While Elliott Williams was lying paralyzed on a medical unit floor in David L. Moss, the jail’s medical director cracked Williams’ cell door open, reached in and touched his foot to see whether Williams had any sensation, the jail’s former director of nursing testified Wednesday.
“He didn’t even go inside the cell,” said Tammy Harrington, the former nursing director.
Harrington also testified medical staff was told to not pronounce inmates dead until after they left the jail.
Harrington’s testimony came Wednesday on the 11th day of a civil trial in federal court over Williams’ 2011 death. Harrington’s testimony was filled with examples in which Williams’ and other inmates’ health care was inadequate.
Dr. Phillip Washburn, the jail’s medical director, didn’t respond to several requests from Harrington and other nurses to examine Williams, Harrington said. Each time she found Washburn had yet to perform his examination, she notified her supervisors.
Harrington said she didn’t understand why Washburn refused to check on Williams.
Former Sheriff Stanley Glanz and current Sheriff Vic Regalado are the defendants in a lawsuit alleging Williams’ Eighth and 14th amendment rights were violated when he was allowed to languish on his jail cell floor without eating or drinking for days before dying from complications of a broken neck. The jail’s former medical provider, Correctional Healthcare Companies Inc. (CHC), settled with Williams’ estate and is no longer a defendant.
Williams begged for help and repeatedly told jail staff he couldn’t move and that his neck was broken. However detention and medical staff concluded that Williams was faking paralysis, although testimony and records indicate they did no medical tests to confirm their assumption. Williams was placed in a cell equipped with video for 51 hours and never moved his feet on his own. He lacked motor control in his arms to grasp the trays of food jailers tossed into his cell and spilled the single cup of water he was given.
Harrington has been a registered nurse for 18 years and served as the jail’s director of nursing at the time of Williams’ death.
Other than Washburn’s treatment of Williams, there were other instances wherein the medical director’s treatment of inmates was concerning, Harrington said.
In one case, nurses were “very worried” about two inmates who were believed to need emergency hospital care. Washburn refused to allow them to be sent to outside care for two days. When the inmates were finally approved, they were sent directly to a hospital’s intensive care unit, Harrington testified.
Harrington was critical of Washburn’s lack of supervision over nurses.
“We supervised him,” she said.
Harrington’s supervisor, Christina Rogers, assigned Harrington to keep Washburn on task. Harrington had to write instructions for him so he could use his computer.
“He was very scattered. …I couldn’t get my work done if I was babysitting him all day,” she said.
When Harrington complained about Washburn to CHC’s human resources director, the director was shocked, Harrington said. A conference call was requested between CHC, Rogers and Harrington. However, Harrington was cut out of the call, she said.
Harrington saw no change in Washburn’s behavior as a result.
The morning of the day Williams died — the sixth day he was in the jail — Washburn still hadn’t examined Williams, Harrington said.
That morning, Harrington told a member of the jail’s mental health team to ensure Washburn saw Williams as soon he came in to work, she testified.
Asked whether she put the blame of Williams’ death on Washburn, Harrington said she partially did.
Harrington told the court nurses were concerned about Williams’ condition and they helped him as much as they were allowed to. Detention officers wouldn’t allow nurses into Williams’ cell because of security reasons, she said.
During cross-examination, defense attorney Guy Fortney pointed out Washburn was employed by CHC, not the Sheriff’s Office.
Asked whether she told Sheriff’s Office administrators about the concerns with Washburn, Harrington said no.
When Fortney asked if Washburn was fired after Williams’ October 2011 death, Harrington said she didn’t know why he left, but the doctor didn’t come back to the jail after December that year.
After Williams died, Harrington submitted a list of what she believed to be deficiencies in the jail’s medical to CHC. The list included issues such as failing to get inmates’ outside medical records, as well as nurses failing to report issues they observed with inmates and assuming they stemmed from a psychological basis.
Harrington said she was treated unfavorably by a CHC corporate employee after she submitted the list.
When she first began working in the jail, Harrington said she believed she could make improvements. However, the longer she was employed there she began to distrust administration. They didn’t want to know about problems happening the medical unit, she testified.
In one instance, a nurse was regularly bringing an inmate to an exam room to have sex with him or her, Harrington said. When nurses brought the situation to the attention of supervisors, they said if there wasn’t proof, “it never happened.”
During cross-examination, Fortney asked whether the nurse was fired immediately after the incident was discovered by jail staff.
Harrington said she didn’t know how much time passed between the event being discovered and the nurse being fired, but acknowledged the nurse was let go.
Another nurse came to work high on drugs every day and wasn’t disciplined until a social worker came in to alert administration of the issue, Harrington testified.
