Supervisors Act on Panel to Review Jail Deaths

Reacting to complaints about procedures for reviewing jail deaths, the San Diego County Board of Supervisors on Tuesday took the first step toward establishing an independent panel of medical specialists to investigate inmate deaths.

By a unanimous vote, the supervisors moved tentatively toward the creation of an eight-member Jail Medical Audit Committee to investigate the circumstances surrounding jail deaths, as well as to review medical treatment in the jails.

Chief Administrative Officer Norman Hickey estimates that the medical panel will cost $100,000 annually, and the supervisors decided to defer consideration of the proposal until they begin deliberations on the county’s fiscal 1990 budget later this spring.

Even that relatively modest amount--seemingly insignificant in contrast to the county’s overall $1.3-billion budget--could pose difficulties because of severe economic constraints, county administrators emphasize.

From 1983 to 1988, there were 28 deaths in local jails, according to a report prepared by Hickey’s office. Of those, the county coroner’s office attributed 11 deaths to natural causes, 10 to suicide, 6 to accidents and 1 to homicide.

The Sheriff’s Department now has the primary responsibility for investigating jail deaths, with the coroner’s office, district attorney, county grand Jury, state attorney general and state corrections board also playing roles.

Increasingly Questioned

However, the objectivity of those investigations has increasingly been questioned in recent years, in large measure because of allegations by inmates’ relatives and others that sheriff’s deputies’ abuse of prisoners or jail officials’ negligence contributed to some of the deaths. Critics of the existing system argue that it is inherently flawed through a conflict of interest stemming from the Sheriff’s Department’s dual role as operator of the jails and investigator of jail deaths.

Those complaints notwithstanding, the county’s existing policies “provide a sound basis for an independent review” of jail deaths, Assistant Chief Administrative Officer David Janssen told the supervisors.

Under Hickey’s proposal, that independent review would be conducted by a board consisting of a surgeon, internist, emergency physician, a nurse, the county pathologist and coroner and the jails’ medical director and nurse coordinator. In addition to enhancing the credibility of jail-death investigations, the panel’s studies could be used to recommend corrective action or policy changes, Hickey said.

To further improve the process, Hickey has recommended that the supervisors adopt procedures, recently proposed by the Grand Jury, to expand the district attorney’s role in the investigations.

Supervisor Susan Golding, who requested the study reviewed Tuesday, praised Hickey’s proposal for the independent medical board, even while agreeing that, because of the county’s tight finances, it should not be reviewed in isolation from the rest of the budget.

“I’m more convinced than ever that an independent investigation is needed,” Golding said.