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A preventable death?

October 12, 2003 1:09 am

Delusional from alcohol withdrawal, Damon Michael Kissam begged for medical help in the Rappahannock Regional Jail, but was repeatedly ignored by guards, six men who were in his cellblock say.

Only when Kissam fell silent did he get the medical attention he had asked for, they say.

By then, it was too late.

"I sat next to that kid and listened to him scream his lungs out," former inmate Noey Vineyard said. "And the guards let him die."

Vineyard is among six current and former inmates jailed near Kissam who say officers dismissed, ridiculed and laughed at the 23-year-old inmate as he pleaded for help for at least several hours before his death April 25.

The allegations come after a summer of scrutiny over deaths at the regional jail. Four inmates have died in custody since last fall--three of them in a 44-day period this spring.

Three of the four deaths were ruled suicides. The medical examiner's office in Richmond lists Kissam's official cause of death as "acute seizure episode due to delirium tremens and acute ethanol withdrawal."

An expert on alcoholism says alcohol withdrawal need not be fatal if medical attention is given soon enough. Inmates say that didn't happen in Kissam's case.

Jail Superintendent Larry Hamilton declined to be interviewed for this story, citing the advice of attorneys. He issued a statement that said the jail regretted the deaths and that the inmates who claimed guards neglected Kissam "probably have malicious motives."

Spotsylvania County Commonwealth's Attorney William Neely, a member of the board that oversees the jail, said the allegations need perspective.

"The jail is constantly besieged with intoxicated people being brought in in various states of intoxication," Neely said. "And those inmates constantly cry--most of it falsely--for medical attention, in my experience.

"If a mistake was made--and I'm not conceding one was--you can certainly see how when officers are dealing with that type of crowding and that type of malingering, which is typical, that a jaded perspective may have been in place."

Of the inmates who made allegations, Neely said: "You're dealing with convicted felons, people with axes to grind. So you have to consider it from that perspective and take it with a grain of salt."

The six inmates who spoke to The Free Lance-Star were interviewed separately. One initiated contact with a reporter through a Kissam family member; the five others were contacted by the newspaper.

Other jail board members, King George County Sheriff Clarence "Moose" Dobson and Spotsylvania County Sheriff Ron Knight, said they were not aware of the allegations, but expressed confidence in the administration of the jail.

Fredericksburg Police Chief James Powers, also a jail authority member, declined comment. All three men referred a reporter to Stafford County Sheriff Charles Jett, the chairman of the jail board. He referred questions to Hamilton.

Several jail employees declined to be interviewed. Some said they had been told by supervisors not to talk to reporters.

In previous interviews, Hamilton has said nothing could have been done to prevent any of the suicides at the jail.

But some who were locked up with Kissam say something could have been done sooner for him. Several say they and other inmates banged on their cell doors and repeatedly urged guards to get Kissam medical treatment the day he died.

"This guy doesn't need a doctor," Vineyard quoted one guard as responding. "He just needs to stop drinking."

Dr. Blair Carlson, a Denver physician who has more than 25 years experience treating patients--including inmates--battling alcohol withdrawal said "with treatment, there shouldn't be any deaths."

He was not familiar with the Kissam case and declined to comment on it specifically, but said severe alcohol withdrawal cannot be properly treated in a jail.

"They should be in an acute-care center. They should be in a hospital--preferably in an intensive-care unit," Carlson said in a phone interview.

Kissam's mom and fiancee say the Sterling man had battled alcohol in recent years, but he was not a violent person. They describe him as a selfless person whose drinking got out of control after his dad died when he was 19.

"He just put everybody before himself," said Heather Benson, Kissam's fiancee. "He was quick to listen and slow to judge."

Benson said the two had been playing basketball at Mary Washington College, where Kissam worked, on the night of Nov. 10. They were about to head to a friend's house nearby.

She knew Kissam's license was suspended for driving under the influence, so she was getting ready to drive the two in her 1995 Saturn.

Benson, now a junior at Randolph-Macon Woman's College in Lynchburg, mentioned she was feeling faint while walking to her car. She's hypoglycemic and needed to eat.

No problem, Kissam said. He would drive. A couple of minutes later, an MWC police officer on foot patrol waved down the car for driving the wrong way on Double Drive.

Kissam was given a 30-day sentence in February for driving on a suspended license, which he appealed. In April, a Fredericksburg circuit judge sentenced him to 20 days in jail.

Kissam entered the Rappahannock Regional Jail around midday on Monday, April 21. By late Friday night, he was dead.

Benson, who was working at Fredericksburg Historical Prints when they met, said Kissam was also a talented artist. He used oil pastels and pencils to create mostly religious images.

"People assume that because he was in jail he was some kind of bad kid," she said. "But he was only in there for a traffic violation."

