Before suicide, Davis County jail doctor denied patient's cancer diagnosis

Sunday , May 28, 2017 - 12:00 AM2 comments

MARK SHENEFELT, Standard-Examiner Staff

FARMINGTON — Tracy Velarde’s life took another wrong turn after he arrived at the Davis County Jail.

The convicted robber, down to 98 pounds and suffering from liver cancer, had just been sentenced to prison for two credit union holdups. The judge gave him a light sentence, four years, because of his medical condition and told U.S. marshals he should be moved to a federal prison hospital in Minnesota.

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A month prior to sentencing, U.S. District Judge Tena Campbell ordered that Velarde “receive a full and comprehensive medical exam with a cancer specialist to determine the defendant's health status and physical condition.”

At the Sept. 15, 2016, sentencing, armed with the results of that examination, Campbell gave specific instruction about his medical care:

The Marshals Service, she said, was “to check into the possibility of a private transport of the defendant to the designated facility due to his medical diagnosis and … look into the pain medications his physician has prescribed and perhaps call his most recent physician to get direction on defendant's pain medications and management.”

“The court also orders that the defendant receive a complete medical evaluation and that special attention be given to his liver cancer,” she said.

The U.S. Marshals Service then took Velarde to the Davis County Jail, which has a contract to hold federal prisoners.

He never made it to Minnesota.

Five days into his sentence, Velarde completed suicide by hanging. Reports show he was apparently despondent after being taken off of medications that had helped him cope with pain, according to an independent investigation by the Utah County Sheriff’s Office

In a handwritten letter to Campbell — dated two days before his death — Velarde complained to the judge that the Davis jail’s medical staff called him in the day after sentencing and said his pain medications were being discontinued.

Velarde’s letter, which was found in his cell, said Dr. John R. Wood, the jail’s medical contractor, told him he did not have cancer, “based on their interpretation of the same radiologist reports” Campbell cited.

“Dr. Wood told me I was not considered a palliative patient and he was discontinuing all my pain medications.”

A FITTING COURSE OF ACTION

During his brief time in the Davis jail, Velarde said he was “in great pain, unable to sleep.”

Velarde told Campbell he was writing her “in hopes that Wood and his staff may be convinced to institute a more fitting course of action for the rest of the time I will be in Davis County.”

Asked about Velarde’s case, Wood referred questions to Sheriff Todd Richardson. The sheriff said he could not comment on Velarde’s situation, but he spoke in general about jail medication policies.

“Obviously, in correctional facilities we do not deal in (narcotic) painkillers,” he said. “Because of that, we have other methodologies approved by our physicians to bring people down off narcotics use. We still provide routine painkillers, but not narcotics.”

Richardson added, “It’s a standard that runs across the state of Utah and other jail systems.”

COST CONTROL

In addition to not dispensing narcotics, policies of jail medical operations and the U.S. Marshals Service emphasize cost control.

The county’s latest contract with Wood for the jail’s medical services calls for strict adherence to a generic medication formulary.

In his proposal to the Davis County Commission, when he first won the jail contract in 2011, Wood emphasized avoiding high-cost newer medications for mental health patients.

“I am very comfortable using the older and generic psychiatric drugs as I am currently doing at the Weber County Jail,” the proposal said.

Wood has been the Weber jail medical contractor for more than 25 years.

He also pledged to protect Davis County from profit-hungry drug companies.

“Pharmacy charges can escalate very quickly,” his proposal said. “One or two inmates with severe psychiatric problems or an inmate on three different HIV medications can easily double the pharmacy bill.”

Cost control measures, he said, include always changing to generic medications when available and substituting to less expensive drugs.

The jail’s medical staff can also save money by delaying non-essential treatments for inmates soon to be released and avoid emergency room visits “if at all possible.”

Moving medically costly inmates out of the jail is another option.

“We also have tried to get inmates furloughed, released or placed on home arrest if their medical needs are extensive and incur high costs,” Wood’s proposal said.

Policy documents for the Marshals Service also stress controlling costs.

The agency’s policy says it works to give prisoners “medically necessary health care while at the same time ensuring that federal funds are not expended for unnecessary or unauthorized health care services.”

The document defines medical necessity as “a valid health condition that, without timely medical intervention, will cause excessive pain not controlled by medication,” among other things.

‘THESE AREN’T THROWAWAY PEOPLE’ 

Velarde’s completed suicide Sept. 20 was the third hanging death in the Davis jail within eight weeks. The Davis County Sheriff’s Office, which runs the jail, has been buffeted by controversy over in-custody deaths, including five in 2016.

Two of Velarde’s fellow inmates who were interviewed about the suicide gave investigators bitter statements about his medical treatment.

“The EMS and other staff did what they could, after the fact,” inmate Brian Phillips wrote. “But it would most likely not have happened had the sadistic medical staff not taken all his medications and made him suffer the pain and withdrawal.”

Velarde’s cellmate, Robert Read, said Velarde’s pain increased and he slept little in the days after his palliative medications were withdrawn.

“Tracy told me that he was particularly hurt that Dr. Wood and his staff treated him as if he had been lying to them about his cancer and his pain,” Read wrote. He said Velarde told him he had undergone two courses of chemotherapy.

Read said Velarde asked him for help composing a letter to the American Civil Liberties Union.

Velarde wanted to learn “what action might be taken to ensure that inmates suffering from chronic / terminal illnesses not be denied dignified and humane treatment by county jail personnel and protocol,” Read said.

Wood or his limited liability corporation, Wasatch Correctional Medical Services, have been named as a defendant in at least 15 federal civil rights suits filed by Weber or Davis jail inmates since 1998. All but one have been dismissed.

Utah County Deputy Sheriff Jeremie Taylor conducted the Velarde death investigation. He addressed the matter of medications in his report, saying, “Just prior to his death, (Velarde) was informed that he did not have cancer. The staff took Tracy off his medications when this information was learned.”

Taylor closed the case on April 19, after receiving an autopsy report from the Utah Office of the Medical Examiner that listed the cause of death as suicide by hanging.

The medical examiner “did not see any evidence of active cancer,” Taylor said. “There was a mass in Velarde’s liver that appeared to be old cancer.”

The toxicology report showed Velarde’s body had a trace of Tramadol, a non-narcotic painkiller.

The ACLU of Utah said recently it is considering a campaign for reform in Utah jails to reduce deaths and improve inmate care and safety.

Convenience through cost control and other policies isn’t worth the increasing loss of life under county government custody, ACLU spokeswoman Anna Thomas said.

“These aren’t throwaway people,” Thomas said. “These are real human beings.”


  NEED HELP? 

Those thinking of harming themselves have several resources available:

Weber Human Services emergency or crisis services, 801 625-3700. 

Davis Behavioral Health 24-Hour Crisis Response Line, 801-773-7060

National Suicide Prevention Hotline, 1-800-273-8255

National Alliance on Mental Illness Utah, 801-323-9900

Family Counseling Service of Northern Utah, 801-399-1600

Intermountain McKay-Dee Hospital Behavioral Health, 801-387-5600

Davis Hospital: Behavioral Health Unit and Emergency Room, 801-807-1000

Lakeview Hospital: Behavioral Health Unit and Emergency Room, 801-299-2200

Live Hannah’s Hope: Empowering Youth. 


You can reach reporter Mark Shenefelt at mshenefelt@standard.net or 801-625-4224. Follow him on Twitter at @mshenefelt and like him on Facebook at https://www.facebook.com/SEmarkshenefelt.

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