Last February, while being held in Ohio’s Montgomery County Jail, Isaiah Trammell suffered a psychotic episode and begged for a blanket, a mat and a phone.
He was refused because he was on suicide precautions.
Tramell screamed and banged his head on the cell door. He couldn’t calm down. The 19-year-old told officers he has autism spectrum disorder and that he has ADHD due to the overwhelming stress of being locked up in jail with no contact with family or medication.
The officers then ridiculed him, told him he was acting like a “bastard,” and forced him into a restraint chair twice.
Prisons across the U.S. regularly contract with private health care companies, often paid for by taxpayers, to meet the needs of their inmates.
NaphCare, a billion-dollar company, was paid tens of millions of dollars to provide medical and mental health care at the Montgomery County Jail.
But they didn’t do that with Isaiah Trammell.
A sheriff’s office intelligence report said officers asked a mental health worker to talk to Trammell and “de-escalate the situation.” Video footage of Trammell’s 10 hours in jail shows the medical worker on duty trying to talk to him but then giving up and saying, “Okay, that’s enough.”
Trammell died three days later after hitting his head against the wall of his unpadded cell, and authorities ruled his death a suicide.
“The doctors and neurosurgeons (at the hospital where he was pronounced dead) said, ‘We could have saved your son sooner,'” Trammell’s mother, Brandi Abner, said recently.
“If the nurse had just said, ‘We need to get your son out,’ he could have been saved. She didn’t care. It was so cruel. My son was dying. He was begging the nurses for help.”
Trammell’s experience is part of a larger history of deaths, legal settlements and other substandard care issues involving NafCare, which is headquartered in Birmingham, Alabama, and operates in dozens of prisons in 32 states.
A 2020 Reuters investigation found that prisons contracted by NafCare have seen more deaths than any other health care provider in the country. In 2022, NafCare was forced to pay nearly $27 million to the estate of a Washington state woman in a wrongful death lawsuit who died after being denied anti-seizure medication under the company’s care.
NafCare was fined millions of dollars for failing to adequately staff its prison facilities after multiple deaths in Massachusetts, California and Arizona.
Other detainees held at the facility are also suffering from life-threatening malnutrition and scabies.
The Justice Department also found the company had overcharged prisons for its services and forced it to pay back about $700,000 in 2021.
A Nafcare spokesman declined to answer questions from the Guardian, including why Isaiah Trammell was denied medication.
Instead, the emailed response said NafCare’s clinical team “provides compassionate, comprehensive and proactive medical care to all patients with integrity and transparency.” The statement also said NafCare staffs the Montgomery County Jail “24 hours a day, 7 days a week.”
“We have continually adapted our service levels and treatments to meet the changing needs of our patients,” Nafcare said.
NaphCare isn’t the only healthcare company under fire for providing shockingly substandard care: Corizon, another company with a contract to provide healthcare and treatment in prisons, has reportedly restructured to form a new company, YesCare, to avoid paying tens of millions of dollars to creditors.
Colleen Kendrick of the American Civil Liberties Union’s National Prison Project said, “County jails are persuaded by the idea that for-profit companies will somehow handle all the problems and responsibilities…Inevitably, there will be for-profit entities determined to make a profit off their work.”
“They need to be held accountable for actually providing the services they are being paid millions of dollars for.”
Activists at the Montgomery County Jail are concerned that their efforts to be included in a $20 million renovation that would add 100 medical beds have been ignored.
“If the renovated jail were to add 100 medical beds, we would assume that NaphCare’s contract would be expanded to include a significant increase in the services provided,” said Joel Proulx of the Montgomery County Jail Coalition.
“I asked how much it would cost and what additional oversight would be put in place. Given that it is a notorious company, the thought of additional liability is frightening.”
Isaiah Trammell was one of seven people who died in the prison or shortly after being detained in 2023. An investigation by the Ohio Department of Rehabilitation and Corrections found that the facility “failed to comply with several applicable prison standards,” but the department also argued that the prison had since implemented “meaningful” changes.
Despite the deaths and controversy, Montgomery County municipalities renewed their contract with NafCare in January for $7.6 million.
Trammell’s mother, Brandi Abner, said her son dreamed of moving to Alaska to become a park ranger and was an avid fan of professional wrestler John Cena.
“He was obsessed with wrestling,” Abner said, “and he would learn anything about certain animals. He wanted to be the next dog trainer.”
But she said she was left to mourn the death of her teenage son because a prison nurse failed in her duties.
“They kept inspiring my son for hours,” she said. “If they had done their jobs, my son would still be alive.”