Two nurses at a juvenile jail were charged with murder and manslaughter Tuesday for allegedly failing to treat a 17-year-old inmate who died of a burst appendix in June after three days in pain.
A Miami-Dade County grand jury indictment charged that the women skipped examinations or falsified medical records on Omar Paisley, who spent his last days "in agony lying on a concrete bed," according to the panel's report.
The grand jury called for wholesale changes in health care, staffing and surveillance at the jail.
The 226-bed Miami-Dade Regional Juvenile Detention Center is operated by the state Department of Juvenile Justice, headed by Secretary Bill Bankhead. Bankhead said he was reviewing the report.
The indicted nurses, Gaile Tucker Loperfido and Dianne Marie Demeritte, worked for Miami Children's Hospital under a contract with the jail. They face up to nine years in prison on charges of third-degree murder and aggravated manslaughter of a child.
Paisley was jailed after pleading guilty to battery for cutting another youth with a soda can.
He wrote a sick form on a Saturday, June 7, saying, "My stomach hurts really bad. I don't know what to do. I can't sleep."
Working that weekend, Loperfido recorded that she examined Paisley, but jailers didn't back up her reports.
A psychiatrist who saw him in bed that day thought he had a stomach virus and gastroenteritis.
On June 9, a jailer grew desperate about getting help for the boy. Demeritte authorized an emergency hospital transfer. She had said she didn't want to examine Paisley because he might have a contagious virus and she had a sick child at home. She wrote that he had a normal temperature and pulse but was delusional.
A volunteer counselor soon found Paisley slumped in a chair outside his cell with no pulse and no one performing first aid.
That was 12 minutes before paramedics arrived and more than an hour before a physician was called about Paisley for the first time. He was dead when he arrived at the hospital.
The panel also criticized the jail staff broadly and said several people played roles in Paisley's death.
"We were appalled at the utter lack of humanity demonstrated by many of the detention workers," the report said.
Among the grand jury's recommendations were switching to an in-house medical staff with same-day examination of sick inmates and timely physician review of charts and adding staff and video surveillance.
Bankhead, whose agency runs 25 juvenile jails, said he would respond to the report and "take further actions as necessary." He noted that the hospital contract has been canceled, the jail staff has been retrained on calling for emergency medical help, and he has called for tougher hiring criteria.
Gov. Jeb Bush said Tuesday he still has confidence in Bankhead. He said he will make sure the grand jury's recommendations "are taken into account."