Saturday, February 12, 2011

Investigating neglect in Lonview death of mother jailed for traffic warrants, denied seizure medication

Brandi Grissom has a feature at the Texas Tribune on the disturbing number of recent inmates deaths at the Gregg County Jail in Longview - nine since 2005 in the smallish East Texas county - focusing particularly on the most recent instance, where a young mother locked up for traffic warrants died after her seizure medication was denied to her. The Texas Civil Rights Project recently complained that poor healthcare in Texas prisons constituted a "secret death penalty," and whether that provocative accusation is justified, certainly in this case it's easy to argue poor jail healthcare turned into a death penalty for Amy Lynn Cowling. And she's not the only one.

Rather than excerpt and comment, those interested should go read the whole thing. Well done, Brandi, and as an aside this is the type of journalism I hoped we'd see from the Tribune when it launched with such deep pockets and its admittedly impressive cadre of writers - not just reporting the same stuff everybody else does from the capital but regional investigative features that folks like me with no resources can't do from Austin, and which local reporters don't have either skills, resources or often editorial backing to perform.

That said, I should add that the Longview News Journal arguably is the best small-town paper in the state (an accolade I don't grant them lightly), and their coverage of this topic has been very good, see:
This tragic story has benefited from some excellent journalism, which is unusual when such things happen to say the least. So I don't have much to add on the subject - go read what the reporters who actually researched the topic have to say.

39 comments:

Audrey said...

This is very sad. I saw it in Dallas County and TDCJ. I was one of many denied asthma medications. I saw several people with seizure disorders in severe trouble, having seizure after seizure. In Dallas County I saw women off the streets with open sores oozing infection and not attended to, placed in general population. Antibiotics were not given. Yet psych drugs were handed out like water. It was our biggest fear that we have something serious happen to our health...indeed it was considered a death warrant. The horror stories abound.

I'm glad someone in the media is picking up this story...I am sorry it took this death. I think generally there is a coverup when people die while incarcerated. People are grossly misinformed that think prisoners get better healthcare than "regular citizens". If the State is so set on taking custody of people, then they have a moral and legal obligation to provide appropriate care.

Anonymous said...

"certainly in this case it's easy to argue poor jail healthcare turned into a death penalty for Amy Lynn Cowling."

Interesting comment Scott. Here's a link to a LNJ story about Ms. Cowling's death.....

State: Inmates not guaranteed own prescription medications
Tuesday, January 4, 2011 12:00 am
County jail inmates in Texas have no guarantee they will be given medications prescribed by their own doctors, the state agency that oversees jails said Monday. Instead, they will receive prescriptions chosen by the government’s physician.


http://www.news-journal.com/news/local/article_c7c246fb-f3b8-5f59-9ddb-c712ec6e57c8.html

Anonymous said...

Additionally is a sad point is the sheriff is using the jailers as escape goats on the blame game. I am willing to bet the jailers were never trained in dealing with this type situation. Hopefully, they along with the ladies family will sue Greg County for a failure to train them. That is the only way any real changes will come to that Jail system.

Anonymous said...

Few jails have written policy. Each shift makes it up as they go along. In Smith County, one shift of jailers will let everyone watch TV, the next shift will institute a lockdown and no meal for....catching the inmates watching TV. They keep it capricious.
You never get fed two days in a row at the same time. No meds. No procedure to ask for meds. You aren't going to get anything you ask for anyway, even an asprin or a band-aid. You sign up for attention from a doctor...but he isn't coming until day after tomorrow. Then they cancel your appointment because you missed it yesterday.

The POINT- to jailers...of having folks in jail is to terrorize and confuse them as much as possible. You are just a low-life inmate or a "bad guy." Nobody cares, nobody is checking and nobody is going to believe you over them.
And there is no written policy so they can never be in conflict with policy.

Prison Doc said...

Not so fast on casting blame. When I read her list of medications, the first thing that springs to my mind is "Wow, this person had a really BAD doctor." This list of meds is dangerous on the face of it. The second thing that comes to mind is, "Discontinuance of any or all of these medications would not be expected to cause a life threatening event." Finally, I didn't see a seizure medication listed but even so, seizures rarely cause death unless one falls into the bathtub or into a position that doesn't allow them to breathe.

So the family's allegation, grabbed onto so tightly by Grits and the columnists he so admires, is an example of the old standard of faulty reasoning: "Post hoc, ergo propter hoc":--after the event, therefore the cause of it.

