Jury deliberating case of mentally ill woman who died while in jail
A federal jury is deliberating whether University Health System and Bexar County violated the constitutional rights of a mentally ill woman who died after spending 150 days in jail under $300 bond for a misdemeanor.
The family of Janice Dotson-stephens, 61, claims she died as a result of being denied adequate medical treatment by Bexar County and University Health System, which provides medical services for inmates at the jail.
The family seeks $100,000 in damages for each surviving relative of Dotson-stephens, who left behind three adult children and 10 grandchildren. A trial began last Wednesday to resolve a lawsuit they filed, and testimony ended Tuesday.
Specifically, the family’s lawyers, Leslie Sachanowicz and Mary Pietrazek, alleged Dotson-stephens lacked the mental capacity to make decisions for herself, and languished in jail without proper medical care. The lawyers claim
she deteriorated and lost 136 pounds during her five months in jail because she did not eat. They accuse University and the county of “exposing” her to a substantial risk of harm, and that they were deliberately indifferent to her needs.
“I told you (in opening arguments) that she was ignored to death, but I should have told you she was ignored because of her medical needs,” Sachanowicz said in closing remarks.
University Health and the county argued Tuesday that they did everything within the confines of the law, including offering her treatment, but that she turned it down. They also argued that her death was sudden, that there was no evidence she drastically lost weight and that neither deputies nor medical staff saw signs of serious health complications.
Dotson-stephens died Dec. 14, 2018, from cardiovascular disease, contributed to by schizoaffective disorder, the Bexar County Medical Examiner ruled.
She was booked into the jail on July 17, 2018, on a charge of criminal trespass after her husband, Reginal Stephens, called San Antonio police. Stephens testified that he did not want to let her back into his apartment, where she had been staying. He assumed police would take her to a mental hospital rath
er than jail.
But for months, Dotsonstephens stayed in the jail’s infirmary ward. She refused to let staff take her blood pressure and weight or do other medical screenings. Several times, she refused to eat.
Her bail was set at $300, and the trial exposed cracks in the criminal justice system, including claims that her lawyer never visited her nor pushed for a competency hearing that could have helped her leave jail.
Despite that alleged failure, Sachanowicz blamed University Health and the jail for her death. He said a doctor who examined Dotson-stephens initially for University did not look at Dotson-stephens’ medical history nor put together a treatment plan. Instead, the doctor wrote in his notes that Dotson-stephens was “vile” because she used foul language, Sachanowicz said.
“There was all this evidence that she had been there previously,” Sachanowicz said. “They knew she had a medical condition. There was never an attempt from anybody to determine if she was able to provide consent or not.”
He showed jurors papers documenting a time in 2017 when Dotson-stephens was taken to the jail and within 12 days was found to be danger to herself and “shipped off ” to a mental health hospital. The papers showed she was also given medications for her mental condition, he said.
Sachanowicz argued that a psychiatrist who examined her in September 2018 determined that Dotsonstephens did not have the capacity to make decisions for herself. The psychiatrist also said giving her medications would help her. Instead, she languished, Sachanowicz argued.
But Laura Cavaretta, a lawyer for University, and Bob Piatt, one of the county’s attorneys, argued that University and the jail are barred by law from forcing medication on an inmate unless they are a danger to themselves or others, or if a judge issues an order for it.
Cavaretta also said there was no evidence Dotsonstephens lacked the capacity to make decisions for herself, and that competence — which necessitated a court hearing — is different than capacity.
The defense lawyers said staff repeatedly tried to help Dotson-stephens and offered her medical treatment. They pointed to testimony showing that staff reached out to prosecutors and her court-appointed lawyer — which they did not have to do — to try to speed up a competency hearing that needed to take place in court. Her lawyer never responded to messages nor visited Dotson-stephens, according to testimony.
One University doctor called Judge Andrew Carruthers directly, yet no competency hearing was ever scheduled, Cavaretta said.
Cavaretta also noted that one of Dotson-stephens’ daughters learned her mother was in jail in October 2018, and did not tell any of her family members, but instead assumed “the system” would take care of Dotson-stephens.
Cavaretta and Piatt cautioned jurors to not come to a verdict based on their emotions, but instead to rely on the evidence and the law. Cavaretta said University’s staff is caring and compassionate and some went out of the way to try to help Dotson-stephens.
“She didn’t die because of anything University Health did,” Cavaretta said. “She died because of heart disease.”
Piatt added: “Janice Dotson-stephens was offered medical care on every shift through her stay in the jail. This consistent, unabated offering, shows she was not denied medical care.”