Negligent in the case of a combat A federal jury in Central Islip, New York recently found that Nassau County jail’s medical provider and the county were negligent in the case of a combat veteran who hanged himself in the jail in 2012.
The jury awarded almost $8 million to the decedent’s family, Newsday reports.
The jury ordered Armor Correctional Health Services to pay $7 million in punitive damages to the family of Bartholomew Ryan, 32, and also awarded the family $890,000 in compensatory damages against Armor and Nassau County.
In their lawsuit, the family contended that former Marine’s death was wrongful because the county and Armor were negligent during the Ryan’s brief incarceration for driving while on drugs. The suit contends that Ryan did not get proper care, despite a screening showing he was a suicide risk. Nicholas Warywoda, of the law firm Parker Waichman, which represented Ryan’s mother, said, “the jury made a point to tell Armor and the county that’s not how you treat our veterans and people,” Newsday reports.
After the verdict was announced, an attorney for Armor said the jury had misunderstood an instruction and had unfairly awarded compensatory damages twice for pain and suffering. U.S. District Court Judge Joanna Seybert ordered attorneys to submit papers on the issue. The family had asked for $3 million for pain and suffering in compensatory damages, and $10.5 million in punitive damages from Armor alone — the amount the company earned for its Nassau jail contract in 2012. Nassau County is reviewing its options.
According to court records, the jury ordered the county and Armor to pay $370,000. Teresa Estefan, an Armor spokeswoman, said, “We consider any loss of life to be a tragedy. However, Armor disagrees with the verdict in its entirety given the evidence presented at trial. We intend to pursue all available post-trial remedies.”
In the lawsuit, the Ryan had alleged that Armor, a for-profit medical service provider to the jail, subjected the honorably discharged U.S. Marine to cruel and unusual punishment and negligence in how he was treated by Armor medical personnel. Warywoda said under Armor’s policies, inmates who get referrals for “urgent” treatment can wait up to 24 hours for care. During the trial, Warywoda said if Armor had paid attention to the form that deemed Ryan a suicide risk, “we wouldn’t be here today.” But the defendants denied responsibility for Ryan’s death, arguing that it was his choice to take his life. The attorneys said the suicide happened while two correction officers were distracted and not because of any lack of medical care or supervision. The county attorney for Nassau Deputy County said jail officials properly evaluated, housed and supervised Ryan.
The state commission found an Armor psychiatrist did an inadequate assessment of Ryan just hours before he hanged himself with a bed sheet in his jail cell on February 24, 2012, less than 48 hours after he was jailed. Armor executive Karen Davies wrote there was “no evidence” Ryan had ideas about suicide “at any time prior to the terminal event.” He was never given medication for drug withdrawal or for mental health issues, according to Newsday. Though Armor has defended its care, the State Commission of Correction has found its treatment deficient in at least five Nassau inmate deaths, including Ryan’s. Ryan’s case is the first of four such federal lawsuits to go to trial against the county and Armor over inmate deaths, according to Newsday.
Investigation into Inmate Deaths
In March 2016, after a series of inmate deaths attributed to failure to provide proper medical care, Nassau County Executive Edward Mangano announced that a team of public health officials would review medical treatment at Nassau County’s jail. The county health commissioner was to form a team “charged with performing a health care assessment” at the East Meadow jail.
The state Commission of Correction found Armor has a pattern of neglectful inmate care. In particular, the commission found that Armor provided inadequate care to four inmates who died since Armor became the medical provider. The commission said that two deaths that occurred in 2014 “may have been prevented.”
FORMER MEDICAL VENDOR FOUND AT FAULT IN THREE NASSAU COUNTY JAIL DEATHS
The Nassau County jail’s former medical vendor, Armor Correctional Health Services, was found to have failed to provide appropriate health care treatment in several cases. This lack of sufficient care directly led to the deaths of three inmates in 2016, according to a New York State oversight agency, a July 2017 report indicated.
The New York State Commission of Correction’s critical findings in the three deaths occurred at the same time as Nassau County in New York and Armor Correctional Health Services are the defendants in four federal lawsuits tied to other Nassau County jail inmate deaths. Armor, a Florida based, for-profit company, was contracted for more than six years at the Nassau County jail. Its contract ended on August 31, 2017, prior to Nassau University Medical Center’s (NUMC) resumption of control of inmate health care under a two-year contract, according to Newsday.
After its 2016 investigation into the three deaths, the New York State commission found that Armor was “incapable of providing competent medical care” and found one of the deaths to be preventable. In that case, the physician did not recognize another inmate was suffering from cancer and that medical staff committed “professional misconduct” and acted with “gross incompetence” while treating the other late inmate, records show, wrote Newsday.
Documents obtained under the Freedom of Information law reveal that Nassau Sheriff Michael Sposato and county Legislature Presiding Officer Norma Gonsalves knew about the commission’s preliminary findings in the three deaths when County Executive Edward Mangano’s administration was seeking a three-month Armor contract extension that May. A Legislative committee approved the deal. The three-month contract extension included a 66 percent increase in Armor’s monthly rate.