"taint so. Patient may indeed have been improplerly denied medication, but based on the information given it was highly unlikely to cause death.

A much more appropriate question is why the hell do people get put in jail for traffic violations of any kind, paid or unpaid?

This isn't a medical problem; it's a too much jail problem.

Gritsforbreakfast said...

Prison Doc refers to the "allegation, grabbed onto so tightly by Grits."

Please point to any language I used indicating this tight grip to which you refer. You're clearly taking the issue personally, but I don't have any dog in the fight. I referred readers to reports on an INVESTIGATION. You draw quite a few conclusions in your comments, but I didn't take a position one way or the other.

Whether the denial of drugs caused her death, she was improperly denied the medication then died: You can see why her family would think causation is possible or even likely. Jailers are being indicted for evidence tampering, so who knows how deep the rabbit hole goes? While I realize you believe you can exonerate medical staff from afar based on selective snippets from media reports, perhaps you should wait till the investigation is complete and see what folks say who've actually evaluated the cause of death on the ground.

Prison Doc said...

I'm all for waiting until the facts are out, which is clearly NOT the case right now.

Anonymous said...

Hey Prison Doc,
This article fails to mention that she had also been taking Xanax for 10 years. As even you probably know that stopping any benzodiazepine cold turkey can cause seizures and death. There's your missing piece of info. Considering this person's (alleged) history of prescription drug abuse, I doubt the librium prescribed by the jail dr. as a substitute for Xanax would account for the disparity in the probable quantity of daily intake of Xanax. Depending on the type of patch used for methadone withdrawal could have possibly blocked the anti-convulsant properties of the librium. Stopping the methadone in and of itself does not cause death, but all the other considerations does not help. This begs the question, is withdrawal a medical issue or a punishment issue?

Anonymous said...

I'm very saddened by this. And also very familiar with the approved list.My son takes Seroquil at bedtime every night. When he first went to tyc last year they tried to take him off his meds and trade out with another medication. All doing this before recieving his medical history are speaking to me. So he calls me asking what do I do? they are not listening to me.Me and him as always discussed his Meds prior to him taking it. So I informed him to refuse till I spoke with medical case manager. And I also put in a grievience and spoke with Obudsman.They argued his Seroguil it not being on the approved list.I informed them he has taken many other meds that has lead to bad reactions it would be a mistake I also advised them of a heartattack months before. Against my wishes he was given 1 Risperdal. He ended in infirmary with a locked jaw seizure like shaking and blue to head to toe by the next morning. They almost killed him because of this approved list. My point is, if it works dont change it. The numorous Docs before the tyc doc have him on this Med because it works for him. Dont go messing things up, and know the history a 100% before changing things up.Because after the fact when his records came in, he was found to have a enlarged heart.Which my County hospital was sitting on that info. He went from the County jail for chest pain. They ran test and before results came back they sent him back to County jail. Noone was ever informed of Hospital results. But not suprised the Doctor was very rude to myself and my son because he was a prisoner.(Sickning)and not all Meds work the same of everyone,there is such a misconception on Seroquil not everybody get's the high I keep hearing about. It has never affected him in this way. It's like night and day when he is on are off it. It works the way it should and it is helping with his tyc stay.So glad they listened to me with this and keep him on it. He is choosing to make the best of tyc and the meds help to.

Anonymous said...

@ prison doc, Like I said in my prior comment with my experience with the approved list. Not all medication's affect everyone the same.My son has never even come close to having seizure like problems, until tyc took him off his free world meds.He was sent to infirmary because that morning they said he look like Barney the purple Dinosaur with lock jaw shaking all over.1 pill of risperdall did all this. And if they are found neglectfull so be it, she was taken off med that was working for her,her medical and mental problems. And again if she was there more than 24 hours check prior medical history, prescription history. One phone call and a fax machine. Oh but this Doctor was getting paid a 100,000 to come once a week. And dont down the reporter, It was a reporter who took my story over my son's medication because that Doctor did not have time to speak with me either.And that's how I finally got a call from the prison doc. And a Lawyer armed and ready know one will play with my son life. Lawsuits happen when you are dealing with doc to lazy to check history, are speak with patient are family members. And think they know more than the numorous docs that was seen before incarceration. God I'm scared knowing you are treating these prisoners.

Gritsforbreakfast said...

