EVERETT — Inside the Snohomish County Jail’s medical detox unit, the screams of inmates going through withdrawals can be heard through the cells’ concrete doors.
Since September, four inmates have died at the jail. Of the four, three were inside the detox unit, intended to monitor inmates with opiate, benzodiazepine or serious alcohol addictions.
Snohomish County Sheriff Susanna Johnson, recently elected on a platform of greater accountability, said her administration is exploring ways to prevent more inmate deaths, such as cameras within the medical detox cells, a K-9 unit to detect drugs brought inside and technology to monitor inmates in the detox center when their vitals approach dangerous levels.
“There’s only so many more ways to try to be creative,” Johnson said.
The potency of fentanyl has made working in the jail — already a stressful and thankless job — that much harder. Amid the recent deaths, corrections staff have saved many inmates overdosing on drugs or experiencing complications of fentanyl withdrawals.
Saves often don’t make headlines or prompt press releases, but deaths do.
Sheriff Johnson, Corrections Chief Alonzo Downing and Health Services Administrator Amanda Ray walked a Daily Herald reporter through the booking process, from searching for contraband to keeping track of inmates going through severe withdrawal symptoms.
After booking, inmates are usually searched, but not always, and undergo body scanner imaging and a urinary analysis. Sheriff’s office policies require pat-down searches when an inmate leaves or returns to their housing unit. Corrections officers also must search inmates they suspect are concealing contraband.
Medical detox is big enough to house 64 people. The unit is monitored “at all times” by a corrections deputy, Downing said. A nurse checks on inmates every four to eight hours.
“Sometimes we get lucky, if we don’t catch it initially,” Downing said. “It takes a collective effort inside the facility to make this thing work. But even with that, we still have that outcome that we had in September and October.”
‘You can hear a lot’
Some inmates booked into the downtown Everett jail report they had been smoking up to 50 fentanyl pills a day on the outside, building up a level of tolerance that could bring withdrawal symptoms in hours, Ray said.
The frequency of medical checkups depends on the severity of an inmate’s symptoms, Ray said.
Medical staff at the jail use the Clinical Opiate Withdrawal Scale, or COWS, to measure inmate symptoms: resting pulse rate, sweating, restlessness, pupil size, bone or joint aches, runny nose, gastrointestinal issues, tremors, yawning, anxiety and goosebumps.
“There’s a work station in the medical unit, and you can hear a lot of what’s going on,” Ray said. “If somebody is vomiting, that’s not usually a super quiet process.”
The sheriff’s office has been in talks with 4Sight Labs to use its Custody Protect biosensor monitoring technology, Johnson said. Inmates would wear an electronic bracelet that monitors their vitals, and jail staff could check an app to determine if a person needs medical attention.
Nurses give buprenorphine to inmates experiencing severe symptoms, Ray said. While the drug is effective at easing symptoms, in patients with a high tolerance it presents the danger of what is called a “precipitated withdrawal” with particularly brutal symptoms — as seen in fentanyl abuse.
Ray said inmates must be in moderate withdrawals before nurses can administer buprenorphine, which usually comes 24 to 36 hours after last using drugs. But inmates are now having withdrawals much sooner, making it a tough process to monitor.
“In recent years, there’s a delicate balance between their COWS scoring and time of last drug usage,” Ray said. “We’re having people that are tangibly sicker earlier on, but if you start them on (buprenorphine) too early, then they’re going to go into (precipitated) withdrawals, which is astronomically worse and so much harder to get somebody out of.”
Deaths from severe withdrawals tend to be gradual.
“We don’t have someone going from 0 to 100 in a 30 minutes time span,” Ray said.
While the rest of the jail is monitored by cameras, the detox cells are not. That will soon change. A $3.1 million project approved under former Sheriff Adam Fortney will include new cameras inside the detox cells. Fentanyl or other drugs brought into the jail are sometimes so small they avoid detection, even with a thorough search.
“It’s harder to find, and the lethality has gained,” Johnson said.
In July, after two inmates suffered non-fatal overdoses, authorities found fentanyl powder had been smuggled in by another inmate hiding the drug in his rectum. In May, seven inmates were taken to the hospital after suffering non-fatal overdoses. An Arlington man was accused of bringing the drugs into the jail, allegedly hiding fentanyl powder in a box of Kellogg’s Club Crackers.
‘Timely and in accordance with policy’
Under a recent state law, authorities must conduct a review of unexpected jail deaths, including an analysis of the root cause and recommendations to prevent them from happening in the future. The findings must be submitted to the state Department of Health within 120 days.
Since the legislation, the Snohomish County Sheriff’s Office has submitted findings in the deaths of Sean Hanchett, from December 2022, as well as Jonathan Reilly and Andrey Biruk, who both died last September. The inquiries “did not identify issues or problems” with the jail’s procedures following their deaths.
Police booked Hanchett into the jail’s detox housing around noon Dec. 10, 2022, for investigation of fourth-degree assault, a misdemeanor, according to court records. At 3:47 p.m. the next day, jail officers conducting routine checks with medical staff found him unresponsive in his cell, the inquiry said.
The sheriff’s office found no fault in the medical response to Hanchett’s death, and inmate welfare checks were done “timely and in accordance with policy.”
The Snohomish County Medical Examiner’s Office determined Hanchett, 32, died from complications of chronic fentanyl and methamphetamine use, according to the review.
Around 8 a.m. Sept. 7, jail staff conducted a routine check on inmates under medical detox watch. Reilly, who shared the cell with two other inmates, reportedly refused the check. Medical staff continued their checks, returning to the cell 22 minutes later to find Reilly, 38, unresponsive. Life-saving measures were unsuccessful.
