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California Jails - Medical



Mother demands answers after sick son's death in jail 
Medical staff suspected him of malingering 
- Jaxon Van Derbeken, Chronicle Staff Writer
Wednesday, August 3, 2005 

A seriously ill inmate in a San Francisco jail begged to go to a hospital three hours before he died but was instead ordered into an isolation cell by a nurse who told sheriff's deputies, "There is nothing we can really do for him,'' reports of the incident show. 

The July 1 death of Edwin Macon Jr., 44, raises questions about how San Francisco jail authorities treat inmates who complain of illness but are suspected of malingering. 

The jail's medical staff never sent Macon to the hospital, even though he had collapsed in court on consecutive days, repeatedly complained of pain in his chest and legs and was so weak he could barely walk. 

Instead, despite Macon's repeated demands for hospital treatment, nurses said he was "carrying on and on'' about heart problems, according to jail medical records provided to The Chronicle by Macon's family. One nurse wrote that Macon wasn't even a "high risk" patient who would need intensive monitoring. 

Macon's death at the Hall of Justice jail is being investigated by San Francisco police, the medical examiner, the Sheriff's Department and the jail medical services. 

Investigators said Macon, who had been jailed on a domestic violence charge, suffered from an enlarged heart, kidney disease and pneumonia at the time of his death. 

Macon's family said the death shows breakdowns in the medical care that inmates receive from the city. 

"They don't let a dog die like that,'' said Macon's mother, Jessie Macon of Daly City, a former nurse who said her son had a history of heart problems and should have been hospitalized. 

Macon was the only son of Jessie and Eddie Macon. Eddie Macon was a longtime professional football player who was the Chicago Bears' first African American player and was once a defensive back for the Oakland Raiders. 

Macon's mother said her son, a onetime electrician who also had done gardening, had been on disability for two years and had used crack cocaine. 

Still, she said, her son needed help. 

"Whether they believed him or not, they could have taken him to the hospital to find out if he was sick,'' she said. 

"Even if they didn't believe him, they didn't have to throw him into the hole,'' she said. "They just threw him in there to die, is what I figure they did.'' 

Dr. Joe Goldenson, head of jail medical services, said he is awaiting the final autopsy report to make conclusions about the handling of the incident. 

"It appeared he received appropriate care, but we won't know for sure until we have all the information,'' Goldenson said. "We just don't know what he died from. Even if it was related to his enlarged heart, it could have been something that wasn't preventable.'' 

Eileen Hirst, spokeswoman for the Sheriff's Department, which runs the jail, said: "We consider every death in custody to be a tragedy. We extend our condolences to Mr. Macon's family.'' 

Macon, who had a history of drug use as well as heart problems, had been brought to the jail on Father's Day, June 19, after being arrested on domestic violence charges. Macon told his jailers he had quit illegal drugs, and he was being treated by the jail with various medications, including children's aspirin to prevent a heart attack. 

"He had an enlarged heart. He was at certain risk for complications from that,'' Goldenson said. 

On June 27, nurses responded to a "man down'' when Macon complained of pain and collapsed in a San Francisco courtroom where he had been brought for his domestic violence case. He complained of kidney pain and chest pain. 

"He's carrying on and on about his medical problems from him having a heart problem that he needs to be sent to SFGH or to be seen by his own doctor bec(ause) he needs a heart transplant,'' nurse Nimfa Punzalan said in a log entry on the afternoon of June 28 about the incident the day before. 

Macon said he had vomited blood, but when the nurse said she didn't see any evidence of that, he became angry and loud and complained "that nothing has been done for him,'' the nurse said. 

"He's not even on the hi(gh) risk board,'' she said, referring to a list of inmates who require intensive medical monitoring. 

On the morning of June 28, another registered nurse responded to a man- down call for Macon, who had been sent back to the same courtroom. According to the jail medical records, Macon accused medical officials who responded to the courtroom of not providing him with proper care and demanded again to go to the hospital. But he was taken back to county jail in a wheelchair and sent to a jail clinic for observation. 

On that same day, records show, nurses decided to confiscate his medicine, as they believed he had not been taking it. This forced Macon to take medication under observation. 

On June 29, Macon was labeled a "high risk'' patient after he again went to the jail sick bay. It was noted that he had been back on his medications and that his blood pressure had improved. 

"Leg pain but consider malingering,'' nurse practitioner John Poh said in a report made the next day, June 30. At the time, Macon told Poh that he had made bail and was awaiting release. He also denied having pain in his chest, according to records. 