Prison Doc, how do you think "facts come out"? Some reporter digs them up and publishes them, bit by bit. It's not an instantaneous process. Questions were raised and reporters are digging into it, publishing what they can in an environment where officials involved are likely thwarting instead of assisting their efforts. (Witness the record tampering charges.)

As I make my four-year old granddaughter recite whenever she's over-anxious to jump to the next thing or draw premature conclusions, the "reason for time is so everything doesn't happen at once."

Prison Doc said...

Too much misinformation flying here. Guess I'll go back in my hole for a few days....

Anonymous said...

Like a bad drug trip, seems as if nothing in this god-forsaken system ever changes, just worsens.
My ex, (addict - bi-polar, everyone knows the rest), had numerous tdcj experiences(DWI's). Meds for both medical and physc reasons were changed, withheld AND EVEN given mistaken drugs. This happened all over the state, medical attention was frequently withheld and then there were punitive treatments when he was suicidal. YES, DOC you took an oath - as did every other Dr. "to do no harm". Any medical professional that is involved in this system needs to seriously look at their moral and ethical responsibilities. IF the med profs were speaking out, things would be very different.

quash said...

Grissom does a good job of giving both sides: why the jail drug policies exist, how the sheriff immediately held employees accountable etc. But that jail doctor needs to go: " For his part, Browne said, he would rather not be saddled with caring for inmates, but it’s part of the job. “Someone’s got to do it,” he said."

Anonymous said...

Doc put this in your pipe & smoke it: My daughter's 40 year old neighbor had seizures that he controlled with meds. About 2 months shone went out fishing in a boat with two 15 year old boys. He had a seizure & died. The boys didn't know how to save him. Maybe I should have the young widow whose husband died respond to the Docs comments that people don't die from seizures. She would give him a piece of her mind!

Anonymous said...

I lived my life as if it was a train wreck***then I ended up in prison.

You see, it's a balanced equation. In this blog, we are completely unbalanced. We focus only on the last half of the equation (then I ended up in prison). We talk about how terrible it is in prison or how terrible it was when the police arrived at the scene of blood and chaos at 2 a.m.

Why is the first part of the equation never mentioned? Are we allergic to the idea of personal responsibility? Why live a life like a train wreck? Why create a scene of blood and chaos at 2 a.m.? Why defend those train wreck folk and never once ask them to do their part?

Does someone have to act on every destructive whim? Those who reign in their impulse to chaos don’t have to complain bitterly about how it’s “all their fault.” Lack of balance defines a questionable political stance. The house has many rooms in the left wing, but only one on the other side—is that balanced? What kind of people—day in and day out--see only one half of the equation? Read this fast because it will be deleted (confirming my point).

Anonymous said...

I recall an old equation about society and their quest for balance. It went something like this. Let he who is without sin cast the first stone.

A man comes here and he talks about balance. He envisions a house with an entry on the right and he is perplexed by that. He sees blood and chaos and righteous police. His thought process is binary. His brain reduced to a simple logic gate he fails to conceptualize his own dysfunction

Anonymous said...

"But that jail doctor needs to go: " For his part, Browne said, he would rather not be saddled with caring for inmates, but it’s part of the job. “Someone’s got to do it,” he said."

I don't know 8:50. Maybe he's saddled with it because no other doctors in Gregg County would take the position. It's kind of like lawyers who won't sign up to be on the indigent inmate rotation, they would rather be doing something else.

Don said...

10:26 What makes you think it will be deleted. Grits is not afraid of allowing incoherent, jumbled babbling on this blog. (speaking of meds. . .um). The price for breaking the law is loss of freedom. That is the punishment. Being denied medication, nourishment, being subjected to inhumane treatment, deprived of dignity as a person, etc. etc. is not supposed to be part of the equation. The judge never says "You are hereby sentenced to ___days, ____years, etc. incarceration, plus whatever some mentally and emotionally warped jail or prison personnel can think up". Nope, just incarceration. The fact that Scott Henson, I, and most others who comment here believe in people being treated according to the law, even when they are in jail, is twisted by you and a few others to mean "criminal coddling", or that we don't believe in accountability. I have seen what goes on in prisons and jails. It is not ok. That doesn't make me "soft" on crime.
Prison Doc, I wonder sometimes if you are actually trying to convince people that the prison medical system, if you can call it that, is ok, too? Maybe it is at your prison, but overall, it is a total mess. When we get back under Federal oversight for another 15 years, guess we'll wish it had been done a little better. Out of curiosity, why do you choose that particular venue to practice?

