Bail or Die: The Choice of a Detained Man in a Broken Jail

When Jeysson Minota bailed out of jail, he didn’t know within a week that he would end up in the Intensive Care Unit at the Valley Medical Center on a respirator with a collapsed lung. He didn’t know that the pain in his chest he felt while in jail that was shortening his breath was actually a growing mass that was stretching his sternum, tearing wires inside of him from a previous operation.

He just knew, as someone who had made it through open heart surgery five years prior, that he needed medical treatment desperately, and he wasn’t going to get it in the Santa Clara County jail.

So on April 11th, 2016 his mother, who works as a security officer, gave $5,000 to a bail bonds company. But that was only the first payment. Minota and his mother owe $32,250 to the bail bonds company.

Though a staggering amount of money, for Minota, the choice to bail out was ultimately not a financial calculation. “I had to get out. The pain kept getting worse. I wasn’t getting any treatment, and I thought I was going to die.”

The Price of a Life
While the decision to bail out of jail is usually a pull from the life being missed outside — jobs being lost during a detention, bills piling up, and the basic human compulsion for liberty — for Minota, it was a push from the inside. Namely, the conditions of a jail embroiled in lawsuits and even criminal charges of guards for its’ treatment of inmates, forced him bail out, and to commit to a life of debt.

Feeling his untreated medical condition was life threatening, Minota signed away $38,000 to a bail bonds company, money he will never get back, regardless of how his court case ends up or if he never misses a court date. Prior to his incarceration, Minota worked for a tree service company. He plans on paying in installments — which he estimates may require him to pay the bail bonds company every month for the next eight years.

The practice of money bail — the process of paying a deposit to the courts, usually through a commercial bail bonds company in exchange for release from custody while awaiting trial — is being challenged nationally through legislation and court actions. Critics argue money bail is unconstitutional, discriminatory, and ineffective in impacting whether or not people appear at court dates. Last year, the federal government filed a Statement of Interest in a lawsuit challenging local bail practices, arguing that “incarcerating individuals solely because of their inability to pay for their release” violates the Equal Protection Clause of the United States Constitution. And earlier this year, U.S. Congressmen Ted Lieu, a Democratic representative from Los Angeles, introduced the “No Money Bail Act of 2016,” a bail reform bill that seeks to eliminate the use of money bail.

Advocates also point to the collateral consequences of having to stay in jail because a person cannot afford to pay bail — the loss of employment, housing, and the impact on other family members. This year, the policy organization PreTrial Justice Institute launched a national campaign called “Three Days Count” to highlight the impact of incarceration on those who can’t make bail, and are supporting states that initiate legislation to end money bail systems. The city and county of San Francisco is currently being sued by the Washington DC based Equal Justice Under the Law for incarcerating people because they cannot afford to pay bail. It’s the ninth lawsuit the center has filed in seven states.

But in Santa Clara County, the urgency to be released from custody is conflated with an even more pressing context — people die in this jail. The most recent example being from April 25th, when the jail reported the death of a 36-year-old man who, like Minota, had pre-existing medical conditions. While in-custody deaths occur in jail facilities nationally, and may not automatically equate to neglect or worse, the escalated public scrutiny on this jail is prompted from revelations of widespread jail failures after the death of another inmate last year.

In August of 2015, Michael Tyree died in custody from a brutal beating, allegedly from three correctional officers who are currently out on bail facing murder charges. Tyree’s death led to the formation of an unprecedented County Blue Ribbon Jail Reform Commission and several independent investigations into the treatment of inmates in the jails, including one by the Department of Justice’s National Institute of Corrections who concluded guards were “failing to treat inmates as human beings.” The various reports surfaced significant problems in the inmate complaint process and medical treatment, and coincided with a lawsuit from the Prison Law Office who stated jail conditions were worse than most California prisons they audited.

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Image of ads of bail bond companies and private defense attorneys that are on the wall of the Santa Clara County Jail.

So for Jeysson Minota, given his unheard calls for more responsive medical help in jail, coupled with a series of scathing investigations by independent firms where he found his experience was not an isolated one, bailing out — regardless of the amount — boiled down to a survival strategy.

When Minota decided to bail out in April, he had been housed in the Elmwood Correctional Facility, awaiting trial since December 2015. He was not there because he was convicted of a crime and serving a sentence, but rather due to his inability to pay the $550,000 bail imposed on his case. Minota was one of the over 70% of the pretrial population of the Santa Clara County Jails — meaning they have not been convicted of the crime. While there are exceptions, such as probation holds, those who are pretrial are mainly there because they cannot afford bail. While the Santa Clara County jails account for a higher percentage of the pretrial population than the nationally average, of the 2.3 million incarcerated in America, an estimated 450,000 people are locked up without having been convicted of a crime.

