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Preventable Sacramento County Jail Death Costs Taxpayers $1.45 Million

by David M. Reutter

The systemic failure of medical care at California’s Sacramento County Main Jail (SCMJ) resulted in a prisoner’s avoidable death that has cost taxpayers $1.45 million. For years, SCMJ’s healthcare system has been severely deficient – yet jail officials continue to use the county’s Correctional Health Services (CHS) to provide medical treatment of questionable quality.

Only days after being booked into SCMJ on a cocaine possession charge on June 7, 2006, William Francis Sams, 27, began complaining of constipation, stomach problems, a burning sensation in his throat, gastric distress and abdominal pain. He went to sick call on June 13 and a nurse ordered milk of magnesia and told him to drink more fluids.

When Sams saw CHS physician Tamara S. Robinson the next day, he could not remain still without prompting, was crying and groaning, and moved his legs and lifted his body off the bed due to severe abdominal pain. Ignoring Sams’ request to be sent to a hospital, Dr. Robinson prescribed Maalox and a “GI cocktail” before sending him back to his cell. She also ordered an abdominal X-ray and other tests that would not be done until the following day.

A short time later, guards brought Sams back for medical treatment because he was vomiting blood. Rather than provide care for a prisoner who had been classified by jail staff as an “overbearing/flamboyant homosexual,” he was returned to his cell.

Around midnight, a deputy again took Sams to the medical unit. CHS personnel noted that his skin was cold, he was perspiring and dizzy, his blood pressure and respiratory rate were high, and his body temperature was low.

“The classic signs of shock,” said attorney Geri Lynn Green. At that point, Sams “needed to be transferred to a hospital.”

Instead he was told to lie down on mattresses on the floor. He complained of shaking and seizures. Less than two hours later, Sams was found unresponsive; he had no pulse and was not breathing. He died just 8 days after his arrival at the jail.

An autopsy revealed that Sams’ death was due to a perforated duodenal peptic ulcer. “Tragic – and wholly avoidable,” said Green, who represented Sams’ mother, Marilee Ann Hewitt, in a wrongful death suit against Sacramento County, the Sheriff’s Department, CHS and jail officials.

The defendants dismissed Sams’ death as nothing more than a bad incident that was unavoidable. “The physical presentation by Mr. Sams did not suggest ... a perforated ulcer,” said County Attorney Van Longyear. “Tragically, Mr. Sams’ perforated ulcer was not diagnosed and, when [his] condition turned for the worst, classic signs of shock were not recognized, and so emergency policies and procedures were not followed in time to save him.”

Apparently the only thing that SCMJ officials had tried to save was money, as evidenced by their use of an on-call doctor, William G. Douglas, who twice had an opportunity to send Sams to a hospital when he was called at home by CHS staff.

“Douglas had a long history of refusing to provide inmates at the jail with necessary and appropriate care and was repeatedly disciplined [and eventually terminated] for failing to provide” such care, Green said. “Douglas disliked his position as an on-call doctor because he was paid only $8.00 per hour for taking calls, which he stated ‘was hardly worth the effort and the responsibility.’”

A Sacramento Grand Jury report released on July 1, 2006, two weeks after Sams died, found that SCMJ’s medical care system was a threat to prisoners’ health. The Grand Jury noted that the jail’s accreditation by the Institute for Medical Quality had lapsed in 2001, and an attempt at re-accreditation in 2003 had failed.

Sadly, little has changed since the report was issued. The jail’s healthcare system remains unaccredited and CHS’s Medical Director, Dr. Peter S. Dietrich, was arrested on January 14, 2009 for writing unauthorized prescriptions for Oxy-Contin. He reportedly obtained 1,750 of the pills, naming his mother as the patient; his medical license was suspended and he was fired on May 13, 2009.

The lawsuit filed against the county over Sams’ preventable death settled in July 2009 for $1.45 million. At the $8.00 per hour that Dr. Douglas was paid, the settlement is equivalent to 181,250 hours – or 20.7 years – of employing a cut-rate on-call physician to evaluate prisoners’ medical needs. Had jail officials paid more for competent care it would have cost them less over the long run. See: Hewitt v. County of Sacramento, U.S.D.C. (E.D. Cal.), Case No. 2:07-cv-01037-DAD.

Additional sources: Sacramento Bee,,

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Related legal case

Hewitt v. County of Sacramento

Please see the brief bank for documents related to this case.