Anonymous said...

I smell a cover up! I just read the story sounds to me she was crying out for help, was blown off left untreated.Well they just knocked her out with Haldol.Just another whinning prisoner.And this Doctor has a private pratice? His comments to the press clearly say's he has no compassion for inmate health care.And the jailers are not Doctor's seems they did not know what to do, but put in a call to Doc who just just shut her up with Haldol.But they are the one's losing their job. Sad story I feel for her family.

Anonymous said...

I don't intend to sound hateful, but Prison Doc! What universe are you living in?? Perhaps if you were to ever have a family member incarcerated in a county jail in the great state of Texas, or sentenced to serve 9 months in the SAFP program at Gatesville "special needs" unit, you would know EXACTLY what goes on with people who have medical/psychiatric problems. To tell you that it is an abomination would be putting in mildly. I wouldn't put a rabid skunk in Texas' criminal "justic" system. Because for people who are on medications, it is absolutely a death sentence when they are denied these meds. Not only are these people put in life-threatening medical situations, they are then made fun of, and told they are faking it. If they begin having symptoms of seizures, or become so scared they cry, they are put in "solitary", where no one checks on them - or if the guards do check, it's once a day. If the inmate asks, no - BEGS - for medical attention, they are denigrated, and then perhaps strapped into a chair until they can "behave". Unbelievable....

Anonymous said...

If anyone has a family member currently in a county jail who is being denied medications, I would encourage them to call Advocacy, Inc. They will go in and start an investigation of the jail. Your family member might not get the meds they were on, but the jail staff/nurses take this seriously and will more than likely begin to pay a little more attention to the individual's medical problems.

Anonymous said...

Are these people ex-TYC that were hired after being canned by the lege? Sounds typical of treatment reported in the press about the TYC cover-ups.

Anonymous said...

Get into incarceration and the whole game changes. The staff isn't interested in your meds because they are concerned with your well-being or health- its just another tool in the toolkit to abuse, manipulate or torture you.

Anonymous said...

Ther's notin' wrong with a few extra feel-ups. With the poor pay, it helps offset the tasks of the day. Some inmates like the extra attention. Its also good for inmate/ward relations. Some situations have even lead to marriage.

zenith15 said...

Two other women died in the Orlando, Florida jail in 1997 and 2002, I believe it was--both from untreated abrupt methadone withdrawals. Their families sued and won a total of 5 million dollars--and now the jail has a methadone program.

This kind of death occurs more often than we realize in jail settings. Methadone withdrawal takes much longer than regular opioids to withdraw from due to it's long half life and therefore, the acute symptoms of vomiting, diarrhea, pain, spiking blood pressure and all the rest last weeks instead of days. SOmetimes this is more than even a healthy person can withstand, let alone a physically fragile one.

The "patch" she was given is almost certainly clonidine--a blood pressure medication. There is no "opioid withdrawal patch". The only other comparable medication is Buprenorphine and she certainly was not being given that.

As far as Prison Doc's claim that abrupt cessation of any or all of these medications should not be life threatening, I say thank GOD you aren't taking care of me or anyone I love!!! Xanax withdrawal ALONE can kill a healthy person--much less a combined withdrawal of three dependence producing drugs at once on a physically fragile individual.

I hope sincerely the family sues this jail for the cold blooded murder of their daughter--a totally unnecessary death, totally preventable, all for the want of a few cents worth of legally prescribed meds that the jail "doesn't approve of", or a trip to the ER so she could have been evaluated for her seizures by a physically present physician instead of this jail doctor who had never even seen her.

Anonymous said...

I agree 9:27 I have many questions about many of the doc's comments. I surely wouldn't allow any of my friends to use this so called doctor. Now one can understand why the treatment is so bad after reading his comments.

Anonymous said...

well ok, I have to admit this sounds like what an incarcerated woman once asked me for, "I need my seizure medications, they are called xanax and effexor". Uh no, neither pill is taken for seizures. However, abrupt withdrawal of both medications should be avoidehd. I had to call 4 pharmacies and use 2 variations of her name to determine she was manipulating her way into 8mg of xanax a day. Yes, we tapered he off gently and is probably back up to that high dose. althought xanax is now cheap, it took my time time, nursing time, free world pharmacy time, to verify her doses and land her gently.

just my thoughs

Anonymous said...