The state commission also released three final reports following the investigations into the 2016 deaths of William Satchell, 63; Emanuel McElveen, 20; and Michael Cullum, 62. Meanwhile state officials heavily redacted portions of the reports that included some medical information under claims of privacy exemptions under the law, noted Newsday. In every case, the agency’s final reports on the inmate deaths cited “systemic deficiencies in the delivery of adequate medical care,” as well as Armor’s “continued failure and unwillingness” to manage problems following the commission’s probes into inmate deaths since mid-2011. “The Board has found in each instance that failures of Armor Inc.’s staff to perform to minimally accepted community medical standards has directly resulted in these terminal outcomes,” commission Chairman Thomas Beilein wrote in a March 2016 letter to Gonsalves (Republican-East Meadow), referencing the preliminary findings, noted Newsday.
Records concerning the reports also reveal how the recent probes led the commission’s chairman to conclude that the Sheriff’s Department shares responsibility with Armor for not implementing appropriate reforms following prior jail custody fatalities, according to Newsday. Nassau County Attorney Carnell Foskey released a statement in response to Newsday’s requests for comment from the sheriff and county executive. “As there is presently litigation of certain inmate deaths it is best that the ongoing legal process address these issues. The county takes the death of inmates seriously,” Foskey said.
Armor, not surprisingly, contests the commission’s findings and claims its staff showed no negligence or incompetence concerning the care of Satchell, McElveen, and Cullum. “As in the past on other matters, we believe our staff took appropriate action and their care and treatment in these three matters did not contribute to the demise of the patients,” Armor executive Karen Davies wrote in a May 2017 letter to the commission. Armor spokeswoman Teresa Estefan also said that it stood by its responses to the commission, Newsday reported.
In the three reports concerning the fatalities, the commission indicated that Nassau County should hire a medical contract monitor with the power to penalize the jail’s health vendor for missed performance standards. This position was written into Nassau County’s Armor contract; however, the New York attorney general found that the position had not been filled since 2013, according to Newsday.
The legislature’s Republican controlled Rules Committee—led by Gonsalves—approved the Armor extension at a May 22 meeting that took place with no mention from Mangano officials or Gonsalves concerning the state’s preliminary findings in the three deaths. The meeting’s findings were not publicly available until several weeks after the state’s reports were finalized.
Frank Moroney, spokesman for Gonsalves, said in a statement that the Armor extension was granted, “to effectuate the transition to NUMC” and “there was no other health care provider that could step in during that transition and provide such services.” The spokesman also said that initial reports indicated that the commission’s reports were not final or available for public dissemination until final. “Gonsalves wasn’t allowed to discuss those cases,” Moroney said. Meanwhile, records indicate that a letter the commission sent to Gonsalves accompanying the initial reports did not prohibit her from releasing some information.
Sposato, a Mangano appointee who runs the jail, responded to the commission’s initial findings on the three deaths in three similar letters on May 12. He wrote that Nassau County was “in the process of transitioning facility inmate health care to another provider” given that Armor’s contract was scheduled to expire at the end of the month and also advised New York State that Nassau County was looking for a candidate to fill a health care contract monitor position; a Health Department employee was filling the role in the interim, according to Newsday. The sheriff noted that he had attached a copy of the May 12 letter that Armor executive, Davies, wrote to the commission. Her letter challenged specifics of the agency’s findings in the death reports for Satchell, McElveen, and Cullum.
In Satchell’s case, Davies wrote that Armor disagreed that treatment he received at the Nassau County jail contributed to his death while hospitalized. Armor also disagreed that treatment of McElveen contributed toward his declining health, adding that he received proper treatment in jail. Davies also wrote that Armor denied that Cullum’s death was impacted by care he received at the jail. “We stand by the work of our caregivers as meeting and exceeding the required standards of care for the patients that we serve at the jail,” she wrote.
Meanwhile, five days following the contract extension approval, a 58-year-old Nassau County jail inmate died after her lawyer said she complained about not receiving blood pressure medication for several days following her booking. Her death remains under investigation.
William Satchell, 63
The commission determined that Armor provided inadequate care in no less than eight of the 14 Nassau County jail inmate deaths during Armor’s time with the jail. The commission also found four of the fatalities—including the death of Satchell in March 2016—may have been prevented. The panel continues to investigate four of the deaths. Treatment inadequacies were not involved in two of the deaths that were deemed natural due to stroke and a fatal assault by another inmate, respectively, according to Newsday.
