A federal jury in Austin ruled today that neither the actions of Travis County officials nor of a former jail psychiatrist caused the death of a mentally ill woman found dead in her cell in 2008. But in an extraordinary move, the jury issued a statement calling on the county to improve the operations of its jails.
Following the jury’s decision in the lawsuit brought by the family of 21-year-old Rachel Jackson, who died while in “psych lockdown” in the Del Valle jail, U.S. District Judge Sam Sparks agreed that the panel could read a statement into the record.
“While we cannot find that Travis County proximately caused the death of Rachel Jackson,” the foreman said while standing in the jury box, “we do see significant opportunity for improvement in the processes, documentation and communication within the Travis County Correctional center.”
Outside the courthouse, jurors declined to elaborate on the statement to a reporter.
Jackson’s estate and her mother, Regina Jackson, and father, Rudolf Williamson, claimed that the negligence of former jail psychiatrist Dr. John S. Ford and Travis County led to her death.
Their lawyer Sean Lyons said during closing arguments that Ford was negligent in part by prescribing Jackson the antipsychotic drug Mellaril, or thioridazine, without first checking her potassium level and the electrical activity of her heart, as suggested by warnings packaged with the drugs.
The warnings state that the drug could cause an arrhythmia — when someone’s heart beats out of rhythm — which could lead to sudden death.
Lyons also argued that a Travis County pharmacist should have passed along warnings when dispensing the drugs that the danger of sudden death would be exacerbated by other medication Jackson had been taking.
Testimony revealed other problems within the jail, including that when Jackson complained of a racing heart three days into her incarceration, a jail guard failed to call for medical help and that when a jail nurse responded to Jackson’s complaint of chest pains one day later, he failed to document the results of a check of her vital signs.
Neither of those complaints made it to Ford for him to consider in administering the medication.
Outside court, Assistant Travis County Attorney Elaine Casas said that the county has computerized its system so when a doctor enters prescriptions, he or she automatically learns about any warnings or dangerous drug combinations associated with the order. She said she would meet with the sheriff’s office to discuss further issues raised during the trial and referred further questions to Chief Deputy Jim Sylvester, who could not be immediately reached.
Jackson was arrested on July 15, 2008, on a previous drug possession warrant after an Austin police officer found her having what Lyons has described a psychotic breakdown on a street near LBJ High School in East Austin. She died 6 days later — 3 days after being prescribed Mellaril.
Dr. David Dolinak, chief medical examiner for Travis County, ruled that Jackson died from a fatal arrhythmia brought on by the combination of drugs she had taken.
An expert testifying for Ford, Dallas County Chief Medical Examiner Jeffrey Barnard, testified that it is impossible to determine how Jackson died.
Ford’s lawyer, Paul Starr, told the jury that Ford was aware of the warnings on Mellaril but believed the drug was safe because he had been prescribing it for about 40 years.
Starr argued that Jackson’s death could have been caused by her use of illicit drugs, a seizure or a number of other factors.
During a deposition prior to trial, Ford stated that he continued to prescribe Mellaril without ordering tests of his patients’ hearts and potassium levels. During the trial, he testified that being sued has made him more careful.
Asked to clarify that statement in an interview after court adjourned, Starr said that Ford said that “while he still does not believe it is medically necessary, he will probably do so (order the tests) in the future.”
Starr said Ford currently works as a contract psychiatrist at the Waco Center for Youth, a psychiatric residential treatment facility for teenagers run by the Texas Department of State Health Services.
(source: Austin American-Statesman)