Crime - Sacto 911

Deaths underscore record of poor medical care at the Sutter County jail

Nathan Prasad had been in the Sutter County jail for a few days when his health began to fail and he started asking for help. Repeated pleas for medical attention got him nowhere, his mother said, and he finally turned to his cellmates.

“Nathan told them, ‘I’m dying, this is my mother’s address, you need to write her and tell her what went on,’” Prasad’s mother, Mary, recalled recently as she fought back tears.

That plea, a Bible and the ingenuity of Prasad’s cellmates may be the only reason Mary Prasad now knows how her son died after a six-day stay in the jail in January 2011.

Prasad and her husband tried to investigate the death on their own. But they said they had no idea what had happened until they were contacted by a pastor who regularly visits inmates. He told them that after he left the jail one day, he discovered Nathan Prasad’s fellow inmates had slipped handwritten letters describing their cellmate’s death into his Bible and asked that they be delivered to Mary Prasad.

The pastor gave copies to her as well as to sheriff’s officials. Some of the letters, in which the inmates recount Prasad’s cries for help, ended up in one of two court cases that have pushed county officials to revamp their medical and mental health care inside the jail and to pay out more than $1.6 million in settlements to the Prasads and the family of another deceased inmate.

The settlements come more than six years after the Sutter County grand jury began warning officials that health care for jail inmates was plagued with problems and nothing was being done about it.

Now, in response to lawsuits by the Prasads and the family of 56-year-old Rodney Bock, the county says it is addressing some of the most serious deficiencies at the jail in Yuba City. Among the steps taken, according to lawyers for the county and its risk manager, are two that might seem basic: the health care workforce has been increased, and training has been beefed up.

But, efforts by the families’ lawyers to get round-the-clock health care at the jail have stalled.

“That crucial time, when they didn’t have medical care, could have saved my son’s life,” said Mary Prasad, 53, whose son died of pneumonia and bronchitis after his stay in the jail in 2011.

Nathan Prasad, who was 30 and had a history of medical troubles, mental illness and drug abuse, according to his family, was well known to Sutter County jailers. Documents generated during his various stints in the jail detailed his health problems, including a history of staph infection, which is what triggered his death, said Aaron Fischer, an attorney for the Prasad family.

Prasad begged the jailers on duty to take him to the hospital, complaining that his foot and leg were turning black and that he was throwing up blood, according to the family’s lawsuit in U.S. District Court in Sacramento brought on behalf of his mother and three minor children.

“Nathan had been telling everybody, ‘I’m dying, I need some help, I need to go to the hospital,’ ” Mary Prasad said in an interview in the backyard of the Colusa home she shares with her husband, Tom. “And he was just met with ridicule.”

‘Not much we can do’

The Prasad case, settled with the county for $825,000, will result in a $360,000 fund set up for his three young children. It highlights the difficulties rural counties face in caring for sick inmates in their charge.

While the state of inmate health care in the California prison system has been the subject of class-action litigation in the federal courts for decades, less attention has been paid to how county jails provide treatment for inmates. But inmate advocates are taking notice as the populations in jails increase, in part because of the state’s realignment program, and lawsuits have been filed in several counties, including Riverside, Fresno and Alameda.

The lawsuit against Fresno County alleges that the jail’s poor design and inadequate staffing make inmates vulnerable to attacks from other inmates. It also alleges that inmates are regularly denied treatment for medical issues, mental health and dental problems, something Fresno County officials have denied as the case continues in federal court.

“It’s hard to get people to spend money on people in the criminal justice system; that’s just a fact of life,” said attorney Michael Bien, who has successfully forced reforms in the state prisons and whose firm sued over the two Sutter County deaths.

“Here’s two people who died unnecessarily because too little attention is given to basic, fundamental care of people who are incarcerated.”

In Sutter County, the warnings have been coming since the 2007-2008 grand jury recommended that, at minimum, a nurse be on duty 24 hours a day at the jail.

Sheriff Jonathan Paul Parker did not respond to a request for comment, but the sheriff has maintained that the county’s health department is responsible for health care in the jail and that he has unsuccessfully sought funding from the Board of Supervisors to improve care in the 352-bed facility.

“ There’s not much we can do about it, other than do the same thing I do, which is constantly whine about it,” Parker said in a January deposition included in the Prasad case.

As a result, there was no medical staff on duty between midnight and 4 a.m. on Jan. 28, 2011, the day Prasad died, according to the family’s lawsuit.

“Nathan Prasad’s condition deteriorated from an infection wholly treatable through basic and timely medical attention to an extraordinarily painful death as a result of Sutter County’s failure to provide treatment,” according to the suit.

