Trial Coverage: Week 2

He was in 17 foster homes from the age of eight; he was in William S. Hall Psychiatric Institute, and by the time he was 18, he was incarcerated.  He described his current medication as having the effect of "slowing the voices down."

Inmates consistently described problems with their prescription medications. From some not seeming to understand them or what they are for, to some who have side effects from many of the drugs, to others having effective drugs changed to those that are not as effective because the effective ones are no longer on the prescription formulary, to many saying they do not receive them regularly.

Wilson was asked "How long he had gone without meds" to which he testified, "between five days to a week. He said "I have withdrawal and end up on Crisis Intervention (CI)."

The mentally ill inmates described their counseling sessions consistently as very short – ranging from two to six minutes; with the longest interview length described as under 10 minutes. For the most part the counseling sessions were described as being through the cell door with no privacy or confidentiality, with inmates and corrections officers able to listen in.

The inmates described reprisals and humiliation from shared confidences, not only from other inmates, but from corrections officers as well. They described difficulty making requests to see their counselors or psychiatrists.

Crisis Intervention (CI) continues to be described by numbers of inmates from various prisons as a response to an attempt to hurt themselves or others. The mentally ill inmates are most often put in CI status for self-harm or threats to themselves. Confiding to your counselor that you feel suicidal is sufficient to be put on CI.

CI differs some between institutions, but much of the treatment is consistently described by the inmates. Most often the inmate is stripped naked, held in a bare concrete room that is filthy with blood and excrement of the previous occupants; more often than not the inmate is not given a blanket and must sleep on a bare cement floor, or in some prisons a steel platform. The room is kept freezing cold and, according to Wilson, "They take all your property out of the room; take your boxers, shower shoes and leave you in the cell; sometimes with a suicide blanket; most times you go days without it. They don’t give you no tissues to wipe yourself… you have to use your hand – whatever…"

He also described being left in the shower stall for four or five hours.

When asked what he perceived to be the reason for CI, he said "to help protect the individual from harming themselves." When asked "Do you feel it accomplishes that?" He said, "I don’t believe it does, because the counselors don’t spend enough time … They don’t help address the situation that led up to the CI… they deny you use of blankets and tissue to punish you – to force you not to go on CI."

The length of the time in a CI cell was described as ranging from 24 hours to over three weeks.

Wilson described a suicide attempt where officers found him hanging in his cell and cut him down. But before they did, he testified that they gassed him (used chemical pepper spray) while he was still hanging.

Describing what it felt like to be gassed, Wilson said, "Not very good. The gas they use – of course it burns; irritates my skin; they don’t give you a shower to clean it off. They had a capacity to turn off the water after they gas you – they turn off the toilet and water."

Albert Kelly described having mental health issues since the age of six. He is in prison for several charges, including homicide. As a child he watched his father stab his mother 20-30 times in the head, resulting in her death. Kelly has been on the mental health caseload since arriving at prison.

He says his illness has been diagnosed as paranoid schizophrenic and bipolar and that without his medication he becomes paranoid and hallucinates: "personalities talk to me, in addition I become depressed."

He described a pattern of being sprayed with chemical sprays and locked in CI frequently. H said he was sprayed "for not walking fast enough." Another time he felt he was sprayed for no reason… "was confused; everyone was being loud; I was lost in my thoughts; confused… I was crying; he said I’m going to spray you again… why did he come – I became paranoid. I didn’t understand why officers were coming to take me; I didn’t get a shower any time after being sprayed."

He described the misery of the CI cell as having "No mattress; shoes or security blanket… you sleep standing up to try to stay warm; cold – steel bed or cement floor… cannot get comfortable; forced to stay up… that time was 30 something days… sometimes 4-6 days."

Kelly told about being "jumped on real bad by officers at Supermax unit" saying they were spraying at the door "real fast. I screamed I want to see my caseworker… they came in shields… seven to eight officers… they said it was because I refused to be handcuffed… you gotta understand… if you are real nice I’ll catch on… how can you expect me to obey if you act like you gonna kill me? I told them I wanted to see my counselor and told them I thought they were going to kill me. Next thing I know they just rolled in.

"They took me to the shower; must have knocked me out," Kelly testified. "I woke up in the shower on my knees."