One of the last times Benson talked to Kissam, she told him she had a surprise for him. She had sculpted a little boy and a little girl together as a symbol of their bond. He never got to see it.

After Kissam's death, Benson broke off the little girl. Kissam was buried with it in his left hand.

State police continue to investigate Kissam's death, in addition to the three suicides at the jail. The Stafford Sheriff's Office also has reopened its investigation into one of the suicides--that of Earl D. "Boogie" Rose Jr.

Rose, 25, was found hanging in his cell Oct. 4, 2002. He had been serving time for malicious wounding and other charges. His death was the first reported suicide at the jail in 35 years.

William T. Chittum Jr., 19, was found hanging from the upper bunk in his cell on May 25, according to the jail. He was just two days from his scheduled release on a reckless-driving conviction.

Philip K. Kristoffersen, 27, was found hanging in his cell on June 8. He had been jailed since May 23 on a felony bad-check charge.

Both state police and Stafford Sheriff Jett said they had not finished the investigations into the deaths and would not discuss the cases.

Inmate Christopher Sillex, who said he was in a cell across from Kissam the night he died, said a state police investigator showed up at the jail last month and talked with him for about an hour about Kissam's death. It was the first time in the five months since the incident that any investigator had approached him, he said.

Family members for all the men have consulted lawyers. They don't believe the jail has shared the whole story behind the deaths.

The jail has released few details about Kissam's stay.

Deputy Superintendent Tod Runyon issued a prepared statement after Kissam's death. It said Kissam began experiencing medical complications about an hour before he was pronounced dead.

Inmates nearby in the jail say that's not true. They say Kissam was in obvious need of medical attention well before that time.

While they differ on the exact time Kissam arrived in the unit--inmates are not allowed watches in that cellblock--the six men tell largely consistent stories of neglect by jail staff they say contributed to his death.

The jail has said Kissam was being treated in a medical unit of the facility.

When he was crying out for help, however, Kissam was in a cellblock reserved for troublemakers--not in a medical unit, inmates nearby say.

The Free Lance-Star asked the jail to provide documentation of what cells Kissam occupied before his death. Hamilton refused to release that information.

The jail called for an ambulance around 10:30 the night Kissam died. He was pronounced dead at Mary Washington Hospital an hour later. A hospital report said he had no pulse when he arrived.

The six inmates say Kissam spent between several hours and a day with them in SP3--a stark and windowless cellblock also known as the hole. The cells in that block have a sink, a toilet and a bed. The walls are concrete. The doors are steel.

The only opening is a slot at the bottom of the cell where guards drop off and pick up food trays.

A couple of inmates heard guards say Kissam was moved to SP3 because his cell mates in the general population complained about his claims that he was seeing rats in his blanket.

The inmates who were awake when Kissam was brought to isolation say it took an hour or so before they realized how serious his problem was. SP3 gets its share of loudmouths, so inmates are often skeptical when a new prisoner causes a commotion.

William Gerard McDowney, who is now in the Powhatan Correctional Center, said he spent much of the past two years in SP3. He has seen and heard plenty of outbursts, but Kissam's constant wailing captured McDowney's attention.

"Nobody asks for help like that. He was keeping me awake. He was crying all night for somebody to help him," he said. "And they did not help him."

The inmates describe Kissam as paranoid and disoriented shortly after his arrival in the hole. He was hallucinating and yelling, they say.

"You know how you can hear a person cry out and tell that he was really in pain?" inmate Kenneth Lewis said. "Well, I felt it. I knew he was in pain."

Besides seeing rats and mice, Kissam thought police officers were in his cell trying to burn him with cigarettes.

"When he'd say something about seeing somebody in his cell, the other officer would say something like: 'At least you've got somebody to talk to,'" Lewis recalled.

The inmates say Kissam begged for medical attention most of the afternoon. They say it sounded as if he was constantly banging on the cell door with his hands and kicking it with his feet. One inmate said at times it sounded as if Kissam was running into the door with his body.

The physician's report from the hospital emergency room indicates Kissam had abrasions to both hands, both feet and his penis when he arrived. His mother, Joy Kissam, said he was still covered in bruises the night of his funeral visitation.

"I need to go to medical," Lewis said Kissam demanded at one point. "I need to see a doctor."

Guards continued to disagree, the inmates say.

"They'd say: 'Just lay down. You'll be all right.' And then they'd just go out the door laughing," Lewis recalled.

According to the inmates interviewed, at least a handful of others in the cellblock joined Kissam's cause, banging and kicking on their doors and screaming for correctional officers to take him to a doctor.

Lewis said he asked a guard: "Why don't you have somebody see that guy?"

"Don't worry about it," he said the guard replied. "He'll be all right."

Sillex's cell was directly across from Kissam's. Other inmates credit him with trying to keep Kissam calm.

