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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.
The plaintiff list could grow. Word has gotten around the jail of the coming legal battle, so the pair receives at least two calls a day from inmates or their families about medical mistreatment behind bars. And letters — penned by inmates who claim they were denied insulin and other medicine in Miami-Dade's lockup — have arrived from as far away as the state prison in Raiford.
Kubiliun might also champion the case of those locked up in the jail's solitary confinement cells, where Ramos was kept. Twenty-four-year-old inmate Waltaire Choute hanged himself in one of those cells May 27. And Christopher Walls, who was 32, did the same August 5. Kubiliun wonders whether jailers checked on the men every half-hour — as required by jail procedure.
Phone records show Choute spoke with family members at 5:02 p.m. According to jail records, he hanged himself by 5:22. "I don't think he had enough time to do that," says Kubiliun. "Something doesn't add up."
And Walls, who was awaiting trial on charges that he killed a bail bondsman, allegedly committed suicide two weeks after corrections officers left him inside a locked van for two hours in the sweltering daytime heat. Walls's family wonders whether the guards might have had a vendetta against the prisoner. "He was calling us every day, stressed out," says Walls's sister, Debora Stovall, age 39. "He was afraid for his life. For a while we thought he was making stuff up, but after the van incident, we got afraid for him too."
Kubiliun and Overmann will try to prove county jailers are not devoting enough time, effort, and money to the inmates' care, medical and otherwise. The two attorneys know it will be a tough fight. Their clients won't arouse much sympathy in a jury. Some are career criminals with lengthy felony convictions; others are low-grade bad guys who just can't stay out of trouble or away from drugs.
It's unclear where all of this will lead. In late April, shortly after Ramos's death, Kubiliun contacted the U.S. Department of Justice to describe the problems in Miami's jails. He sent documents of several cases, including photos of Ramos on his deathbed.
Kubiliun and Overmann are determined to continue the fight, even if it takes years. After all, even the alleged terrorists locked down at Guantánamo Bay, Cuba, receive decent health care.
County leaders deny there is a problem. "To say that inmates are not getting the best, I totally disagree with that," says county Commissioner Rebeca Sosa. The only problem, she says, is the amount of money inmate medical care is costing taxpayers.