Inmate Barton seemed agitated as he testified; he stated he has set his cell on fire in the past and has a diagnosis as a paranoid schizophrenic. He rocked slightly as he looked around and spoke about his ability to see fire and shadows all through the courtroom. He says the fire floating all around his cell burns him while he sleeps and he hears voices.

He said his medications are not helping control the symptoms: "Not at all… ain’t stopped. Been on ’em on and off… not working; I’m put on another or they might increase the dosage… then he like come back in 90 days and check the progress… but it’s the same. I don’t like taking them… so strong I might be… boom (leans forward quickly in his chair)… makes you dizzy and fall. Nobody check you."

He described a medication that stopped the voices as having worked but had terrible side effects. "I took it but for three days I couldn’t move… then boom I’d fall."

He described swallowing six razor blades: "I was in my room three weeks straight; so paranoid I don’t want to be around staff. In 2001, they pushed me down stairs. I don’t even go out for showers. No recreation; I’m in cell 24 hours a day – I read and write folks; the other half of my day is pacing back and forth back and forth just walking."

He said he lost visitation privileges. "My last time to see my son was 2003 – he is 21 now."

He described seeing his counselor, through a "locked solid steel door with bars… solid steel window… take the locked steel off; they don’t open the window except for laundry/sheets out. Or for the library to give you books; how do you communicate with a counselor? It’s so loud in that house – how can you hear?"

Christopher Pettit described being in restraints at Gilliam Psychiatric Hospital:

"I had cut myself with a paper clip I’d found on the window sill because the voices were bothering me so much. They put me in four-point restraints. They forced me to lie down on a steel bed on my back; my hands and feet were shackled with leather restraints connected to a piece of steel under the bed; I was placed there for 24 hours. It bothered me that (I was) laying in urine. It was cold, it stunk and I was lying in my own urine."

Jonathan Roe has generalized anxiety and bipolar and antisocial personality disorders and began cutting himself in 2005.

He described getting sprayed with CO spray (pepper gas) at Broad River and not being allowed to wash the residue off for about a week. "I was not allowed to wash off or take a shower. I was kept in a locked up cell… the officer told me to deal with it – that I shouldn’t have done what I done.  It feels like you are set on fire; it burns your skin… causes burning of eyes… face… the gas will blister you if you don’t get it off… I tried to get it off in the holding cell but had no water so I washed in the toilet… it was burning really bad. I did the best I could, but I was denied access to shower for a week. It blistered."

When asked if he reported it he replied "They had a nurse look at me before putting me in lockup and the nurse said I was fine."

He described being put in the restraint chair after he cut himself twice.

He was shackled to the chair, with his hands and arms outstretched behind him and to the back – attached to the bed in a way that expert corrections witness Steve J. Martin has testified is not the intended use of the chair and Dr. Jeffrey Metzner said is dangerous because of the risk death from deep vein thrombosis.

Roe was left in that position for eight hours without medical attention to the cuts.

He testified that inmates must request medical assistance through the use of "sick call" staying up until 2 a.m. to sign the sick call roster "because the policy is that you have to sign the sick call roster whenever it comes around. The officer who comes around with roster told me they do that to limit the influx."

If inmates are sleeping, which he says often occurs because his medication makes him very sleepy, he has to fill out another form, which takes another week or two.

Defense cross-examined the witness about benefits of counseling programs he is in; however upon redirect it was established those programs had begun very recently.

The testimony was about topics of medication; a lack of privacy in counseling, limited access to counselors and conditions in the prisons. There was much testimony about treatment administered to control the population, such as restraint chairs, gassing with pepper spray and being kept naked in "very cold, filthy conditions."

Several testified to being pepper sprayed while in their cells or the restraint chair, being kept naked and cold for days or weeks while in what is called "Crisis Intervention" or CI. One might presume that CI is for the inmate’s own protection from self-harm, but inmates testified that when an inmate suggests harm to himself or others they are held for a period of up to several weeks in a condition that consists of being kept in a cell without clothing, oftentimes not even a blanket, having to sleep on the cold cement floor strewn with feces and blood of previous occupants. Many inmates say they are not fed regularly and some were not given water.

Lee County Correctional Center was identified by many as having the worst conditions during CI.

One inmate described sleeping on the Styrofoam food trays that the officers do not pick back up to insulate him from the cold. Another described the cold as being all year long – "they blast the air conditioning even in the winter." Each said it was nearly impossible to sleep during their time in CI, several describing how a lack of sleep exacerbates their mental conditions.

