CHS is a huge operation, with a $49 million annual budget. Imagine a constant stream of potential new patients — hundreds every day — each of whom is more than likely to be addicted to drugs or alcohol and less than likely to have seen a doctor in the past year.
Lauren Gilger
Bertha Oropeza rests at her Phoenix home the day after being released from the hospital.
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On any given day, there are about 9,000 inmates in the Maricopa County jails, according to the U.S. Department of Justice. According to CHS documents, 130,000 people were admitted into the jails last year alone. The jails take in 350 new inmates on an average day.
That means CHS has about $6.39 to spend on each inmate's healthcare per day, according to the March report.
Now, imagine trying to take care of that constant stream of patients, while they are being processed and packed into concrete cells, in poor shape and facing worse conditions.
Add a healthcare system that has been plagued by problems for years, and you've got the Maricopa County jails. It's a dangerous situation for medically fragile inmates.
"We're talking about life and death here," says Winter. "So a jail stay for some offense that may be very minor, and for which you might not even have been convicted, can result in a life sentence or some terrible lifelong injury because you didn't get the access to care that you should have."
Before her eight-day stay at Good Sam, Bertha Oropeza had spent just 10 hours in jail.
Her condition that first night didn't seem critical, according to medical records. She must have appeared to be just another narcotics-addicted inmate from Fourth Avenue.
But one day later, Oropeza was rushed to the ICU, intubated, and treated for cardiogenic shock, a life-threatening condition that occurs right before your heart fails completely.
Doctors inserted a balloon pump in her throat to keep her breathing. Her kidneys failed, and she stopped producing urine because of dehydration, according to medical records.
It wasn't until close to midnight on the day she was arrested that her family tracked her down at the hospital.
"We were really worried," Bertha's eldest daughter, Blanca Oropeza, says. "And then we find out her heart's crashing and that she might not make it through the night."
Two days later, Oropeza was out of danger. It was a surprise.
"The heart doctor told us she had a 40 percent chance of living through the night," Blanca says.
Both CHS and Good Samaritan records cite withdrawal from pain medications as possible causes of her near-death. But, at least one thing wasn't the cause: Oropeza's "social history," as doctors call it. Medical records show that she smokes a pack of cigarettes each day and smokes marijuana — the very offense that landed her in jail.
But the records state: "Social History: Noncontributory."
In other words, it wasn't anything Oropeza had done to herself that brought her so close to death.
Oropeza plans to file a lawsuit against the county but doesn't know where to begin.
"The thing is, if I wouldn't have been in jail and something like that would have happened to me, I would have started straight to the hospital," she says.
"I could have been dead."
In fact, the court-ordered report released this month makes that even more apparent. "The Fourth Avenue jail intake facility is not medically suitable," the doctor writes, for people "prone to instability due to complex acute or chronic diseases" or "those with significant physical or functional disabilities."
Clearly, the Fourth Avenue jail intake facility was not medically suitable for Bertha Oropeza.
