Jail Blamed for Inmate’s Excess-Water Death

     SAN DIEGO (CN) — A San Diego jail is accused of not properly monitoring a schizophrenic inmate with a documented psychological condition that caused him to drink water uncontrollably, leading to his drowning death.
     The family of 46-year-old Ruben Nunez sued the County of San Diego, Sheriff William Gore and the San Diego Central Jail staff June 8 for wrongful death, deliberate indifference to serious medical needs, failure to properly train and eight other violations for Nunez’s Aug. 8, 2015, death while in custody.
     Nunez’s parents, Lydia and Albert Nunez, also claim that despite a requirement that medical information about state hospital patients be faxed ahead of a patient’s transfer to another facility — essentially alerting staff of any medical risks or special needs of inmates such as Nunez — either the state hospital failed to send the discharge form to the jail, or the jail ignored the records indicating Nunez’s problem with water intoxication.
     For patients with water intoxication, there is an additional form that lays out strict protocol for monitoring water intake and blood levels, according to the lawsuit filed last week.
     Nunez was off his schizophrenia medication when he became homeless in 2014 and was later arrested for throwing a rock through a car window. He was sentenced to Patton State Hospital, an inpatient psychiatric hospital after he was found incompetent to stand trial.
     While at Patton, Nunez was involuntarily medicated and was later diagnosed with psychogenic water intoxication, also known as psychogenic polydipsia, according to the complaint. The condition causes affected individuals to drink water uncontrollably, sometimes to the point of death.
     On Aug. 8, 2015, Nunez was transferred to San Diego Central Jail while awaiting a court appearance for a competency hearing to determine if he should continue being involuntarily medicated. His jail records indicated he had hyponatremia, a condition caused by excessive water intake, and required water restriction, but staff at the jail did not restrict his water use, Nunez’s family claims.
     Five days later, Nunez was found vomiting in his cell during a routine security check and a nurse was called. Bloody vomit was found splattered on the cell wall, yet the nurse didn’t alert medical staff and left Nunez in his cell with further access to water, according to the complaint.
     An hour later, Nunez was found by a deputy on the floor not breathing. He died from cerebral edema, or brain swelling, caused by excess water consumption. He reportedly had vomit in his nasal cavity and on both hands.
     “There had been a systemic failure to adhere to the written policies and procedures with respect to providing adequate health care to inmates in the San Diego County jails,” Nunez’s parents claim.
     But the Nunez family’s claim extends beyond just what happened to their son: they allege Gore and other defendants were aware of the “systemic problems with preventable deaths in San Diego county jails,” but took no action to prevent the deaths.
     Nunez’s family listed off a number of what they claim were preventable deaths in San Diego jails including multiple suicides, death from drug withdrawal complications and even two inmates who died from oxygen deprivation when guards attempted to restrain them.
     In 2011, Gore declined to adopt five recommendations made by the Citizens Law Enforcement Review Board for alerting them of an inmate’s death. Because Gore and other sheriff’s department officials did not alert the board to some cases in 2009 and 2010, the board was unable to investigate the deaths after the one-year window to do so passed.
     Nunez’s death was first reported by San Diego freelance journalist Kelly Davis, who wrote in the San Diego Union-Tribune about Nunez and 40 other people who died in San Diego jails between 2013 and 2015. San Diego County’s inmate mortality rate is even higher than Los Angeles County, where the jail system has come under federal scrutiny, Davis wrote.
     Patton State Hospital executive director Harry Oreol, medical director Kayla Fisher and hospital administrator Marcy Moon were also named as defendants, along with Bruce Leicht, the medical services administrator for county jails, and Alfred Joshua, the medical director for the sheriff’s department.
     Jan Caldwell with the San Diego Sheriff’s Department said the department cannot comment on pending litigation.
     The Nunez family is represented by Julia Yoo, who told Courthouse News all the public information about the case was included in her clients’ complaint. The family seeks punitive damages.

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