Reilly died of heart disease and complications from drug abuse, according to the medical examiner’s office.
The day after Reilly died, deputies booked Biruk into jail for investigation of first-degree robbery, second-degree assault and residential burglary. Corrections staff also placed Biruk in the medical detox unit, according to the inquiry.
Three days later, a corrections deputy noticed Biruk acting odd in his cell. Around 3:36 a.m., he tested positive for methamphetamine, fentanyl and cocaine. The cocaine was not initially present in Biruk’s urinary analysis, according to the documents.
Corrections staff moved Biruk, 42, to an observation cell, a room designed to hold one person with a corrections deputy observing at all times, according to the sheriff’s office. Around 9:20 p.m., staff found Biruk unresponsive. Medical staff and firefighters tried life-saving measures for 33 minutes before pronouncing Biruk dead at 9:57 p.m.
Biruk died of peritonitis, or inflammation of the stomach lining, according to the medical examiner. The ailment is often caused by a burst appendix. The review recommended cameras inside and outside cells in the observation unit.
In October, corrections staff found David Koeppen dead in his cell. The Florida man was being held on charges of first-degree murder in connection with a shooting at a motorhome in Granite Falls.
And around 11 a.m. on Jan. 15, a corrections deputy found Brendon Tesch, 36, unresponsive in his cell, according to the sheriff’s office. Corrections staff began lifesaving measures, but he was pronounced dead at the scene. He was in jail for investigation of second-degree assault and nonviolent offenses. The cause of Tesch’s death had not been determined by the medical examiner’s office, as of this week.
The sheriff’s office has not yet submitted unexpected fatality reviews in the deaths of Koeppen or Tesch.
Inmate deaths since 2005
Twenty-seven inmates have died inside the Snohomish County Jail since 2005. Of those, at least seven died by suicide, and at least 10 died of drug overdoses or complications from drug withdrawals:
• July 2, 2005: David Herget, 62, killed himself while on suicide watch. He was booked on child sex allegations.
• Jan. 21, 2006: Jon Barker, 44, died of a prescription drug overdose. Public jail records do not list the charges he was booked on.
• March 17, 2006: Ronald Lemon, 52, died of a brain hemorrhage. Records don’t list the charge he’d been booked on.
• Aug. 15, 2009: Mikhail Merlowicz, 25, died of a methamphetamine overdose. He had booked on nonviolent offenses.
• April 7, 2010: Landon Hays, 38, died of heart disease. He was booked on unlawful imprisonment and death threats.
• April 20, 2011: Diane Cowling, 65, died of a heart attack. She was booked on animal cruelty.
• Nov. 11, 2011: Lindsey Lason, 27, died of a lung infection. She was booked on nonviolent allegations.
• Dec. 21, 2011: Jason Elliott, 32, killed himself in his cell. He was booked on domestic violence and a nonviolent offense.
• July 3, 2012: Michael Saffioti, 22, died of asthma following a severe reaction to a milk allergy. He was booked on a nonviolent offense.
• Sept. 14, 2012: Bill Williams, 59, died of heart problems after being shocked twice with a stun gun by corrections officers. He was booked on a nonviolent offense.
• Feb. 28, 2013: Leon Moore, 41, died of a methamphetamine overdose. He was booked on a nonviolent offense.
• July 29, 2013: Kathleen Swann-Deutsch, 51, died of complications of alcohol withdrawal. She was booked on a nonviolent offense.
• Jan. 13, 2014: Lindsay Kronberger, 24, died of complications of an opiate withdrawal. She was booked on a nonviolent offense.
• May 22, 2014: Melissa Bradford, 42, died of complications of alcohol withdrawal. She was booked on domestic violence.
• Sept. 9, 2014: Travis Nelson-Martinez, 19, killed himself in his cell. He was booked on nonviolent offenses.
• Sept. 23, 2014: Marilyn Mowan, 62, killed herself in her cell. She was booked on assault.
• Sept. 29, 2014: Crystal Holloway, 33, killed herself in her cell. She was booked on nonviolent offenses.
• April 17, 2017: Arcan Cetin, 20, killed himself in his cell. He was booked on multiple aggravated murder charges.
• Feb. 1, 2018: Denise Huffer, 62, died of a methamphetamine overdose. She was booked on nonviolent charges.
• Sept. 16, 2020: Christopher Hankins, 34, died of a heroin overdose. He was booked on second-degree assault.
• Dec. 18, 2020: Evan Cochron, 34, died of blood clotting in his lungs while waiting to be escorted to video court. He was booked on domestic violence offenses and a nonviolent offense.
• March 5, 2021: Gregory Bennett, 35, killed himself in his cell. He was booked on unknown allegations. He was booked on fourth-degree assault and harassment charges.
• Dec. 11, 2022: Sean Hanchett, 32, died of complications of fentanyl and methamphetamine withdrawls. He was booked on a nonviolent offense.
• Sept. 7, 2023: Jonathan Reilly, 38, died of heart disease and the overall effects of chronic drug abuse. He was booked on driving under the influence.
• Sept. 11, 2023: Andrey Biruk, 42, died of peritonitis. He was booked on robbery, assault and burglary.
• Oct. 25, 2023: David Koeppen, 38, died of a fentanyl overdose. He was booked on first-degree murder charges in connection to a shooting at a motorhome in Granite Falls.
• Jan. 15, 2024: Brendon Tesch, 36, cause of death is still under investigation. He was booked on second-degree assault and nonviolent offenses.
Jonathan Tall: 425-339-3486; jonathan.tall@heraldnet.com; Twitter: @snocojon.
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