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DRAPER — An inmate at the Utah State Prison died Sunday as the result of apparent cardiac arrest due to renal failure, officials said.
Prison medical staff and outside responders were getting ready to transport Ramon C. Estrada, 62, to University Medical Center for treatment at about 10:30 p.m. when he died, according to Brooke Adams, public information officer for the Utah Department of Corrections.
The Utah Department of Correction’s Law Enforcement Bureau is currently conducting an internal investigation, but a preliminary review shows Estrada’s death may have been caused in part by a lack of dialysis treatment, Adams said.
A kidney dialysis treatment was scheduled for Estrada in the prison’s on-site treatment center on Friday, but the technician with the University of Utah South Valley Dialysis Center, based in Sandy, didn’t show up Friday or Saturday, Adams said.
Adams would not comment on why the technician failed to show up or why it took prison officials until Sunday night to get treatment for the inmates.
"Obviously, we are aware that he didn't (show up)," Adams said, but she would not say when prison officials discovered that the inmates hadn't received their scheduled treatment.
Six other male inmates who need ongoing dialysis treatment but had not received it were transported to University Medical Center for evaluation after Estrada’s death, Adams said.
Four of the inmates were admitted overnight for treatment and two were found in good condition. One remains in the hospital in stable condition while the others are back at the prison, Adams said.
“The delayed response in ensuring that the inmates received needed medical care is unacceptable,” Adams said.
Kathy Wilets, a spokeswoman for University of Utah Heath Care, released a statement Tuesday regarding the scheduling error for the dialysis.
"We are saddened to learn of this prisoner's death and are concerned about the scheduling error for dialysis services provided at the prison by University of Utah technicians," Wilets said. "We have a responsibility to provide quality care for patients. We will now conduct a thorough review of the circumstances that led to this unacceptable mistake and will take whatever steps are necessary to improve communications and procedures."
Aside from the Department of Corrections' internal investigation, the Unified Police Department is also investigating Estrada's death, which is standard procedure. Lt. Justin Hoyal said his department is primarily interested in finding out Estrada's cause of death from his autopsy.
"(Criminal culpability in Estrada's death) is one of the things that could play into this and one of the things we will look into," Hoyal said. "But as far as the investigation as to what took place there at the prison, as far as his medical care and what may or may not have been taken care of, is being conducted internally by prison officials."
The Utah Department of Correction's internal investigation will review all aspects of the situation, the medical leadership and staff response, the contract provider’s actions and an analysis of preventive measures, Adams said.
The department’s Clinical Services Bureau director, Richard Garden, was placed on administrative leave while the investigation is being conducted, Adams said.
The spokeswoman also declined to comment on the circumstances surrounding Garden being placed on leave.
“In the meantime, the Department has taken immediate action to improve communication with and oversight of the dialysis contract provider,” Adams said.
The action includes getting a schedule calendar and contact information for dialysis technicians, requiring its nursing staff at the Olympus facility to contact and receive post-treatment reports from the on-duty technician on days of dialysis, making better chart notes about the inmates' statuses and conditions and “requiring timely notification to the charge nurse when the dialysis schedule changes or a technician fails to show up,” Adams said.
Estrada, a Mexican citizen, had been in the prison since August of 2005 on a rape conviction. His parole date was coming up on April 21, and the Federal Immigration and Customs Enforcement Service had an active detainer for him.
Estrada's body was sent to the state medical examiner to determine the exact cause of death, Adams said.
The Unified Police Department is also conducting an investigation as standard procedure, Adams said.
Contributing: Ben Lockhart, Andrew Adams
