by Jo Ellen Nott

When a 35-year-old detainee died in his cell at the Fulton County Jail (FCJ) in Atlanta on September 13, 2022, he was found covered in lice. Officials then discovered that every man in his unit – which is reserved for those diagnosed with mental illness – was infected with lice, scabies or both. More than 90% were so malnourished that they had also developed cachexia, a wasting syndrome that is typically seen in patients with advanced-stage cancer.

“The fact that people held in the custody of Fulton County are so malnourished and ill that they are experiencing muscle wasting commonly seen in people with late-stage cancers is horrifying,” said the Executive Director of the Southern Center Human Rights, Terrica Ganzy, who called FCJ “a public health nightmare.”

The dead detainee was homeless and had a documented history of mental health problems before his arrest on a misdemeanor charge in June 2022. An Alabama warrant for skipping trial for alleged car theft prevented him from bonding out of jail. 

After his death, reports by NaphCare, the Alabama-based private company providing health care to FCJ’s 3,000 detainees and prisoners, revealed widespread neglect of those in his unit, who are among the jail’s most vulnerable. They also were not receiving needed medication nor completing such daily living activities as eating, using the toilet or showering.  

A female guard with concerns about the unnamed detainee’s rapid deterioration had gone to his cell to take him to the Medical Observation Unit for “psych observation.” Finding him slumped over on the floor, she called for NaphCare staffers, who began performing CPR when they arrived. But the man never regained consciousness.

It was NaphCare’s incident report that indicated every person held in the dead man’s unit had lice or scabies or both – an outbreak the company “discovered” only when the detainee died. NaphCare detailed a four-point action plan, including screening new detainees for vermin and implementing “door-to-door pill pass.” To address widespread malnutrition, the jail was also advised to supplement nutrition.

With $78 million in estimated 2021 revenue, NaphCare is not the largest private provider of medical care to jails and prisons in the country. But like its competitors, it has a rocky history of legal challenges. Most recently, in July 2022, a federal jury in Washington awarded $27 million to the estate of woman who died from medical neglect in the Spokane County Jail. See: Estate of Hill v. NaphCare, Inc., USDC (E.D. Wash.), Case No. 2:20-cv-00410.

As of late October 2022, 10 people have died at FCJ this year. An investigation of the state’s five largest jails by the Atlanta Journal-Constitution published on October 27, 2022, revealed that FCJ had recorded more deaths since 2009 than any of the others.

Sources:  Atlanta Journal-Constitution, The Appeal, Seattle Times  

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