The similarities were so striking that Miami-Dade’s top prosecutor convened a grand jury to study the deaths — eight years apart — of a Miami teen and a Palm Beach County teen who were detained at state juvenile detention centers.

Both youths, grand jurors wrote, had no ability to secure medical care when they became deathly ill and suffered because guards failed to call a doctor on their behalf.

The difference: 17-year-old Omar Paisley of Opa-locka died in 2003 because the Miami juvenile justice lockup was governed by poor policies and procedures that discouraged officers from seeking emergency aid, while 18-year-old Eric Perez died in the West Palm Beach lockup because guards failed to heed new policies that required them to seek help.

“One death was one too many,” grand jurors wrote of Eric Perez’s July 10, 2011, death, adding that grand jurors who studied Omar’s 2003 death “were hoping to prevent a second death.”

“It appears that the Omar Paisley tragedy occurred, in part, due to certain policies and procedures at the [Miami lockup] that precluded [officers] who were trying to help Omar from calling 911,” the report said. “It appears that the Eric Perez tragedy was not a repeat of the Paisley incident and it occurred because staff ...failed to follow the new policies.”

Seven years after Omar’s death, Miami-Dade State Attorney Katherine Fernández Rundle asked grand jurors to determine whether state juvenile justice administrators had heeded any of the advice a prior grand jury offered. The new report said Fernández Rundle undertook the inquiry after reading in The Herald about Perez’s death in West Palm Beach.

On June 7, 2003, a day after he had signed a plea agreement that would have transferred him to a moderate-risk youth camp, Omar began complaining of intense abdominal pain. Over three days, Omar experienced severe pain and begged guards for help.

A nurse who was contacted by guards promised she would examine Omar, the report said, but the nurse complained she was “busy with other things.” When a visitor saw the youth — brown fluids oozing from his nose and mouth — he persuaded guards to seek help. By the time help arrived, Omar was dead.

Perez, who was finishing his sentence though he had already turned 18, sustained a head injury after guards “tossed [him] in the air” during horseplay, records say. “In the process of flying through the air, Mr. Perez struck the wall and/or floor with his head,” the grand jury wrote. Though Perez began to hallucinate, “staggered” around his cell and complained of pain, guards did not immediately seek medical care for him.

In the report released Thursday, grand jurors said the state Department of Juvenile Justice implemented many of the recommendations included in the 2003 report, including one that guards and supervisors be allowed to call for help whenever a detainee appeared to be critically ill. “At the time Omar Paisley was being detained,” the report said, “the culture at [the Miami lockup] was one of fear as it related to DJJ officers reaching out to outside agencies.” Now, the report said, staff members are “empowered,” even if they fell short in the Perez case.

“Reforming the juvenile justice system in Florida remains a paramount priority for this administration,” said DJJ spokesman C.J. Drake.