117 Dead

The county's corrections department issued a tepid response: "'While incarcerated, Mr. Ramos was regularly seen by doctors and medical staff, and hospitalized as needed. While Mr. Ramos's medical history is quite extensive and complex, there is no indication of a lack of medical care or attention in his case. However, as with any death at our corrections facilities, Miami-Dade County is investigating this matter.''

The story hit one 33-year-old Hialeah man, Chris Jimenez, hard. A diabetic like Ramos, he had been locked up for two weeks in 2005 at Metro West on a violation of probation charge. The guards, he recalls, made it difficult for him to get insulin and food. Nurses sometimes gave him an incorrect dose or none at all. Not long after his release, the former army officer's blood sugar level spun out of control. Then he contacted county leaders, including Mayor Carlos Alvarez, to complain about inadequate medical care at the jail.

Then came Ramos. "This death could have been avoided," Jimenez says. "I was given promises that things were going to be fixed, procedures changed. Nothing was taken care of. The people at the jail are not doing their job."

Shortly after Ramos's death, several nurses were talking in Ward D, the medical wing at Metro West. They discussed the ant bites, the feces, the rats. They recalled how they had given him insulin and how his condition had deteriorated over several months. They questioned whether they could have done more.

"We sat there in horror as we talked," says one nurse, who asked not to be identified for fear she would lose her job. The nurse, who has worked around inmates for several years and has the no-nonsense demeanor of a schoolmarm, had tears in her eyes as she thought about Ramos in solitary. "The cell was almost as big as his wheelchair," she says. "A safety cell. He wasn't a high risk of escape."

The situation bothered her so much she decided to speak up — as much as she dared. On June 22 she wrote an anonymous letter to Corrections Director Ryan. It accused a high-ranking nurse of incompetence. "As a direct result, inmates ... are placed in danger because proper techniques and procedures are not encouraged and followed. The recent tragedy with Inmate Rodolfo Ramos illustrates the above statement because proper technique and procedures were not followed."

Though the letter contained nine fax numbers at the jail and Jackson hospital, New Times could not confirm it was sent or received.

There is no indication in the high-ranking nurse's personnel file of complaints or problems. She is a 20-plus-year employee of Jackson Health System who has received excellent reviews.

Asked about the letter and allegations, Jackson spokeswoman Lorraine Nelson e-mailed a three-line response: "Jackson Health System takes these allegations very seriously. We will conduct an internal investigation. At this time, we have no further comments on this issue."

Moreover, the Health Trust insists it gives inmates proper care. Despite the 117 deaths, there has seemingly been little fallout. Arthur Brown, director of nursing for CHS, resigned from his job July 3, said Robert Alonso, Jackson's vice president of public affairs and marketing.

The documents in Brown's personnel file indicate the 25-year employee had done well at his job. There is, however, one sign he wasn't completely focused on the $121,000-a-year job: He submitted two requests to work an outside job, once in 1996 and again in 2005 — the year 16 people died in county jails.

Brown couldn't be reached for comment. Asked if the resignation had anything to do with allegations of poor treatment, Alonso responds only that it was because of "personal reasons."

Says the anonymous nurse: "It's just a job for them. They're getting a salary — they don't care."

Sometime soon, Miami attorney Kubiliun and his partner Lynn Overmann, both former public defenders, plan to file a lawsuit in federal court on behalf of five dead inmates — including Ramos and Kippo — and more than a dozen others who are still alive. In June they sent the Health Trust and the county corrections department notice of the suit.