MANSFIELD — Twice in four years, Richland County Jail inmates who complained of symptoms from alcohol or drug withdrawal collapsed while incarcerated. Both men were taken to the hospital by rescue squad, but neither survived.
Family and friends of Michael Paul Reid and Corey S. Tolar were left with questions about whether the jail is safely staffed and equipped to deal with chronic substance abusers.
Michael Reid’s blood-alcohol level was 0.347 when he was booked in April 2, 2009, on a misdemeanor probation violation. The 37-year-old, who told sheriff’s employees he had a history of withdrawal seizures when he stopped drinking, was placed for observation overnight in a concrete cell. He suffered a seizure, striking his head as he fell. Despite surgery, he died of brain injuries five days later at MedCentral/Mansfield Hospital.
His mother, Susanne Reid, wonders why her son wasn’t taken to a hospital when first incarcerated, and why he was placed in a cell with hard surfaces rather than padding.
A corrections officer in the vicinity when her son fell described the sound as loud as a gunshot, she said.
Susanne Reid said she practically lived at the hospital as her son’s condition continued to deteriorate.
When surgery was done to try to relieve pressure on Michael’s brain, doctors found he’d damaged his dead so severely that they could not put the large damaged area back into place. “That surgeon said that was the first time he ever saw a piece of skull crumble in his hands,” she said.
Corey S. Tolar, 28, who served as an Air Guardsman, was stopped for expired license plates Sept. 25, 2012. He was arrested on charges of possession of cocaine, heroin and suboxone. During book-in he denied using street drugs, but later the same day he admitted he was undergoing heroin withdrawal.
Tolar was placed on suicide watch until Sept. 28, then went back into the general jail population. Around 2 a.m. Sept. 29, he walked into the bathroom and suffered a seizure. He was taken to a book-in cell, where he was found unresponsive that afternoon. Though rescue squad staff found a faint heart rhythm and attempted to rescuscitate, Tolar was pronounced dead at MedCentral.
Mental health officials say risk of death from withdrawal historically is believed to be much lower for people abusing heroin than for people abusing alcohol.
After consulting with a Summit County pathologist, Richland County Coroner Stewart Ryckman ruled the cause of death for Tolar as “complications from heroin withdrawal.”
Withdrawal deaths across U.S. jails
The cases in Richland County were not unusual among U.S. jails.
• New York City agreed in February 2011 to pay $2 million to settle a lawsuit alleging a 51-year-old former postal worker died in the Manhattan Detention Complex. He suffered a severe withdrawal from alcohol that went untreated. Oscar Livermore died in the jail’s general population, about 28 hours after being booked into the jail.
• A federal lawsuit was filed after Andrea Armstead, 21, died Nov. 8, 2011, while going through heroin withdrawal in the Kalamazoo County (Mich.) jail. Armstead, who told officers she was withdrawing from heroin, convulsed, collapsed and lost consciousness.
That lawsuit alleges Armstead was given a single dose of Pepto-Bismol, instead of assessing her need for Clonidone, a withdrawal medication. It also claims a nurse at the jail left Armstead on the floor after her collapse while he went to consult jail protocol. She went into cardiac arrest and was taken to a hospital where she died, according to the lawsuit.
• Rachel M. Hammers, booked into the Douglas County Jail in Kansas for failing to appear in court on a DUI charge, died May 12, 2012, after being discovered unresponsive. An autopsy said the 33-year-old had a history of seizure activity during withdrawal from alcohol. Though her cause of death could not be established, the best explanation was related to seizure activity, according to an autopsy.
By the Numbers
Drug or alcohol intoxication ranked as the third among causes of death for inmates in local jails, after heart disease and suicide, according to the U.S. Bureau of Justice Statistics’ “Mortality in Local Jails and State Prisons, 2000-2010.”
The report notes 64 inmates in local jails across the U.S. who died from drug or alcohol intoxication in 2009, the year Reid died.
• Seventy-one percent of drug or alcohol intoxication deaths occurred within seven days of the person going to jail, the study said. An earlier BJS report, for 2000-2007, said smaller jails holding fewer than 50 inmates had an intoxication mortality rate three times higher than the nation’s 50 largest jails — or 31 inmates per 100,000, compared to 8 per 100,000 for bigger jails.
• A five-year study of deaths in North Carolina jails and prisons during the 1970s specifically singled out alcohol withdrawal as responsible for 30 of the 223 deaths in custody statewide. The report advocated jails taking steps to reduce risk where they can. For example, North Carolina managed during the course of the study to drastically reduce jail suicides by instituting belt removal policies for inmates.
• The Ohio Bureau of Adult Detention, responsible for inspecting Ohio jails, reported receiving 148 complaints that required the Bureau to work with local jails for resolution during 2008, the year before Reid’s death. “The vast majority were associated with medical issues, e.g. treatment, medications, specialty care,” the agency said in its annual report.
