Seven deaths blamed on poor medical care in city jail, according to long-running lawsuit

City jail is a cause of death, lawsuit alleges

Seven people have died since 2013 while in custody of the Baltimore City Detention Center, according to a court filing in a long-running legal dispute. The deaths came, at least in part, because they did not get adequate medical care, the filing says.

The Public Justice Center and the American Civil Liberties Union filed a 103-page legal brief today—the last possible day it could be filed under a 2009 settlement—to reopen the case now captioned Duvall vs. Larry Hogan. The brief can be downloaded here

"For generations, the Baltimore City Detention Center has repeatedly promised to provide conditions of confinement that conform to constitutional requirements," the brief states. "Yet for a half-century, the City, and subsequently the State, have continued to expose detainees and prisoners serving sentences at the jail to unreasonable risks that too often have resulted in serious harm, including death."

The original case was settled in 1993 by consent, but a late 1990s law called the Prison Litigation Reform Act prompted the state to move for the case's closure. That battle lasted until 2003, then the case was settled by consent again, in 2009, with the details of the decree finalized only in 2012, according to Debra Gardner, a lawyer with the Public Justice Center who has litigated the case since 2003.

"We've been monitoring since then," she says. "We did not always get complete monitoring reports from them . . . More recently we acquired the death records on which we based the motion."

Under the settlement, state officials in control of the Baltimore City Detention Center agreed to provide necessary medical screening and prompt care to those in the jail. An on-site psychiatrist was to be provided five days per week. The building's plumbing, heating, and cooling systems were to be maintained in good order.

None of that happened, according to the plaintiff's brief, which says the lawyers obtained medical records for 24 randomly chosen inmates with medical conditions.

"The death cases showed multiple failures that were frequently implicated in the fatal outcomes," the brief says. "The other medical records also showed a continuing pattern of health care that poses obvious dangers to detainees and has caused serious injuries, such as interruptions of prescriptions for insulin and HIV antiretrovirals; failures to respond to hypertensive crises; failures to attend to detainees' need for placement in disabilities-accessible housing; and the denial of necessary medical supplies. These latter failures not only produce serious medical risks, but in some of the disabilities cases has denied the detainees basic human dignity."

According to the brief, AIDS patients did not get their medications. People withdrawing from heroin were left in their cells without treatment or meaningful monitoring. A man with prostate cancer had his chemotherapy injected, three months late, into his upper arm instead of his buttocks as required. People with heart disease and other chronic conditions saw medication confiscated and not replaced.

"Two of the four patients with diabetes experienced an interruption of their insulin during intake; one of those had a blood test showing a dangerous level of glucose in his blood," the brief, which refers to all of the patients by number instead of name, says. "Strikingly, every detainee with serious disabilities experienced failures to accommodate those disabilities in safe housing and to provide needed supplies."

Gardner says the plaintiffs have been trying to give the state "room to solve the problems," as the Prison Litigation Reform Act sets a very high bar for plaintiffs. 

"In order to put together the picture for the court that there are likely constitutional violations . . . we have to have enough evidence to persuade the court that there is a problem," Gardner says. "In all likelihood a single death record wouldn't do that."

In March, City Paper reported the state is considering turning control of the Baltimore City Detention Center back over to the city.

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