Restraints’ Use in Jail Infirmary Probed

State and county health authorities are investigating the use of restraints in the Los Angeles County Jail infirmary following the death of a man who was strapped to a cot by the jail medical staff for six days.

Carl Bruaw, 49, a general contractor and real estate broker serving a one-year sentence for misdemeanor assault, was pronounced dead on arrival at County-USC Medical Center after he was taken from the infirmary on July 3. The official cause of death was a pulmonary embolism, officials said.

Pulmonary embolisms--blood clots that travel to the lungs--can be a result of prolonged immobility, said Jacqueline Lincer, district administrator of the state Department of Health’s licensing division.

Bruaw’s widow, Joyce Amiri, filed a civil rights and wrongful death lawsuit in Los Angeles County Superior Court against the county Thursday, alleging that her husband should not have been placed in restraints because he was passive and depressed, not aggressive and hostile.

The suit also charges jail medical personnel did not follow federal and state regulations governing care of patients in restraints, causing the fatal embolism.

Prompted by Amiri’s complaint, the state Department of Health is examining medical records and jail policies to see if state laws on the use of restraints are being followed in the jail infirmary, Lincer said.

State Department of Health rules for licensed hospitals state that a mental patient may be placed in restraints only when “alternative methods are not sufficient to protect the patient or others from injury.”

Although the infirmary is not a licensed hospital, the Sheriff’s Department is under a court order to obtain such a license and provide a standard of medical care that would be given in hospitals.

A patients’ rights advocate of the County Department of Mental Health Services has written a letter to the Sheriff’s Department stating that the “documentation in Mr. Bruaw’s chart fails to justify this intervention on a continuous basis” for six days.

“Moreover, other regulation requirements governing the use of restraints did not appear to have been met,” said the advocate, Barbara Leifer.

Earlier this year, a jury awarded $2.5 million to the family of a North Hollywood man who died of a pulmonary embolism after jailers kept him strapped to his cot for 40 hours. In a San Fernando Superior Court trial, an attorney representing Stanley Malinovitz, who died in jail in 1984, argued that Malinovitz’s death would have been averted if he had been taken to a hospital instead of being strapped to a cot in the jail infirmary for 40 hours.

Deputy County Counsel Philip S. Miller, who defended the county in the Malinovitz case and has reviewed the Bruaw case, said pulmonary embolisms can strike anyone at any time and that the jail medical staff could not have anticipated the embolisms in either case.

But R. Samuel Paz, the attorney representing Amiri, charged that Bruaw died because the infirmary staff ignored state and federal regulations requiring that the decision to use restraints be reevaulated every two hours. According to Paz, the infirmary staff also failed to check on Bruaw every 30 minutes and give him an opportunity to move each limb for 10 minutes every two hours--as required by regulations.

Miller said he did not know if those regulations had been followed. The restraints used in the infirmary allow a patient to move from side to side, he said, and deputies, the jail doctors and nurses check patients twice an hour for circulation problems.

The Sheriff’s Department refused to answer questions because of the pending litigation.