PUBLIC STATEMENT FROM THE LAW DEPARTMENT
An investigation by The City’s Law Department into the events surrounding the death of Lavonda Kimble has been conducted. Kimble, a thirty-year old female, was admitted to the Justice Center early in the evening of April 10, 2007. She was treated during the night in the Justice Center’s medical unit, which is staffed by Correctional Medical Services, for asthma-related symptoms. At approximately 1:35 a.m., on April 11, after her condition worsened, a CMS nurse placed a 911 call. Two emergency crews responded and transported Kimble to an area hospital, where she was pronounced dead at 2:44 a.m. on April 11.
A newspaper article published June 7, 2007 in the St. Louis Post Dispatch set out numerous allegations relating to Kimble’s detainment at the Justice Center and the care she received there. The article included several quotes from the report of Chastity Girolami, a paramedic who was a member of the second emergency crew that responded to the 911 call. Unfortunately, because Ms. Kimble’s death will be the subject of litigation, the details and documents comprising the Law Department’s investigative files cannot be released at this time. However, after interviewing thirty-nine witnesses and reviewing all relevant documentation, we believe that some response to the public accusations is in order.
“Kimble... wasn’t supposed to be in jail in the first place.”
Ms. Kimble was arrested on an outstanding warrant issued by the City of Bel-Nor and brought to the Justice Center by the St. Louis Police Department. The Corrections Staff did not have the discretion to release her prior to receipt of notification from Bel-Nor that bond had been posted, and the completion of her release paperwork. At the time Kimble was experiencing asthma-related symptoms and the medical staff was treating her, the required notice had not been received.
“The delay [in paramedic Girolami reaching Kimble] was ‘detrimental to the patient’s outcome’”.
When the 911 call was received, an Emergency Medical Services (“EMS”) crew and a Fire Department AFirst Responder@ crew were dispatched. The first responder crew encountered no difficulty whatsoever reaching Kimble. The main control center at the Justice Center overrode the locked doors in the facility so that this crew could quickly reach Kimble. Because the Justice Center was not informed that a second emergency crew would be responding, after the first responders entered the medical unit, the doors were again locked.
It took approximately a total of fifteen minutes from the time the second responder crew was dispatched until it reached Kimble. About two minutes of this time was spent waiting for a door leading to the medical unit to be unlocked. It is important to bear in mind that the crew was responding to an emergency in a jail: a facility designed around security concerns. It is also significant to note that, prior to the EMS crew reaching Kimble, she was being treated by the first responder crew, which included an EMT. Before that, she was being treated by nurses.
“Firefighters told [Girolami] that they had arrived to find nurses trying to perform CPR by compressing Kimble’s stomach instead of her chest”
This is simply false. None of the firefighters who were on the first responder crew stated that they observed the nurses performing CPR on Kimble’s stomach, nor did any of them make such a statement to Girolami. In fact, they each reported that when they arrived, the nurses were performing CPR properly on Kimble’s chest. Girolami’s statement is completely unsubstantiated.
“’ [An unknown correctional officer] didn’t know the patient was in cardiac arrest.’”
This allegation is irrelevant to the care that Kimble received. The fact that an unknown bystander, who neither Girolami nor any other witness was able identify, was not specifically aware of Kimble’s condition had no impact on the care she received. The treating nurses were aware that Kimble slipped into cardiac arrest as soon as it occurred, which was after the 911 call, and they administered CPR until the first responder crew arrived.
“When medics asked a nurse if she had used an automatic defibrillator to try to restore Kimble’s heartbeat, ‘She just looked at us and asked what we were talking about.’”
According to the nurses, Girolami was agitated and accusatory when she questioned them at the scene about their care of Kimble. The nurse in question was taken aback at the implied accusations and responded accordingly. An automatic defibrillator (“AED”) is kept in the medical unit and the nurses are trained in its use. It can be used in certain circumstances to help to restore a heart’s normal rhythm; if the patient has some heart activity to begin with. Unfortunately, as the first responders found when they arrived, the AED would not activate because Ms. Kimble had no heart rhythm, whatsoever.
“Autopsy findings ... showed no trace of the drug that jail nurses said they repeatedly administered to ease Kimble’s breathing.”
According to Michael Graham M.D., the Medical Examiner, the negative toxicology screen does not compel the conclusion that Albuterol was not administered. For example, the half-life of the Albuterol that was administered may be too short to be detected on a toxicology screen. Additionally, a patient may be unable to breathe deeply enough for the Albuterol to be absorbed by the body.
Three nurses on the evening shift described, during interviews, administering two Albuterol nebulizer treatments to Ms. Kimble. These treatments are reflected in the medical records. They were ordered by the doctor on call. Two of the nurses on the night shift stated in interviews that, when they arrived for their shifts, they observed the second treatment being administered at approximately 11:30 p.m. and were told at that time that an earlier treatment had been administered. These nurses, along with the night charge nurse, described attempting to administer a third treatment well after midnight, but Ms. Kimble being unable to effectively utilize the nebulizer. This was when the 911 call went out. The correctional officer, assigned to the medical unit on the night shift, also described witnessing the administration of these treatments.
“The jail care was ‘substandard at best’”
Determining whether the overall medical care that Kimble received from the CMS nursing staff was "substandard" requires the expert opinion of a medical doctor or nurse (not a paramedic), with all of the relevant medical information. However, many of the factual allegations underlying this accusation do not support it or are simply false, and neither paramedic Girolami, nor the Post Dispatch, had all the relevant, first-hand facts.