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Medical care in a jail setting is a very specific and unique situation not faced elsewhere because both the correctional staff (guards, deputies, officers, etc.) and the jail medical staff have duties and responsibilities that by the nature of the in-custody setting overlap.

If you get sick or injured and need medical care, you go to the doctor or to the emergency room on your own and when it is convenient to do so. You generally choose your own doctor and/or hospital for treatment.

In contrast, if you are in jail and get sick or injured, you do not get to choose your own doctor or when you want to seek treatment. In fact, if you are in jail you will most likely be seen by a Licensed Vocational Nurse or a Registered Nurse, before and if you ever see a doctor

In jail, the only way to get medical care is if the jail correctional staff sends you to the medical services unit of the jail, or have you taken to an outside emergency room.

Jails can have the best nurses, the best doctors, the best labs, and equipment available but it is all meaningless if the correctional staff (guards, deputies, officers, etc.) fail to bring the inmate and medical staff together.

Some of the cases I have consulted on illustrate how the overlap of responsibilities between correctional and medical staff in a jail setting require a jail practice expert familiar with this unique set of circumstances.

- Having the nurse direct a jail lieutenant to medically monitor a sick inmate. In this case, the inmate died.

- Repeated requests from an inmate to be seen by the medical staff went unanswered until it was too late. In this case, the inmate died.

- The required safety welfare checks were not done properly. In this case the inmate died.

- A jail nurse had an inmate worker (trustee) act as her assistant and monitor a sick inmate. One of the directed duties of the "assistant" was to assist in the medication delivery to the sick inmate. The sick inmate died.

- A sick inmate refused his scheduled appointment with the jail doctor. The correctional deputy failed to follow the proper policy and procedures regarding what to do when an inmate refuses a medical appointment. The inmate died.

- During the intake process at a jail, the officers and deputies failed to follow policy and call for a jail nurse to approve the inmate's housing. The inmate died a few hours later.

- A jail nurse failed to call for paramedics and insisted the deputies transport an inmate, who was already dead, to the hospital.

- The medical staff's response to a jail suicide was improperly delayed. The inmate died.

The importance of retaining a jail practices expert in cases involving jail medical care cannot be overstated. To reiterate, in jail medical cases there is always an overlap of duties and responsibilities between the guards, officers, and/or deputies and the medical staff.

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Richard P. Lichten, CLS, (Lt. Ret.), has over 30 years of experience within Law Enforcement. He has expertise in Administrative, Tactical, and Policy and Procedural Areas of Law Enforcement and specializes in many areas of Police and Jail Procedures, including the Use of Force (lethal and less lethal), use of the TASER, and jail suicide and jail medical cases, just to name a few. Mr. Lichten continues to seek out and attend training to further his expertise. In April 2017, the Institute for the Prevention of In-Custody Deaths (IPICD) certified Mr. Lichten as an Arrest-Related and In-Custody Death Investigative Specialist.

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