Hennepin County jailer died after attack by mentally ill, HIV-infected inmate

By Andy Mannix Thu., Apr. 19 2012 at 3:47 PM

Derres King was committed as mentally ill and dangerous this week.

If the Hennepin County mental health commitment system worked properly, a guard at the Public Safety Facility might still be alive today.

Last December, a Hennepin County jailer was bitten by an inmate named Derres King. King suffers from severe mental illness that had gone untreated in jail. He is also infected with HIV.

Because the bite broke his skin, the guard started on preventative HIV treatment. The side effects were extreme, and debilitating for the 50-year-old jailer. Last month, the guard died.

"Though the exact cause of death has not yet been released by the medical examiner," writes Judge Jay Quam, who presides over the civil commitment court, "it is fair to conclude that the bite Mr. King inflicted contributed to [the guard's] death."

This tragic case illustrates the problems facing Hennepin County's civil commitment system. As we documented in our March cover story, "Unfit for Trial," a combination of bureaucracy, budget cuts, and a mysterious increase in mentally ill offenders coming to the system through the jail has made it the norm for offenders to languish in a cell for months on end waiting to be hospitalized.

The consequences can be dire for everyone involved. Often times untreated and in a solitary cell, offenders can decompensate by the time they finally get help, and sometimes end up leaving in worse condition than when they came in. The guards are also put in the dangerous position of trying to control mentally ill inmates who resist them, which can easily lead to attacks.

Thursday, Quam ordered that King be committed as mentally ill and dangerous, a commitment that comes with an indeterminate sentence to the Minnesota Security Hospital. In his order, Quam goes into detail about the dysfunctional civil commitment system, citing City Pages' coverage to highlight an example.

Read more about civil commitment in our March cover story, "Unfit for Trial."

Writes Quam: "While they are sitting in jail they often recede further into the depths of their illness; they present a danger to themselves; they present a danger to their fellow inmates; and they present a danger to the good men and women who run the jails."

Here is what happened, according to Quam's order:

King was first arrested last October after attacking his neighbor with a butcher knife, coffee pot, and flaming piece of paper, and was eventually charged with second-degree assault.

King, then 24, had been exposed to HIV while in the womb. He suffered from a number of mental illnesses that had gone untreated, including: Depression, Bipolar Disorder, Schiophrenia, Personality Disorder, Adjustment Disorder, Attention Deficit Disorder, Antisocial Personality Disorder, Schizoaffective Disorder, Generalized Anxiety Disorder, Obsessive Compulsive Disorder, Panic Disorder, and Posttraumatic Stress Disorder.

A jail cell may have been the worst place for him. It would eventually be determined that King was not competent to stand trial, and his case would be sent to the civil commitment system.

But in the meantime, King remained in jail, and refused to take medication. His behavior quickly became a problem for the jailers. He threatened to spit at one guard, and was "very disruptive and verbally assaultive," jailers noted.

Here's how one jailer described King: "Manipulative, labor intensive behavior due to medical issues. Currently not suitable for [general population]."

Craig Lassig.

Judge Jay Quam believes that the civil commitment system needs to be reformed.

On New Year's Eve, King complained to a guard that he hadn't received a spoon with his meal. The guard suspected King might have been hiding the spoon, possibly to be used for a weapon, and asked him to step out so his cell could be searched.

During a pat-down, King broke free from the guards, grabbed a food tray, and threw it at one of them. Two deputies restrained and handcuffed King, but he still struggled. That's when another guard jumped in to help.

With all three jailers trying to restrain him, King took a bite out of one guard's leg. He bit down for "several seconds," breaking through the pant leg and skin. King was charged with fourth-degree assault.

The guard quickly began the treatment to prevent HIV infection.

"This treatment regimen was debilitating to [the guard], causing him to suffer many serious side effects," writes Quam. The guard "was never the same after receiving treatment."

He died only a few months later.

"The danger that mentally ill people in jail present is not theoretical," writes Quam. "To verify this you could ask [the guard], if he were still alive."

