Lack of medical care led to death of 19-year-old in Pa. jail, mom says in lawsuit

Patriot-News - 12/14/2021

Police arrested Jonathan Merced in 2019 after they said he stole a van and led officers on a chase. The 19-year-old was taken to Schuylkill County Prison for failure to pay $75,000 bail.

Merced never got out of jail. He never even had his day in court.

Instead, on Nov. 12, 2019, Merced died, making his arrest and incarceration a death sentence, according to his mother, who on Nov. 10 filed a federal lawsuit against the county and its medical provider.

The new federal lawsuit alleges the jail and its for-profit medical provider, PrimeCare Medical Inc., failed to give proper medical care for an existing heart problem and allowed Merced to wither away, without treatment, until his condition deteriorated to the point that death was inevitable.

According to the lawsuit brought by Merced’s mother, he was born with a disease that causes defects in the heart and can lead to heart failure and muscular dystrophy. Merced was treated for both conditions his entire life and was considered in reasonably good health up until the point he was taken to the jail, according to the lawsuit.

Merced’s death bears similarities to a case earlier this year in Dauphin County, where a 19-year-old with a previously manageable bowel disorder died after being incarcerated for a probation violation. Kejuan Cooke’s death was ruled from “natural causes,” by the coroner.

Dauphin County also uses PrimeCare Medical Inc. for its healthcare services for inmates.

PrimeCare is the named defendant in 18 federal lawsuits filed in Pennsylvania this year, including seven filed in just the last four months alleging the company provided inadequate medical care in jails across the state.

Schuylkill County officials did not respond to multiple calls for comment from PennLive.

Similarly, PrimeCare did not respond to multiple phone calls from PennLive and an attempt to email PrimeCare’s corporate office using the email address on the company’s website was returned as undeliverable.

When young men die of otherwise manageable health conditions, loved ones want answers.

“In general healthcare at county jails is pretty abysmal,” Alexandra Morgan-Kurtz, managing attorney for the Pennsylvania Institutional Law Project – a nonprofit focused on litigation and advocacy for the rights of incarcerated people.

Morgan-Kurtz is not directly involved with Merced’s case but said she was not surprised to hear the allegations against Schuylkill County and PrimeCare.

“Jail and prison healthcare is particularly bad when it’s dealing with people who have pre-existing conditions that require chronic care and constant attention,” she said. “No jail or prison system that I’ve come across has the ability or the desire to provide the constant care that people with heart conditions, diabetes, asthma, any kind of long-term condition needs to survive in the regular world, let alone when you’re dealing with the additional pressures of incarceration.”

According to the lawsuit, Merced made several attempts to notify staff of his health conditions and get treatment. But those efforts were repeatedly ignored, the lawsuit alleges.

During the first week of October 2019, Merced’s condition began to deteriorate to the point where he was having trouble breathing and he was having chest pains, the lawsuit says.

Merced had become so frail, losing nearly 15 pounds from his small, 120-pound frame, that other incarcerated people referred to him as “the walking dead” and “the ghost,” according to the lawsuit.

He again tried to seek treatment but was denied care.

It wasn’t until October 29 that the prison started treating Merced, according to the lawsuit. On that day, the prison performed a chest X-ray on Merced which showed he had developed excessive fluid around his lungs, a complication from his heart condition.

Around 5 p.m., he began to have seizures.

Merced was transferred to Lehigh Valley Hospital a short while later, but it was too late, according to the lawsuit. While at the hospital, Merced’s heart stopped, he was resuscitated multiple times and he had to be intubated, the lawsuit alleges.

Merced then was transferred on Nov. 7 to Thomas Jefferson University Hospital in Philadelphia, where he died a few days later.

According to the Bureau of Justice Statistics, 63 people died in county jails in Pennsylvania in 2019.

The agency’s data show that the total average number of deaths in county jails in Pennsylvania rose by more than 50 percent between 2010 and 2019 even as the average number of people incarcerated fell.

But this data may not include all deaths.

Advocates have raised concerns that not enough is being done on the state or federal level to properly count how many people die while in the custody of police or while incarcerated.

Since October 1, 2019, the federal Deaths in Custody Reporting Act requires counties to report quarterly to the Pennsylvania Commission on Crime and Delinquency when any incarcerated person dies in custody.

Schuylkill County, however, did not report Merced’s death to PCCD, according to records obtained through a Right to Know request.

The lawsuit also alleges the jail is denying Merced’s mother access to his medical and inmate records.

