Miami Herald - Saturday, August 3, 2002
Daniel de Vise, ddevise@herald.com

A report by New Mexico consultant Dr. Steven S. Spencer also faulted the jail's medical staff in four other deaths over the previous nine months.

Attorneys filed the reports in federal court Thursday as part of an ongoing dispute over inmates' rights. A team of three independent consultants also cited repeated cases of excessive force against inmates and an inadequate system for investigating complaints.

"There is insufficient involvement of physicians in the care of patients. This deficiency has had some very unfortunate and tragic outcomes," wrote Spencer, who spent a week in the jails and reviewed reams of jail documents.

In a letter to U.S. District Judge William Hoeveler, attorneys for the Broward Sheriff's Office contend Spencer's report falls short of alleging "systemic and deliberate indifference to the serious medical needs of inmates."

Attorney Bruce Jolly said all three independent reports "are very favorable" overall. He said their release to the public was premature.

"These are reports to the court, and it would be the court's determination as to when if at all the report or any reply to the report should be disclosed," Jolly said Friday. "And that's because we're eventually going to have a public hearing on this."

Sheriff Ken Jenne wants the judge to lift a 1994 consent decree that called for ongoing court oversight of Broward jails. Attorneys for the ACLU's National Prison Project want the judge to extend the consent decree and the outside oversight.

In a report in May, Spencer cites three jail deaths that might have been prevented with adequate healthcare.

Inmate David A. Taylor, who had a history of psychiatric problems, killed himself Feb. 15 by tearing open a vein that had been enlarged for kidney dialysis.

Taylor, 56, a one-time Pompano Beach minister, apparently got no mental health assessment or psychotropic medication while in the jail, despite "subtle but recognizable calls for help," Spencer wrote. "This tragic case attests to a serious systems failure and communications breakdown," he concluded.

Another inmate, an unidentified 36-year-old man, died of a ruptured brain aneurysm Dec. 9 after jail workers found him unconscious on the floor.

The man had a two-decade history of aneurysm, Spencer wrote. But when he repeatedly reported severe headaches, medical workers gave him Sudafed, cough syrup and Motrin and made no apparent effort to diagnose the deeper problem. Records indicate no doctor ever saw him.

The third case is John Beraglia, whose Sept. 16 death sparked controversy although it was ruled accidental.

According to Spencer's report, Beraglia suffered from side effects of the antipsychotic drug Haldol and required another drug called Artane to control the side effects. But jail records indicate he never got that drug.

The day he died, Beraglia was experiencing involuntary neck movements and difficulty breathing, the side effects of Haldol.

Unable to get the drug he needed, Beraglia began scratching his wrist with a broken spoon and banging his head against the wall.

When jail staff removed him from his cell for medical care and attempted to strap him in a restraint chair, he fought them off.

In the ensuing struggle, six to eight guards held him down for at least five minutes despite his complaints that he couldn't breathe, Spencer wrote.

Spencer concluded that "the failure to provide him with Artane precipitated the cascade of events that led to his death."

Spencer cited concerns with four jail deaths from December 2000 to August 2001:

* A 50-year-old man who died Dec. 17, 2000, his body overwhelmed by infection. Spencer said the patient was never seen by a doctor.

* Another 50-year-old man who leapt to his death Jan. 13, 2001, after twice reporting severe back pain. He was never seen by a physician, Spencer wrote.

* A 48-year-old man who died March 2, 2001, of a "large brain mass." Spencer concluded too much of his medical care was dispensed by nurses rather than doctors.

* A 43-year-old woman who died April 19, 2001, of complications from AIDS. Spencer found that jail staff underestimated the severity of her symptoms.

Spencer cited "appropriate" healthcare in three other deaths and reached no conclusion on others.

BSO attorneys said the jail was in flux at the time of Spencer's research because it had just signed a contract for healthcare work with Wexford Health Sources. The company has been constantly updating staffing, record-keeping and procedures since then, Jolly said. He said the county's jail system is the only one in Florida with full accreditation from three different professional organizations that oversee prisons.

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