But at 12:39 a.m. on July 1, sheriff's Sgt. B. Bloom reported that he found Macon on a mattress in his cell, with feces and urine rubbed on his body. "Macon was moving and saying he needs to go to Seton Hospital,'' Bloom said. 

Nurse Evangeline Anacleto and another nurse arrived and told Bloom to put Macon in an isolation cell instead. His vital signs seemed normal, and his blood pressure was measured at 120/60, in the normal range, the records suggest. Anacleto said Macon had been seen by a nurse practitioner earlier that day. 

"There is nothing we can really do for him,'' she said, adding that he should be placed in the safety cell as "gravely disabled'' with "no obvious physical injury,'' according to records. 

Macon had trouble moving and could not walk on his own. His pants dropped to his ankles as he was moved and was left standing naked in the cell, according to Bloom. 

At 3:15 a.m., Macon appeared to be sleeping to a deputy who was checking on him, but about 10 minutes later, the deputy looked again and saw that he did not respond to the deputy and appeared lifeless. Efforts to revive him failed, and he was pronounced dead at 4:08 a.m. 

E-mail Jaxon Van Derbeken at  jvanderbeken@sfchronicle.com


California jails dealing with outbreak of staph infections 

Friday, January 31, 2003 
©2003 Associated Press 

(01-31) 04:07 PST LOS ANGELES (AP) -- 

More than 1,000 inmates housed in county jails were infected with drug-resistant Staphylococcus bacterial infections last year. Fifty-seven required hospitalization. 

Federal health officials believe the outbreak of the Staphylococcus aureus, commonly called staph, is the largest of its kind in any of the nation's correctional systems. By comparison, a similar outbreak in Mississippi prisons in 1999-2000 infected 59 inmates. 

Staphylococcus can cause the skin to boil and forms deep abscesses. An infection can be fatal if it spreads to the blood and antibiotics fail, or if it goes untreated. 

The infections were often misdiagnosed as spider bites before doctors began seeing similar symptons among inmates. 

"The problem at the jail is not under control yet," said Dr. Jonathan Fielding, the county's public health director. More than 100 infections have been reported this month alone. 

Staph infections are believed to be spread by skin-to-skin contact or shared personal items in the county's jails, officials said Thursday. 

©2003 Associated Press 

February 1, 2003 

Dear Cayenne: 

The article referring to jails and prisons taking precautions regarding inmates infected with TB.  How strange, my son didn't have TB prior to entering jail but within months he was so ill and kept insisting his cough and illness was serious. 

He felt awful and asked to be tested, finally he was allowed to see a doctor and tested positive for TB.  He was not separated and had no pressurized room other than the pressure of over 100 other inmates housed in the same dorm or room breathing each others airborne sputum through coughs and choking on their own phlegm.  Although we only had "glass" visits, I am sure that the amount of inmates with TB increased throughout the facility rapidly. 

My son did recover after treatment for six months.  We will never know how much damage was done to his lungs or those of others. 

The public cannot be that gullible to think that reports are a sufficient means of information.  If that were true, why would Gov. Gray Davis be planning to visit the LAC CSP?  Wouldn't reports save tax payers money? 

Especially since they intend to beautify the yard prior to the visit.  Why not let him see it as it is every other day?  I wonder if he will actually think those patio tables with the mystifiers are enjoyed by inmates on any regular basis. 

I can personally testify to them being open to visitors and their loved ones on only two occasions throughout the past 6 months.  The rest of the time during the sweltering and oppressive heat of the summer we could only look out at the mist dissipating into thin air.  It is very nice for the birds to refresh themselves in I suppose.  I will be glad to write to the Center for Disease Control on the current conditions. 



How can the prisons and jails in California be allowed to threaten the health of the whole community with their lack of the most basic elements of hygiene and medical care for inmates. These same inmates who enter healthy and re-enter the community diseased because no control nor prevention of 
illness spread inside. 

The fact that the health department does not have access to these facilities is appalling. In fact what is going on inside is criminal. Stories of staph infection, HIV, TB, and Hepatitis are rampant. Why is the 
health of the nation being jeopardized by these institutions and what are you doing about it? 

Why is the health department barred from entering and assuring the public and yourselves that the staff isn't covering up a time bomb that can kill and destroy quality of life for tens of thousands by released prisoners infecting the community. Why should anyone contract a wholly controllable 



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