ASHEVILLE - Hannah Guffey was in despair.
Accused of a fatal hit-and-run of a bicyclist while driving under the influence, the 25-year-old Brevard resident was arrested on felony charges and jailed in theBuncombe County Detention Facility in downtown Asheville.
Nine days later, on July 28, 2020,she died after hanging herself with a bedsheet, a death certificate said. She left behind her parents, afiancéand their 3-year-old daughter.
A day later, Buncombe jail detainee Jacob Biddix, 26, died after being found on the floor of his cell. He had been in the detention facility two months, arrested during a racial justice protest and charged withproperty damage. His sister and mother continue to question the adequacy of themedical care he got in the jail.
On April 10, 2021, TaniaShepherd, a 37-year-old massage therapist, died from a drug overdose threehours after being booked into the jail on charges of possessinga stolen motor vehicle.
Detainee Robert Charles Austin, 68, charged with first-degree murder, died in jail July 23of congestive heart failure.
Jesse Lee Owenby, 49, who was facing an assault with a deadly weapon charge, died in the facility Oct. 30from complications of staphylococcus pneumonia and sepsis.
Less than a month later, on Nov. 19, detainee Faith Denise Cox, 57, who had been charged with assault with a deadly weapon, also died. Initial reportsassigned Cox's deathto natural causes. A final determination is still pending.
In less than 16 months, the publicly funded facility, which has the primary job of detaining and safeguardingpeople accused of crimes until their day in court, racked up a dismal tally: six dead.
That number was exceeded only by GuilfordCounty,home to Greensboro, the third-biggest jail system in the state with nearly twicethe detainee population of Buncombe.
Now an extensive Citizen Times analysis reveals the deaths in Buncombe's detention facilityare part of an alarming yearslong trend.Usingmore than a decade of jail information collected by the Citizen Times and Reuters, the analysis shows Buncombe has the most deaths per inmate of the state's 10 largest detention systems from 2008-21, making it North Carolina's deadliest jail.
Determining NC's deadliest jail:Behind the Citizen Times investigation to determine Buncombe has state's deadliest jail
Its rate of deaths over those 14 years is 2.9, nearly twice the national average of 1.5.
Last year alone, there were four fatalitiesin the jail. That put the county’ death rate at 9.6 per 1,000 detainees, far exceeding the death rate of the other jail systems. Buncombe’s deaths per 1,000 detainees was 58% higher than the second-worst jail system, Gaston County with a rate of 6.1.
Tony McClure, Guffey's stepfather, said the jail failed the young mother in multiple ways— by taking her off suicide watch, giving her the means to hurt herself and providing inadequate medical care.
"There wasn't anyone who looked in on her but another detainee," McClure said.
More:Mother of woman who died in Buncombe County jail custody demands answers from sheriff
Devon Biddix, sister of Jacob Biddix, said she was heartbroken by her brother's death and alarmed it was part of a larger trend.
"Even if I didn't have a personal connection to it, it would be absolutely terrible," she said.
Heather Shade, a54-year-old licensed Asheville attorney, said she was nearly on thelist of fatalities. In 2020, Shade said she called in to McDowell County court to say she wassick and could not appear on acharge of failing to display a properlicense plate. But the judge ordered her arrested for failing to show, and for a reason she said she did not understand, Shade was jailed in Buncombe.
Shade, who has Type 2 diabetes,said she pushed an emergency button in her cell repeatedlyto say she needed insulin from her purse and that she was at risk of dying. But she said she was told she was not experiencing a medical emergency. Then, she went into diabetic ketoacidosis and was taken to Mission Hospital.
"I definitely could have been one of those who died. It was awful there," she said.
Of the recent deaths reviewed by the State Bureau of Investigation, no criminal wrongdoing has been found, according to District Attorney Todd Williams. The North Carolina Department of Health and Human Services showed no deficiencies after Guffey's death, said Aaron Sarver, spokesperson for Sheriff Quentin Miller, who as the county's top law enforcement officer is responsible for managing the jail.
No review was done after Biddix's death because he was released from custody by a judge after he was found unresponsive in the jail but before he died in the hospital. The Citizen Times has not seen any of the reviews by DHHS, and Sarver had declined to providethem.
More: Buncombe DA: BCDC cannot be allowed to unload a dead, or dying, man without notification
That happened as Biddix was being transferred from the jail to the hospital, something that critics say is a way to keep jail deaths off the books, but that local officials said meant a deputy did not have to stand guard over Biddix in the hospital. While no health review took place, Jail Administrator Capt. Jeffrey Littrell did submit a detainee death report to DHHS.
