DOVER — In a report issued Tuesday officials said no criminal charges were warranted in the 2014 death of an inmate after correctional officers removed him to an infirmary cell.
The report also noted the Delaware Department of Correction has altered procedures since the incident.
Ronald W. Shoup, 48, died as an inmate at Sussex Correctional Institute on Feb. 27, 2014. Ann autopsy one day later ruled the manner of death as a homicide caused by multiple blunt force injuries to the torso, lower and upper extremities.
A Delaware Department of Justice (DOJ) investigation “concluded that Mr. Shoup’s death was caused by one or more correctional officers, and it is also possible that the absence of prompt and appropriate medical attention contributed to his death.”
Ronald W. Shoup
While no criminal activity was found among anyone involved in the incident, the DOJ said “the family does have other legal avenues through which to seek redress, and we are hopeful that the changes DOC has indicated that it has made will prevent future tragedies of this type from occurring.”
On Tuesday, Stephen Hampton, representing Mr. Shoup’s family said he was working on a civil complaint “that’s quite lengthy. It’s just a matter of getting it together.”
Mr. Hampton said the lawsuit would include the medical vendor contracted with the DOC, and some DOC employees.
“As far as I can tell, nobody is being held accountable,” Mr. Hampton said. “How can somebody die under these conditions? It’s just horrendous medical care, terrible care overall.”
Mr. Hampton said Mr. Shoup was suffering physical and mental health issues when contacted by correctional officers, and called out what he claimed were long-time faults within the SCI system as problematic.
“The lack of accountability for anybody at SCI for decades has led to this situation where a man who is suffering from withdrawal and hallucinating, is brutally abused multiple staff, while the medical vendor employees, who called for the DOC staff in the first place, just watch it happen,” he said.
The DOJ concluded that the Quick Response Training manual “contained no exceptions or modifications permitted to the QRT protocol for inmates who were passively as opposed to aggressively resisting, nor were there any exceptions or modifications permitted … for inmates whose medical condition might make them more susceptible to injury from the use of standard QRT techniques.”
The training changes
The Department of Corrections indicated to the DOJ “that training and/or procedures have changed since the time of Mr. Shoup’s death” regarding use of standard Quick Response Team techniques.
On Tuesday the DOC released the following statement:
“This afternoon the Department of Correction received the DOJ’s report and we are reviewing its recommendations.
“The Department of Correction is committed to taking all necessary action to ensure the health and wellbeing of the inmates we are entrusted to supervise and the safety and security of our staff, visitors, and facilities. DOC policies and training procedures are reviewed on an ongoing basis to make certain that our interactions with inmates are governed by best practices.
“Consistent with that ongoing commitment, the DOC has implemented recent changes and we will consider the additional recommendations made in this report.”
The DOJ thanked Mr. Shoup’s patience and help during the investigation, while extending condolences at the same time.
“The investigation has been lengthy, in part because DOJ sought the advice of an outside medical expert to assist the investigation,” the report read.
The DOJ said it took the rare step of issuing a written report on the matter regarding police officers’ use of deadly force due to “the complexity of the factual issues involved and the importance of the public understanding the facts and legal standards that led to DOJ’s decision.
“Additionally, we believe that it is important to highlight areas where heightened attention must continue to be given to DOC training and procedures to ensure the safety of other inmates.”
Incarceration timeline
According to the DOC, Mr. Shoup was incarcerated on Feb. 20, 2014, in default of bail on two counts each of failure to have insurance identification in possession and driving while suspended or revoked, and a count each of felony noncompliance with conditions of recognizance bond of conditions, failure to have registration plate light, fifth offense DUI after four prior offenses – DUI of Alcohol, and breach of release.
According to the DOJ, investigation found that Mr. Shoup was taken into custody when he appeared for a court preliminary hearing while intoxicated.
