There are any number of reasons why the U.S. Justice Department decided to investigate the health practices at the Dallas County jail, but perhaps none of them cut to the core like the gaping gash in Jeffrey Ellard's left leg. On the morning of his court hearing, he shows off exhibit A: a six-inch wound that cuts a path to his upper thigh before widening into a soggy, pinky-length crater oozing with pus and the shards of toilet paper he stuffed in to stop the bleeding. Inmate, heal thyself.
On Friday, District Judge Robert Francis hastily arranged a court hearing for Ellard so that the former surveyor could finally seek the medical care he was not receiving while behind bars. For the five months he was incarcerated at the Lew Sterrett Justice Center on a felony drunken driving charge, Ellard claims he did not see a doctor for his wound, even as the infection was eating its way into his thigh. Worried that he was in danger of losing his leg, his sister, Julie Ellard-Levine, pleaded with the staff at the jail and its medical provider, Parkland Health & Hospital System, to take him to the doctor, but they never gave her a firm answer. Ellard's own court-appointed lawyer also failed to act.
So last week, Ellard-Levine sought out attorney David Finn, who is one of the lawyers involved in a federal lawsuit against the jail. He took one look at Ellard's ugly wound before asking the judge to put the inmate on his jail docket. Otherwise, Ellard would have had to wait until July 24 for his next court hearing.
Dallas County Jail
"I have no idea what would have happened if I didn't have any help," Ellard says from his home in southeast Dallas.
On December 17, Ellard was arrested for driving under the influence, and as a multiple offender he received a felony charge and a $50,000 bond. Before he was even admitted into the jail, Ellard was taken to Parkland. Sixteen years earlier, he fractured his femur in an industrial accident and has had numerous surgeries on his leg since. The doctors at Parkland faxed the medical staff at the jail a handwritten letter instructing them to give him pain medication and antibiotics. The letter also directed them to change his bandages every day.
Ten days later, the jail staff stopped changing his bandages, Ellard says, forcing him to jam toilet paper into the wound. He rarely received antibiotics or pain medication and when he did, it was the wrong kind. Ellard's sister says that when her brother was first booked into Lew Sterrett, his wound was narrow, like a coin slit on a laundry machine. Doctors at Parkland left it open slightly to heal from the inside out. But left unattended for weeks and then months, the infection grew and grew, as yellow, brown and green pus began dripping out and down his leg.
"There were larger and larger amounts of drainage pouring out," he says. "The odor became greater and greater."
Ellard tried to improvise, buying gauze on the sly in a jail black market and swiping disinfectant for his cell from the staff bathroom. His sister desperately pleaded with the medical staff and the guards to at least bandage his wounds. When they listened, they scheduled his dressing changes for 2 a.m. Ellard reserves his sharpest criticism for the jail's medical staff, which is now supervised by Parkland, but he also complains that many of the guards seemed tired and lazy. Every day, he says, they were working double shifts. After recurring episodes of inmate neglect, the sheriff's office last year ordered guards to intervene if they saw someone in desperate need of medical attention, but that's not what happened here.
"The infection has gotten so bad, there are times when the pain is so bad I almost pass out and nobody gives a damn," Ellard wrote in a letter to Finn.
Ellard says that even his nurses worried that he was in danger of losing his leg, but still nobody would schedule a doctor's appointment. He saw several physician assistants, but they told him he needed to see a wound care specialist at Parkland. Meanwhile, the infection continued to grow deeper, wider and longer. On June 2, Finn visited Ellard at the jail after his sister wrote him a letter detailing her brother's plight. Finn was horrified.
"It's awful; it's open and it looks like you can see into the bone," he said before Ellard's court hearing.
Finn convinced Judge Francis to put Ellard on his jail docket for the next morning. That's when Ellard had to make a choice: He could accept the offer of a 10-year sentence from the district attorney's office, in which case he would be released until he was formally sentenced and could seek medical attention in the meantime. Or he could ask to go to trial, be released immediately on a personal recognizance bond to seek treatment, but then would be shipped back to the jail to recuperate. Ellard, who has been repeatedly arrested for DUI and says he's an alcoholic, decided to take the plea bargain. On Monday, he visited his regular physician, who was stunned at how the wound had expanded, according to Ellard. He reports for formal sentencing in two months.
Although Ellard is grateful to be out of jail for the time being, he says that he was pressured to take the sentence so that he'd have a few weeks to take care of his leg. Had he chosen on Friday to reject the plea and go to trial, he would have been returned to the jail after he visited Parkland.
"Oh my God, it would have been horrible," his sister says. "I don't even want to think about him in jail after surgery lying in his own blood."
Parkland officials insist that Ellard did see a physician while he was incarcerated, but they declined to provide further details. Still, Ellard's broad depiction of incompetent, possibly nonexistent, health care at the jail has been corroborated by not only other inmates, but judges, outside physicians and the Sheriff's Department's own internal affairs investigators. In addition, late last month, plaintiffs' lawyers involved in a federal lawsuit against the jail released a rather damning deposition from Dr. Steven Bowers, the medical director of the jail from 1993-2006, when Parkland Hospital took over the care at the jail. In it, Bowers talks of a chronically understaffed jail that continually failed to attend to the basic health needs of ailing inmates. The deposition is a part of the lawsuit of James Mims, the inmate who suffered severe renal failure two years ago after guards turned off the water in his cell for 10 days.
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In his statement, Bowers concedes that the jail continually fails to screen new inmates for tuberculosis. Bowers also reported that of the jail's 28 cells specially designed to isolate inmates with tuberculosis and prevent the bacteria from circulating through the jail, none of them was functioning properly.
Bowers also faulted the jail for failing to screen for mental illnesses, including cases such as Mims, who was severely mentally ill but did not receive any follow-up care while he was incarcerated.
The saga of Jeffrey Ellard, along with Bowers' new deposition, comes at a particularly bad time for the Dallas County Commissioners Court, which has claimed that it has begun to repair the long-standing problems at its jail.
Finn, who is one of the attorneys working on the Mims case, says the county's problem is one of deliberate indifference to the ailing inmates in its custody. "The county says all problems have been solved, and time and time again we see that is not true."