Says staff failed to adequately treat fractured neck

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Donnie Nichols walks slowly, like a man wading through quicksand.

His gait is jerky, almost robotic. He uses a cane to get around.

The movements, he says, are tied to a jailhouse neck injury now at the center of a years-long legal battle with Knox County that, if not dismissed, could go to trial this summer.

He says the medical staff at the Knox County Detention Facility failed to adequately treat him, allowing a fractured neck and crushed vertebrae to go undiagnosed for 70 days after he fell off his top bunk while sleeping.

"It felt like somebody was sticking a knife right in my head," Nichols, 60, tells WBIR 10News in an interview. "I couldn't hold my head up whenever I'd get out of the bunk. I had to carry my head with my hands. I couldn't sit down unless I had something to lean my back against or my head would just flop over."

Defense attorneys, however, aren't buying his story.

Lawyers for the county and the six nurses Nichols sued in U.S. District Court in 2011 say they provided adequate treatment. They also argue that the county and the employees are entitled to "qualified immunity," a legal argument available to governments that shields workers from liability.

Both sides have asked U.S. District Judge Pamela Reeves to issue her own judgment. Nichols' attorneys want the county to pay for medical expenses, which at this point have surpassed $240,000, and for pain and suffering.

The defendants' attorneys, after taking some depositions, want the case dismissed, according to records.

Neither side denies that Nichols fell or that he claims he was seriously injured from the fall. Instead, the crux of the federal legal argument is whether the jail and its staff were "deliberately indifferent" to the serious medical needs of the prisoner, meaning officials knew there was a medical need and didn't treat it.

'TEARS CAME TO MY EYES'

Authorities booked Nichols, then 56, into the county detention facility in mid-August 2010 for violating a protective order. At the time he drove without a license to his ex-wife's home and threw a rock through her window. He then struck her car with his car. Records show he'd been locked up roughly 30 times, mostly for misdemeanors tied to alcohol or driving violations, and during a more recent stint authorities assigned him to a bottom bunk because he had knee and ankle injuries.

In August 2010, though, officials gave him a top bunk on the second floor of the jail. And on Aug. 27, a sleeping Nichols rolled from his four feet high bed.

"I was laying on the concrete floor and blood was running out of my head and I couldn't reach – my arms were paralyzed," says Nichols, a Knoxville resident who worked construction most of his adult life.

Records note that nurses Amy Luxford, who no longer works for the county, and Selenia Allen responded to a "code blue" emergency call. Luxford cleaned the head wound, gave him Ibuprofen and moved him to the lower level of the jail pod. Nichols later regained sensation in his arms, according to court documents, and was given a muscle relaxer.

The next day nurses again responded to an emergency call, this time finding Nichols on the floor near the toilet. He then spent three days in the medical unit where records show he asked a nurse for an x-ray.

He didn't get one.

On Sept. 13, he filed a sick call request. It noted: "Neck pain, terrible headache, need to see Doctor or Nurse. Never got anything except what Nurse gave me. Been almost 3 weeks. Still have really bad headache. Please help me."

Another sick call followed later that month: "Neck pain with headache 4 weeks straight. Need Ibuprofen 3 times a day."

Nichols says that in October he also filled out two more requests for someone to treat his neck, but that a correctional officer threw them away.

"Nobody would pay any attention to me," he says.

Finally, on Nov. 3, a nurse referred him to Diagnostic Health of Knoxville where two days later – and 70 days after he first requested an x-ray – officials there found two fractures along the base of his neck, and a "settling of the skull base as a result of the displacement," according to medical records.

"Tears came to my eyes. I thought I was going to die," Nichols says. "The jailhouse doctor told me: 'If you move your head a certain way, or just turn a certain way, you could die or be paralyzed . . . .'"

The county released Nichols on Nov. 10 – several months before his scheduled release date – and told him that indigent care would pay for his surgery, according to his attorneys, Jonathan Taylor, Arthur Knight III, and Robert Kurtz.

However, the operation, which would eventually take six hours and leave a scar running from his neck to his shoulder blades, was delayed until January 2011.

That's because the doctor he needed wouldn't accept indigent care, Nichols' attorneys say. The state's medical insurance program, TennCare, which the doctor does accept, is expected to cover part of the bill.

Nichols, though, says he still "gets dizzy-headed sometimes."

"I get these muscle spasms in my neck. It feels like someone is grabbing it and squeezing it as hard as they can," he says.

Nichols adds that the fall also has affected him mentally.

Years removed from jail, he sleeps on the floor of his house, afraid that he'll roll from a bed again.

"I don't think anybody deserves to be ignored like I was," he says. "Yeah, I've made my mistakes and I've paid for them, too. But to be sitting there with your neck swelling up and they're telling you that there's nothing wrong with you, and you're hurting so bad that you've got tears in your eyes, I don't think anybody should be treated like that."

ASSIGNING FAULT

Nichols' attorneys argue that his complaints were "completely ignored" and that the neck fracture went untreated until a nurse finally arranged for an x-ray 70 days after his initial request.

They also note that the jail had x-ray equipment and the ability to process x-rays.

Further, they say that "detention facility officials were clearly aware of a potential problem with inmates falling off" top bunks, and that each year about a dozen inmates on average fall from their bunks, according to jail records.

The county's attorney, Deputy Law Director Amy Hickerson, however, argues that Nichols never requested a lower bunk when he was initially booked into the jail. In court records, she also says that even if the jail officers were aware of Nichols' previous leg surgery, "that information would not lead any officer to determine that there was a substantial risk that (Nichols) would fall off of his bunk while sleeping after he had safely climbed into it."

Jerome Melson, who represents five of the nurses, says in court documents that the "record is literally teeming with instances" that Nichols received medical attention. He says nurses responded to the inmate's needs after he fell and in September – at Nichols' request – the jail dentist pulled eight of his teeth.

Melson also notes that Nichols, after he was discharged from the medical unit in late August, "returned on his own power to the general population in the building where he was housed previously and was again provided a bottom bunk."

In addition, Leslie Ridings, who represents Luxford, argues that "no medial proof has been developed or produced (that) shows additional problems, furthering of (Nichols') medical issues or a detrimental impact on his neck condition as a result of the alleged delay in diagnosis of the extent of his neck injury."

Nichols disagrees.

He says he struggles to take care of himself, his elderly mother, and he's awaiting another surgery.

A date to hear the attorneys' arguments has not been set.

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