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CLAYTON • The St. Louis County inmate whose health deteriorated for several days before he was found dead in his cell on March 1 died of acute leukemia, a report from the county medical examiner said. The illness was not diagnosed before his death.

The report, obtained Thursday by the Post-Dispatch through a public record request, said Lamar Catchings, 20, most likely had acute promyelocytic leukemia, a condition in which immature white blood cells called promyelocytes accumulate in the bone marrow. Their overgrowth leads to a shortage of normal white and red blood cells and platelets in the body, often causing fatigue and pain. The condition can be diagnosed through blood tests.

Because of advances in diagnosis and treatment of this disease, this form of leukemia is considered the most curable form of adult leukemia, according to the Leukemia & Lymphoma Society. Cure rates of 90 percent have been reported from centers specializing in APL treatment.

“It’s a complicated case because we weren’t expecting this until the microscopic examination came back,” the medical examiner, Dr. Mary Case, said Thursday in an interview. Clots in his bloodstream had also caused liver and lung damage. “You couldn’t tell that by grossly looking at him and his tissues and organs.”

For a person to develop leukemia and die before it is diagnosed is “not common at all, but that’s not to say it can’t happen,” she said. “It happened in this case.”

Catchings, who had been in the county jail for 11 months on charges of assault and armed criminal action, was the third inmate to die there this year. The County Council has scheduled an inquiry into jail procedures starting with a hearing on Tuesday.

“The cause of death of Mr. Catchings brings more questions about procedures that were apparently not followed,” Rochelle Walton Gray, chairwoman of the County Council’s Justice, Health and Welfare Committee, said in a statement Thursday.

“We want to know what process and procedures are in place for assisting an inmate who is having obvious health issues,” Gray continued. “Were these protocols being followed? If not, what needs to change? The County Council will continue asking questions until we have all the answers about what happened in the days and hours before the death of Mr. Catchings and two other inmates earlier this year.”

As to whether leukemia should have been diagnosed, Case said, “That’s not for me to say.” A person suffering from acute promyelocytic leukemia would usually be “desperately ill” and seek medical attention, she said, but she said she wasn’t sure what types of symptoms Catchings had had.

Signs of distress

In a jailhouse interview on March 7 with a Post-Dispatch reporter, an inmate in a cell next to Catchings’ cell said he appeared to be extremely sick and weak for at least two weeks before he died, and said several inmates on the floor had been worried about him and were devastated when he died.

Desean Pitts, 20, said Catchings had told him his eyes and ears hurt, that he could not hear out of one ear, and that he had pain on one side of his body. Pitts said a nurse repeatedly took Catchings’ vital signs and said they were normal. Pitts said Catchings never left his cell during the times inmates could go to a common area. He said that when he passed Catchings’ cell, he would see him bent over with a blanket over his head. And when Catchings had to appear in court, Pitts said, jail officers had to help him walk.

Catchings may have died several hours before he was discovered, the report found. The medical examiner found a jail guard did not follow protocol by having Catchings stand in his cell when checking on inmates at 10 p.m. the night before. Instead, the guard looked through his cell door window and saw Catchings lying on his back in bed in the same position in which he was later discovered dead.

The decline in Catchings’ health was explored in a Post-Dispatch story published online on Wednesday.

Catchings had been able to walk into a St. Louis County courtroom on Jan. 25, but at his next court appearance on Feb. 22, he was in a wheelchair. Courtroom video obtained by the Post-Dispatch through a public record request showed that Catchings struggled to rise when the judge entered the courtroom, and he frequently held his head in his hands.

The medical examiner’s report said a nurse working at the jail reported that Catchings had been acting “weird” in the days before his death. Asked to elaborate, she told an investigator that he had complained of headache, nausea and vomiting on Feb. 18 and Feb. 22, and of weakness, dizziness and a burning feeling in his chest on Feb. 26.

Medical notes from Catchings’ Feb. 26 visit to the infirmary found that he had an unsteady gait. But he was not found to have blood in his vomit or stool or have had any injuries or accidents. The nurse volunteered that the jail had had problems with smuggled heroin and fentanyl. But the medical examiner’s investigation did not turn up any trace of drugs in Catchings or his jail environment.

Julia Childrey, the county’s interim justice services director, did not respond to a request for comment.

In a statement, Catchings’ mother said the news was devastating.

“I would have given anything just to hold him and help him through his pain,” Tashonda Troupe said. “They ignored him and left him to die an inhumane death, which to me is criminally negligent.”