Mentally ill inmates told of being sprayed with gas for asking to see their counselors. Counseling sessions are not held in private, but are shouted through the cell doors, making the inmates’ concerns able to be overheard by other inmates and corrections officers (CO’s). Two inmates testified about that confidential information being used against them by officers; others said they don’t reveal information about how they are really feeling because "if I tell them I want to hurt myself or someone else, they will put me in CI."

One mentally ill inmate, whose conviction was for assault and battery of a high and aggravated nature, and who is held on a maximum security unit for the past seven years after two escapes was asked to describe his experience.

"Don’t know how to explain it. I stay in my cell," he testified. "There isn’t any rec (recreation – an hour a day out of the cell for exercise). I’m fully restrained; black box; leg irons. I ain’t been out none this year and only two – four times last year… but the recreation room is not much different than my cell… 10x12 or 14… couple feet bigger than the cell… solid concrete walls; steel grated roof overhead. You don’t get to see nobody – no people. The only time you see people is when officers put you in there. You just see the officers, then they close the door and close another door -- two doors between.  I’m in restraints – two pairs of handcuffs; black box, waist chain, leg chains and more."

The access to counseling during detention in CI is often less, rather than more, according to the prisoners in crisis. They testified to a range of time spent at their cell door with counselors between two and six minutes.

The chilling effects of CI appear to go beyond the cold cement floor on their naked bodies. The effect on their ability and willingness to talk to counselors and psychiatrists while on CI was attested to as learning "That I shouldn’t confide in them… or I’ll get on CI."

There was a sense at one point in testimony that the fear of reprisals for testifying was very real for these inmates, which was addressed by the Honorable Judge Baxley, who assured the inmates that he would not tolerate any reprisal.

Several described how it feels to be sprayed with pepper spray: "It burned. It burns for days. Even after you are out of the restraint chair – they spray you, place you in restraint chair then let you out after four hours to shower, even though I asked for a shower before. No - it burns like fire."

One inmate described a time he was "jacked up" – where his restraints were put on incorrectly – with a  black box restraint, two pair of handcuffs; leg irons, belly chain; explaining "they twisted leg irons around my arms … pulling on the arms and binding my wrists even more; running around the leg irons tight so I have to bend down." 

He described being wet from a flooding sprinkler head and left there in his boxers for 30 minutes.

"Then they took me out to the recreation area open to the sky at 2 in the morning for an hour with the temperature in the 30s."

He described feeling very cold, saying he was, "Freezing… shaking – couldn’t stop shaking. The correctional officers were standing inside the door watching me."

The inmate said that resulted in an Internal Affairs investigation. The inmate reported that he was told that, because the supervising officer was no longer at the department, "no further actions were needed."

Defense counsel cross-examined that witness on his multiple escapes and disciplinary record, as well as the lawsuits he has filed on the basis of "cruel and unusual punishment" for lights being on 24/7 in his camera cell to prevent escape. That appeal is up for consideration by the United States Supreme Court.

Other efforts to single out inmates were testified about, including one inmate who said he is forced to wear a pink jumpsuit because he was told a "pervert is put in pink."

Another aspect several testified about revolved around lack of correctional officers’ response to requests for medical care, and in two inmates’ statements, that they had been assaulted by officers causing pain and bodily harm.

One testified to having a corrections officer kneel on his hand while putting him into the restraint chair, breaking it, then being left in the chair for four hours despite asking for the nurse. He stated he was not taken to the nurse for three days at which point he said the hand was swollen to five times its size, which he attested caused gasps from the nursing staff. He said she thought he needed to go to the hospital but instead his hand was wrapped and he was sent back to his cell. Days later he was given medical treatment.

Another inmate, an asthmatic, described having been gassed without being allowed access to his inhaler about a month ago. "My cellmate busted the window out; I was in the room; I got gassed along with cellmate; my cellmate was charged, not me. It was burning really bad."

One of the final statements of the day was from an inmate who described trying to get medical intervention for another mentally ill inmate who had just returned from the hospital. "He was gurgling and trying to breathe. He wouldn’t answer; he was having some kind of seizures. I tried to knock on doors and get CO’s; no one showed up. We got louder and louder and screaming medical emergency. I took a wheelchair part and beat on the door for an hour before the officer came. I have a digital alarm and wrote the times down."