Asked during cross-examination whether she ever saw the employee using drugs, Harrington said no. Medical staff noticed the nurse “acted funny” but they didn’t know why, she said.
Asked about the overall care inmates received, Harrington said she believed medical staff “did the best they could with the staff they had, but they needed more staff.”
However, Harrington also said she believed nurses were understaffed and poorly trained.
Fortney asked whether any practices changed in the medical unit after Williams died, and Harrington noted nurses began finishing assessments of patients by 10 a.m. and asking them whether they needed anything
Harrington also testified to the jail’s use of EMSA ambulance services. She said staff wasn’t allowed to pronounce inmates dead until after they left the jail. They were told to keep doing CPR on inmates until EMSA arrived to take over, she said.
When Don Smolen, an attorney representing Williams’ estate, asked why it was important inmates appeared to die elsewhere, Harrington said administration didn’t want the area to become a “crime scene.”
“I also believe they didn’t want the bad publicity,” she said.
During cross-examination, Fortney asked what medical employees were expected to do when they found an inmate without a pulse. Harrington said the practice was to immediately begin CPR and not stop until EMSA arrived, although medical staff wasn’t allowed to go in a cell without detention officers for security reasons.
Harrington recalled one instance when a jail doctor wanted to pronounce an inmate dead at the jail but Rogers told the doctor not to.
Harrington also testified to the jail’s falsification and manipulation of records in order to pass medical audits.
On Tuesday, Elandia Maloy, the jail’s former medical records director, testified that former Sheriff Stanley Glanz, former Undersheriff Tim Albin and others ordered staff to falsify or hide inmates’ medical records in order to pass audits in 2007.
Harrington had similar testimony Wednesday, saying Rogers ordered staff to place unfavorable medical charts out of the view of auditors in 2010.
Asked whether she reported the falsification of records to Sheriff’s Office administrators, Harrington said no.
“Because what happened in medical need to stay in medical, correct?” Fortney asked.
“Yes,” she replied.
In a 2014 affidavit, Harrington cited indifference by medical staff and a lack of leadership. On Wednesday, she said she believed the majority of nurses cared, “but a lot of things needed fixed.”
Asked when Williams should have become a medical emergency, Harrington said after he wasn’t able to move. However, an emergency wasn’t called until he was found dead in his cell.
Smolen asked whether Harrington saw Williams eat or drink while he was in the medical unit, and she answered no.
Smolen then asked how many days needed to go by without food or water before his treatment was considered inhumane.
“I would think 24 hours would be inhumane,” Harrington answered.
“We have six times that, correct?” Smolen asked of Williams’ time in the jail.
Harrington told the court she wanted to call an ambulance but Washburn wouldn’t allow her to because he “just didn’t care.”
Asked whether she could have called one if she wanted to, Harrington said yes. She didn’t because it was drilled into her head she wasn’t supposed to do anything without a doctor’s approval, she said.
Records show Williams’ vitals were never taken while he was in the jail. When Smolen asked whether that was surprising, Harrington said no. Detention officers wouldn’t let nurses into his cell, and Williams couldn’t walk to the door to have his vitals taken through a slot because he was paralyzed, she said.
Smolen asked whether Washburn, nurses and detention officers failed Williams, and Harrington said yes.
She began to cry when Smolen asked her whether she also failed Williams.
“Yes, I did,” Harrington said.
Williams wasn’t an isolated incident, she said. Three to four people died in Tulsa’s jail while she was employed there.
Asked whether Rogers directed medical staff to falsify records of dead inmates, Harrington said yes.
She recalled Lisa Salgado, who died in Tulsa’s jail in 2011. Rogers directed a nurse to alter Salgado’s records after she had died to give the appearance Salgado’s health was assessed and her vitals were taken, Harrington testified.
Salgado was hospitalized shortly before her DUI arrest on June 14, 2011, and medical records indicate she had a long history of serious heart issues requiring treatment and prior operations.
The day after her arrest, Broken Arrow police took Salgado to St. John Medical Center because of medical concerns.
After being discharged from the hospital, she was taken to Tulsa’s jail with instructions to watch for “warning signs” signaling a heart attack. She told medical staff she was on prescription medications.
The day after Salgado entered the jail, she was seen “hyperventilating and rubbing her chest,” jail medical records show. She complained of nausea, increased chest pain and shortness of breath.
Salgado continued to complain of chest pains, dizziness, weakness and similar symptoms as her health deteriorated, but she wasn’t sent to a hospital.
Three days after Salgado entered the jail, a nurse found her dead in a medical cell.
A lawsuit brought by Salgado’s estate is pending in federal court.