WHAT IS WRONG WITH YOUR MORAL COMPASS???
When you became a medical prof, did they ask if you only wanted to treat healthy, "law abiding" citizens?????

I wouldn't leave a stray animal that was suffering a medical condition, because it"took my time"!!!

THE ENTIRE MEDICAL STAFF IN tdcj ARE SOCIOPATHS!

Gritsforbreakfast said...

Whoever keeps trolling Grits comments adding unrelated allegations about abuse at Gatesville, please stay on topic. I've been tolerant but won't further allow you to divert comment strings off topic. Please stop, or I'll just delete all your comments, as I've done on this string. If that's what you want to talk about, either find someone who's talking about it and go there to comment or launch your own blog.

Anonymous said...

WOW GRITS!!! I thought this was about medical abuses and your blog was fair, balance and unbiase. I guess some of us were wrong. Keep deleting that is why there will never be a fair investigation into any prison abuses.

Gritsforbreakfast said...

1:00, If the Gatesville comments contained any substance, I might feel differently. But since they're just anonymous, repetitive smears - and since the same allegations have now been added to the comments of MANY other unrelated Grits posts - I see no further value in tolerating them.

I could care less about your opinion of me, just stay on topic. You're a guest here. Behave like it and respect the rules.

parent-smith said...

Grits I understand your anger, but I'm also very concerned with the health care in Gaitsville.And what if anything can be done? I never see comments on how anyone can change the prison health care. So it's frustrating. TDC, the media, advocacy groups etc.. all know this is taking place. What can be done? These jail deaths I read about alot of them. And nothings being done.I really want to know! Lets do it if it can be done.The Topic is people are dying in Texas in lockup.

rodsmith said...

sounds to me like it's long long long past time for the 100's of thousands of the family and friends of these people to put the state and the jails on notice...any further death that is not a iron clad guaranteed accidental deal WILL result in the immediate EXECUTION of ALL EMPLOYEES OF THE JAIL CONCERNED by the public!

Public would ONLY have to do it once....then the govt would get off it's ass and do it's job!

Gritsforbreakfast said...

I don't know a simple answer to what can be done, Parent-smith, but anonymous, fact-free allegations in blog comments (unrelated to the blog posts, no less) won't help anyone in Gatesville, it just makes the person venting feel better, which isn't the purpose of this blog. I don't mind comments about Gatesville when they're relevant to the post - if we're talking about TDCJ healthcare, guard on staff relations, etc., then such comments would be on topic. My beef is with y'all showing up OFF TOPIC and repeating the same allegations in post after post. It needs to stop, and it's going to.

If you've got specific allegations, gather documentation and take it to the Inspector General, the media, legislators, etc.. If you've got nothing more than the non-specific complaints that keep recurring in Grits comments, though, I doubt there will be anything they can do for you.

Anonymous said...

Grits...

Ms. Grissom's article referred to the high turnover rate of the Gregg County Jail.

Gregg County judge Bill Stoudt may want to give the city of Longview $10 million for an events center (news story, Feb. 8 Longview News Journal)) when he feels the county does not have enough funds to give its employees a pay raise for the last 3 years.

Perhaps the money could be better used to address the jail employee turnover and issues in the Gregg County Jail and realize if these employees were paid a better wage you might get better employees. If you look at comparable counties, these employees are well-below the pay standards.

No pay raises ok. Spend the money on better jail conditions then.

Comments?

jamie said...

Grits- My son was in a media story back in 2007 over the health care issue. And just a few months later his arm was dislocated and broke. Took 4 hours to get to ER, when it was right directly across the street from facility. I always believed in that 4 hours was when they was scrambling to get their story together on how to cover this up. Like at the exact moment were his arm was yanked and broke,there was a clinche in video of a few sec. Almost 17 hours later got treatment at UTMB. My point is, less than 24 hours of this I spoke with the Obudsman. Then the Inspector General was not much help. The staff walked,it was a No Bill.I have done all the right things, Even as we speak my son has a Advocate to help with any civil right issues that come up. Will it take one family member of everyone in prison to Rally in front of the office of tdc are the house were our law makers sit? When these people are held accountable only then will we see change.It works in other Countrys. They can force Presidents out.

Anonymous said...

The Ombudsman and the Inspector General's office is as corrupt as they come.

Anonymous said...

The autopsy is back. It was death related to a seizure as a result of withdrawls from Xanax and Methadone.