Jenny Fulton was on parole for a heroin conviction, when, after two years of being clean, she tested positive and landed in the Mason County Detention Center for the violation.
According to documents in a $750,000 settlement that Fulton’s mother was awarded in May, the 27-year-old spent the next three days in October 2014 lying in a cell begging to be taken to the hospital. She said she was dying.
Long before she ultimately lost consciousness, her dehydration was so severe that her hands were curled inward and she could hold a bottle of Gatorade only between her knuckles, according to a deposition provided by Lexington attorney Jim Thomerson, who represented Jenny Fulton’s mother, Teresa Fulton. According to documents in the case, she had uncontrollable vomiting and diarrhea. She was “grey-looking,” according to another inmate’s deposition, and reached a point where she couldn’t move or speak.
Fulton was in heroin withdrawal and also suffered from the bowel condition Crohn’s Disease.
She died on her fourth day in jail.
Experts say her case highlights a growing challenge for Kentucky jails: inmates suffering through withdrawal as the state’s opioid epidemic continues to spiral.
“If you’re a heroin addict and get put into one of these county jails, you’re at real risk for lack of care and something bad happening,” Thomerson said.
Van Ingram, executive director of the Kentucky Office of Drug Control Policy, did not comment on the Mason County jail case. But he said “opioid withdrawal is a big problem for correctional settings.”
“It is a real problem, just one of the many ways that this opioid epidemic is taxing all of our systems, whether it is the jail system, the court system, the foster care system,” Ingram said.
Addiction has reached epidemic levels in Kentucky, where painkiller and heroin abuse are rampant as is illicitly manufactured Fentanyl , said Ingram. Heroin is a highly addictive drug derived from morphine. A growing number of people who previously used expensive prescription drugs are switching to heroin, which is cheaper and easier to buy, he said.
Ingram said jails in Lexington and Louisville have medical units to handle withdrawal; smaller jails do not.
“Constant medical monitoring is important because … of the dehydration that can occur and other serious medical events that can come from withdrawal,” Ingram said.
Lisa Lamb, a spokeswoman for the Kentucky Department of Corrections, said the department’s administrative regulations establish procedures for delivery of medical services in jails. The jail’s medical services must be provided by contracting with a health care provider licensed in Kentucky, but each jailer decides who to contract with. Under regulations, the medical authority must be a licensed practical nurse, a higher level of licensed nurse, a licensed medical doctor, or licensed doctor of osteopathy. Emergency medical services must be available to inmates commensurate with the level of care in the community.
The young woman with the given name Audrey Geneva Fulton entered the Mason County jail on Tuesday, Oct. 28, 2014, a pre-settlement document provided by Thomerson said.
She had reason to believe she was among friends who would take care of her at the facility in Maysville, the document says. The jailer at the time knew her family, she had grown up with one of the guards. Another guard was a neighbor who had known her since she was a teenager.
After her first night in jail, her vomiting and diarrhea were constant and uncontrollable.
“Jenny’s vomiting was so bad that they had to take her to the shower, change her clothes and clean her cell on multiple occasions Thursday and Friday,” said Thomerson.
But she was not sent to the hospital. Instead staff went out and bought adult diapers. They put them on her and about 40 minutes before she died asked another inmate to watch her while they attended to other duties, according to depositions and the pre-settlement document.
On the day that Fulton died, her eyes had sunk in and she could not move or speak, the pre-settlement document said.
According to a deposition, a jail sergeant said to a deputy, “They’re going to fool around and let her lay there and die.”
An inmate watching over Jenny Fulton said in a deposition, “She was grey-looking … there was stuff coming out of her mouth and nose … it was really thick mucous.”
At about 8:10 p.m. on Friday Oct. 31, 2014, nearly four days after she was booked into the jail, Jenny Fulton’s eyes rolled in the back of her head and her hand, held by the other inmate, went limp, the pre-settlement document said.
A jail guard who had grown up with Fulton said there were efforts to resuscitate her, but her jaws were locked, according to the pre-settlement document. An ambulance was then called. She was pronounced dead at the hospital.
Teresa Fulton filed a lawsuit against the Mason County government, then-Mason County Jailer Gerald Curtis, four deputy jailers/guards, a nurse practitioner and nurse who worked at the jail and the local Health Department for its part in creating the medical policies and its supervision, or lack of supervision, over the medical staff, Thomerson said.
Jail staff members said in depositions that having someone go through heroin detoxification could be at times a daily occurrence at the jail.
Thomerson said that after the extended period of being clean while she was on parole, Fulton’s gall bladder was removed and after surgery, she took painkillers, which could have led to her using opioids again.
The jail’s written policy provided to the Herald-Leader by Thomerson said drug withdrawal constituted a medical emergency, meaning that inmates in withdrawal should get the same emergency medical care they would get in the community. But the pre-settlement document said that staff members were unaware of the policy.
Depositions and the pre-settlement document show that staff members alleged that it was Advanced Registered Nurse Practitioner Cynthia Schaefer’s decision not to send Fulton to the hospital. Such a trip to the hospital would cost the local government money, the pre-settlement document alleged.
Thomerson said Schaefer had seen Jenny Fulton only once in the four days she was in jail, in the morning on the day she died. Schaefer said in a deposition that jail staff didn’t tell her later in the day when she talked to them by phone that they thought Jenny Fulton should have been sent to the hospital. Schaefer said in the deposition the staff could have sent Jenny Fulton to the hospital on their own.
“While everyone pointed fingers at one another, the reality is that people saw and watched what she was going through, could have called 911 and gotten her help, but didn’t,” Thomerson said. “And what happened to Jenny was that nobody acted on what they saw and knew was happening — her slowly moving toward death over a number of days.”
Thomerson added: “We took lots of depositions and it was clear that the guards at the jail knew Jenny needed to be sent to the hospital.”
Jeff Mando, a Covington attorney who represented the non-medical jail staff, including the guards, said the “settlement was undertaken without any admission of liability.”
“It was done simply to avoid the additional expenses associated with a trial of this nature. Cases like this involve the retention of experts, deposition costs, additional attorney fees, and so a decision was made to resolve the case without any admission of fault,” said Mando. “As far as the deputies employed by the Mason County jail were concerned, the evidence in the case established that they asked for and sought medical assistance from the jail’s medical provider, Ms. Schaefer, and she was in charge of all medical decisions.”
Bruce Leslie, a Greenup attorney who Thomerson said represented Schaefer, the medical staff, and the health department, declined to comment Thursday.
A Mason County Grand Jury heard evidence regarding the case, but failed to return indictments, said Thomerson.
According to the settlement, the defendants’ insurance carrier, the Kentucky Association of Counties All Lines Fund, paid the $750,000.
“What always struck me about this situation, and really hit home emotionally, is the violation of the social contract that we have in our current society and that we all have to rely on,” said Thomerson. “Whether it’s having a parent in a nursing home, a kid in a school, a baby at a daycare, or a family member who unfortunately is incarcerated, we all have to rely on others to do everything within their power to protect and care for the person who is 100 percent under their care and control.”