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⚠️ Este contenido ha sido traducido automáticamente. El texto original en inglés es la versión oficial. La traducción puede contener errores.
Findings and Recommendations 6 findings
F1
Sonoma County Sheriff’s and CFMG medical staff failed to fully intervene in Mr. George’s further deterioration after return from SMC. (7/06/07 – 7/09/07).
Related Recommendations (1)
R1
That “proof of life” be required at each “check” of an inmate in medical observation cell. Vital signs should be taken at each change of shift and recorded for as long as the inmate is in medical detention.
F2
Although Title 15 of the state penal code requires that an inmate receive six hours of uninterrupted sleep, failure by Sonoma County Sheriff’s correctional staff and/or medical staff of CFMG, to require proof of life, at each fifteen (15) minute interval, may have contributed to Mr. George’s death.
Related Recommendations (1)
R2
That the Sonoma County District Attorney complete the review of the Sonoma County Sheriff’s investigation
F3
CFMG staff also failed to provide Mr. George with a physician’s examination within 24 hrs of his return to MADF as was required by the discharge orders from SMC.
Related Recommendations (1)
R3
CFMG and Sonoma County Sheriff provide complete investigational files to the Grand Jury.
F4
A complete medical record of Mr. George was not sent with him to SMC. On 7/01/07.Medical records are essential to accurate diagnosis and treatment.
Related Recommendations (1)
R4
CFMG be requested to keep complete employee time records, particularly for physicians.
F5
CFMG and the Sonoma County Sheriff failed to provide a complete set of requested documents to the Grand Jury including accurate time records and telephone calls.
Related Recommendations (1)
R5
CFMG medical staff comply with discharge orders for hospitalized inmates and document compliance.
F6
The Sonoma County District Attorney’s Critical Incident Report was not received until February 2010, although the incident occurred July 2007. The review did not address all salient details; ie., ineffectual bed-checks for proof of life. [3] RATS Logs are mechanized logs indicating times of inmate surveillance by CDs RECOMMENDATIONS
Related Recommendations (1)
R6
That CFMG undergo regular, independent peer review of medical care provided to jail facilities. Required Responses to Findings: Sonoma County Sheriff F-1, F-2, F-3, F-4, F-5 Sonoma County District Attorney F-6 Required Responses to Recommendations: Sonoma County Sheriff R-1, R-3, R-4, R-5, R-6 Sonoma County District Attorney R-2 Requested Responses to Findings and Recommendations: CFMG F-1, F-2, F-3, F-4, F-5 • R-1, R-3, R-4, R-5, R-6
No Responses Found 2
Government entities assigned to respond to this report. No response documents have been linked in our database.
Sonoma County District Attorney
Elected County Office
Sonoma County Sheriff
Elected County Office