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St. Louis County Justice Center

A holding area in the St. Louis County Justice Center is shown in this 2005 file photo.

CLAYTON — A coalition of civil rights groups in a letter accused St. Louis County Executive Sam Page and other officials on Thursday of keeping the public in the dark about the county’s response to the deaths of four inmates of the county jail.

Lawyers in the St. Louis County Counselor’s office have refused to release documents to the Post-Dispatch about the county’s investigations into the deaths, citing exemptions to the Missouri Sunshine Law that allow governments to keep confidential some records about legal issues and personnel.

Page has talked about changes he has ordered at the troubled jail, expressed sympathy for the family of the victims, and talked about the need for improvements. And on Thursday, he made appointments to a Justice Services Advisory Board that has been neglected for years.

But the county has yet to provide an accounting for what went wrong and how officials were addressing specific failures.

“What little information has been released to the public about the circumstances of these deaths is troubling, and suggests these men were denied necessary medical care,” the letter said. It was penned by officials from MacArthur Justice Center, ArchCity Defenders, the ACLU and other groups.

Page’s advisers had no immediate answers Thursday to a reporter’s questions: how the county investigates jail deaths, where the focus is applied, what types of reports are produced and to whom they are distributed. Page’s chief of staff, Winston Calvert, was scheduled to meet on Friday with staff members from the jail, the county health department and legal staff to review all records from investigations.

The national standard for investigating inmate deaths calls for an administrative review to assess the institution’s response to the death, a review of the incident and procedures used, training received by involved staff, emergency response and recommendations for changes to policies or procedures. The National Commission on Correctional Health Care recommends that a preliminary administrative review occur as soon as possible to identify any obvious areas for immediate improvement.

It also calls for an assessment within 30 days of the death of the clinical care provided to the patient and the circumstances leading up to the death. At least three key questions should be asked during this review: Could the medical response at the time of death be improved? Was an earlier intervention possible? Independent of the cause of death, is there a way to improve care?

The only facts in the cases have been provided by outside investigations with limited scope. The medical examiner’s investigation determined the causes of death. The Clayton Police Department investigated whether crimes were committed.

St. Louis County Prosecuting Attorney Wesley Bell reviewed the investigations of the deaths and said he found systemic problems in the jail, a situation he said was “troubling” and “terrible.” And he said he would have some recommendations for how the jail could improve.

But none of those entities are responsible for studying the failures at the jail and making systemic changes.

A failure to provide care

All of the cases in St. Louis County displayed a pattern of jail staffers refusing to treat very sick patients. In the death of Larry “Jay” Reavis on Jan. 18, an inmate working in the infirmary told police that he had informed a guard that Reavis said he couldn’t get up because he was having a seizure, and that the guard responded, “I don’t know about that.”

John M. Shy, 29, bled to death from an intestinal hemorrhage on Feb. 23. He was transported to St. Mary’s Hospital in Richmond Heights twice that day, but the hospital released him back to the jail each time. He screamed intermittently in the infirmary for nine hours. Two nurses saw him lying in blood at least 15 minutes before anyone entered his cell.

Lamar Catchings, 20, of Jennings, died March 1 from acute leukemia that had never been diagnosed. A nurse accused him of faking symptoms four days before he died. He had to be wheeled to a court date a week before he died and no one asked what was wrong with him.

In the most recent death, inmate Daniel Stout, 31, died on June 11 from peritonitis caused by an ulcer that perforated his intestine, an autopsy found. A source with knowledge of the case told the Post-Dispatch he had tried to seek medical care overnight in the jail but a nurse refused to come to his cell. He died the next morning less than an hour after being transported to a state prison about an hour away.

The county’s lawyers refused to let a reporter review video from Stout’s final night at the jail before his death.

Public release of such video can be a key to accountability. In California, officials in San Luis Obispo County denied requests from The Tribune newspaper and other organizations for video of an inmate who died after spending 46 hours in a restraint chair. But the newspaper obtained the footage from another source and it contradicted county officials’ version of events leading to the death. Sheriff’s deputies watched as the man writhed on the floor, lost consciousness and died. The video showed the inmate was not “found unconscious and unresponsive” and was not in a doctor’s care as county officials had asserted.

On Tuesday, Page told the County Council that the county Department of Public Health was struggling to find adequate staffing for its corrections medicine unit to deliver high-quality care. And he pointed to a high rate of chronic illness, mental illness and substance abuse among inmates.

He pointed to changes he ordered, including a reorganization of jail staff, increasing mandatory inmate checks by jail guards and lowering thresholds for medical intervention. He said his staff changed many other policies to increase oversight, created a critical incident review team, and made it so both correctional officers and inmates could request medical care for inmates. And he said the county was preparing to install cameras in the infirmary.

‘Here is your chance’

The letter sent Thursday was also addressed to interim jail chief Troy Doyle and County Council member Rochelle Walton Gray. Gray chairs the council’s justice health and welfare committee.

In addition to MacArthur, ArchCity and the ACLU, the letter was signed by officials from Empower Missouri, the GrassRoots Accountability Movement, Metropolitan Congregations United and the Khazaeli Wyrsch law firm.

“This letter is a call for an in-depth investigation into these deaths and the overall policies and procedures of the St. Louis County Justice Center,” the letter said. “It is a call for transparency in operations of the jail. And it is a call for accountability to ensure those responsible for the well-being of detainees at the Justice Center are complying with their constitutional obligations.”

It continued: “The County has responded largely by refusing to disclose information about these four deaths.”

The letter said recent events have pointed to how “corruption and toxicity can fester in the dark.” It noted that Page had pledged to make government more transparent.

“Here is your chance,” the letter said.

In a brief response letter, Page pointed to the actions he’s taken to improve the jail and said he would “welcome any input you can offer.”

Jeremy Kohler is an investigative reporter for the St. Louis Post-Dispatch.