Jamal Rivers, Steve Patterson, Curtis Boyd, Wayne Thomas, and Damon Howard each testified about their convictions, diagnoses, medications, their understanding of their diseases, and their personal interactions with counseling and psychiatric staff. They described at length the conditions of prisons in various units and testified about their treatment and the effect of sanctions on them.

Rivers described being "gassed while in lockup" for wanting to speak to his attorney. Many said it could be months without a shower. They described being kept in filthy solitary units with no clothes or blankets with the temperature "freezing… was kept cold all year" without a mattress or blanket and sometimes without food or water.

Rivers, who testified he believed that there was a snake in one cell he was placed that bit him, also said, "They wouldn’t feed me sometimes; wouldn’t give me a tray."

Several inmates testified about hearing voices. Most described intermittent, irregular, short visits with counselors in a very public setting with no privacy or confidentiality. One testified that what was shared in counseling was overheard by security officers and used against him later.  The witness continued his testimony, saying that "it makes you afraid to say what you want to say for it will get out."

Counseling and visits with a psychiatrist were described as intermittent, short, often in earshot of other inmates and correctional officers, not kept confidential, and often curtailed or interrupted. Medication dispensing was said to be irregular, except from those who are at Gilliam Psychiatric Hospital.

Cells were consistently described as filthy, often with blood and feces from a previous occupant on the walls and floor. In Crisis Intervention (CI), the inmates testified about sleeping on steel or cement slabs or on the floor without clothing or blankets in most cases.

Several inmates said water supplies to the toilets and sinks were kept off and they were provided no water to drink.  One was kept in a small room with no sink or toilet for two days with food, but no water.

Supermax section of Lee Correctional Institute was described as "Terrible… we were gassed more often."

Gilliam Psychiatric Hospital was described as being "much better" because it helped with "the voices," however the inmate said upon return to Lee County Detention Center, "It was worse… they would… they [staff and counselors] would be hostile" because he said he was sprayed more upon return despite his behavior not being any different.

Steve Patterson likes his prison job as a clerk. He also says he hears what others don’t hear and sees what others don’t see, and has since the age of 11. He says his medication helps muffle the voices so he can deal with them better.

He first stabbed himself at age 12; was hospitalized in a psychiatric hospital where a suicide attempt was foiled by his roommate. He says he has to bleed the voices out.

Like several others, he described the restraint chair and being kept in a strip cell without a blanket, sleeping naked on the cold, dirty cement for weeks at a time.

He described being put in the shower at Lieber Correctional Institute for talking about the voices, where he was kept from 8 a.m. until shift change at 5:30 p.m. without food or bathroom breaks. He was put in the restraint chair five or six times. One time he was kept in the chair for 12 hours for threatening to cut himself. During those 12 hours he had no clothes and was given only one bathroom break.

Curtis Byrd – Kirkland ICS – described himself as a "paranoid schizophrenic, depressed and delusional" and said his symptoms started at age 21 after an auto accident while he was in the service.

He described being in Crisis Intervention with no clothes and no blanket in the cold with no light or window. He described an experience of being gassed in the face for asking if he could clean his cell.

He described the chemical spray as "horrible… you can’t see, you are gasping for breath – coughing."

He also testified to dirty cells, no showers, no time outside of the cell, "not being fed right" and no access to counselors.

He described Lee County Detention Center as "horrible, humiliating; treatment" that had a "bad effect" on his mental health.

Wayne Thomas described never being allowed to go to recreation or group therapy. He compared Lee County Detention Center to Lieber Correctional Institute, saying, "Lee County Detention Center is filthier… when you walk on ‘the rock’ [the lockup area with cells] you smell feces. Filthy dirty… the cleanest I could get it was still nasty; I tried to scrub floors and walls."

He described being sprayed with gas twice at Lieber Correctional Institute, "once a short warning shot through the food service flap, but the first time was up the nose dead in the face while I was strapped in the restraint chair - fully shackled, handcuffed and strapped in."

He described how after four hours in the chair he could not walk because his ankles had swelled. "Lt. Lloyd, who no longer works there, she said ‘stand up inmate and move’ but I couldn’t step in the shackles."

He testified that "she put me back in the chair roughly… very rough… and an officer put his mace in my nose and sprayed me… then left me just like that for about 20- 30 minutes." He said they finally took him out because "they couldn’t even finish buckling me up because there was so much gas."