It Sounds Like a Clock
On Thursday March 10th, 2016, Minota started to feel chills while sitting in his cell. The next day he woke up to an intense pain resonating from his back and chest. He tried taking a deep breath and the area near his heart began to hurt. He thought maybe he just had the flu, but also knew given his medical history, it may be something more serious.

Five years ago, Minota had bicuspid aortic valve replacement with melodic valve — a rare operation, particularly for someone who was 28 years old at the time. Doctors said his heart was getting too big, that extra blood was going back into the heart, and it could prove fatal. He had emergency surgery, and would require medication and regular check ups for the rest of his life. But he was getting used to his new life with a partially metal heart. “When it’s real quiet, you can hear it knock — it sounds like a clock is inside of me,” he says.

So the unusual pain inside him alarmed him, and he filled out a “white card” — a request form to be seen by health services. But he was told by the nurse that there were no doctors available during the weekend, and he would have to wait until the Monday.

The sharp pain in his chest got worse that Friday, and he had a hard time breathing and swallowing. It would get worse as the day became night. Around one in the morning, his bunkmate saw him groaning in obvious pain and told him, “If you need to hit the button, go ahead.” So Minota hit the button in his cell for an emergency guard response.

The guards came and took him to the nurses. They checked his vitals and sent him to Valley Medical Center, a local hospital the jail transports inmates to when they need medical needs that can’t be addressed at the jail. There, Minota says, they did an electrocardiogram and other general tests to see if he was going to have a heart attack. He says he wasn’t given any sort of diagnosis, and was just told, “you aren’t going to die,” and was sent back to the jail with a pain prescription.

When he got back to Elwood, health services told him he was not allowed to take that stronger pain medicine prescribed from the hospital and would be switched to Tylenol. He says the Tylenol was ineffective. “I couldn’t stand the pain, and tried to sleep sitting up, because it hurt so much laying down.”

So on the evening of the March 13th, he hit the button again, and once again was taken to Valley Medical Center. But this time, Jeysson knew he had to be more proactive in communicating his concerns to the doctors and requested a computerized tomography (CT) scan. It is a result of the CT scan that his medical report states they found, “a small amount of high density or stranding in the anterior mediastinum near the aortic arch which is more prominent compared to prior and could represent a hematoma.” Meaning, the wires from when they opened him up before were cutting into him. There was also something abnormal found on his heart — and it was growing. The doctor at Valley Medical Center told him and the escorting guard that the medical staff at the jail needed to review the CT scan.

But once back in the jail, according to Minota, the doctor did not review the CT scan findings and told him he would not be given the pain medication prescribed by the doctor at Valley Medical. He says the doctor then had guards escort Minota out of the medical room. “He told them, ‘he just wants narcotics,’” recalls Minota. In response to a grievance form Minota wrote after being sent back to his cell with only Tylenol, the jail staff wrote, “Sir, you met with MD yesterday and became quite aggressive.” Minota, a soft-spoken 33-year-old Colombian immigrant, admits being frustrated, but denies the caricature as “aggressive.”

He went again to see that same jail doctor on March 17th, hoping that he had reviewed his CT scan this time and would offer a different prescription or treatment approach, but was told the same thing. Over the course of the next few weeks, he went through this process multiple times — white cards, waiting to see the doctor, grievance forms, then ultimately being told he couldn’t get any different treatment.

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Copies of grievances and white cards from Minota.

During this period, Minota even wrote a letter intended for the judge presiding over his case, imploring him to intervene. In the letter he writes, “It’s been two weeks of continuous pain, I can’t sleep, I can’t eat, I lost six pounds already and doctors at Elmwood don’t do nothing for my treatment, and Tylenol doesn’t even help with the pain.” He concludes the letter by asking if the judge could release him so he could take himself to the emergency room. Minota’s defense attorney declined to turn the letter into the judge.

So by early April, Minota decided to switch strategies. He requested another doctor in an area of the jail that is closer to him. This doctor reviews the CT scan, and according to Minota, is amazed that his medical conditions are not being taken more seriously. “He seemed angry that my condition wasn’t being looked into or treated.” The doctor ordered another trip to Valley Medical Center, but this time for a more thorough examination. But when Minota is taken to the medical area to be transported to the hospital, he is told there isn’t enough staff to take him there. He is told he will have to wait even longer because they have to do lab work at Elmwood first — even though Minota says he had just finished a round of the exact lab work they were proposing to do.