Previous Coverage:

COVER: Unfit for Trial

Hennepin County court gap cycles out mentally ill offenders

Tags:

Civil Commitment, Derres King, Hennepin County Jail, Judge Jay Quam

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seawall

I am sorry that the guard responded so poorly to PEP (treatment to prevent HIV transmission after an exposure). This leaves me wondering where were his medical providers? It appears that the system has failed everyone in this scenario. Very sad. Too bad the inmate's private mental health history and HIV status has been outed. It would appear that only some people have the right to privacy and HIPAA laws only protect those deemed worthy of protection.

Get Real

This is a ridiculous story. HIV is not transmitted this way. HIV medications do not kill people in 10 weeks. He died of acute alcohol toxicity.

Jodala

Andy Mannix: you failed to mentioned the jailer died of acute alcohol toxicity, according to the medical examiner - why did you leave that out?

Andy Mannix

Jodala--

As noted in the article, the medical examiner's report had not been released at the time of publication. There are many details related to this guard's death that are still unknown, but I believe Judge Quam's statements are clear. Thanks.

Jodala

Andy: Thanks for your reply - where has City Pages published an update stating this jail guard died from drinking too much alcohol, please?

Mort

It looks as though some City Hall Insiders have hijacked this comment section!

Supe31

This is another reminder of the importance of investing in mental health services in our communities. We like to slash budgets in an effort to save costs, but when individuals like this enter our government systems in inappropriate ways, we pay for it many times over financially. And apparently sometimes with our lives.

The conservative "every man for himself" individualism ethos really ends up costing more money when we choose not to support eachother.

HIVInformed

I find it unfortunate that the article could lead people to believe that HIV can be spread through saliva. HIV can only be spread through blood, semen, vaginal fluids and breast milk. Not only do I find it shocking that the guard was put on HIV medication because of a bite, but I'm horrified that he may have died from complications of the medication. Not only is the article misinformed, but the medical staff seem to be misinformed on the HIV infection process, which is a very scary thing to read about.

Med Student

Actually, there is a theoretical, and possibly proven, risk of transmission of HIV through saliva and into a bite wound. Yes, saliva tends to have an inhibitory effect on HIV, but it does still exist on mucosal surfaces, and thus could inoculation could occur during a bite. You are correct that saliva to saliva transmission is virtually impossible.

http://www.ncbi.nlm.nih.gov/pu...

The missing link here is what happened with the medications. Side-effects of HIV medications can be quite strong, but they are rarely fatal on their own. Especially with proper monitoring, which would lead to a change in medications. We can't know because of HIPPA, but it would be interesting from a medical perspective to know what other factors contributed to this officer's death. Sad to hear all around.

Ryan Rollinson

The implication that a bite from a person living with HIV was the cause of this guard's unfortunate death is just irresponsible journalism. Shame on you, City Pages, for spreading misinformation about the virus and the way it is transmitted.

Mort

That animal would have been put down years ago in my world.

think100

the idea here is that regardless of what he's done or not done, regardless of whether or not he's crazy or mean spirited or a danger to society or whatever, the best treatment option (for EVERYBODY) is for King to be civilly committed and required to take medications to stabilize him. that can begin the long journey of tweaking a med regimen so that it works for him and for society. a jail cell, while appropriate for criminals, isn't appropriate for someone with severe mental illness because it makes it worse, and it makes the person more dangerous. yes, of course, keep him away from people while he's dangerous, but there are hospitals and institutional settings that are very high security and can treat the underlying illnesses. yes, it's expensive, but so is the fallout from this poor guard being bitten (killed). appropriate medical care and appropriate natural consequences / criminal accountability are not mutually exclusive.

Where You At?

Another shining example of "diversity" in Minnesota.

Brian

Oh, oh! I see what you did there! If a crazy white guy bites somebody it's because he's crazy. But, if a crazy black guy bites somebody it's because he's black. Thank you! It all makes sense to me now.

Beefbiffbarf

"The danger that mentally ill people in jail present is not theoretical," .... Don't you mean Democrats?

MNJean

I think what they are saying is that the system is flawed when it comes to those suffering from a mental illness. The red tape they have to go through to have a person evaluated, diagnosed and treated takes far too long and those that are trying to run these jails and prisons are not equipped properly to effectively detain or deal with these people either with proper training or proper medical help.