Pubdate: Thu, 25 Jul 2002
Source: Philadelphia Inquirer, The (PA)
Copyright: 2002 Philadelphia Newspapers Inc
Contact:  http://www.philly.com/mld/inquirer/
Details: http://www.mapinc.org/media/340
Author: Nancy Phillips
Bookmark: http://www.mapinc.org/prison.htm (Incarceration)

NO CHARGES TO BE FILED IN DEATH OF INMATE

Jose Santiago-Perez Was A Diabetic Who Died After Begging For Help. The 
System, The D.A. Said, Failed Him.

His pleas for help were ignored, so Jose Santiago-Perez, a diabetic and a 
heroin addict, spent the last day of his life vomiting and writhing in a 
Philadelphia prison cell - becoming so thirsty that at one point, other 
inmates say, he drank from a toilet.

His death, on Sept. 16, 2000, was the result of "a systemic failure" and 
was evidence of prison medical care "in chaos," District Attorney Lynne M. 
Abraham said yesterday. But she said no one would be criminally charged for 
the inaction that allowed Santiago-Perez, 28, to die.

His death will cost the taxpayers, though. His family's lawsuit against the 
city and a company that provides prison health care was settled Tuesday for 
an undisclosed sum, a lawyer for the family said.

"The entire system failed to look after this prisoner's condition," Abraham 
said at a news conference. "There was a callous indifference to [his] health."

After a two-month investigation, she said, her office could not pin blame 
for the death of Santiago-Perez on any one person. Rather, she said, 
"systemic failure to provide a standard duty of care was the real culprit 
in this case."

According to prison internal-affairs investigators, corrections officers at 
Curran-Fromhold prison in Northeast Philadelphia failed to summon medical 
help for Santiago-Perez because they believed he was suffering from drug 
withdrawal. When fellow inmates tried to summon help, the report says, they 
were repeatedly told that Santiago-Perez was "dope sick" and would have to 
wait for his symptoms to pass.

Santiago-Perez, of North Philadelphia, who was awaiting trial on 
drug-possession charges, would have survived if he had gotten the insulin 
he needed that day, according to a report prepared by Assistant Medical 
Examiner Gregory McDonald.

Abraham said her investigators did not find evidence of criminal conduct on 
the part of any corrections officers or nurses - or by the doctor who 
treated Santiago-Perez about an hour before his death and ordered water and 
insulin.

While the district attorney said she empathized with the pain his family 
must feel, she added: "There is no relief that we can offer them in the law 
that we could in good conscience sustain... . We can't prove gross 
negligence, nor can we prove that there was any deliberateness."

She criticized Arnold Berkowitz, the prison physician who saw 
Santiago-Perez shortly before he died and ordered insulin but did not stay 
to monitor his condition - even, the prosecutor said, as the prisoner lay 
curled up on the floor.

"He abandoned his patient," said Abraham. "No doctor, I think, who has any 
even rudimentary information about diabetes would leave him in a fetal 
position on the floor, order insulin, and leave. A doctor's oath requires 
more."

Berkowitz was removed from his job at Curran-Fromhold soon after the 
episode. Through his lawyer, he declined to comment yesterday.

The family of Santiago-Perez sued the city and Prison Health Services Inc., 
which has provided medical services in Philadelphia jails, and reached a 
financial settlement Tuesday, their lawyers said yesterday. All parties are 
barred from disclosing the dollar amount.

"There was an institutional failure" at the prison, Dennis J. Cogan, the 
family's lead lawyer, said yesterday in an interview. "A lot of people 
messed up. There was a lot of negligence here, and there's a lot of blame 
to go around... . It's absolutely inexcusable."

While relatives of Santiago-Perez said they were pleased with the 
settlement, his sister, Rosangela Cesario, appeared startled to learn that 
no criminal charges would be filed.

"Oh, my God, that's horrible," Cesario said of Abraham's decision. "You're 
supposed to trust in the law. They're leaving those people free for what 
they did to my brother? What we really wanted was for them to be charged."

A lawyer for the city referred a reporter's questions to Mayor Street's 
office yesterday, where spokesman Frank Keel declined comment. Lawyers for 
Prison Health Services, too, declined to discuss the settlement, citing the 
confidentiality agreement.

In the aftermath of Santiago-Perez's death, prison officials disciplined 
seven nurses and two corrections officers. They also put in place new rules 
that require medical personnel at the police administration building, where 
many prisoners are processed, to call ahead to the jail and alert them if 
someone with medical problems is on the way, said prisons spokesman Robert 
Eskind. By all accounts, Santiago-Perez had told medical aides at the 
administration building that he needed insulin, and he received two doses 
while he was in custody there.

At Curran-Fromhold, however, his pleas for a doctor went unheeded for more 
than 24 hours, investigators determined.

In March 2001, a prison internal-affairs investigation recommended that the 
case be referred to the District Attorney's Office. For reasons that are 
not clear, this did not happen. Abraham said her investigation began in May 
at the request of Councilman Angel Ortiz, who has decried the quality of 
health care in city prisons.

The city announced last month that it was ending its contract with Prison 
Health Services.
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