Blog note: this article references a 2014 grand jury report on deaths in the county jail.
SANTA CRUZ -- Krista Lynn DeLuca grew up in North Hollywood in the San Fernando Valley. She was brought up by her mother and stepfather, but her mother died when she was 14. Her stepfather, Ron Pinotti, raised her and his son in an apartment.
DeLuca became a rambunctious and social teenager, her family said.
"She was a little bit out of control, but nothing out of the ordinary. She would always have friends over when I was at work," said Pinotti, 48.
He now works in the air conditioning business in Texas.
At 18, DeLuca told her family that she wanted to attend a cosmetology school in Sherman Oaks, but she decided instead to move in with friends in Santa Cruz County. She lived on Portola Drive in Live Oak. Pinotti sometimes sent money to her.
When she visited him in Los Angeles a few years ago, Pinotti said she seemed in good spirits but slightly slimmer in her 5-foot-4, 100-pound frame.
DeLuca met a man from Santa Clara County in 2012 and got engaged. The couple had a daughter in 2014 and later broke up. DeLuca's daughter now lives with the man's parents near Hollister, Pinotti said.
Pinotti said he didn't know much about DeLuca's meth or heroin use around this time, although law enforcement in Santa Cruz and Santa Clara counties encountered her several times because of it. Since 2010, DeLuca had at least five encounters with law enforcement in Santa Cruz and Santa Clara counties for petty theft and drug-related charges. She also failed to appear at court hearings several times, according to court records.
"She was a sweet girl. She just made some bad choices," Pinotti said. "I know that she could have turned things around if she would have got the help she needed, or at the very least, proper care. It's what anyone deserves."
When Capitola police found DeLuca about 11:45 p.m. Sept. 24, 2015, she was 23 and was arrested on suspicion of being under the influence of drugs, drug paraphernalia possession and five warrants that required court appearances, Santa Cruz County sheriff's Lt. Kelly Kent said at the time. Court records also show that she gave a fake name to police and tried to smuggle heroin and a syringe into jail that night.
AN ARREST
She spent four days in jail withdrawing from heroin. Then at 6:58 a.m. Sept. 29, DeLuca was found in "medical distress," Kent said. Jail staff and paramedics tried to revive her, but she was pronounced dead at 7:28 a.m., according to the Sheriff's Office.
An autopsy showed that DeLuca had acute aspiration pneumonia, dehydration and probable electrolyte imbalance due to frequent vomiting associated with opiate withdrawal.
"Opiate dependence from chronic heroin abuse" prompted those withdrawal symptoms, sheriff's Lt. Bob Payne said.
DeLuca was the seventh person to die in County Jail since 2012 and the third inmate to die from complications with opiate detoxification in that time, according to the county.
DeLuca's uncle, George DeLuca, a Santa Barbara County sheriff's deputy who has experience in jails, said this month that he still hasn't received answers about why his niece wasn't sent to a hospital after prolonged vomiting.
"I don't understand how someone's in custody for several days and dies," he said. "If somebody's that sick, they should be in advanced care."
Jason Hoppin, a spokesman for Santa Cruz County, said DeLuca had been transferred from her cell to the jail's infirmary in the early morning the day she died. Hoppin and leaders of the Sheriff's Office at the jail declined to comment on whether DeLuca asked to go to a hospital. They also declined to talk about other specifics of DeLuca's case because they fear litigation, Hoppin said.
Hoppin noted that of the roughly 11,000 bookings in the jail in 2015, about 20 percent were related to drugs.
"The jail is not a hospital. We can't send everyone who comes in to the hospital, that's why we have medical staff in jail. While this (death) is unfortunate, eventually it was going to happen again. It happens. People do die in jail," said Hoppin.
However, the U.S. Bureau of Justice Statistics paints a different picture.
Nationally, 82 percent of local jails averaged zero deaths annually from 2000 to 2013. About 12 percent of jails reported one death annually, and 6 percent reported multiple deaths, according to the bureau.
TIME LINE
DeLuca was booked in the Main Jail at 259 Water St. in Santa Cruz at 1:31 a.m. Sept. 25, 2015, according to the Sheriff's Office.
At 4:45 a.m. Sept. 29, she had contact with jail medical staff. At some point that morning, she was put in the jail's infirmary.
She had contact with medical staff again at 5:45 a.m., then was checked on about every 15 minutes until jail staff called paramedics at 6:58 a.m., Hoppin said. Paramedics arrived at the jail at 7:08 a.m. to join lifesaving efforts. DeLuca was pronounced dead at 7:28 a.m.
