The U.S. Department of Justice's civil rights division has found that conditions at the Baltimore City Detention Center violate the constitutional rights of inmates and appear to have played a role in the deaths of several prisoners, some of whom received little or no medical attention for chronic health problems.
Chief among the findings in the Justice Department's report is that the state-run detention center - parts of which were built in 1803 - has a poorly run system of health care and suicide prevention that often takes days to assess an inmate's medical needs. In some cases, the problems proved deadly, according to the report, which gives state officials 49 days from Aug. 13, when the report was issued, to propose solutions.
"We find that persons confined suffer harm or the risk of serious harm," the report concluded, citing several examples of jail suicides, heart-attack deaths and fatal asthma spasms that federal authorities deemed "preventable if the inmates' conditions had been properly treated."
The report was made public yesterday, when state officials released it.
Stuart O. Simms, chief of the Maryland Department of Public Safety and Correctional Services, which oversees the detention center, acknowledged yesterday that the jail faces serious problems. He said he has begun to speak with health care administrators for advice and help in delivering better care at the jail, which each year admits more than 43,000 inmates.
"We have collectively become the largest emergency room in the state," Simms said. "Our arrest population has some of the most severe health problems in the country. We're faced with a community health issue."
Justice officials visited the detention center and the city's Central Booking and Intake Center several times in 2000. Among the deaths that they document in their report:
A 29-year-old woman who hanged herself with a paper gown Aug. 16. She had tried to kill herself the same way the day before but failed and was ordered on a suicide watch in which she would not receive the gown. Despite that, she was given the paper gown rather than the smock typically provided to suicidal prisoners.
A male inmate who died of natural causes Nov. 22 after collapsing in his cell at central booking. Although his cellmate tried to get corrections officers' attention, CPR was not performed on the man for several minutes.
A man who died May 19 of hypertension and cardiovascular disease a day-and-a-half after being jailed. The man, who had a long history of medical problems, was not given a medical screening though he had needle tracks on his arms, and cocaine and other drugs in his system that should have raised concern that he was going through withdrawal.
A heroin-addicted man who died July 18 after being in custody 24 hours and who had told an officer during a medical screening that he was on medication for high-blood pressure. He was never seen by one of the jail's health professionals and died of cardiovascular problems likely aggravated by his detoxification from drugs.
A man who died of an asthma attack Dec. 2 after having last received medical attention 19 days before, when he was put on intravenous fluids because of severe breathing problems and other health concerns. He died struggling to use an asthma inhaler that failed to work because of overuse.
A mentally ill 41-year-old inmate who committed suicide Dec. 18. The inmate was never referred to a mental health professional at the jail for evaluation, and was taken off a suicide watch by a nurse who apparently did not perform a suicide assessment.
"These and other completed suicides illustrate lapses in the suicide prevention system and also reflect the systemic mental health delivery problems such as inadequate access to care," the Justice Department report states. "The booking screen process does not sufficiently identify those who need medical attention or observation, nor sufficiently trigger medical care when needed."
The inmates' names are not provided in the Justice Department report, and state public safety officials said yesterday that they weren't able to track down the names.
Leonard A. Sipes Jr., a spokesman for Public Safety and Correctional Services, said state officials are trying to come up with solutions to the problems, many of which he said are attributable to a lack of funds and poor conditions inside the jail. One option would be to replace the antiquated jail building - at a cost of about $100 million, he said.
Another option would be to form a partnership with a hospital or health system that would take over aspects of the jail's health care. Sipes pointed to statistics that show that Baltimore correctional facilities have one of the highest rates of intake for people with AIDS and tuberculosis.