Because alcohol withdrawal in jail can be fatal if not treated appropriately, it is incumbent on jail medical staff to ensure that alcohol-dependent detainees and inmates are properly monitored for symptoms of withdrawal when they are admitted to a jail. When alcohol withdrawal symptoms exist, they must be properly addressed. This can include close monitoring and supervision by trained medical personnel, the administration of certain medications such as benzodiazepines to address the withdrawal and, in the case of moderate or severe withdrawal, transfer to a hospital or acute care facility for treatment as appropriate.
One tool that should be used by jail medical staff is known as the Clinical Institute Withdrawal Assessment for Alcohol (CIWA for short). The CIWA is a ten-item scale used to assess and manage withdrawal. Each item on the scale is independently assessed and given a numerical score. The scores for each category are then totaled, which yields an overall score ranging from 0-67. Mild alcohol withdrawal is defined with a score of less than or equal to 15, moderate with scores between 16 and 20, and severe with any score great than 20.
The CIWA takes only minutes to administer, and regularly administering the test during the initial days of a person’s confinement in jail (and taking appropriate responsive action) can be life-saving.
The ten items on the CIWA include some of the most common signs and symptoms of withdrawal including nausea and vomiting, tremors, sweats, anxiety, agitation, tactile disturbances, auditory disturbances, visual disturbances, headache, and loss of orientation. Heart rate and blood pressure should also be monitored.
An example of the CIWA scale is reproduced here: http://wiki.hl7.org/images/2/25/Alcohol-Withdrawal-Assessment-Scale.pdf.
When death from alcohol withdrawal occurs in jail, the facts and circumstances should be investigated to determine if proper protocols and procedures were followed by jail staff. When jail staff either fail to monitor an at-risk detainee for alcohol withdrawal or fail to take appropriate action when signs and symptoms of withdrawal exist, they can be legally liable for the death.
Tragically, deaths from alcohol withdrawal occur far too often in American jails. Most of these deaths are preventable by following basic protocols and standards. The attorneys at Budge & Heipt are experienced in handling alcohol withdrawal death cases in federal courts around the country. If a loved one has died from alcohol withdrawal in jail and you are interested in assessing the merits of a potential wrongful death case, please contact Budge & Heipt for a free consultation.
Please contact Budge & Heipt to discuss your case. There is no cost or obligation to do so. Call us today at 206.624.3060.