Video: Review blasts King Co. Jail health officials in inmate's death

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SEATTLE – A scathing new report says health officials at the King County Jail failed to provide proper medical care to a King County Jail inmate who died in custody last summer, and in one doctor's opinion, the medical staff "let this man suffer."

Lynn Dale Iszley, 48, died last July of a perforated ulcer. At the request of his family, the King County Ombudsman's Office called on an independent review from two doctors.

One, Dr. Dean Dellinger of Oregon Health and Science University in Portland, determined based on medical reports that if Iszley had been transferred to the emergency room 12-24 hours after the ulcer perforated, he might have survived.

The other expert, Dr. Lori Kohler of the University of California, San Francisco was very direct in her summary.

"From an outside observer perspective, is (sic) appears to me that they let this man suffer and did nothing," wrote Kohler.

The report states that when Iszley was arrested July 15, 2007 in Seattle's Cowen Park, officers say Iszley told them he had MRSA. Before he was booked, the report says a Jail Health Services employee discovered signs of bleeding on Iszley's wrist and some skin sores. Iszley was taken to Harborview Medical Center where he was diagnosed with abscesses and prescribed the antibiotic Bactrim.

Iszley was booked into the King County Jail the next morning. He told jail medical staff that he used heroin and alcohol daily. The report says later that night, he began to suffer apparent signs of opiate withdrawals and had been vomiting. The medical staff gave him medication for the vomiting.

The next morning, Iszley had open wounds. A doctor prescribed antibiotics and diagnosed Iszley with alcohol and opiate withdrawal.

One day later, on July 18, Iszley called for help. When a corrections officer arrived, he said he found Iszley curled up in his bunk and told the officer" I think my liver exploded." Iszley later told a medical staff member that he had severe abdominal pain and was sweating and writhing around. However, the medical staff member cleared Iszley to stay in his bunk after an examination.

Dept. of Corrections

Lynn Dale Iszley, 48, died July 19, 2007 of a perforated ulcer while in custody at the King County Jail in Seattle.

Later that morning, a nurse was called to Iszley and found him lying on the floor, sweating and suffering from tremors. He was also complaining of nausea, vomiting and said he wasn't able to eat or drink. Iszley was taken to a clinic, where a doctor noted his symptoms were getting worse and he was dehydrated. He also had a heart rate over well over 100 beats per minute just sitting. Notes from the infirmary also indicated that Iszley said he hadn't urinated in three days. Iszley was given 400mg of Motrin.

That night, the report says Iszley complained of pain, especially in his ribs and chest. Around 5 a.m. on July 19, two fellow inmates had to help him to the floor when he stumbled while trying to stand up.

About two hours later, a corrections officer wasn't able to wake Iszley up and called a nurse, who also was unable to wake him. CPR was performed for about 20 minutes until Iszley was declared dead.

An autopsy revealed Iszley died of acute peritonitis due to a perforated duodenal ulcer. About two-thirds of a gallon of fecal matter leaked into his abdomen through the ulcer, causing an infection that killed him.

The Ombudsman's Office review says Iszley should have been given an IV and sent to the emergency room the day before he died.

In his review, Dr. Dellinger identified these as just some of the problems with Jail Health Services:

--Jail Health Services initially failed to document they continued Iszley's antibiotic prescribed by Harborview Medical Center.

--Tachycardia (heart rate over 100 beats per minute) is associated with acute illness as well as dehydration and withdrawal, but Jail Health Services did not send Iszley to the emergency room.

--More careful evaluation of Iszley's hydration would have been appropriate.

--Documentation of patient history was limited.

--Abdominal pain and lack of urination were not specifically noted as negatives or positives in the medical history.

The Ombudsman's Office recommended reviewing every medical staff member who was involved in Iszley's case to determine disciplinary action. It also recommends reviewing how Jail Health Services responds to inmates in severe pain, whether to transport them to the emergency room and reviewing basic protocols, such as dosing of medicine prescribed by Harborview Medical Center.

King County Public Health Director, Dr. David Fleming, responded last week, saying the case had been reviewed, but due to confidentiality, the specifics were not immediately discussed. He also says procedures to respond to inmates in severe pain are regularly reviewed. As far as decisions on when to transport inmates to the emergency room, Fleming writes that a "clear decision tree" has been developed to determine when to transport a patient to outside care.