10 minutes too late

Jail staffers knew there was a “long-standing and trenchant problem with contagious bacterial infections” at the jail, and they knew Prasad was vulnerable to them; he had been treated at the jail years earlier for a staph infection, court documents state.

Despite that, his access to medical care was limited once he was arrested Jan. 21, 2011, the suit contends.

“He had a failure to appear and a probation violation, and he was in one of his dark places,” Mary Prasad said of the day her son was arrested at his Yuba City apartment. “He actually called 911, because he was thinking somebody was going to attack him and kill him.

“He thought people were in his air vents.”

Prasad was taken to the jail and placed in a padded cell, then moved after a few days to a cell with seven other inmates, according to his family. On Jan. 26, after he complained of “enormous pain in his lower extremities,” he was taken from jail to Rideout Memorial Hospital in Marysville. The hospital was a defendant in the Prasad suit, but that part of the settlement is legally not public because it involves only private parties.

At Rideout, Prasad underwent testing over a 2½-hour period, and was sent back to the jail with instructions that he should be brought to the emergency room “immediately if his symptoms worsen or new symptoms develop,” according to the suit.

His condition began to spiral downward almost immediately. His blood pressure was falling, his pulse was racing, and the discoloring and bruising that began in his leg moved to his midsection.

“Fellow inmates desperately sought medical help for Nathan Prasad, going so far as to collect the blood he coughed up in a used milk carton, which was provided to jail staff,” the suit states.

Finally, before dawn on Jan. 28, a deputy and a licensed vocational nurse who had just come on duty observed Prasad, and the nurse documented that his “blood pressure and blood oxygen saturation were dangerously low, that he was coughing and/or vomiting up blood, (was) dizzy, sweating, cold and clammy,” the suit says.

They placed him in an office and told him to lie down, the suit says, and no one summoned an ambulance for another four hours.

“By that time, Nathan Prasad’s condition had deteriorated dramatically and his skin had turned blue due to severe oxygen deficiency and cyanosis,” according to the suit. “His blood pressure could no longer be detected. Nathan Prasad was at this point suffering from severe sepsis.”

Sheriff’s officials were becoming concerned.

“Just for your info, we almost had an in-custody death,” sheriff’s Capt. David Sampson wrote in an email to the undersheriff that day that is included in the court documents.

With Prasad at the hospital, sheriff’s officials decided to release him on his own recognizance “so he could attend to his medical issue,” Sampson testified in a January deposition for the lawsuit.

No one alerted Prasad’s family that he was in the hospital until just before he died, Mary Prasad said, and she got there 10 minutes too late. The family had no idea Prasad was in peril because he and his mother had agreed not to communicate whenever he was arrested.

“This is one thing I will regret for the rest of my life,” Mary Prasad said, and began to weep at the memory. “We had made a pact that if he was in jail, I wasn’t going to go see him, and I wasn’t going to take his calls.”

County takes action

Less than a month after Prasad’s death, Sutter County was sued by the family of another inmate, who had died in the jail 10 months earlier.

Rodney Bock was a fruit farmer and vendor who lived north of Marysville and who suffered mental issues that were made worse by a November 2009 beating that left him regularly making “erratic and paranoid statements that God and Rush Limbaugh were talking to him and telling him what to do,” according to his family’s lawsuit, also filed in federal court in Sacramento.

Bock’s family took him to a county psychiatric facility in early April 2010, where specialists decided he was psychotic and required two weeks of involuntary hospitalization, the suit says. For reasons that are not clear, he was instead released to the jail on a failure-to-appear.

Despite a Superior Court order that he be admitted to the Napa State Hospital for treatment, Bock remained in the jail until April 29, 2010, when he suffered “a violent and psychotic episode, including repeated forceful banging of his head and body against a hard cell wall, causing substantial bleeding and hemorrhaging, and his hanging himself in the jail,” the Bock lawsuit says.

Bock’s four daughters, who maintain the family fruit farm north of Marysville as well as a roadside fruit stand, said it was obvious their father was deteriorating in jail.

“He had stopped shaving, brushing his teeth, it was just very visible he was not doing well,” said Kellie Bock, his 29-year-old daughter.

The county settled the Bock lawsuit on May 20 for $800,000, less than three months after it settled its portion of the Prasad case for $825,000.

The Bock settlement includes promises by the county that improvement of health care at the jail is ongoing. The county has hired a new medical director, as well as two nurses with emergency room experience, a public health nurse and a licensed vocational nurse. The settlement also calls for the county to consider other recommendations from the plaintiffs’ lawyers.

It does not, however, include a promise to have medical staff on duty in the jail 24 hours a day, as the sheriff has repeatedly sought.

“The sheriff’s pleas continue to fall on deaf ears at the Board of Supervisors,” said Fischer, the Prasad family attorney. “You can bet it will be one of our recommendations.”