Incarceration Can Be Hazardous to Your Health

When he was booked into the Dade County Jail, Earl Cole was a sick man. Not for long.

Nurses at the Dade County Jail closely monitored the behavior of 50-year-old inmate Earl Laron Cole on November 19, 1994. He was sleeping at 7:00 a.m., they noted in the hourly log. At 10:00 a.m. he was eating. At noon he was resting. He continued to rest and sleep, lying in his cell bed, until 11:00 p.m. on November 21, when he went into shock and was taken to Jackson Memorial Hospital. He was pronounced dead at 8:15 a.m. the following day.

The Dade County Medical Examiner's Office classified Cole's demise as a "natural death." According to the report, Cole died of rheumatic heart disease, with kidney failure cited as a contributing cause.

But Cole's sister Phyllis Gunn was suspicious. Cole had told her he feared for his health in the jail. And while she sat grieving at his side, Gunn recalls, a nurse came in and remarked as if speaking to herself, "If they had brought him here sooner we could have saved him." Now the family has sued the county and Jackson Memorial Hospital for negligence and deliberate indifference.

Lawyers who represent Cole's four children say the circumstances surrounding his death typify the lackadaisical treatment sick inmates receive from Dade's Department of Corrections and Rehabilitation. "There is a consistent pattern with everyone we hear from who complains about medical care," asserts Peter Siegel, an attorney at the Florida Justice Institute who is representing Cole's family in their lawsuit. "There seems to be an absolute inability on the part of the medical staff to respond in a timely manner -- it takes them weeks and weeks and months and months, sometimes."

Jail records show that Cole told his jailers about his medical problems on November 12, 1994, the day he was arrested for writing bad checks. He informed them that he had been receiving dialysis three times a week for the past eleven years and that he was due for treatment that day. On November 13 Cole was examined by a doctor at the jail who prescribed medication and hemodialysis. Nevertheless, he did not undergo dialysis until November 16, a full week after his most recent prior treatment.

After Cole returned from dialysis, a nurse noted that he was "breathing with difficulty." She scheduled him for additional treatment the next day, but according to jail records that appointment was never kept. On November 18 Cole complained that he had a sore throat and chills and was coughing up white mucus. Once again he was scheduled for dialysis. "For reasons unknown, no dialysis treatment was provided," says attorney Jeff Norkin, who is representing Cole's family along with Siegel. Cole did not receive any further treatment until he went into shock on November 21.

Janelle Hall, spokeswoman for the county corrections department, declines to comment on Cole's treatment, citing the pending lawsuit. Eric Gressman, the assistant county attorney who is handling the lawsuit, says the county denies all allegations of negligence or indifference.

After conducting a routine investigation into Cole's death, the Florida Department of Corrections cited the jail for three deficiencies. "The medical record documentation does not indicate that all dialysis treatments were provided as prescribed," reads an inspector's report. "It is unclear whether special diets were provided as ordered.... On many occasions, doses of medication were not documented as being given; one medication, Procardia XL [for angina], was never administered at all." The report also notes that although the state required that every jail inmate go through medical screening upon admission, there was no record that Cole had been screened.

The state sent the report to the jail, where it apparently was ignored. "To be honest with you, there's not a lot we could do," confides the state's chief corrections inspector E.A. Sobach. "[The jail] was not required to provide us with a corrective action plan. The only enforcement authority we had was to file for injunctive relief in circuit court."

No such filing was made. In fact, as of this year the State of Florida no longer inspects county jails; the legislature has determined that state regulations shall no longer apply to county institutions.

"That's another disaster waiting to happen," comments Peter Siegel. "The fact is they just don't have a system that provides any insurance that an inmate with a medical problem is going to be seen and dealt with in a timely fashion."

This year alone, 28 inmates have died while in custody at the Dade County Jail, which for nearly two decades has been dogged by persistent overcrowding and other highly publicized woes. (New Times staff writer Jim DeFede examined some of those problems in his March 21, 1996, cover story "Jailhouse Rumble" and in a column, "Prisoners and Politics," in last week's issue.) Some of the victims committed suicide, others overdosed on drugs. One inmate died of spinal meningitis, and another suffered a fatal seizure. Siegel says dozens of inmates have complained to him about the lack of medical attention. "I had a case a number of years ago of a gentleman who had a growth on his face," he recalls. "It took them three or four months for doctors to see him, and then they had to get a biopsy done, and of course it was cancerous. Then it took them another three or four months to get him to a doctor, and of course by then it had grown. It had started out a small spot, maybe the size of a dime, but by the time he got to a doctor it was the size of a quarter or a 50-cent piece."

Phyllis Gunn keeps a letter her brother wrote to his attorney before he was arrested that documents his worries about returning to jail. Cole, a former Delray Beach police officer, already had spent time in jail at least twice on similar charges. He had been arrested in February 1994 in Deerfield Beach after police searched his car and found fourteen false IDs. According to the state Department of Motor Vehicles, he held licenses or IDs under 60 different names. At the time, he avoided jail because of his poor health. He was arrested again that November when he tried to pay for merchandise at BrandsMart with a check that was drawn on a closed bank account.

"My brother was, like, almost frightened," Gunn recalls, speaking from her Delray Beach home. "He just didn't want to go back there. He had been there once before and they treated him mean. They thought he was lying and they wouldn't take him for his treatment. He said they put him in a room and just left him there for so many hours without even coming to check on him, and when they finally came to check on him he was so weak he was lying on the floor."

Charo, Cole's twenty-year-old daughter, says her father was fastidious about his health. "My father knew how sick he was and he knew he needed his dialysis," she insists. "He would have made sure that he got his treatment. Someone needs to find out what happened, because it doesn't make any sense."

Dr. Luis Sirotzky, Cole's personal physician, has stated in an affidavit drafted in support of the lawsuit that Cole received inadequate care and that his death was caused by "acts of medical malpractice and negligence."

Dr. Roger E. Mittleman, the chief Dade County medical examiner, reviewed the report of Cole's autopsy at New Times's request. At the time of his death, Cole suffered from pneumonia and heart disease as well as kidney problems, Mittleman says. Although the primary cause of death was heart failure, the medical examiner points out that kidney failure could have irritated Cole's heart condition. "This is a man who was really a time bomb. He could have died at any second," Mittleman observes.

If that was the case, Jeff Norkin wants to know, why wasn't Cole taken to the hospital? "He was allowed to waste away in his cell with little or no medical attention until it was too late," fumes the attorney. "They watched this guy sleeping for three straight days and they did nothing.

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