The Herald of Everett, Washington
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Published: Sunday, August 25, 2013, 12:01 a.m.

Records detail events that led to man's death at jail

A day earlier, hospitals were alerted man was having pyschiatric episode

EVERETT -- Bill Williams died after spending less than an hour in the Snohomish County Jail.
Williams, 59, battled mental illness most of his life. He fought with cops when he didn't take his medication. He would become agitated, uncooperative and seemed to have super strength. A year ago, a struggle with jail corrections officers ended with the Everett man's death.
Records recently obtained by The Herald say Williams succumbed to a heart attack after suffering from a phenomenon called excited delirium. Doctors describe excited delirium as a form of mania that follows severe physical agitation combined with combative or violent behavior. Episodes of excited delirium can be common among people living with severe mental illnesses or those who abuse drugs.
Williams had been diagnosed with schizophrenia and bipolar and psychotic disorders. He'd fought with police officers and medical staff in the past. A day before his death, his mental health caseworker warned local hospitals that Williams was having a psychiatric episode. Cops didn't get the same warning.
Inside the jail, corrections officers wrestled a combative Williams to the ground and shocked him with a Taser. He had trouble breathing and turned blue. His condition caused enough alarm that the sergeant called for a nurse. Before he was evaluated by medical staff, Williams seemed to recover. Corrections officers hauled him up, but he continued to resist being put into a cell. The sergeant again used a Taser on him. Finally, at least four corrections officers wrestled him into a cell. He was left on his stomach with his hands cuffed behind his back.
A sergeant estimated that about a minute later, she saw Williams take two deep breaths. Then he stopped breathing. Officers flipped him onto his back, pulled him out of the cell and started resuscitation efforts. Paramedics took over.
Williams died on the floor of the jail. He'd been brought there for shoplifting beer and cigarettes.
The medical examiner concluded that the fight with corrections officers produced extreme stress. The stress coupled with Williams' agitation would have created an "abnormal physiological state that led to cardiac arrest," according to records. Williams also had minor to moderate heart disease. Toxicology reports showed low levels of an anti-psychotic medication that is known to cause cardiac arrhythmias, which may predispose a patient to sudden electrical abnormality in the heart. The medical examiner couldn't say whether the drug contributed to Williams' death.
Detectives with the Snohomish Multiple Agency Response Team investigated the fatal struggle. They gathered hundreds of pages of reports, dozens of pictures and numerous other investigative documents. The Herald obtained documents from the investigation under the state's public records law.
The case has been forwarded to Snohomish County Prosecuting Attorney Mark Roe, who is expected to decide whether any of the officers involved will be charged with a crime. Roe has met with Williams' family and lawyer. He plans to meet with the family's lawyer one more time before finalizing his decision. The lead detective wrote that he didn't find any evidence that the corrections officers were reckless or negligent. He called the Sept. 14, 2012, death accidental.
Williams' death is one of at least eight that has occurred in the Snohomish County Jail since 2010. There has been enough concern over the deaths and medical care for inmates that the sheriff's office asked for an outside investigation by the U.S. Department of Justice. A team from the National Institute of Corrections was at the jail last week, sheriff's spokeswoman Shari Ireton said. A written report is expected in the coming weeks. Meanwhile, recently appointed Sheriff Ty Trenary has put new people in charge at the county lockup.