Discouraged and tired of filling out white cards and grievance notes, on an April evening, Jeysson Minota sat on his bunk and listened to his cellmate read a jail investigation report out loud. The findings are from a study solicited by the Blue Ribbon Jail Reform Commission called the Mascone Report. “He was reading it, and starting see a lot of complaints about medical, and wanted to read it to me because he said it was about stuff happening to me, so I just sat there and listened.” The report was the result of 11 attorneys interviewing 944 inmates, families of inmates, and guards at the Santa Clara County Jail. One of their key findings was that, “Inmates report avoidable delays and deficiencies in medical care.” Culling responses from interviews, the report goes on to say, “Inmates consistently complained of long delays and outright denials of access to medical and dental care. Common complaints included difficultly in getting medical attention, appointments, and prescriptions.” The report was shared publicly through the commission, and was also shared with inmates. When Minota listened to the report, told to him page by page, he hears his own story echoed in the voices of other anonymous respondents. “What other people were saying from other parts of the jail was exactly what was happening to me. I asked him to circle complaints that sounded familiar.”

At his next court date he gives the report to his attorney to give to his mother, Luz Dunn. “I saw the parts where he circled cases, and they sounded like what was happening to Jeysson,” says Dunn.

But Luz already knew there was something seriously wrong with her son’s health. At visits he was pale, his breathing was labored, and his face could not hide his pain. “I just had never seen him like that, he never complains. When I saw him cry in front of me, telling me he may die in there, I was just thinking I had to do something.”

So simultaneously, Minota from the inside and his mom from the outside, decided the only way to get proper medical attention was to get him out of jail. But with bail set at over $500,000, this was a family decision with lasting implications. It would mean paying a bail bonds company around 10% of that total. They agreed there was no other choice, and Luz paid the first installment of $5,000 to a bail bonds company. While practices of how much a bail bond company demands upfront, the industry has boomed in Santa Clara County. In 2015 alone, the bail bond industry posted $198 million bail, meaning they collected $19.8 million from families like Minota’s. Luz put it all on her credit card, and worries about the interest running away from her. Plus, she says, “$38,000 is not behind the door, and it’s not falling from the trees,” As a single parent who also has a 10-year-old daughter, she has been trying to get more hours at work to help her son pay off the debt. She says she is considering having her daughter live with other relatives in Florida in order to dedicate more time to work.

From Jail to the ICU
When Minota was released from Elmwood Correctional Facilities in the early morning ofApril 11th, exactly a month after he first felt symptoms, he already had a court date scheduled for that day. So when he got out, he went to court and then straight to Valley Medical Center. The emergency room doctors immediately checked him in, put him on a pain medication regiment, and scheduled pre-surgery testing. He stayed there until May 14th, 2016.

Outside of the issue with the wires, the main concern the doctors had was the growing mass attached to his heart. And given its location and his past operation, it makes surgery particularly life-threatening. In the second week of his stay, they attempted a biopsy and made contact with one of the nerves which collapsed his lung. He spent two days in the Intensive Care Unit.

Minota recovered from the collapsed lung and was ultimately discharged. His doctors say his aorta has an infection, which is causing the mass. He is currently living with his mother, and is on a continuous antibiotic and pain medication regiment, while the doctors monitor the growth. In a letter addressed to the courts, to share what Minota would need just for court appearances, the main surgical doctor wrote, “Jeysson Minota is currently an admitted patient at the Santa Clara Valley Medical Center…He has been undergoing an extensive workup for a mass in his chest and has had a complicated hospital course, including an ICU stay.” The note, goes on to say what medical support Minota needs, including antibiotic infusions and reads, “Missed doses could be very detrimental to his health and may necessitate hospitalization, or could result in permanent disability or death.”

Minota’s hopeful recovery coincides with two county efforts to address the issues that are deeply woven into his story — reform of conditions in the jails and changing the money bail system. Though the Blue Ribbon Commission for Jail Reform has concluded, they have delivered a litany of proposed changes to be deliberated on by the Santa Clara County Board of Supervisors who are responsible for the jail. Included in the recommendations is the implementation of an independent inspector general to oversee the jail and a revamping of the complaint system and medical delivery system.

Meanwhile, the Board of Supervisors also created a Bail and Release Work Group composed of county stakeholders and community representatives. One of the suggestions currently being reviewed is tactics to reduce the county reliance on money bail.

On April 25th, while Minota was still in the hospital, he received a call from his Aunt who just read an article in the Mercury News. She read about an in-custody death of a 36-year-old man who had pre-existing medical conditions. While the article had very few other details, the news hit eerily close to Minota. “I felt so bad for that person. I lived that. I can imagine what they were thinking. That could’ve been me. Good thing I got out of there when I did.”

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