Report: Charleston inmate recommended for hospitalization twice before death

A coroner’s report released Friday states medical personnel evaluated him and recommended he be hospitalized twice before he was found unresponsive.
Published: Mar. 31, 2023 at 4:11 PM EDT|Updated: Apr. 1, 2023 at 5:26 AM EDT
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CHARLESTON, S.C. (WCSC) - A Charleston County Coroner’s report released Friday states medical personnel evaluated him and recommended he be hospitalized twice before he was found unresponsive and then taken to a hospital where he died.

The report, from Coroner Bobbi Jo O’Neal, focuses on the death of 28-year-old D’Angelo Brown, who died at MUSC on Dec. 29. Earlier this month, O’Neal listed Brown’s cause of death as Enteroaggregative Escherichia coli sepsis with septic shock and multiple organ system failure because of “gross medical neglect,” and said the manner of death was homicide.

The report from the Charleston County Coroner’s Office states medical personnel evaluated Brown and recommended that he be hospitalized on Nov. 8. Instead, his condition continued to deteriorate. The coroner’s report states that on Dec. 12, “medical personnel again recommended that he be emergently hospitalized.”

But the report states he was not transported to the hospital until the morning of Dec. 21, when he had been found unresponsive in his cell at about 6 a.m.

Brown arrived in the ER unresponsive, intubated and hypothermic, the report states. Imaging of his brain showed no fractures, lacerations or bleeding, but “profuse brain swelling was noted,” it states.

A drug screen was negative but he tested positive for E coli, it states.

Brown was admitted into the intensive care unit where he remained unresponsive until his death eight days later.

“Mr. Brown had a medical history of hypertension and schizophrenia. During his incarceration, it was documented that he refused his medications,” the report states. “Mr. Brown’s condition worsened. Detention and medical personnel noted bizarre behavior, including smearing feces on the wall of his unit.”

Brown was pronounced dead at 1:30 p.m. on Dec. 29. An autopsy was conducted on Jan. 3.

The report cites records from the Al Cannon Detention Center; Wellpath, the jail’s medical provider; and MUSC, as well as a review of video and bodycam footage from the detention center.

A lawsuit filed on behalf of Brown’s family alleges that Charleston County deputies continued to observe Brown’s worsening medical condition but “failed to intervene on his behalf.”

Documents released by the Sheriff’s Office reveal more than 50 non-conformance reports from May 2022 through March 2023 about Wellpath, the current jail medical provider.

Complaints from inmates not being seen by medical staff, not receiving medicine, no medical staff on site and staffing shortages are noted several times.

Kyle White, a lawyer with experience litigating cases against jails and their medical providers, including in some cases Wellpath, wrote in a statement:

“For various reasons, I am unable to comment on any of my own current or past cases against Wellpath, but in general, jails in South Carolina are required to provide detainees with access to adequate medical care. Unfortunately, many times when a county hires an outside contractor to provide medical care, the medical contractor actually operates as a barrier to adequate medical treatment, because if the contractor was not there, the patient would be transported from the jail to the emergency room where they would receive adequate care. Instead, the medical contractor retains responsibility for providing treatment that it has no business trying to provide. These arrangements in reality are just a cost-shifting or liability-shifting arrangement for the jail, and provide no benefit and are dangerous to the patient. I do not know all of the details of D’Angelo Brown’s death at the Al Cannon Detention Center, but from what I have seen released publicly, it is an horrendous case, and the jail and any of its medical contractors should be very concerned, particularly in light of the family’s decision to hire some of the most skilled and aggressive civil rights lawyers in South Carolina.”

Brown’s family lawyers with the Evans Moore law firm say that they do intend to sue Wellpath once more medical records are made available.

After multiple requests for comment, Wellpath provided the following statement Friday night:

Wellpath is focusing on providing high quality care to patients at the Sheriff Al Cannon detention center while the County’s procurement process is completed. We will work with the County’s new provider to ensure a solid transfer of patient care. As you know, we made the difficult decision to notify this client that we would not seek to renew our contract, due to concerns for the safety of our front-line healthcare providers that we previously raised, including those in our letter dated 1/27/2023. We are aware that the Sheriff’s office released certain selectively chosen e-mails to the media; we look forward to full government transparency in this matter as required by the South Carolina Freedom of Information Act. We hold patients at the center of everything we do, and their care remains our top priority.

A few background points:

· The accreditation by the National Commission on Correctional Health Care, which is part of the National Sheriffs’ Association’s Triple Crown Award described in this letter, is based on the stellar work done by the facility’s health care vendor – in this case, Wellpath. We appreciate the Sheriff’s office commending our work.

· The emails by the Sheriff’s office clearly do not reflect a comprehensive accounting of the correspondence between Charleston County officials and Wellpath staff. If transparency is the goal, there’s a lot more work left to do.

· It is not, nor has it ever been, the responsibility of the health care provider to clean county facilities or engage in forced cleaning of patients.