At least two of the recent deaths have resulted in pending claims against the county.
Some who work inside the jail have complained anonymously about a lack of adequate medical treatment for inmates, especially those living with mental illness. In numerous court hearings, defense attorneys also have alleged that their clients receive substandard care. Lawyers have complained about long pre-trial delays for their clients because the jail doesn't adequately treat mental illnesses. They say their clients often deteriorate once they are moved from state's psychiatric hospital to the jail. Others have questioned why the jail's mental health ward has been mothballed.
Over the years, officials have acknowledged that by default the jail has become the county's largest mental health care facility, creating ongoing challenges to meet the medical needs of a transient population.
* * *
Williams had lived with mental illness since he was 19, according to records. Over the years, he'd been involuntarily hospitalized, court-ordered to take anti-psychotic medications, and regularly seen by a therapist. He was under the care of Compass Health at the time of his death. Detectives spoke with his case manager as part of the investigation. Only bits of that interview were released to The Herald. Much of the interview was protected under privacy laws, according to an Everett police records specialist.
Detectives, however, noted that a day before Williams died, Compass Health workers had issued a crisis alert advising hospital staff that if they came in contact with Williams, he was having a "psychiatric episode." There's no protocol to give police the same warning, according to the detective's report.
Everett police were first to encounter a resistant Williams the night he died. Officers were twice called to a gas station on Broadway. The owner complained that a man had shoplifted some cigarettes and a lighter. Police initially couldn't find the shoplifter. About 30 minutes later, the station owner called back. The same man had returned and left without paying for a six-pack of beer.
Everett police found Williams nearby. He was carrying a six-pack and was drinking from one of the cans. The officer reported that Williams ignored his commands and tried to step inside a nearby apartment. The officer grabbed him. Williams resisted, trying to pull free. The officer was able to drop Williams to the ground and put him in handcuffs. Williams continued to struggle against the officer. The officer detailed how he used pain compliance techniques, primarily applying pressure to Williams' arms. He used his knees to pin Williams to the ground. Another officer joined the struggle, and the two were able to push and pull Williams into the back of a third officer's patrol car.
Williams was given a portable breath test. It barely registered any alcohol. He reportedly kept asking for his beer and lighter.
An Everett officer asked a dispatcher to relay to the jail that he was bringing in a combative man. Corrections officers reported clearing out the booking area of inmates in preparation, per policy.
Five corrections officers met the Everett officer outside. They reported that Williams was calm. He said he wasn't going to be a problem. They took him into the booking area. He appeared groggy. A corrections sergeant asked Williams whether he had taken any drugs. Williams told the sergeant he takes Seroquel, an anti-psychotic medication, and Toradol, an anti-inflammatory.
Williams was escorted into a room to change his clothes. That's when he reportedly lunged at corrections officers.
Five corrections officers tried to restrain Williams. They reported that he was swinging his arms and legs. He reportedly was able to lift one corrections officer up off the floor with one arm while being held down by several other officers, records said.
A sergeant then used an electric stun gun, zapping him while he was on the floor with officers. Williams appeared to turn blue, and some officers thought he'd stopped breathing. He was rolled onto his side. A sergeant was concerned enough about his response that she called for a jail nurse. Williams appeared to recover after a few moments. He was asked if he had a seizure disorder. He answered "eat (expletive)."
Corrections officers quickly hauled a handcuffed Williams to his feet. He twisted his body, stiffened his legs and ignored their commands, according to the records. He was warned again that if he didn't settle down, the sergeant was going to use her Taser for a second time. She fired the electric gun, launching two probes. The barbs dug into Williams' flesh. The sergeant later reported that she didn't think the Taser had much effect because the probes weren't embedded deeply enough or spread far enough apart to create a good circuit. Williams continued to struggle against efforts to push him into a cell.
He eventually was placed into a cell and lowered to the ground on his stomach with his hands cuffed behind his back. Corrections officers reported that a nurse was unable to check his vital signs because he was still combative.
The sergeant ordered a watch on Williams to monitor his well-being. She asked the nurse to check on Williams as soon as he calmed down. The sergeant said that about a minute later, she looked through the window of the cell and noticed that Williams appeared to be in distress. He was turning blue and his hands were pale, she reported. She yelled, "He's not breathing." Corrections officers and a nurse rushed to the cell.
An officer started cardiopulmonary resuscitation. The nurse yelled for her emergency cart loaded with medical equipment. Officers ran for oxygen and an automated external defibrillator. They noted that the handle on the oxygen tank was broken. They used a pair of pliers to turn on the tank.
Everett paramedics were at Williams' side about eight minutes after he stopped breathing. They attempted to revive him for about 40 minutes. Williams was dead less than an hour after he was brought to the jail.
* * *
Records say Williams had never been booked into the Snohomish County Jail before Sept. 14, 2012.
In 2011, he struggled with two sheriff's deputies after his wife called 911, reporting that Williams was having a psychotic break. A deputy reported that Williams ignored their commands as he walked toward his wife. The officer grabbed his wrists and wrestled him to the ground. Two deputies were on top of him, and he continued to struggle.
"He attempted to stand up and was almost successful in doing so with (approximately) 400 lbs of deputy attempting to hold him down," according to the police report.
The struggle lasted about three minutes. The two deputies handcuffed him and restrained his legs to keep him from standing. Instead of taking him to jail, they called for an aid car. His wife told the deputies her husband was off his medications. He hadn't slept. He was walking around the house, flicking a lighter. She reported that he'd punched her in the face. She told the deputies her husband was living with bipolar disorder and schizophrenia.
Williams was restrained to a backboard and loaded into an ambulance. He didn't seem coherent and began repeating words. Hospital staff restrained him to a bed. Williams was never charged with a crime in connection with the incident.
He didn't have another brush with the law until the day he died, according to records released so far in the case.
Diana Hefley: 425-339-3463; hefley@heraldnet.com.

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