The two chatted, and Sillex said at one point they knelt down to their food-tray slots--the only openings in the cells--to talk. According to Sillex, Kissam's pupils were huge, his face was flush and he looked greasy.

"I was like, 'Man, are you OK?'" Sillex said.

"I just want to go home," he remembered Kissam saying. "I don't want to die here."

A tense exchange ensued among Kissam, a jail guard and other inmates, Sillex said. He and three others in nearby cells offered the following account:

In a defiant plea for help, Kissam stuck his arm through his tray slot. He demanded to use the phone and to be given medical attention.

The guard agreed to get Kissam medical attention if he removed his arm.

"No, no. You're lying," Kissam responded. "You're gonna leave me here and let me die."

Sillex then jumped in.

"You're not qualified to help this guy," he shouted at the guard. "He needs medical."

The guard then turned to Sillex and bent down to the food-tray opening in his cell.

"You see this badge?" he asked, thumping his chest. "This makes me qualified."

Then the guard turned back to Kissam.

"If you don't move your arm I'm gonna slam it in the slot," he told the inmate.

Kissam complied.

The guard closed the slot. But he didn't open the cell.

And he didn't get Kissam to the medical unit.

The jail's alcohol-withdrawal policy calls for an inmate to be placed on "a 15-minute intoxication watch" if he experiences "obvious tremors, is moderately disoriented or is an alcoholic with a history of seizures when withdrawing."

That did not happen in Kissam's case, the other inmates say.

The policy also says employees should call a doctor for anyone showing extreme signs of alcohol withdrawal. The jail has not said whether a doctor was ever called to check on Kissam.

In addition, the first line in the jail's employee "Rules for Conduct" says: "We are committed to ensuring that inmates are treated with human dignity and provided with generally accepted standards of decent living and human relations." Those rules also call for employees to "be respectful, polite, courteous and professional" when dealing with inmates.

A Mary Washington Hospital report indicates Kissam was experiencing delirium tremens--characterized by tremors and delusions--while in the jail. It says Kissam showed "signs of acute alcohol withdrawal\DT's" including excessive sweating, "acute anxiety and agitation" and "visual hallucinations."

Kissam also was "noted to have generalized seizure activity of unknown duration with vomiting, followed by full arrest," according to the report.

The hospital report said Kissam was given an alcohol-withdrawal drug, "without improvement," but did not specify when and where the drug was administered.

A semiretired internist and nationally-recognized expert on alcohol withdrawal, Carlson has worked with a panel studying medical care inside correctional facilities.

He said an untrained observer might not realize a person was going through alcohol withdrawal. But because many inmates abuse alcohol, he said it's important for jail staff to be taught to recognize early symptoms such as sweating and agitation.

He said the jail needs to assess every inmate's potential to go into withdrawal when the inmate enters the facility--and to be alert for those who might slip through that screening process.

"The problem here is that there's not adequate recognition of what's happening," Carlson said.

At Hamilton's request, a suicide expert from the Department of Justice recently reviewed the hangings in the jail and found that the facility needs more mental-health resources. It has only one mental-health worker for the more than 800 inmates it has housed in recent months.

In his report, Lindsay Hayes also recommended more frequent checks of inmates in their cells to thwart suicide attempts. He was not asked to study--and his report did not address--the jail's policy for dealing with inmates going through alcohol withdrawal.

Internal jail logs indicate officers checked on inmates roughly every half-hour in the cellblock housing Kissam on April 25.

Inmates dispute that. They say guards looked in the cells only about twice per 12-hour shift.

The 264,000-square-foot brick building off U.S. 1 in Stafford was designed to house 662 inmates. Three years after it opened, the average daily population now exceeds 860 and rose to more than 900 in August.

Hamilton told the jail board in August that he was addressing some of the recommendations in Hayes' report. He also said overcrowding was causing security problems and serious tension among inmates, but neither he nor the jail board discussed hiring more guards--an unlikely prospect given the jail's tight budget.

Four inmates remember the jail's lone mental-health counselor visiting Kissam in the hole. One said the man was accompanied by a substance-abuse counselor.

The mental-health counselor asked Kissam simple questions such as his name and whether he knew where he was, former inmate John Nordlund said. Kissam could not answer, he said.

Contacted at home by a reporter, the mental-health counselor declined to answer questions.

After several hours of banging and screaming, Kissam was largely quiet for the last hour or so he spent in SP3, except for an occasional groan, the inmates say.

The inmates who remember a counselor stopping by say at least an hour passed before Kissam was removed from the hole. No one heard him make a sound on the way out.

Some inmates say that was late in the afternoon; others say it was well into the evening.

All agree it was later than it should have been.

Said Vineyard: "They were doing a long- overdue check."

Free Lance-Star staff writer Kari Pugh contributed to this report.

To reach BRIAN BAER: 374-5000, ext. 5765 bbaer@fredericksburg.com

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