Cell Disease

In many of the lawsuits filed against the jail, sick inmates allege that guards continually fail to respond to serious health needs. Advocates, who say that problems of health care at Lew Sterrett go back at least 20 years, say that while all jails could be beter, Dallas County's is one of the worst. Lanny Priddy is an attorney for the North Texas Region of Advocacy Inc., which monitors jail conditions throughout the region including Fort Worth, Denton, Tyler and Texarkana.

"We find that the Dallas jail generates more complaints about medical and mental health conditions than all the other jails in the region put together," he writes in an e-mail. "Whether considered on the basis of complaints per capita or in terms of absolute numbers of complaints, the Dallas jail presents by far the greatest problem in the region with regard to jail medical and mental health care."

Not all of the jail's problems can be easily traced to a lack of funding. Attorney Tona Trollinger, who has a seriously ill client at Sterrett, says the jail's problems are also rooted in the attitudes of some of the people who work there. "They get doctors who just want to work 9-to-5 jobs. Everybody just gets jaded," she says. "The staff is so acerbic. They get complaints from so many inmates who are not sick that when someone really is in pain, they can't tell if that's real."

Some of Dallas County's problems stem from years of bad management, poor funding and a dysfunctional relationship between the two county offices responsible for the fate of the jail. Ex-Sheriff Jim Bowles feuded with many of the county commissioners over budgets and staffing, and the relationship between the sheriff and the commissioners became so acrimonious that as the jail endured bad press and explosive lawsuits, some of the commissioners felt as though they couldn't even trust what the sheriff was telling them about his facility.

In an August interview, Dallas County Commissioner Mike Cantrell showed the depth of distrust when he explained why they had to enlist the support of an outside consultant to study Sterrett. "We had a sheriff who would not allow us access to the jail," he explained incredulously.

Bowles refused to be interviewed for this story, and the three commissioners who served with Bowles, Mike Cantrell, Kenneth Mayfield and John Wiley Price, did not respond to repeated requests for comment.

Sheriff Lupe Valdez, elected last year in a surprise victory for the openly gay Democrat, has instituted several modest departmental changes. Still, while many lawyers and judges had high hopes for Valdez upon her election, particularly given the polarizing last few years of her predecessor's two-decade tenure, problems continue, including yet another case where a guard inexplicably turned off an inmate's water. That incident was almost identical to what happened to James Mims last year. Although captains had been authorized to turn off water in an inmate's cell if it had been reported up the chain of command, Valdez writes in an e-mail that she has now ordered that "there will be no water turned-off within any of our jail facilities. Period."

Valdez also says that jail employees have been ordered to be more attentive to sick inmates. She says that jailers now have to take any inmate who appears ill or even just complains of being ill to a nurses' station for immediate examination. Over the years, ailing inmates have complained that nobody took their pleas for medical care seriously, in part because so many of their peers fake illnesses for attention. Now, under Valdez's orders, guards can't pick and choose which inmates they believe.

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Arguably cast as the biggest villain in ongoing conflict over the jail has been its medical provider, the University of Texas Medical Branch at Galveston. County commissioners in particular criticized UTMB after reviewing the detailed and critical report submitted by the county's outside consultant earlier this year. Conducted by Dr. Michael Puisis, the former medical director of the Cook County Jail in Chicago, and funded by Health Management Associates, the report sharply criticized how the jail monitors its most disturbed inmates, noting it is "only a matter of chance" whether a severely disturbed psychotic individual is assigned to a cell where he could be monitored versus a cell where he is hidden from view. He also reported that the jail's suicide cells recklessly shut out the inmate from nearly all human contact, which can result in psychotic behavior.

Although he was at the facility for only a week, Puisis also discovered one inmate who died after the jail's medical staff failed to diagnose his chronic illnesses--the report doesn't say what sort of illness--for more than six weeks. Another inmate who had been on medication for tuberculosis before he came to the jail and had obvious symptoms of the contagious disease was inexplicably kept in the general population. The inmate did not have a physical examination for the first four months of his incarceration. Overall, the doctor characterized the UTMB's monitoring of chronically ill inmates as "poor to non-existent," resulting in excessive hospitalizations.

"I'm disappointed in their performance," Keliher says of UTMB. "They were used to prisons instead of jails, and in all fairness, they probably underbid and understaffed it."