He described the pain of being sprayed as "indescribable… what I would imagine salt on raw flesh feels like. You will burn – that first burn for probably about two hours… then it will subside… it is oil based… worst thing is to try to wash it off; it gets in your pores… can inflame… goes on for three days."

He described another holding cell where he was kept for several days without clothing or blankets; there was no bathroom facility in the room, and he said he was given nothing to drink for that period of time.

On cross examination the attorney said, "You denied having mental health issues," which the witness denied, saying "it is known through any record that Wayne Thomas has a mental history."

Although the inmate ultimately admitted he did, when asked about whether he knew the rules about fighting in prison, he replied, "If I got someone about to attack me, I don’t stop to say, ‘should I get into this fight?’ - I’m going to defend myself."

Damon Howard has been in prison for 16 years and stated he had not gotten any mental health care until he got sent to Evans in about 2000. The inmate was sent from solitary in Lieber Correctional Institute to Gilliam Psychiatric Hospital about two weeks ago. 

The testimony of Mr. Howard primarily consisted of his extensive description of the voices and his belief that devices are implanted in his body that enable him to see anyone anywhere in the world.

He testified that he was recently tested at Gilliam Psychiatric Hospital and that he understood his duty to tell the truth.

When plaintiffs’ attorney was asked by Judge Baxley what the witness was intended to demonstrate, the plaintiffs’ attorney answered that Mr. Howard was called to give the Court an opportunity to observe the mental health condition with which Mr. Howard has been living in 23-hour lockup for the past 12 years.  The defense moved to disqualify Mr. Howard as a witness alleging he is incompetent.  Court denied the motion, ruling that "Mr. Howard would not be competent to defend himself under criminal court standards, but finds he is competent to testify in a civil proceeding about where he is, where he is housed, and what he was experiencing."

Martin continued to emphasize that he is not against the use of gas by saying, "On the record, I have not criticized the need to use in this particular case some level of force; what I’m critical about is the amount of chemical agent deployed."

The Defense countered that even more had been used on others with no effect.

Regarding Martin’s concerns about use of the restraint chair, he was adamant about the fact that it should only be used for the least amount of time to obtain control, and said that the "primary issue is that it was used as a rule for a minimum of four hours or more -- that and it was used in the spread eagle position."

The defense countered by asking "if there is some degree of risk of harm the lesser of the two evils is to keep the inmate in the chair longer than letting go too soon."

Martin answered that was true, but when asked if he sees the crucifix position at other institutions, he answered no.

When asked whether it presented a lesser risk of harm to use gas or the restraint chair than to allow the inmate to continue to cut or harm himself, Martin replied, "Am I to take that as the only two options? I don’t believe that is appropriate to state it that way."

He stated that "When you are analyzing use of force, that is the dilemma – not reducing it to the lesser of two evils… that is not the appropriate analysis.

He continued, "That analysis starts with whether alternate measures could be employed; then if there is a need to use any force and would proceed from that point through what the minimum amount of force would be."

1)      Mentally ill inmates – by definition and class – you need to gauge effectiveness of spray on the inmate; it might be contraindicated or ineffective because he is psychotic.

2)      It is pedestrian thinking to say "if a little didn’t work, more must be better."

3)      These are all tactical weapons intended to incapacitate aggression – intervention is to neutralize the behavior; not to cause pain or punish.

Regarding the extremely large doses of OC spray used in the SCDC, Martin testified that according to the N.C. Medical Journal, "Dangers caused it to cease to be used in training programs"

He stated that he took exception to the defense characterization of the spray as "mild," because it can cause ocular damage; pulmonary edema and other medical issues. It "increases risk substantially to be exposed to OC spray," Martin said. He also said it concerned him that the studies being used to justify the spray were based on applications that he says are far removed from the amounts used by SCDC.

When asked "Have you ever seen the use of OC spray to the extent you have seen used in your visits to other states as you have in S.C., he replied, "I know of no instance that I recall when they used more than a third or fourth half-second application of a burst. In New York, where OC spray was frequently used, I don’t recall a case of more than 1 or 2 ounces used (the equivalent of 56 grams).

Data supplied by the SCDC, evaluated by Martin through records and video, showed amounts between 200 and 400 grams used, which he said were far over recommended amounts.

He also found instances where SCDC "records were tampered with and falsified; which makes it questionable."

