117 Dead

About 89 inmates expired in the cells and medical wards of the county's jails between 2000 and 2005 — most from cancer, heart attacks, or bad living, which makes the system the nation's eighth worst, according to the most recent information from the U.S. Bureau of Justice. (In 2006 18 died, and so far this year, nine more have perished — for a grand total of 117 in seven years.)

Moreover, local jails have had significant problems with medical care in the past few years. In 2003, after 17-year-old Omar Paisley died of a ruptured appendix, a grand jury investigated the Miami-Dade juvenile lockup and Florida lawmakers held hearings. The boy had asked for medical help, but jailers thought he was faking. The result: Three top state juvenile justice administrators were fired.

The same year 13 nurses at Metro West, the county's largest detention center, located on NW 41st Street, complained only three or four nurses worked any given daytime shift — and there was only one nurse at night. "This ... limits their ability to adequately process all requests," the nurses wrote in a letter to administrators. "Patient services are delayed."

And the number of full-time employees in the county's jails continued to decline from 203 in 2003 to 180 in 2006, though the Corrections Health Service budget was steady at around $24 million annually. Some CHS administrators earn more than $120,000 a year. "Obviously the care got worse and worse as the staffing went down," says a nurse who signed the memo.

Yet CHS Medical Director Dr. Kathryn Villano is confident prisoners get the best medical attention possible. "The inmates have much greater access to health care in jail than on the street," she says. "In jail a nurse can refer them to a clinic and they go there within a day or a couple of days."

Corrections Director Tim Ryan told county commissioners in July that because many inmates have health problems — 44 percent of them are diagnosed with some sort of disease — "it is not unusual" that there are deaths. He said it is "safer to be in jail than out in the community."

Ryan tells New Times that although Miami-Dade's corrections agency is the largest in Florida, it ranks number two, behind Jacksonville, in mortality rates. He also says, "The poor health level of inmates has been constantly rising, meaning we should expect a higher health acuity [sic] as well as a higher mortality rate."

Even if Villano and Ryan are correct, inmates and judges often can't convince corrections officers to allow doctor visits to treat the problems, says former Miami-Dade Judge David Young, who left the bench earlier this year. During his six years in court, Young received hundreds of calls from worried family members regarding relatives' suffering in jail. He says he repeatedly ordered the county corrections department to provide medical testing and care, but his instructions were often flubbed or ignored. "You would have thought that we were asking to meet with the president of the United States," Young comments. "I was very frustrated with the lack of quality care received by inmates."

In 2005 Young heard the case of Elizabeth Lingerfeldt, an 18-year-old awaiting trial on armed robbery charges. She asked for a cancer test. The teen's mother had died of cancer, and Lingerfeldt had discovered a lump in her neck — in the same place her mom had found a tumor. The corrections department wouldn't send her to be tested, she said. Young ordered the test, but Assistant County Attorney Randy Duval, on behalf of the corrections department, responded that Young didn't have the authority. Young then released Lingerfeldt. In open court, he told the young woman: "I don't have any faith in the county getting you the medical attention that you need."

"We have a lot of people putting in requests for medical attention," Duval told the Miami Herald. "If every inmate went to the top of the list based on a judge's order rather than their medical needs, it would wreak havoc on the system."