Hoppin and Sheriff's Office representatives declined to comment on whether DeLuca was given an IV, which would have helped her dehydration symptoms, according to an emergency department nurse at Dominican Hospital and federal correctional medical care guidelines.
"The process of dehydration and resultant electrolyte imbalance is a gradual process," said Dana Scruggs, a Santa Cruz attorney who has represented Santa Cruz County Jail inmates in medical lawsuits. "That's a lot of vomiting, without any fluid intake. It's something any jail nurse should notice. The four-day process to get this young lady to her death was not a pretty one."
"Twenty-three-year-old heroin addicts seldom die on the streets from the consequences of withdrawal, and they certainly should not (die) in an infirmary," Scruggs said.
The jail's infirmary has 12 beds. Doctors, nurses and medical technicians check on patients throughout the jail, as well as administer medications and record vital signs, Hoppin said. There are typically five medical staff during the day, three in the evening and two at night, Hoppin said.
After five people died in the jail in less than 12 months in 2013 and 2012, the Santa Cruz County Civil Grand Jury looked into the deaths and published a report in 2014. It noted that a 27-year-old woman died in August 2012 after 12 days in jail from a lung collapse related to opiate withdrawal.
Opiate withdrawal, which is a similar if not the same condition as DeLuca, falls under the jail staff's medical protocol outlined in the grand jury report. The minimum protocol for care states that the patient should be started on oxygen, put in a comfortable position and started on an IV with normal saline. Jail staff should then "prepare to transfer patient to outside facility or admit to a facility capable of providing a higher level of care if indicated."
Opiate withdrawal symptoms of vomiting, anxiety and insomnia can last up to several weeks, according to the National Institutes of Health.
PROTOCOLS
In DeLuca's case, it's not clear if any of the protocol was followed because Sheriff's Office staff have declined to comment on the specifics of DeLuca's care.
"We get a lot of people in medical distress, and we believe we have all the systems and protocols in place to care for them properly," Hoppin said. "No one wants to see this happen. We take the care of inmates very seriously."
Some of the protocols include a form about medical problems that every inmate fills out upon entry. If the inmate answers "yes" to any medical problems, the inmate is evaluated by the jail's medical staff and sent to a hospital if necessary, according to county representatives.
Also, intoxicated inmates are supposed to be put in "sobering cells" where there is more frequent medical observation.
Medical care in the County Jail has been outsourced to the California Forensic Medical Group since September 2012. The firm provides inmate care at jails in 27 California counties including Monterey.
Kip Hallman, its CEO, said Thursday that he did not know if DeLuca received an IV or asked to go to a hospital.
"It's a tragedy. We treat every life as precious. It's unfortunate," Hallman said of DeLuca's death. "People do die in jails. They die in nursing homes and they die in hospitals and they die at home despite the best efforts of really good people."
When asked what assurance that others in the jail should have if they are detoxing from drugs, Hallman said, "I'm not answering a loaded question."
In California jails where California Forensic Medical Group is the medical care provider, 21 people have died from drug or alcohol overdose from 2004 to 2014, according to Department of Justice records obtained by the Sacramento Bee.
The firm also settled six lawsuits from 2009 to 2014 but has not admitted to any wrongdoing.
Krista DeLuca Time Line
11:45 p.m. Sept. 24, 2015: Krista DeLuca is arrested in Capitola on suspicion of being under the influence of drugs, drug paraphernalia possession and five warrants.
1:31 a.m. Sept. 25: DeLuca is booked in Santa Cruz County Main Jail.
Sept. 26 to 28: In jail.
4:45 a.m. Sept. 29: DeLuca has contact with jail medical staff. At some point in the morning, DeLuca is put in the jail infirmary.
5 a.m. Sept. 29: Jail staff serves breakfast to DeLuca.
5:30 a.m. Sept. 29: Jail staff speaks to DeLuca during a regular check.
About 5:45 a.m.: DeLuca has contact with medical staff.
6 a.m.: Jail staff checks on DeLuca.
6:15 a.m.: Jail staff talks to DeLuca.
6:30 a.m.: Jail staff checks on DeLuca.
6:50 a.m.: Jail staff checks on DeLuca.
6:58 a.m.: Jail staff calls paramedics because DeLuca is in medical distress.
7:08: Paramedics arrive at jail.
7:28 a.m.: DeLuca pronounced dead in the jail infirmary.
February 7, 2016
San Jose Mercury News
By Stephen Baxter, Santa Cruz Sentinel
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