednesday, he would not be able to have any insulin. The inmate, fortunately, was released by Monday. However, his condition was already serious, and the former inmate went directly to a hospital for adjustment of his blood sugar.

The sheriff ran into numerous complications in his effort to improve procedures for providing inmates with needed medical care. Before anything was resolved, the number of inmates who died in that jail spiked alarmingly.

See Part 1 and Part 2 of this series.

On this website, there is never an intention to imply that a person or entity has been a participant in misdeeds. Providing help to Texas county jail inmates is the purpose of posts on this site.

–Guest Contributor

Richard Altamirano died in the custody of Bexar County Jail in San Antonio, Texas, on November 8, 2021. He was 58 years old. The cause of death is currently pending autopsy results, according to the custodial death report.

The Texas Commission on Jail Standards reports that, year after year, the number of complaints about medical neglect outnumber all other sorts of complaints against county jails in the state. A watchdog group brought complaints about inmate medical care in some Texas county jails to light a few years back in an article that was published online. The following are some of the allegations made at that time:

• A county jail inmate was in need of antibiotics because he’d had a recent surgery. His wound began to ooze because his incision was not properly cleaned. The inmate claimed that gnats entered his body through the wounds. In spite of requests, a doctor did not see the inmate until there was a development of an additional abscess filled with pus.
• A juvenile had a heart defect, which was known by the jail staff. When the teenager suffered from chest pain, he was given Pepto-Bismol. Soon after, the teen collapsed and died. The cause of death was a split heart valve.
• A Texas county jail inmate suffering from AIDS reportedly sobbed in his cell, claiming that he was not provided with his medication. He ultimately died in custody.

The report further claims that inmate requests to see doctors went unread for weeks at a time. At one jail, the requests were haphazardly tossed into filing cabinets. There was no distinction in the approach between handling a minor issue and a major issue. For instance, a complaint about shower shoes might be next to a request regarding a lump found in an inmate’s breast.

See Part 1 and this continuing series.

There is never an intention on this website to make any sort of suggestion that misdeeds have occurred on the part of any person or institution. Providing assistance to inmates in Texas county jails is the purpose of each of this site’s posts.

–Guest Contributor

The custodial death report filed by the Wharton County Sheriff’s Department about the death of Henry Donell Stephens provides a detailed narrative of care he received beginning on January 12th, 2021, at Wharton County Jail in Wharton, Texas. At that time, Mr. Stephens reportedly complained about heartburn. He died on the 15th of January after being transported to a nearby hospital emergency room. 

The suicide prevention plan applicable to county jails in Texas is included in the portion of the Texas Administrative Code about health services. The Texas Commission on Jail Standards (TCJS) provides all guidelines for the operation of county jails in the state. Because suicide is among the top two leading causes of death in virtually every jail in the U.S., it is recognized as a potential threat to virtually every inmate.

In order to help protect inmates who are either mentally disabled or potentially suicidal, appropriate training of jail staff members is essential. Every member of the jail staff is trained on procedures for recognizing potentially suicidal and/or mentally disabled inmates and how to supervise, document, and handle them. Any member of a jail’s staff whose responsibility includes intake screening must also have supplemental training in that regard.

Determinations made during the intake of prisoners affect where they are housed and the level of supervision they receive. 

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

There is no intention on this site to make an implication of wrongdoing about anyone or any institution. Each of this website’s posts is intended as a resource to help inmates now or previously detained in a Texas county jail.

 –Guest Contributor

Richard Altamirano arrived at Bexar County Jail in San Antonio, Texas, on November 5, 2021. Three days later, after Mr. Altamirano reportedly refused a diabetic check, a Corporal arrived to his cell and initiated a code for medical help. Mr. Altamirano was moved to a medical facility, where a physician pronounced him dead at approximately 3:32 AM on November 8, 2021.

The Texas Commission on Jail Standards (TCJS) has the responsibility of creating the guidelines for minimum jail standards in all of the state’s county jails. The required health services plan that serves to guide operations in Texas county jails includes a right to refuse medical care. 

RULE §273.2(9) 

• In accordance with informed consent standards for certain procedures and treatments, inmates have the right to refuse health care.

The Sandra Bland Act

After the high-profile, controversial death of Sandra Bland in Waller County Jail on July 13, 2015, in Hempstead, Texas, the Sandra Bland Act was passed and signed into law on September 1, 2017. The law mandates telemental health access, though telehealth had been accessible in U.S. prisons for decades.

In addition to meeting the demands of the new law, telemedicine also helps to mitigate the high cost of healthcare access in county jails.

The Sandra Bland Act addresses various issues in addition to improving access to mental health resources. For instance, the law has prompted a change in law enforcement training, the equipping of jails, and the resources available to people with intellectual differences and substance abuse problems.

See this continuing series.

There is no intention on this website to make an implication of wrongdoing on anyone’s or any entity’s part. Each of the posts on this site is meant as a potentially helpful resource for inmates now or formerly housed in a Texas county jail.