On Feb. 25, 2014, Mr. Shoup was transferred to the prison infirmary after exhibiting what officials described as “strange and aggressive behavior, including threats against officers and other inmates …”
A nurse noted he was disoriented and delusional, “believing he was at his parents home,” the report stated. “The comprehensive psychiatric evaluation found Mr. Shoup to be evasive and uncooperative.”
While Mr. Shoup’s condition deteriorated later in the day on Feb. 26, according to findings, “There is no indication that Mr. Shoup received any type of medical treatment other than restriction to solitary confinement and the insertion of an IV tube for fluids from the time he was assessed with mild to moderate alcohol symptoms at 8:30 a.m. until at least nine hours later, when his outward behavior began to further escalate.”
In the late afternoon, a mental health observer noticed that Mr. Shoup had become agitated and spoke of breaking out of his cell, along with threatening to rip out an IV, according to the report.
A prison Quick Response Team (QRT) was requested for restraint assistance after medical staff determined at 6:45 p.m. that Mr. Shoup was in need of a calming injection of Ativan, papers said.
Mr. Shoup was shackled and handcuffed as a nurse entered the cell to administer the shot in a 10-minute sequence in which the inmate did not apparently suffer any serious physical injuries, papers said.
Second QRT team
According to the report, the shot did little to curb Mr. Shoup’s agitation and aggression, and a second QRT was assembled after midnight to help in the administration of a second shot. The team arrived at 12:50 a.m.
As the team entered, the report stated, Mr. Shoup was suck with a shield, then restrained, handcuffed and shackled. A second shot of Ativan was administered and “Mr. Shoup was not combative or aggressive during this time,” according to the report.
The second QRT response took less than five minutes, according to investigation.
According to the report, Mr. Shoup was getting up as QRT members left the cell, “being generally quiet and sitting immediately thereafter.”
The DOJ reported that two mental health observers continued to watch Mr. Shoup every 15 minutes. He was described several times as moving around in his cell and was seen lying down at 4 a.m., papers said.
Between 12:55 a.m. and 4:55 a.m., Mr. Shoup “was observed either quiet or mumbling; the mental health observers did not observe any struggling, yelling, or crying.”
By 4:55 a.m., Mr. Shoup appeared to be sleeping, according to the report. However “one of the mental health observers contacted the nurse because it appeared that Mr. Shoup was breathing slowly.”
At 5:06 a.m., it could not be determined if the inmate was breathing. A nurse entered and no pulse could be found; CPR then began.
Paramedics arrived at 5:20 a.m., according to the report, and a pulse was detected 15 minutes later. Mr. Shoup was transported to Beebe Hospital at 5:40 a.m., arrived at 6:27 a.m. and was pronounced dead at 9:25 a.m., according to papers.
Independent review
After the state conducted an autopsy, the DOJ requested an independent review of the findings by a forensic pathologist.
“His initial conclusion was that Mr. Shoup’s death was the result of complications associated with alcohol withdrawal,” the report read.
The conclusions evolved, however, and the pathologist determined that Mr. Shoup died from injuries sustained in the second QRT entry.
“This was based upon forensic evidence of a patterned abrasion attributed to the pinning shield employed by the second QRT,” the report read. “This abrasion was in the area of rib fractures and crush injuries found within the chest …” due to QRT members putting weight on Mr. Shoup during the restraint attempt.
“In short, there is no evidence that any member of either QRT team initiated his actions … with any intention other than his compliance with his training and DOC policy (flawed though both the training and execution may have been),” the report read.
The DOC said no officers were placed on administrative leave regarding the incident, and the deadly force mater was reviewed internally and investigated by law enforcement agencies.
“The decision to implement administrative leave in a case of this nature is determined after the internal review of an incident to determine if it is appropriate and is necessary to maintain security and safety,” the DOC said.
The DOC said it “has cooperated fully with the independent investigations conducted by the Delaware State Police and Delaware Department of Justice, through which the DOC provided significant amounts of information and documentation.”