Sonoma County D.A . clears staff in 2007 death of jail inmate

The Sonoma County district attorney has concluded there was no criminal negligence in the 2007 death of a 25-year-old jail inmate who succumbed to an acute sickle cell anemia crisis.

That finding released Friday was immediately criticized by the legal firm representing the family of the inmate, Ryan Kelsey George, in a $25 million civil lawsuit that alleges that timely and adequate medical care could have prevented his death.

“I think the district attorney has white-washed this case — it's the only way to say it,” said Steven Wittels, of Sanford Wittels & Heisler, a civil rights firm with offices in New York, New Jersey and Washington, D.C.

Wittels said Passalacqua's finding does not effect his case because criminal negligence requires a higher standard of proof than required in a civil case.

In a written statement released Friday morning, District Attorney Stephan Passalaqua said George's death, while “sad and unfortunate,” was not the result of criminal negligence on the part of the jail's medical staff nor the doctors at Sutter Medical Center of Santa Rosa, where George was treated several days before he died.

George began serving a 10-month domestic violence jail sentence on May 31, 2007. On June 28, he reported that he had sickle cell anemia. The next day he was seen by a jail doctor, who placed him on medication.

Sickle cell anemia is a blood disorder in which red blood cells are misshapen — sickle shaped instead of disc-shaped — and tend to obstruct blood vessels. Blocked blood vessels can cause pain, serious infections and organ damage.

On July 1, George was taken by ambulance to Sutter Medical Center of Santa Rosa, where he was treated and discharged two days later. He died in the jail medical housing unit on July 9.

Because of the medical complexities of the case, Passalaqua said he retained an expert in the field of sickle cell anemia, Dr. R. Ward Hagar, director of the adult sickle cell program at Children's Hospital in Oakland. Dr. Hagar reviewed George's medical records, including the findings of the forensic pathologist Dr. Ikechi O. Ogan of the Fairfield-based Forensic Medical Group.

Dr. Ogan found, as the district attorney's statement Friday noted, that “it is likely that early diagnosis of this relatively common disease, with rapid therapy (including vigorous re-hydration, adequate analgesia and blood transfusions) may have prevented this death.”

Wittels, the civil attorney, said George was not given any such treatment, and that the Sutter doctors who discharged him after two days of treatment knew he was still having a sickle cell crisis.

Wittels said that in a deposition taken about a month ago, Dr. Richard Flinders, the physician supervising the second-year resident who treated George, stated that George had an abnormal MRI and EEG, was still experiencing a sickle-cell crisis and was both incontinent of both stool and urine.

According to a transcript of the deposition, Dr. Flinders was asked if George was “was still suffering from sickle cell crisis?”

“Yes, but less so,” Dr. Flinders said.

Wittels said, “you don't discharge patients who are unable to control their bowels,” adding that Passalacqua “should certainly revisit and reopen this case” after he's had a chance to review the deposition testimony in the civil suit.

Passalacqua insisted that the sickle cell expert did a thorough review of the medical records in the case.

“This was a lengthy review and we spent months and months and months making attempts to obtain an expert in the field,” he said. “This is a sad case, and attorneys in civil arena can posture at times.”

Wittels said that George's mother, Valerie George, was “deeply disappointed by Passalacqua's decision.

In a statement relayed through Wittels, Valerie said, “we are confident that when the jury hears all the evidence about the mistreatment of my son Ryan by the jail and the doctors, they will agree with the coroner's opinion that proper medical care would have saved Ryan.”