According to the lawsuit, PrimeCare has refused written requests for Merced’s medical records and that former warden Eugene Berdanier went so far as to take Merced’s inmates records from the prison’s records department after Merced died.

Morgan-Kurtz said it can be difficult to get information about what happens on the inside. Records are often protected from public view and not subject to open records requests. She said obtaining records can often require a subpoena, which is generally too costly, time consuming and difficult for many people.

Beyond the difficulties of getting access to records, Morgan-Kurtz said many incarcerated people are afraid to go public with abuses they experience while incarcerated for of fear of retaliation from jail staff.

“We don’t even set up legal calls with some people until we get their permission in advance, because we’re afraid of what will happen to them, whether they’ll be placed in solitary, whether they will get less access to care, just by us inquiring, and them being aware that they’ve been in contact with us,” she said.

Morgan-Kurtz said Merced’s case is indicative of a system that has created significant financial incentives to not provide robust medical care.

Schuylkill County, like most counties in Pennsylvania, contracts with for-profit medical companies to provide health care in jails. In this case, PrimeCare Medical provides health care services in the jail.

PrimeCare is one of the largest medical providers in jails in the state. The company has paid millions to settle lawsuits levied against them in federal court in recent years, including paying more than $850,000 to a woman who claimed the poor medical care she received inside Berks County Prison led to her left leg being amputated and $190,000 to the family of man who died by suicide in Northampton County Prison in 2017.

In 2016, a federal jury awarded nearly $12 million to the family of a man who died by suicide in Monroe County jail in 2009. The jury levied $8 million in punitive damages because they found PrimeCare’s negligence caused the man’s death.

Morgan-Kurtz said counties typically pay medical providers a flat fee for health care services over the course of a contract. This ultimately means the more services a company like PrimeCare provides, the less profit the company makes from the contract.

She said this leads to medical providers focusing on only treating immediate problems rather than providing preventative care or proper care for chronic conditions, which are expensive to treat and can consume a lot of time for nurses and doctors.

“People with chronic conditions, people who are disabled have the least chance of surviving jail and prison, because the systems are designed to leave them at an even greater disadvantage,” Morgan-Kurtz said.

Counties often tout hiring companies like PrimeCare as a cost saving measure, as counties are on the hook to pay for most medical expenses for people who are incarcerated. Federal law bars the use of Medicaid to pay for medical care in prisons and jails, meaning counties often pay out of pocket when an incarcerated person is sick or injured. However, these cost-savings may lead to irreparable harm and, in some cases, death for the people held in the jails, according to a 2020 analysis by Reuters.

The news outlet reviewed more than 7,500 deaths in more than 500 jails across the country and found jails that relied on private medical providers, including PrimeCare, had a higher death rate than those that used public providers.

“As long as the privatization of medical care continues, you’re going to see people dying, because someone else wanted to make money,” Morgan-Kurtz said.

Counties can provide their own health services by hiring medical staff to work at the jails. While the costs may be greater, Reuters found jails with publicly managed health services saw significantly fewer deaths.

The lawsuit by Merced’s mother seeks financial compensations alleging the lack of medical care was part of a pattern of practice at the jail that amounted to medical malpractice that violated Merced’s due process rights and directly caused his death.

Merced’s mother is also asking the court to issue an injunction against the county and PrimeCare to force them to make changes to prevent a similar situation from happening again, including creating a system that allows for independent monitoring of the jail.

“You’re taking people out of their homes out of their lives, where they can make decisions to provide for themselves…and you’re putting them in an environment where they have absolutely no control over anything,” Morgan-Kurtz said. “If the government did not want to have the obligation to provide for people then they shouldn’t incarcerate them and the moment they’re incarcerated it is the state’s duty to provide care for them.”

Here are summaries of other lawsuits against PrimeCare:

In one case, a man who was incarcerated at Montgomery County Jail in 2019 alleges that PrimeCare medical staff there ignored his complaints of severe and persistent pain in his left side for nearly a month. The man was ultimately admitted to a local hospital where it was discovered that he had developed septic arthritis, sepsis and MRSA - an antibiotic resistant infection.

In another case, a man who suffers from epilepsy incarcerated at Northampton County Jail earlier this year said PrimeCare medical staff refused to provide him treatment after having a seizure. The man claims a nurse called him a “faker” and asked “did you piss yourself” when corrections officers brought him in to be seen.

Two other suits, one in Dauphin County and another in Schuylkill County allege that PrimeCare did not adequately monitor and treat two individuals with a history a suicidal thoughts before they died by suicide in their respective jails.

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