Miami-Dade County

After inmate deaths, Miami-Dade jail medical services heads resign

The director and the doctor in charge of medical services at Miami-Dade’s beleaguered jail system have both resigned, following a recent rash of inmate deaths and complaints about shoddy medical service.

Director Patrick Morse and Dr. Calixto Calderon were both employees of the corrections arm of Jackson Health System, which runs medical care services for the county’s jails.

ISn their resignation letters signed Tuesday and released by Jackson on Wednesday, neither man mentioned the recent turmoil at the jail medical services unit, and Jackson would not say if they resigned under pressure.

Still, Jackson CEO Officer Carlos Migoya acknowledged the resignations in a letter Wednesday to Jackson’s board of trustees, saying that “important operational challenges” remain, and that Jackson is “in the midst of a detailed review of operating procedures.”

The letter did not detail what procedures would be reviewed. Migoya was not available for comment.

Migoya tapped Bill McKeon, operations director at Jackson North’s Medical Center, to serve as the interim director of Corrections Health Services. Dr. Gabriel Zambrano will serve as interim medical director.

“As you know, we are consistent in confronting challenges like these: We investigate all issues, determine root causes, hold leaders accountable and improve processes. Jackson is committed to providing appropriate and compassionate care in all services, including CHS,” Migoya said to the board in his letter.

The resignations come after the July death of a mentally ill Miami-Dade County Jail inmate who suffered a broken pelvis in a fall, as well as the release of a scathing affidavit from one jail nurse who complained about dangerous policies and practices within the medical unit. Another inmate died in April in the jail’s psychiatric ward.

“I’m pleased that prompt action was taken,” said Miami-Dade County Judge Steve Leifman, a long-time advocate for mentally ill defendants. “However, it is important that a fair investigation is done on the two most recent deaths of inmates with serious mental illnesses so that we can understand what went wrong and we can prevent it from ever happening again.”

Tim Ryan, the head of Miami-Dade Corrections, could not be reached for comment.

The turmoil comes as U.S. Justice Department officials continue monitoring the jail system. In 2011, the department concluded a three-year probe, saying the nation’s eighth-largest jail system engaged in a “pattern and practice of constitutional violation” of the rights of inmates housed in deplorable living conditions under abusive, inadequate or limited care.

In April, Miami-Dade County and Jackson agreed to a long and expensive list of ways to improve how the system treats inmates, particularly those who are mentally ill or suicidal.

As part of the deal, the county agreed to build a new mental-health facility, long championed by Judge Leifman, to replace the ninth-floor psychiatric ward, which has long been criticized. So far, ground has not been broken on the new facility.

Among the changes agreed upon, the jail said it would have a medical doctor evaluate inmates with serious medical or mental conditions within 24 hours of their arrival, report to the court and DOJ each death or serious suicide attempt within 45 days of each incident and require suicide-prevention training for officers.

The county and Jackson also agreed to prohibit retaliation against inmates by sending them to suicide-watch cells.

The DOJ investigation found that the jail does not provide proper medical care, has failed to provide proper screenings and health assessments, and even botched the dosages of medicine handed out on a daily basis.

Investigators also noted a series of deaths after jailers failed to treat patients as they suffered withdrawals from drugs or alcohol.

But scandals still persist. In July, a mentally ill patient named Joaquin Cairo was booked into Miami-Dade’s psychiatric ward and broke his pelvis and suffered internal bleeding. He claimed a fellow inmate “propositioned” him for sex, then hurled him to the ground when he resisted..

Miami-Dade police are investigating Cairo’s death. Homicide detectives probe all inmate deaths, whether they are natural or not.

Three months earlier, another psych ward patient, Juan Matos-Flores, died after jailers found he had collapsed.

The turmoil has boiled over within the corrections services department itself.

Last month, nurse Richard Reckley sent an affidavit to supervisors and the Jackson board detailing problems in the jails. Among his allegations:

• Inmates detoxifying from alcohol and drugs at the Turner Guilford Knight Correctional Center are housed in an upper-level unit alongside inmates with serious health concerns such as cancer and HIV. Moving the patients back and forth — some of them are elderly and diabetic — up the stairs is impractical and taxing.

• The detox unit often has more than 20 patients, and sometimes more than 40, overseen by just one nurse. Some patients are relegated to sleeping on the floor.

• One inmate at the Miami-Dade County Jail had a seizure and fell, spilling blood over the floor. When a nurse ordered him to an outside emergency hospital room, the jail’s medical administrator, Morse, “reprimanded and disparaged [her] in front of her coworkers for doing the right thing.”

In another case at TGK, Reckley wrote, an inmate who hurled himself from the second-tier of a wing at TGK to avoid an attack from fellow inmates suffered a broken ankle and fractured lower vertebrae. But there was a lengthy delay in taking him to an emergency room because no staff was available to transport him, Reckley wrote.

“This individual had to unnecessarily endure over 30 hours of pain and suffering,” Reckley wrote.

Jackson Health spokesman Ed O’Dell said that staff has met with Reckley over his concerns.