Medical Viewing at Jail to Improve

Orange County Jail officials have decided to increase their ability to observe inmates in medical observation cells, where two inmates have died this year and a third attempted to hang himself Sunday night, the jail’s medical administrator said Monday.

At present, the cells have solid doors with small windows. Frank Madrigal, who is in charge of the jail’s medical facilities, said these doors might be replaced with regular jail bars and wire mesh. County Health Care Agency Director Tom Uram said Sheriff Brad Gates may end up replacing the solid doors with some kind of glass or Plexiglas.

“It’s the sheriff’s decision, but we are for anything that will improve the situation,” Uram said.

In another development, observation cameras are being installed this week in cells of the 30-bed infirmary in the men’s jail, an area separate from the 18 observation cells.

The jail’s infirmary has 15 medical cells and 15 mental health cells, all visible to a centrally located nurses’ station. The 18 observation cells are for inmates deemed too ill for the infirmary area but not ill enough for hospitalization, officials said. Sometimes, depending on how crowded the jail is on a given day, more than one inmate can be placed in one of the observation cells with their solid doors that impair observation by deputies and nurses.

The decision to improve visibility into the observation cells was made before Sunday’s suicide attempt, Madrigal said.

Inmate John Franklin Wilcox, 71, died Jan. 17 and inmate Arthur Oviedo, 25, died Jan. 31. Inmate Juan Ceja, 27, was listed in critical condition at the UCI Medical Center after he apparently tried to hang himself at the jail Sunday afternoon.

All three men were housed in the 18-cell medical observation section.

The district attorney’s office is investigating whether Wilcox and Oviedo may have been killed by another inmate with whom each was sharing a cell. The Oviedo family hired a private pathologist, who determined that the young man had been strangled. Bruises were found on Wilcox, and prosecutors are awaiting autopsy results on him.

“It’s an extremely unfortunate situation,” Madrigal said. “We’ve made tremendous gains the last two years to improve medical care at the jail. It’s really just a coincidence that the first two deaths were on the medical floor.”

But Madrigal acknowledged that some of the incidents might have been prevented if deputies had better visibility into the cells.

If bars and wire mesh are used, the solid doors would be retained, Madrigal said. He pointed out that solid doors are occasionally needed if an inmate has a contagious disease.

Similar observation cells in the women’s jail are equipped with both the solid doors and the bar and wire mesh doors, he said. The solid doors open away from the cell and are only in use in special situations.

“It’s a system that works, and we think it could work on the men’s side too,” Madrigal said. “You cannot only see into those cells, you can hear what’s going on, and that’s important.”

American Civil Liberties Union attorney Richard P. Herman said he applauded the decision to improve visibility into the jail cells. But Herman questioned whether improved visibility will be enough.

“I think you need cameras in the (medical observation) cells to make sure that the inmates are safe,” Herman said.

Madrigal, though upset with many of Herman’s published statements about the quality of medical care at the jail, agreed about the need for cameras.

“We very much support cameras in the (medical observation) cells,” he said. He added that this was still under discussion. The cameras being installed in the men’s infirmary were on order before any of the jail deaths this year, he said. They will give the medical staff visibility into the shower area of the infirmary’s 30 cells, where an inmate committed suicide two years ago.

Herman, who has led the lawsuit against the county over jail overcrowding, has received approval from U.S. District Judge William P. Gray to bring his own medical expert to the jail to examine the medical operation.

Dr. Armand Toomajian, a 20-year veteran of the Los Angeles County Jail who is now doing private consulting, will inspect the facilities on March 27 on behalf of the ACLU, Herman said.

Herman said that if Toomajian confirms the ACLU’s doubts about the quality of medical care in those cells, he would file a motion before Judge Gray asking that the 18 medical isolation cells be shut down.

Despite the ACLU criticisms and the recent incidents on the medical ward, medical administrator Madrigal staunchly defends the quality of medical care at the jail.

“In the last two years, our budget has gone up about 200%, and we’ve had a staff increase of 60% to 70%,” Madrigal said.

Madrigal in particular praised nurses who treated Ceja after jail deputies found him hanging in his cell Sunday.

“Our nurses did an outstanding job, performing CPR (cardiopulmonary resuscitation), setting up a heart monitor and an IV (intravenous feeding unit) before paramedics arrived,” Madrigal said. “Doctors told us later that our nurses probably saved the man’s life.”

Ceja was booked at the jail Friday night on suspicion of murder after the fatal shooting of the owner of a Santa Ana video store.

Madrigal said that because of a previous medical condition--which he refused to specify--Ceja was taken directly to the medical ward instead of the regular housing section of the jail.

But Ceja showed no signs of mental illness and jail officials had no reason to believe he might be suicidal, Madrigal said. He was alone in his cell.