The News Journal
Demetrius Caldwell, a 24-year-old drug dealer, had been undergoing unspecified treatment for a month in the state's newest prison infirmary before he was found dead this week, laying on a mattress on the floor of his infirmary cell.
A medical staffer had checked on him 25 minutes before he died.
Prison officials ruled out meningococcal meningitis as the cause of death Friday, after naming it as a possibility Thursday evening. A less virulent strain of meningitis remains a slight possibility.
"Everything's negative," said James Welch, the Department of Correction's health services administrator. "There's no trauma, no heart problems, no brain tumor. We're still waiting on toxicology. We can't find anything. We're as concerned as anyone else is."
The length of time Caldwell spent in the state's prison infirmary and the lack of an explanation for his death point to the same medical deficiencies that prompted the U.S. Justice Department last month to find "substantial civil rights violations" in four Delaware prisons, said Senate Minority Leader Charles L. Copeland, R-West Farms.
The federal investigation was prompted by a series of articles in The News Journal that revealed inadequate health care and questionable treatment within the prisons. In their report, federal prison regulators found "consistent backlogs with the respect to the treatment of chronic care inmates."
Any inmate who has been in the infirmary for a month meets the "chronic care" definition and should have been taken to a private hospital, said Copeland, one of the co-founders of the Delaware Coalition for Prison Reform and Justice.
"Someone should have recognized that the prison infirmary was not the place for him to be," he said. "The fact they failed to identify that re-emphasizes the legitimacy of the constitutional violations of prison health care performance."
Federal investigators, who negotiated an 87-point settlement with the state to improve prison medical care, declined to comment about Caldwell's death.
Correction commissioner nominee Carl Danberg said Friday that doctors from Correctional Medical Service, or CMS, the prison's contract medical provider, along with the Department of Correction's medical team, the Chief Medical Examiner's Office and Public Health are reviewing the case.
"Additional outside expertise might be sought, depending upon what we find in the tests that are still pending," Danberg said. "We are following Department of Correction procedures and following Delaware law for a death in custody. All informa- tion is being turned over to the Medical Examiner."
The State Forensic Sciences Laboratory is conducting some tests, and additional testing has been outsourced to independent labs.
"I am not a medical person. I don't know why he died. I am waiting for the doctors to tell me why he died," Danberg said. "We are continuing our own internal evaluation and reviewing behavioral reports, to determine whether or not there are any clues in the documentation."
Just in case, the prison began "preventive antibiotic measures" Thursday evening for all inmates and staff that may have been in contact with Caldwell's bodily secretions.
Rather than using a ward setting similar to private hospitals, the infirmary at the Smyrna-area prison consists of separate cells with locked doors.
At the time of Caldwell's death, Welch said there were nurses in the infirmary. A doctor was at the prison, but not in the infirmary building when Caldwell was discovered. The entrances to the building are videotaped, Welch said, but the cells are not covered by a camera.
Ken Fields, spokesman for CMS, said federal privacy laws prevent him from discussing the condition or care of any inmate.
"Inmate patients housed in the medical housing unit of the prison facility are seen regularly by health care staff," Fields said. "Certainly, if an inmate patient displays symptoms of illness or otherwise indicates the need for urgent medical attention, those needs are addressed promptly by qualified medical staff."
Caldwell, of Dover, had been an inmate since Nov. 6 for violating his probation on a 2005 charge of possession with intent to deliver cocaine, to which he pleaded guilty. Nearly half of his incarceration was spent in the infirmary.
