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Deaths at Texas Jail Reveal Health Care Deficiencies

When Amy Lynn Cowling, 33, was arrested for speeding and outstanding misdemeanor theft warrants, no one expected that she would receive the death penalty. But Cowling never even had the opportunity to present her case to a judge or jury; five days after she was arrested, she died in the Gregg County Jail in Longview, Texas.

Cowling, who suffered from bipolar disorder, had a history of prescription drug abuse. Arrested for possessing a fraudulent prescription in 2001, she had been using methadone to keep herself clean for a decade. She was also receiving Seroquel for bipolar disorder and medication for arthritis, high blood pressure, a failing kidney and heart problems.
Cowling and her mother, Vicki Bankhead, begged jail officials to give her the medication that was in Cowling’s purse located in the jail’s property room, to no avail. Jail policy prohibited the use of methadone and Seroquel.

Cowling died on December 29, 2010 after a horrific day of screaming and seizures. She became the ninth prisoner to die at the Gregg County Jail since 2005 – far more prisoner deaths than reported at other comparably-sized jails during the same time period. [See: PLN, May 2011, p.16]. Since Cowling’s death, another Gregg County prisoner – also on methadone – has died at the jail. Micah Aaron Garner, 30, died on June 6, 2011; the cause of his death was ruled undetermined.

Dr. Lewis A. Browne, county health administrator and the jail’s doctor for nearly two decades, is the official who decides which drugs prisoners are allowed. He prohibits methadone and Seroquel because they are frequently traded among prisoners. Gregg County officials claim that Cowling was given appropriate substitute medications.

However, a report submitted to the Texas Attorney General stated that Cowling had been experiencing “seizure activity,” and a nurse at the jail had called Dr. Browne and reported that Cowling was “howling and uncooperative.” Dr. Browne reportedly told the nurse to administer a dose of Haldol, an antipsychotic drug, and ordered a second dose later when Cowling resumed yelling. He also had her placed on suicide watch.

According to an autopsy report, the “probable” cause of Cowling’s death was seizure due to methadone and prescription drug withdrawal. A second opinion was requested by county officials, who turned to the time-honored tactic of blaming the victim. They said Cowling was not honest about her medical condition.

“I absolutely do not believe that the jail or jail staff contributed to this inmate’s death whatsoever,” said Robert Davis, an attorney for the county.

“They didn’t watch her,” countered Cowling’s aunt, Lisa Doolan. “She died on their watch.”

Following Cowling’s death, Gregg County Sheriff Maxey Cerliano initiated an investigation. As a result, five jailers were fired and a sixth, Darrell McClenton, resigned.
Not all of the misconduct discovered during the investigation was related to Cowling’s death, but one jailer was terminated for falsifying observation logs on the night she died.
The guards who were fired included Brian West, Tomeka Cross, Kashena Davis,
Jacqueline Smiddy and Gary Lewis. West and Cross were charged with tampering with a government document.

“I’m pretty disappointed for the way this happened, and we’re trying to ensure that we have an isolated incident and not a widespread problem,” said Sheriff Cerliano. However, he also remarked that jail personnel had followed medical protocol in regard to Cowling.

But who determines whether a jail’s medical protocols are adequate? Gregg County Jail prisoners have filed over twenty complaints with the Texas Commission on Jail Standards since 2008 – most of them citing inadequate medical treatment.

One prisoner who hanged himself in 2009 had complained that he was being refused the medication he was taking before he was arrested. Nearly all of the complaints received the same answer from Adan Muñoz, Jr., the commission’s executive director: “The Texas Commission on Jail Standards does not question the professional opinion of medical personnel.” Indeed, state standards merely require that a jail provide prisoners with medical treatment according to the facility’s health care plan. So long as the jail has a plan on file and follows it, the commission will not intervene.

Dr. Browne, who also has a family medical practice in Longview, receives more than $100,000 a year to be the jail’s physician and the county’s health administrator. Blaming the prisoners for the jail’s health care problems, he said prisoners are often uncooperative and dishonest about their medical conditions. He remarked that many are drug addicts, which presents a challenge to medical personnel, and also complained of difficulty in retaining medical staff at the jail.

In fact the Gregg County Jail has difficulty retaining all of its employees. In 2009 and 2010, over 40% of the jail’s 167 employees quit or were fired. Sheriff Cerliano blamed low pay, challenging work conditions, months of training and having to pass drug tests as reasons for the high staff turnover. Logically only the first two factors would make jail employees want to quit, whereas the last two might make it harder to attract new employees. Further, the reasons cited by Cerliano are faced by all county jails, yet other jails don’t have such a high turnover rate.

Brazoria County Sheriff’s Department Lt. David Drosche, president of the Texas Jail Association, said that retaining jailers is difficult but called the 40 percent turnover rate at Gregg County “extremely high.”

Diana Claitor, executive director of the Texas Jail Project, an organization that advocates for improving jail conditions, said monitoring jail employee turnover rates and improving health care standards could help prevent deaths like Cowling’s. She noted that over 280 Texas jail prisoners statewide had died from medical conditions between January 2005 and September 2009.

“One of the chief factors playing into mistreatment or neglect would be ill-trained, inexperienced staff,” said Claitor. But she also noted that the state budget crunch made it unlikely that additional oversight of county jails would be approved.

Recently, the Texas legislature passed a bill (SB 1687) that requires county jails to report monthly staff turnover data to the Texas Commission on Jail Standards. “I think it will help put a spotlight on the problem and hopefully lead to more scrutiny,” said state Senator Rodney Ellis. The measure was signed into law in June 2011 and became effective on September 1. However, the legislation does nothing to lower staff turnover rates or ensure adequate staffing, including medical staffing, at county jails.

The courts are apparently not the answer to substandard health care at Texas jails, either. Since 2005, prisoners have twice sued Sheriff Cerliano and Dr. Browne alleging deliberate indifference to their serious medical needs. However, the court held that Dr. Browne and the jail had attempted to provide adequate care, which was sufficient to defeat a deliberate indifference claim.

Another suit against Gregg County was filed in June 2011 by the family of Amy Lynn Cowling, alleging inadequate medical care at the jail. The second autopsy requested by county officials confirmed that she had died due to seizures resulting from medication withdrawal. See: Bankhead v. Gregg County, U.S.D.C. (E.D. Tex.), Case No. 2:11-cv-00279.

PLN has previously reported on deaths in Texas jails due to inadequate medical care, dating back to 2007. Apparent-ly not much has changed over the past five years. [See: PLN, May 2011, p.16; July 2010, p.16; Oct. 2009, p.1; Sept. 2007, p.9].

Sources: Texas Tribune, New York Times,

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Related legal case

Bankhead v. Gregg County