$3 Million Paid by San Diego County for Diabetic Detainee’s Jail Death; NaphCare Settles Separately for Undisclosed Amount
by Chuck Sharman
San Diego County attorneys agreed to a $3 million settlement on June 30, 2026, resolving claims filed by the Estate of Keith Bach, 63, who died of diabetic ketoacidosis at the Men’s Central Jail in September 2023, after his insulin pump ran dry and its alarm went ignored by jailers and medical staff with NaphCare, the County’s contracted jail healthcare provider. The settlement resolved only the claims against the County, and those against NaphCare were settled separately for a confidential amount, the Estate’s attorney, John H. Gomez, told the San Diego Union-Tribune.
Deaths in County jails have fallen sharply since 2022, when the detainee mortality rate topped that of all other large California counties, as PLN reported. [See: PLN, Nov. 2022, p.1.] But that was of little consolation to Cecilia Bach, who represented her dead husband’s Estate in the suit that Gomez and fellow lawyers with Gomez Trial Attorneys in San Deigo filed in the U.S. District Court for the Southern District of California.
A heating and air conditioning technician, Bach was arrested by Chula Vista police on suspicion of vandalism and making a threat on September 25, 2023. Bach, a Type 1 diabetic, was already so sick that they took him to a hospital, where he was cleared for booking with a warning that his insulin pump alarm was going off and it needed to be refilled. Arriving at the jail, Bach quickly passed out, prompting another roundtrip to the hospital before he was returned the next morning with the same orders to have his insulin pump refilled.
That never happened. Over the course of the day, Bach’s blood sugar level was checked a half-dozen times by NaphCare staffers, who eventually gave him a minimal dose of 10 units of insulin. They offered the same treatment the next morning, when his blood sugar hit a dangerous high. Bach initially refused it because the dose was too low. But he eventually accepted it just before 2:00 a.m. on September 27. A NaphCare nurse then put in a request for a higher dose.
That request remained “pending” over the course of the next day, as Bach gave fellow detainees his food, fearful that eating would cause a fatal spike in his blood sugar. His pump alarm was still beeping when he was found unresponsive early on September 28, and he was declared dead around 4:00 a.m. Coroners found the alarm on Bach’s dry insulin pump still going off when they arrived at the jail after his death. It had probably been going off nonstop for 24 hours, they said.
In September 2024, the County medical examiner ruled Bach’s death a homicide, only the second such ruling in 20 years. But no jail or NaphCare staffer was charged, despite the fact that Bach’s pump alarm was ignored and the detainee left unchecked for the last 19 hours of his life. His death may have been attributable to “complications of a natural disease,” the coroner allowed, but “considering the inaction (i.e. neglect) characterizing the events leading to inadequate care … the manner of death is classified as homicide.”
Bach’s widow filed her complaint that same month, and the parties proceeded to reach their settlement agreements. The one with NaphCare was kept confidential. The agreement reached with the County included the payout to the Estate, which also covered costs and fees for its attorneys. The County and NaphCare also signed a mutual release of all related claims, meaning neither attempted to recover from the other any part of what it paid. See: Bach v. Cty. of San Diego, USDC (S.D. Cal.), Case No. 3:24-cv-01687.
County Sheriff Kelly Martinez and her department offered no statement on the settlement. But the Sheriff’s Office said that several new medical practices had been initiated at the jail, such as flagging diabetic detainees like Bach for “immediate care” and placing them in a jail medical unit when their insulin pump alarms go off. The changes came too late for Bach. But as Gomez observed, “When it comes to change, money talks loudest.”
Additional source: San Diego Union-Tribune
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