–Guest Contributor

The Bexar County Sheriff’s Office, in San Antonio, TX, filed a report regarding the death of Richard Altamirano. Mr. Altamirano was only 58 years old at the time of his death. We provide in this post information we obtained from that report, and we make no allegation of any wrong doing against anyone.

Summary portion of the report reads in its entirety:

“On November 08, 2021 at approximately 0220 hours, a welfare check was conducted on inmate Altamirano, Richard SID#276215, due to him refusing a diabetic check. Upon Corporal C. Cruz arrival to inmate Altamirano’s assigned cell, she initiated a code for medical assistance. Once inmate Altamirano was evaluated in medical, a subsequent Code 1 blue (medical emergency), was initiated. At approximately 0253 hours, the SAFD Ambulance arrived to the facility and departed at approximately 0315 hours, along with Deputy S. Montez. At approximately 0332 Dr. Kristen Baker pronounced inmate Altamirano deceased.”

The report also indicates that the date and time of Mr. Altamirano’s custody was 12:40 pm on November 5, 2021. The report indicates nothing about what occurred between that time and the November 8, 2021 incident.

The United States Constitution guarantees the right of those in Texas jails to receive reasonable medical care, it also assures the right to such persons to receive reasonable mental health care. If these rights are violated, and a person dies as a result, then pursuant to the 14^th Amendment, certain surviving family members may be able to file a lawsuit. These lawsuits are typically prosecuted in federal court.

The Live Oak County Sheriff’s Department, in George West, TX, filed a custodial death report with the Attorney General of Texas regarding the death of Johnny Ray Ximenez. Mr. Ximenez was only 54 years old at the time of his death. We provide in this post information obtained from that report, and we make no allegation of any wrongdoing against anyone.

The summary portion of the report reads in its entirety:

“On November 7, 2021, Ximenez, Johnny was booked into the Live Oak County Jail, charged with Public Intoxication. On November 8, 2021, the decedent was housed in a separation cell at approximately 7:04 P.M. Security checks were preformed within the Texas Jail Standards time frame. A check was completed on inmate Ximenez at approximately 8:33P.M. At which time the inmate appeared to be fine. The inmate appeared to have a medical issue at approximately 8:46P.M., which I later saw on the surveillance footage from Ximenez’s cell. The next security check was completed at approximately 8:51P.M. During the security check, at approximately 8:51P.M., the jailer noticed that the inmate was mostly on the floor, with his neck and head on the bunk. The jailer tried to get the inmate’s attention without any success. The jailer called for assistance, another jailer arrived at the cell at approximately 8:53P.M., then both jailers entered the cell. The inmate was assessed by the jailers. The jailers then placed the inmate flat on the floor, and began chest compressions on the inmate, until Emergency Medical Staff arrived at the jail and took over the scene. The inmate was pronounced deceased at approximately 9:44P.M.”

It is our experience, as a Texas jail abuse law firm handling civil rights cases, that the Texas Rangers are likely to conduct an investigation of Mr. Ximenez’s death. The Texas Rangers typically investigate deaths occurring in jails in smaller- to medium-sized counties. However, the Texas Rangers will only investigate regarding any potential criminal conduct resulting in or contributing to Mr. Ximenez’s death. The Texas Rangers do not investigate whether there is any civil liability under the United States Constitution.

If jailers fail to provide reasonable medical care to a person in a Texas jail, and the person dies as a result, then certain surviving family members may be able to bring a lawsuit. The claims in the lawsuit are brought pursuant to the United States Constitution. The 14^th Amendment to the United States Constitution guarantees the right of pretrial detainees to receive reasonable medical care.

Tyler Jay Huffman died at age 38 in a single cell of Tarrant County Jail in Austin, Texas, on November 10, 2021. He had been incarcerated for 5 days. The custodial death report currently shows that the cause of death is pending the results of an autopsy.

Success in preventing suicide in county jails hinges not only on guidelines provided through minimum jail standards but also on the actions of jail staff members. It has been identified that competently following procedures for intake screening is pivotal in correctly housing at-risk prisoners who need to be supervised more stringently than others. 

In a jail inspection report dated October 15, 2021, details are provided about a Texas county jail found in non-compliance during an annual jail inspection. The Texas Commission on Jail Standards (TCJS) sets the standards for county jails. An inspector with TCJS provides details of the following area of non-compliance.

RULE §273.5(a)(2) – Mental Disabilities/Suicide Prevention Plan

The segment of the above-named rule titled “Identification” describes procedures for screening inmates so that any who are mentally disabled or potentially suicidal might be identified and referrals can be made to available mental health officials.

An inspector with TCJS made a note regarding non-compliance with this rule. He found that members of the jail staff are not entirely filling out the screening form for the identification of impairments in medical or mental development. The jail had been given technical assistance on this area of compliance during the inspection conducted in FY2020.

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

Suggesting that wrongs have occurred on the part of individuals or institutions is never intended on this website. Helping inmates in Texas county jails is the purpose of posts on this site. 

–Guest Contributor