Julie Downs hopes that no one else dies the way her son, Brian, did – vomiting on a jail cell floor as Morgan County Jail personnel watched.
Morgan County is being walloped with a $6 million settlement in federal court for negligence in the 2022 heroin withdrawal death of 40-year-old Brian Downs. Parties in the case have reached agreement and it is expected to soon be signed by a judge.
Julie Downs told Illinois Times she hopes the monetary settlement will serve as an impetus for the sheriff’s department to make changes. So far, neither she nor her attorney, Richard Frazier, see any reason to be encouraged.
“To the best of our knowledge, no one within the sheriff’s department has been fired or disciplined because of this death, and we are unaware of any changes of policy made there since Brian’s death,” Frazier said.
Morgan County Sheriff Mike Carmody told IT that there were no personnel changes made as a result of this incident. But he said the department has provided jail personnel with additional training to better evaluate whether an inmate needs medical care.
“How much training does someone need to know when someone vomits blood more than 50 times they need to go to the hospital?” Frazier said in response.
According to the lawsuit, at the time Brian was arrested, his “behavior was erratic and he was disoriented.” Officers recognized that he was having severe heroin withdrawal and Brian was taken to Jacksonville Memorial Hospital, where a blood test showed the presence of heroin in his system.
He was treated with the anti-anxiety drug Ativan. On orders of the correctional officers – and against medical advice – Brian was discharged from the hospital and returned to the jail, the lawsuit states.
Frazier said the correctional officers were instructed by the medical professionals to return Brian to the emergency department if his confusion increased or his vomiting became more persistent.
At the time, Morgan County retained Advanced Correctional Healthcare, a Tennessee-based corporation, to provide remote medical direction within the jail.
“The county pays $53,000 a year for this,” Frazier said. “Anything that’s done outside of the detention facility, they have a cap per year of $13,000 before the county has to pay out of their own pocket. If they would have sent Brian back to the emergency room, which they should have, it probably would have hit the $13,000 limit. … Two correctional officers said they were ordered not to give this inmate any further medical care.”
Frazier said he learned of these orders from an investigation conducted by the Illinois State Police of Downs’ death while in custody. No criminal charges were filed as a result of the investigation.
Carmody said the county has since discontinued its relationship with ACH but he stopped short of blaming the company for Downs’ death.
“At this point, you know, there’s no sense in trying to figure out who is to blame,” he said.
But Frazier said now is the time to determine who is responsible.
“If you just paid $6 million, you better do an evaluation to make sure it doesn’t happen again,” he said.
Carmody denied that the potential cost to Morgan County was in any way a factor in Downs not being transported back to the hospital.
He noted that jail personnel were preparing to take Downs to the hospital when he died.
“I’ve seen in the past where people are very bad, and they get worse, and then they get better. And this just wasn’t one of those times,” Carmody said.
While a settlement has been reached with Morgan County and its insurance carrier, Frazier said the lawsuit is pending against Advanced Correctional Heathcare.
“This nurse practitioner, who’s employed by ACH, … her job was to (remotely) supervise the inmates’ medical care. How could she provide any medical care for an inmate when she doesn’t have (in-person) experience in doing that? She’s the one who sent him to the hospital when he was first arrested, when he was having symptoms. She didn’t even bother to get his discharge instructions to make sure that they were followed up on,” Frazier alleged.
He added he has no evidence that ACH maintained a medical chart on Downs.
ACH CEO Jessica Young did not immediately respond to a request for comment from IT.
Julie Downs said she believes that her son was viewed with indifference by the jail staff because he was an addict. She said they watched him vomit more than 100 times over three days.
A video recording of Downs retching in his cell as the county nurse enters paints a heart-rending image.
“She walks in his cell, and there’s puke all over the floor. It looks like blood on the floor from his vomit. She steps over it and almost slips and falls in it to take his blood pressure,” Frazier said. “It’s unbelievable. Obviously, she never read the discharge instructions or she didn’t care or she was instructed not to take him back to the hospital. She was an RN.”
According to Jacksonville police reports, Brian was arrested April 22 on charges of possession of a controlled substance and resisting or obstructing a peace officer.
In a 2023 interview, Julie said because Brian lacked dental insurance, he didn’t go to the dentist and his teeth became infected and painful.
“He started borrowing pain pills from friends, and we think that is when he got hooked on opioids,” she said. From there, she said he progressed to heroin.
Julie said Brian did at least three stints at drug rehabilitation centers. She contends his path to sobriety was hampered by not having health insurance.
“He did one stint in Jacksonville. He did twice in Bloomington. And those were both for heroin. I know that he attempted to get into rehab many more times. And that is a struggle. If you don’t have insurance, Lord help you, because they do not take you.”
After each time in rehab, he would experience a period of sobriety, she said.
On April 25, 2022, Brian collapsed in the jail’s booking area. A Morgan County sheriff’s deputy asked guards why Brian wasn’t receiving medical care, according to the lawsuit.
“The jail staff informed him that they could not get an off-duty correctional officer to come to the jail to transport Brian to the hospital,” the lawsuit contends. The deputy “expressed alarm at this excuse” and prepared to transport Brian to the hospital in his patrol car.
But before that could happen, Brian died on the floor of the jail. An autopsy later determined that he had died from dehydration and septic shock as a result of a bowel obstruction amid opioid withdrawal syndrome.
“I’m just sick about this,” Julie told IT in an interview this month. “It took us a very long time to even consider (the settlement) because our thought was just to take it to court and let everybody know how things fell apart. What we want, we can’t have – we want my son.”
She added she filed the lawsuit to prevent this from happening to someone else’s child.
“And apparently it will, because nothing is going to change,” she said.
Scott Reeder, a staff writer for Illinois Times, can be reached at sreeder@illinoistimes.com.
This article appears in A critical loss for District 186.
