Judge set to decide blame in death
Posted on Saturday, January 7, 2006
URL: http://www.nwanews.com/adg/News/141808/
Testimony concluded Friday before a federal judge being asked to decide if the state violated the rights of a mentally ill Bella Vista man — and similarly violates others’ rights — by failing to ensure the availability of timely, adequate mental-health care.
The man’s son contends that his father’s placement in a Benton County jail cell for four days while he awaited an opening at the State Hospital, the only state-run inpatient facility for the acutely mentally ill, led to his death on Jan. 1, 2003, from an otherwise treatable condition.
The state says that problems created or exacerbated by the common practice of temporarily holding seriously mentally ill people in county jails are greatly exaggerated.
U. S. District Judge G. Thomas Eisele said Friday, after hearing four days of testimony in the nonjury trial about perceived deficiencies in the state’s mental health care system, “It’s an important case.”
Eisele said that before he issues a ruling, he will have to review legal issues, testimony and arguments of attorneys, as well as written briefs he wants the attorneys to submit addressing specific concerns. He plans to define the issues and establish a timetable during a telephone conference next week.
If Eisele ultimately finds the state mental-health system unconstitutional, the onus will be on the state Legislature to find a solution.
Mental-health professionals testified that any reasonable solution would cost the state millions of dollars each year, with at least $ 3 million needed annually just to meet the most basic needs of the seriously mentally ill.
A 2001 federal lawsuit over the practice of keeping criminal defendants awaiting initial mental evaluations in county jails for extended periods of time resulted in a settlement requiring the State Hospital to prioritize treatment, add bed space and hire more staff to deal with those kinds of patients.
The latest case stems from a lawsuit that Darin Winters filed in 2004 alleging that Benton County and the state violated the rights of his father, Donald Winter, by failing to allow his immediate transfer to the State Hospital after being involuntarily committed by a judge.
The elder man’s legal name was Donald Winter, but he went by the name Donald Winters for more than 20 years. Darin Winters, who was 8 when his mother married Donald Winter, has legally changed his name to Winters, saying he always considered the older man to be his father.
On Friday, an associate state medical examiner, Frank Peretti, testified that an autopsy showed that Donald Winter died of peritonitis, a serious and painful inflammation in the abdomen, as a result of a chronic ulcer that had perforated. Peretti said the ulcer had been present for some time, but he couldn’t say when exactly — or how — it was perforated.
Pressed by Eisele, Peretti estimated that Winter died “probably less than 24 hours” after the ulcer perforated.
Peretti said Winter did not die from wounds he sustained from directly flinging his head against a metal toilet in his jail cell or his violent struggle against officers who arrested him on Dec. 28, 2002, on a misdemeanor criminal trespass charge. Peretti said those incidents, however, likely caused “at least 49” bruises on Winter’s body, and may have caused his broken ribs as well. He acknowledged that stress could have contributed to the perforation of the ulcer.
Before jailing Winter, sheriff’s deputies tried to get Winter admitted into Bates Medical Center, which would not admit him in his psychotic state.
Pat Dahlgren, director of the state’s Behavioral Health Division of the Department of Health and Human Services, testified Friday that there are never more than five to seven people at a time waiting in county jails across the state for one of the State Hospital beds reserved for the acutely mentally ill. The maximum is usually two or three, she said.
Earlier in the week, Washington County jail administrator Randall Denzer testified that when his jail has to hold mentally ill people who have been involuntarily committed to the State Hospital, “We probably keep them anywhere from two weeks to three or four months.”
During that time, he testified, “It is a full-time fight trying to keep them safe and keep the officers safe,” as well as to feed and medicate the generally uncooperative detainees who are not facing criminal charges.
Benton County Sheriff Keith Ferguson, represented by attorney Mike Rainwater of Little Rock, testified about similar problems, saying his officers did all they could to protect Winter from himself — and others from Winter.
Eisele told attorneys on Friday that his “inclination at this time” is to dismiss the lawsuit’s claim against the sheriff and Benton County.
Bob Gale, former director of the state Division of Mental Health Services and now a part-time psychiatrist at the Pulaski County jail, testified that last year, an inmate who had been involuntarily committed to the State Hospital, but was awaiting an available bed, crawled naked on his cell floor, smearing feces on himself and urinating on himself, for five days until a bed came open at the mental hospital.
Gale said the prisoner refused to eat or drink, but Gale’s medical background allowed him to legally force the man to drink by holding him down and pouring water into his mouth.
Gale testified that he has seen instances in which charges against a mentally unstable inmate would be dropped in order to get the person admitted to University Hospital, in the hopes that the hospital’s connections to the State Hospital would ensure the person eventually got admitted to the mental hospital.