Report Lists ‘Dispiriting’ Problems at County Jails

The medical care system in Los Angeles County jails is fraught with serious delays in access to doctors, lapses in prescription renewals and interruptions in treatment for inmates transferred between facilities, according to a report to the Los Angeles County Board of Supervisors released Tuesday.

“It is dispiriting to find . . . that acute problems persist,” wrote attorney Merrick Bobb, who monitors the Sheriff’s Department for the board. “Our review also confirmed our belief that these problems will continue until their systemic causes are addressed.”

Bobb also found potentially disturbing increases in the use of force by deputies departmentwide. At the same time, he reported substantial, positive changes at the previously troubled Century Station, which includes the Lynwood area.

Bobb reviews chronic problems facing the department, which runs the largest jail system in the country. He previously has criticized the department for its handling of medical services for inmates, but the new report is the first in which he has examined medical complaints of inmates.

In his study, Bobb looked at complaints that were corroborated by department records. The Sheriff’s Department received 7,181 complaints in 1999; Bobb reviewed about half of them.

The most frequent complaint--raised in more than half of the forms submitted to the department--concerned delays in medical treatment. In many cases, inmates reported having to make repeated requests before being allowed to see a nurse or doctor. Many reported waiting weeks or months for appointments with a physician or a dentist. In some cases, inmates reported that nurses “simply refused” their requests to see a physician, according to the survey.

Bobb attributed those and other problems to chronic medical understaffing and periodic “substandard” medical care provided by some Sheriff’s Department physicians. He also found that interruptions in medical care stem from problems with coordination, communication and logistics.

In an interview Tuesday, Bobb said the department should be viewed as operating not only jails but also “a very, very large public health facility. They’re operating both: a jail and a hospital.”

Capt. Marc Klugman, who recently began overseeing medical services for the department, agreed that procedures and policies need to be reviewed, but he maintained that inmates receive quality care. About 6,000, or a third, of the inmates in the county jails are under some form of medical care at any given time.

“There are certainly some very serious issues in medical services that need to be addressed; some of it is procedural, some of it is staffing,” Klugman said. “It’s not fun, it’s not comfortable . . . [but] they are getting proper care. . . . I don’t think we’ve lost anybody because they’ve sat waiting for a doctor.”

The department, however, has been criticized, and at times sued, over that issue. In one recent case, the family of a man who died in custody Jan. 1 charges that he would have survived if deputies had obeyed court orders to provide him with medical care. The coroner’s office determined that Henry A. Torres Jr. died after a piece of a hypodermic syringe found in his lung caused that organ to fill with blood and other fluid. Torres had been held at the Century Regional Detention Center in Lynwood on heroin-related charges.

Sheriff’s officials said Torres, whose family has not filed a lawsuit, had been seen by the medical staff but that an X-ray did not reveal the syringe piece.

Bobb’s survey found many cases of inmates who had serious or life-threatening conditions complaining about lack of access to doctors and medication. One inmate with a heart condition waited for more than three weeks to see a physician and then was given heart medication and a cardiology appointment. Another asked for about a month to see a doctor for pain associated with Hodgkin’s disease; he had filed three complaint forms before the appointment. A third complained that he had requested a doctor’s appointment for 10 days for an AIDS-related emergency.

The complaints also reveal a potentially serious deficit in dental resources, the report found. Hundreds of inmates complained of severe toothaches and painful abscesses that had been left untreated for weeks or months.

Many inmates also complained about delays in the renewals of their prescription medications. Particularly disturbing, Bobb said, were accounts of inmates who failed to receive AIDS/HIV medications in a timely, uninterrupted manner.

The Sheriff’s Department has been slow to implement a $25-million computer system that would alleviate some of the delays, according to Bobb and department officials.

While Bobb’s report found some serious, and what he said may be intractable, problems, he also said the department is moving in the right direction on many fronts.

Bobb found that shootings by deputies in the Century Station have declined largely because of increased supervision in the South Los Angeles station. In 1997, Century deputies shot 12 suspects, Bobb reported. In 1999, deputies shot one suspect.

Since he arrived at Century two years ago, Capt. Kenneth Brazile said, he has tried to change the culture of the station, once viewed as a place where “cowboy” deputies aimed for high numbers of arrests.

Not all the deputies in the station are pleased with the new management style. The deputies’ union recently surveyed their members on their captains and Brazile was given the lowest ratings.