Martin indicated that a lack of charges of excessive force was a "red flag" that something is wrong systemically at SCDC.

"A system of this size (mid-size setting with 23K inmates)  even with a well-trained and supervised staff, you will have instances of excessive force – it is the nature of the beast  - we are humans and they occur; you cannot find a system that does not have a few," he said. "It is a huge red flag when reports contain no cases of use of excessive force.

He said it is a "huge consideration if the instances where the parties were excessive and they were left untended and not sent for review or action, then the risk is substantial for abuse [because] in every instance identified pattern and practices of use of excessive force – that fact is confirmed – practices that have been left unchecked and uninvestigated and unmanaged whether through a culture of silence or a culture of understanding – there are clear cases where excessive force are left unattended.

"The cases I selected were fair representations of cases – I did not cherry-pick these examples. Counsel had access to the documents – in fact, they provided the documents."

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Afternoon session: Ms. Joy Jay, M.Ed., Executive Director of the S.C. Chapter of Mental Health America will testify for the plaintiffs.

Ms. Jay has a special education bachelors’ degree and an M.Ed. in counseling; much training and experience in the mental health field (34 years). Started in 1978 in children’s’ programs; later worked with chronically mentally ill adults.

Joy Jay describes the many challenges mentally ill individuals face on a daily basis.

She described what she does to try to assess their illness; what type; how symptomatic; medications; their understanding of medications; if they are compliant; where they were before jail in order to make best placement when they come out.

Jay interviewed 50-60 inmates at Perry and Graham to determine what services they receive. She noted that many of the clients that used to be served outside are now in prisons.

She assessed:

1 – If they could name their illness; what meds they were on for their illness;

2 - If they had been treated for mental illness before prison;

3 - What kind of individual or group therapy they were receiving in prison;

4 - Symptoms of their illness; and

5 - How they felt prison was affecting their illness.

Jay said "We would talk to the inmate at length about what they thought their treatment had been and what they were getting or not getting for treatment. Always the goal is to do a treatment plan for that client; and have it written up that he understands and is a part of it, so you can successfully treat someone with mental illness."

She said "All but two felt they did not have access to their counselor; they felt as if there was little or no privacy with their counselors; that there was lots of turnover in staff; and were no counselors at Perry for a time. Group counseling was rarely offered, which I think is critical in this setting. I felt there was very poor discharge planning; the treatment planning was the most outrageous."

She said these clients could not follow their treatment plan because they didn’t know they had one. She said "When someone is openly psychotic, they are not getting what they need as far as treatment. Delusions and voices indicate one is not in touch with reality. Those people need immediate services; sometimes hospitalization. I felt as if they were getting little or no counseling services; based on their lack of knowledge of mental health - even basic knowledge."

Jay said when she asked one social worker about her client’s discharge plan, she said "we’ll just not worry about it; we’ll call his daughter when he’s ready to get out."

Jay said she was concerned because of the inmate’s anxiety disorder. Jay testified that she herself got him into a hospital upon discharge – felt as if he’d be returned to prison if he didn’t have support; It was setting him up to fail. Jay went to the prison and picked him up and took him herself to the hospital, and noted he is now a member of the community. Jay recommended that counselors should start calling to set things up six months in advance.

She said she had gotten a grant that offered support for those services to SCDC staff, but no one took advantage and the grant funding expired.

He reiterated that according to national standards and the state’s own corrections policy, restraint chair use is for control only; punishment uses are strictly prohibited. Policy limits its use to imminent danger, risk of harm to self or others, or damage to state property. Martin said "restraints should not be applied in a way to cause pain, and no inmate should be forced to stay in them for a prolonged period of time."

National guidelines he quoted say that restraints should use the least restrictive form; and only for as long as necessary; and never for a prescribed period of time. Additionally a person should not be held in unnatural positions, such as hog-tied face down or spread-eagled.

When asked about particular uses of restraints, Martin testified that Warden McCall at Perry Correctional said in his deposition that standard use of the restraint chair is four hours, and is rarely, if ever less than four hours because it is the standard procedure and practice in place.

Multiple instances were described in which an inmate was kept in the restraint chair for several four-hour sessions in a row, despite being logged as quiet.

