St. Louis inmate dies after delay in care - @

St. Louis inmate dies after delay in care


Heather Ratcliffe | | Monday, June 25, 2007

ST. LOUIS A delay in letting paramedics into the city jail and "substandard" emergency care by staff there may have doomed an inmate who suffered an asthma attack, according to a blistering report by the fire department.

One of the paramedics who treated LaVonda Kimble early April 11 wrote of commonly encountering delays and apathy on calls to the St. Louis Justice Center, at 200 South Tucker Boulevard.

And autopsy findings obtained Wednesday showed no trace of the drug that jail nurses said they repeatedly administered to ease Kimble's breathing.

The reports were obtained with a court order by John Wallach, a lawyer representing Kimble's family in considering a wrongful death lawsuit. He shared them Wednesday with the Post-Dispatch.

"People don't generally die of an asthma attack when they go to the hospital," Wallach said. "I fully believe our evidence will show if she was treated properly, she would have been fine."

Sam Simon, the city director of public safety, pledged to learn more about what happened, and about the medical care provided under contract for more than $5 million a year by Correctional Medical Services. The Creve Coeur-based private company has come under heavy criticism in Missouri and elsewhere for years.

Kimble, 30, the single mother of a 12-year-old child, wasn't supposed to be in jail in the first place.

Her boyfriend had posted bond for her about 6:30 p.m. on April 10 in Bel-Nor, which had a traffic warrant against her. That was about four hours after her arrest by St. Louis police. But a release order went to the wrong jail, a mistake that wasn't corrected until she was already dying.

Kimble fell ill about 10:20 p.m. According to jail records, she received three separate treatments of Albuterol, a medication to ease breathing, before she collapsed at 1:25 a.m.

Firefighters from nearby Engine Co. 2 arrived at 1:40 a.m. and began CPR. Medic 5 was five minutes behind, but spent seven or eight minutes thereafter waiting to get in, according to a report by fire department paramedic Chastity Girolami.

The delay was "detrimental to the patient's outcome," Girolami wrote.

She said firefighters told her they had arrived to find nurses trying to perform CPR by compressing Kimble's stomach instead of her chest.

Girolami noted that when medics asked a nurse if she had used an automatic defibrillator to try to restore Kimble's heartbeat, "She just looked at us and asked what we were talking about."

The jail care was "substandard at best," Girolami wrote in her report.

She also wrote that a corrections officer distracted paramedics with questions about their ID numbers while they struggled to save Kimble's life; the medics twice asked jailers to back off.

"She kept persisting and finally my partner informed the staff that this patient was in cardiac arrest and basically dying, and they would have to wait," Girolami wrote. "The staff was surprised at this. They didn't know the patient was in cardiac arrest."

Kimble was rushed to St. Louis University Hospital, where she died at 2:44 a.m.

"This experience at the Justice Center was by far my worst," Girolami wrote.

She complained, "Every time I've been to the Justice Center, it takes 10 to 15 minutes to even get to the patient. There is never anyone to guide us and never any sense of urgency."

Her report was one of a variety of documents Kimble's family has gathered in preparation of a wrongful-death lawsuit.

The autopsy report shows that corrections officials asked for and got a special toxicology test for Albuterol, and that none was detected.

Wallach said the medical examiner plans to send samples to an outside laboratory for further testing.

"If, in fact, she was not given Albuterol, then the official records are false," the lawyer said, "If that's the case, LaVonda's civil rights were blatantly violated and it led to her death."

An internal investigation concluded, "There was no evidence that the Division of Corrections violated any policies or procedures."

But Simon, the public safety director, said Wednesday there will be an investigation to reconcile reports from the fire department, corrections department and medical examiner.

"We need to conclude our investigation and determine what happened," Simon said. "What I know is these are just allegations at this point."

Ken Fields, spokesman for Correctional Medical Services, said he could not comment on a specific patient.

However, he insisted that the jail's medical staff is trained to properly administer life support techniques, including CPR and use of automated external defibrillators.

"Our services and equipment are in keeping with the standards of care in the community," Fields said. "All nurses at CMS are licensed by the appropriate entity and are qualified to provide the care they are asked to provide."

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