• “Behind Bars II, ” a 2010 study by the National Center on Addiction and Substance Abuse at Columbia University, said nearly 85 percent of local jail inmates are involved in substance abuse in some way. But pharmacological therapies for substance abuse remained “under-utilized” by the corrections system, the report said.
Of 1.5 million prison and jail inmates with substance abuse disorders in 2006, only 11.2 percent had received any type of professional treatment since they were admitted, that study said.
Jail death answers?
“Many of these deaths are preventable,” said Dr. Kevin Fiscella, professor of family medicine, public health sciences and oncology at the University of Rochester School of Medicine and Cancer Center. He collaborated on a study of alcohol and opiate withdrawal risks in U.S. jails reported in the American Journal of Public Health in 2004.
The study found only 28 percent of jail administrators reported their institutions had ever detoxified arrestees. It also stated inadequately treated drug and alcohol withdrawal seemed widespread in local corrections facilities.
Fiscella said a growing number of jails now recognize intoxication represents a hazardous medical condition and have implemented appropriate policies and procedures to reduce risk for their recently admitted inmates.
Procedures for universal screening on jail admission followed by medical evaluation, risk stratification, and corresponding medical management, apply to both intoxication and withdrawal as overlapping conditions, he said.
Closer to home
When Mansfield decided to merge its smaller holding facility into the new Richland County Jail, the reasons included city officials’ awareness of the medical risks associated with a growing number of inmates addicted to alcohol or drugs, and a lack of medical staff working at the city jail, said former Mansfield Safety-Service Director Phil Messer.
Prisoners at the city jail who showed signs of medical risk were taken to MedCentral, said Messer, also the city’s former police chief. As long as the inmate wasn’t a flight risk or a danger to the community, and the judge concurred, the inmate was released from city custody, with hospital bills left to the prisoner’s responsibility.
If it was deemed unwise to release the prisoner from custody, he was taken to the hospital under city control, even if that meant the medical bills were on the city’s dime, he said.
“The judges all worked with us,” he said. “We had 12 or 15 inmates, where they (the county) have 200. But to me, as a CEO, my greatest concern was the safety of the prisoners.
“It’s a huge responsibility. You are ultimately responsible for the care of someone in your custody.”
“There’s a huge problem nationally with issues of detoxification and withdrawal — mostly from opioids, but also from alcohol in jails — that has resulted in relatively high numbers of deaths,” said Bradley W. Brockmann, director of the Center for Prisoner Health and Human Rights at Miriam Hospital/Brown University Medical School in Rhode Island.
“The majority of people coming into jails are substance-involved. We know that 60 percent or more are either actively on drugs, or have been using drugs in the past month,” he said.
Challenges posed by that include the possibilities of seizures or other complications directly related to withdrawal, but also medical conditions that sometimes accompany addiction, including heart problems and other infections in the body. Inmates in withdrawal may experience heart arrhythmias, convulsions and delirium, may choke on their own vomit or die from severe hydration, Brockmann said.
“It’s something that any jail is going to deal with. It’s a question of whether they have the protocols to deal with it. Many jails simply don’t,” he said.
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Comment by one of his counselors?…
Interesting that this fella went through “new begginings” – when I went there through our Employee Assistance Program to get help with an alcoholic it was made that underlying causes were my fault they drank too much. Great system they have there, reminds me of all our left wing liberals who continue to blame others for their own short comings. Not saying these people deserve to die, it’s just we need to start holding these people responsible for their own choices and quit blaming society on the reasons they make this choice.
I agree they will more than likely sue and win!, that’s how left wing liberals have made our justice system. I do believe we need the “right” facilities to look over these people, the only crimes they are committing are those to themselves. Keeping them locked up when we should be looking for other ways to get them straight makes the jails responsible when they are not prepared to take on this responsibility!. Surely IF something happened to them in our care it would be our fault as well, so DEAL WITH THE SYSTEM! – YOU LIBERALS MADE IT THIS WAY!
I HOPE YOU GO BANKRUPT, OR CHANGE THIS SYSTEM OF TRYING TO RUN FOLKS LIVES WHO ARE HURTING NOBODY BUT THEMSELVES. WE NEED TO PUT THE RESPONSIBLITY BACK ON “THE PERSON”, NOT THOSE WHO WILL EVENTUALLY PAY FOR THIS BEHAVIOR (TAX PAYERS)BECAUSE THIS IS YOUR ONLY WAY YOU THINK CAN HELP THEM FROM THEMSELVES. YOU ARE BANKRUPTING THE CITY AND THE COUNTY WHEN YOU CONDONE ABUSE, AND DON’T HAVE THE MEASURES TO COUNTER IT WITHOUT DEATH AS YOUR EXCUSE. MAYBE A GOOD LOOK IN THE MIRROR IS A START ON HOW WE SET THE EXAMPLES FOR OTHERS. PEOPLE IN GLASS HOUSES SHOULDN’T THROWN STONES, YOU KNOW WHAT I MEAN?.