Martin noted that logs "are suspect" when the required 15-minute notations are all made at exact 15-minute intervals. When asked why that was unusual, Martin said, "As officers attempt to make rounds as required, it is unusual that they would make a series of 16 rounds precisely at quarter-hour intervals. I don’t recall ever being able to accomplish that."

Martin cited case after case of logs for inmates indicating compliance but continuing to be restrained for four or more hours. He stated that "at some point a judgment could and should have been rendered that control was established and he should be released or transferred to a more appropriate setting than the restraint chair."

He said the practice suggests that the four-hour period they set in place is a minimum irrespective of whether or not control has been established. He cited several cases where inmates were kept for eight hours, and one, whose log entries indicated he had been quiet, was restrained from 6:30 at night until 6:30 the next morning for a total of 12 hours.

When asked if he found that use of restraint chairs involved unnatural positions, Martin stated, "It was apparent that inmates were restrained on occasion in a spread-eagle or crucifix position for hours at a time."

Martin said he had never seen this practice used in the U.S. as a routine practice during his 40 years of experience in corrections administration.

He said, "It was demonstrated for me at Perry Correctional, and I was unable to determine what tactical or restraint advantage was opposed to the proper use of the restraint chair."

When asked to describe the technique of restraint staff had demonstrated to him, he said, "the inmate is placed in the chair in the nude in a spread eagle position – arms stretched back and down and cuffed to the bedpost or bars."

He said, "The chair immobilizes the body, so having some minimal garment does not compromise security. That has to be rigged. No manufacturer of a restraint chair provides a way to cuff to the bed or cell."

One case involved an inmate who was self-mutilating. He was put in the restraint chair for at least eight hours in the crucifix position and cuffed to the bed with his arms behind him. That inmate lost feeling and circulation in his limbs; and had been restrained in the chair 13 times in a seven month period. 

Martin was asked why that would be done. He replied, "I have not been able to determine what use that would have other than to cause pain – and it does seem to do that. It should be used in a logical fashion. The basis for use of the restraint chair must be related to the need for control, per national standards."

Martin detailed the difference between appropriate use of the chair to regain control of an inmate versus other avenues of control that can be attempted. He emphasized that the use of the chair is viable when other options have been exhausted and danger exists.

During a recitation of numbers of cases of what Martin considers misuse of the restraint chair he reiterated a point made by Jeffrey Metzner, M.D. who had testified last week about the need for constant observation of someone in a restraint chair. Martin said, "The fifteen minute observation [intervals] are problematic. If you place someone in a restraint chair they need to be constantly watched. Too much can happen quickly if the inmate is not being observed."

National standards call for constant observation when inmates are in full immobilization restraints.

Plaintiffs showed a video of one inmate who, after four hours in the crucifix position in the chair, asked "who said I don’t want to come out?" multiple times calmly in response to a guard telling the camera that the inmate wanted to stay in the chair for four more hours. The inmate was strapped back in. 

Martin described him as being, "rather casually engaged in dialogue about what the staff was doing" "What’s going on, I thought I was coming out?" the inmate inquired. Martin described the inmate’s behavior:  "He was no trouble."

Another video showed an extremely thin and pale inmate in the chair for four hours and who remained quiet. Upon release he appears weak, seems to be in some pain, and had to be helped by several officers out of the chair to his cell. When told he is being returned, he quietly pleads and cries almost inaudibly, begging them, "please don’t put me back in that chair."  He asked, "If you put me back in the chair please don’t put my hands behind my back," and "don’t put my arms behind the chair like that, please," followed by a plaintive, "please, it hurts." His begging continued for several minutes, finally saying, "Please I can’t move…"

When asked why Mr. Martin selected that particular video, he responded that "The need to restrain is a situational control event; if there is a need, restrain them, incapacitate them until you have control, and then get them out of there. This violates all five elements in a blatant disregard of sound practice in regard to immobilization restraints."

Martin’s opinions were read into the record that the restraint chair should not be used:

• For periods longer than necessary to gain control.
• In absence of immediate need to immobilize.
• In a manner that creates pain or discomfort.

Martin stated that the mentally ill inmate population at SCDC is subjected to use of force at a rate nearly five times greater than the general population. Despite standards set in the 1960s, mentally ill inmates are much more likely to be segregated, which he says should be for the shortest period to accomplish the goal; and not over 30 days. Martin reviewed over 100 cases of segregation and said that sanctions involving wholesale imposition of loss of privileges were also used to excess and that inmates are about twice as likely to be in lockup status if they have a mental illness than if they don’t. In addition, they are more likely to lose "good time" if you have a mental illness.