The report on Satchell’s death indicated the he died on March 24, 2016 due to cardiac arrest as a result of arterial blockage in his lungs while under treatment at the Nassau University Medical Center. The man, a retired janitor from Hempstead, New York, was jailed following an arrest the week prior on marijuana and weapon charges. The commission found the death of the father of four “was preventable if not for the shocking level of inadequate medical care and negligence of the medical staff” at Armor. The commission also indicated that Armor repeatedly failed to recognize “life threatening manifestations” of “a new onset medical condition”—or diabetes. The commission also found Armor made a “definite medication error,” giving Satchell an antipsychotic that is known to increase blood sugar levels, potentially causing the onset of his “unstable condition.”
The report further indicated that Armor “grossly mismanaged” Satchell’s high blood pressure and delayed seeking emergency hospital care for “a critically unstable” patient. The report also indicated that the doctor’s behavior was “contributory to his death” and requested state offices to investigate the Armor doctor for gross incompetence, and investigate an Armor nurse practitioner for gross incompetence and professional misconduct. The identities of both were redacted from the report. Also, as part of a settled lawsuit against Armor, New York Attorney General Eric T. Schneiderman alleged in 2016 that Satchell did not receive medication until three days after his incarceration and that Armor’s failure to conduct a routine screening led to a delay in Satchell’s diabetes treatment, wrote Newsday. The investigation alleged wide-ranging deficiencies in the treatment of inmates. Armor settled the lawsuit paying a $350,000 fine and agreeing to a three-year ban on new business in New York. Armor admitted no wrongdoing.
The commission advised Nassau County to appoint an independent medical authority to conduct a thorough review of jail health care and provide oversight of it, according to the Satchell report, wrote Newsday.
Emanuel McElveen, 20
The commission’s report on McElveen indicated that he died on July 5, 2016 of respiratory failure and concluded the man’s death was caused by a preexisting medical condition; however, Armor’s failures “were contributory to his worsening health.” The report also indicated that Armor did not sufficiently identify and treat his illnesses, recognize and treat serious changes in his condition, appropriately follow-up on medication issues, or adequately respond to McElveen’s sick call requests. The report also revealed that one of the illnesses from which McElveen suffered was large cell lymphoma (cancer) that impacted multiple organs. The commission concluded an Armor doctor (identity redacted) neglected to provide proper medical supervision, did not conduct thorough exams, missed follow-ups on laboratory tests and exams, and failed to detect McElveen’s developing cancer. Records also reveal that McElveen had been serving a one-year jail sentence following a February 2016 guilty plea to a misdemeanor charge of unauthorized vehicle use. A week prior to his death, McElveen indicated in a jail grievance, that Armor staff had not seen him following several requests. He said he was suffering from pain throughout his body, hearing loss, swollen feet, facial numbness, and an allergic reaction, according to the report, Newsday wrote. The maternal grandmother of McElveen’s toddler son, Pamela Gales, said she believed all along that McElveen never received proper medical care at the Nassau County jail. “They wouldn’t let him see the doctor,” she said, according to Newsday.
Attorney Nicholas Warywoda, who represents Gales’ family, said the inmate did not have to die, adding that Armor staff misdiagnosed McElveen’s cancer symptoms as being “moderate malnutrition.” Warywoda, an attorney at the national law firm of Parker Waichman LLP, said “This is just another example of Armor getting paid to provide medical care, and they fail to do it, again resulting in someone losing their (sic) life.” “Manny had a type of cancer which was treatable when he was making the complaints to the doctors and because of their incompetence, he lost his life for something that was treatable and curable,” Warywoda added. Warywoda was the attorney who represented military veteran Bartholomew Ryan after his 2012 suicide at the Nassau County jail.
Michael Cullum, 62
Cullum died on September 5, 2016 when a blood clot formed in the veins in his leg and traveled to his lungs, the commission noted. Pancreatitis and opioid dependency were contributing factors in Cullum’s death. The commission also discovered that Cullum’s death was “impacted” by Armor’s failure to appropriately treat chronic illness, recognize and treat significant changes in his condition, provide appropriate follow-up on treatment refusals, and swiftly transfer him to a higher level of care. After he died, his sister, Dorothy Cullum, said her brother would be alive if Armor “gave him his medication like he should have had.” The family’s attorney said that Cullum went for more than one week without “his lifesaving medication.”
After his August 26, 2016 arrest by Glen Cove police on drug charges, Cullum told authorities that he was in a methadone treatment program, records indicate, according to Newsday. The commission learned that an Armor doctor showed gross incompetence by neglecting to understand the necessity of sending Cullum to the hospital following serious changes in his condition. An Armor licensed practical nurse was also found to have shown unprofessional conduct by breaking detoxification protocol.
The commission noted an “unacceptable delay” of four hours and 40 minutes before a physician saw Cullum, despite his unstable vital signs. The commission also noted that Armor staff neglected to send Cullum to the hospital in a timely manner when emergency care was needed. The panel asked other state offices to investigate the Armor doctor for gross incompetence, as well as multiple nurses for professional misconduct, and for a probe into Armor’s use of licensed practical nurses (LPNs) without proper supervision. The names of the Armor staffers were redacted.
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