Even when an inmate has been deemed not accountable for his actions that led to disciplinary infractions, the corrections hearing officers have been instructed to impose sanctions as normal.

Individual cases of mistreatment were reviewed, including that of one inmate with schizophrenia and mental retardation. That inmate was left for days until a nurse visited and noted a terrible smell from the cell, which contained partially rotting food.

The report said she noted his breathing was labored; he was face down with no clothing or security blanket, and was covered in vomit and feces, which had been there for some time. She reported that the stench was the worst smell she had ever encountered. The inmate had been observed having been thrown onto the bare concrete with his hands cuffed.

Martin was asked, "How would you rate someone being thrown into a cell handcuffed?

He said "It raises the risk of injury exponentially because he cannot break his fall."

The officers would not comply with the nurse’s request to transport the inmate to the hospital. Inmates were rounded up to move him. He was brought in at 2:20 p.m. with a body temperature of 80.6F indicating hypothermia and pronounced dead at 5 p.m.

Martin testified, "One thing I want to make clear to the court is that during the course of this investigation the investigator sought to establish the supervising official who placed the inmate in the status that started this series of events, but could not find nary an official – as remarkable as that can be – who would admit authorizing putting the inmate in this status.

"There is a requirement for frequent supervision," he continued. "This is driven by active supervision – in order to allow an inmate out at the earliest possible point. Clearly supervision was not provided after he was in the position; and we could not find anyone who would say they had authorized it. What precipitated it? Who observed it? Who supervised it? The investigator asked everyone – no one would acknowledge it.  The placement officer would have had to assume responsibility to assure supervision would be approved; pretty weighty responsibility and decision for someone of that rank."

Another case involved the case of an inmate who had been dead for at least 12 hours, however, Martin said during that time "officers made the rounds and entered logs that he was alright; he was found dead on the floor; but officers did not make a report that he was unresponsive."

Yet another case involved a cell check log that indicated the prisoner was "checked in bed" – that is very suspect since he was found on the floor of the cell and the cell checks were at time the medical examiner determined that the inmate was already dead.

When asked if the officers were consulted, Martin testified that they admitted "they were false entries."

Another suicide investigation focused on the cell check log as well, which Martin stated was "clearly a false log with an entry made at 6:30, which was after the inmate was found dead."

Martin testified that the entire system of documentation is suspect based on false entries. 

On cross-examination, counsel for the defense (SC Dept. of Corrections) challenged Martin about treatment based programs, which he called a care-giving model. Martin cited New York, California and Minnesota systems as being systems heavily dominated by treatment services and counseling and programming and therapeutic environments.

Martin was asked how many deaths resulted from use of chemical spray or restraint chairs, to which he replied, "None."

Defense counsel brought up other state’s records of abuse and asked if Martin had encountered any cases of officials rounding up inmates with horses or hitting them with bats? Martin said no.

He was asked if he had seen instances of hog-tying, firearms use on inmates, to which Martin answered no.

Martin agreed that an inmates’ history can affect the way an officer deals with him and that inmates with a history of assault are more likely to be put in segregation.

Counsel proposed multiple hypothetical situations. Martin criticized the system saying, "One pervasive thing in your system is your administrators assume the worst."

Counsel for SCDC asked, "Should they not assume the worst?"

Martin emphasized that the state’s own standards and rules stipulate that it is not what about what the inmate might be capable of; it is not about a license to abandon or abdicate sound correctional standards for a perceived threat.

Martin testified that "No one, not even your own expert would suggest you could step into the cell and hit an inmate with a closed fist to the head. But this chemical spray is no less the impact."

Martin agreed that there are times when use of chemical sprays is warranted, and that a limited application of spray can be more humane than hands-on treatment, adding, "It’s less risk of injury but I’m not comfortable with counsel terming it mild."

He later advised defense counsel to "do your research," adding, "you do not have to hit the inmate in the face for it to work; it is designed to be used in open spaces. MK4 streamer in an 8x10 cell will affect him whether you hit him in the eye or not."

Counsel asked, "Don’t you have to be in a position to reach him?" to which Martin replied, "Yes, but the cell is small."

The court recessed for the day.  Cross-examination will continue Tuesday morning at 9 a.m.