Millerand his staff would not comment on some allegations by Guffey's and Biddix's families or by Shade, citing federal health privacy law. Sarversaid sheriff's office staff met with McClure and other family members to review the body camera footage and answer questions. An internal review found no policy violations, Sarver said.
Dying before their day in court
Justin Blackburn, who helps formerly incarcerated people improve their lives as apeer support specialist at Asheville'sYMI,one of the country's longest-running Black cultural centers, said the numbers mean the county institutionis failing a fundamental responsibility.
"The idea is the individuals who are accused of committing a crime are brought in, and then it is on the facility to ensure they make it to see their day in court. They become your responsibility," said Blackburn, 37, himself a recovering alcoholic who spent time in jail after arrests for driving while intoxicated and disorderly conduct but who said he has been sober for nearly eight years.
"It might be somebody who was having an off day. Maybe they got into a disagreement, a heated exchange and they're charged with disorderly conduct, and then, they don't make it;they die in jail."
Even the smaller percentage serving time in jail for a conviction should not face a de facto death sentence, said attorney Luke Woollard with Disability Rights North Carolina.
"Everyone should care about jail conditions, because anyone’s family member or loved one could end up in one of these facilities," Woollard said. "And if that happens, each person in jail and their loved ones should be guaranteed, at the very least, that the person in that cell will not suffer bodily harm or death because of unsafe jail conditions."
After the spike in deaths over the last two years, one deficiency was found by DHHSinspectors, said Sarver.That was missed guard rounds the day before Austin died, he said. A Dec. 22 autopsy obtained by the Citizen Times said Austin had been foundmaking "hooch" alcohol to drink in his cell.
The Citizen Times requested inspections and reviews for Buncombe and the other nine large jails. DHHS spokespeople said Dec. 2 they wouldsupply the records in a fewdays. On Jan. 7, more than a month later, they delivered death reports.They did not respond to a message Jan. 7 asking when they would providejail reviews.
When asked for the records, Sarver summarized the reviews but referred the Citizen Times back to DHHS for the documents.
A different state agency responsible for determining causes of death, the N.C. Medical Examiner, sent death investigations and autopsies for Guffey, Biddix, Shepherd and Austin.
DHHS is tasked with doing twice-annual surveys of jails and inspections based on complaints. Theymay also do compliance reviews after deaths, department spokesperson Kelly Haight Connor said.
Miller declined to be interviewed about the deaths. Elected in 2018 as the county's first Black sheriff, Miller is seeking reelection this year.
In emailed statements, Miller said he fully supportedLittrell, 38,saying the 17-year sheriff's office veteranseeks "self-improvement."
Littrell, who does not have a college degree, is working toward onein criminal justice administration.He graduated from the Western North Carolina Law Enforcement Leadership Academy and is attending the N.C. Sheriffs Association Jail Administrators Institute of Leadership, Littrell said.He earns $84,391 plus benefits.
Miller noted jail upgrades under his administration, includinga$160,000 high-tech X-ray scanner fordrugs and weapons, a $79,000 electronic tracking system to ensure proper timing of guard rounds, medication-assisted treatment to reduce drug withdrawal deaths, morefood for detainees and a medical contract for round-the-clock nursing care.
The B-Scan X-rayhas resulted in 31 people being sent to the hospital to check for ingested drugs prior to being booked into jail, Sarver said. But the scanner, installed March 13, 2020, prior to the six deaths, did not prevent Shepherd from succumbingto a methamphetamineoverdose in April 2021.An autopsy showed folded plastic in her stomach, something the machineis meant to detect.
The Guardian electronic rounds system came into useJuly 28. That was before the last two deaths, of Owenbyand Cox, the causes of which are still being determined, though Cox's was initially assigned to natural causes.
In his written responses, Sheriff Miller said any loss of life concerned him and that he would look to address the increased deaths by improving procedures, technologies and addressing capital needs with county commissioners, the elected officials whofund the jail's $21.5 million budget.
Miller did not give specifics on the capital needs. County finance documents for the fiscal year ending June 30show$174,000 budgeted for a heating and cooling system upgrade.
A capital project not started is an installation of metal screens to stopfalls and intentional jumping from upper level housing units. It was proposed to be built in 2019.
"At least 10 incidents have occurred," the finance documents said, making the $318,000 project a high priority, though the documents said contractors have shown no interest in bidding. Falls have not been attributed to any recent deaths for which causes have been assigned, according to information provided by the sheriff's office.
Board of Commissioners Chair Brownie Newman said the deaths were concerning but emphasized increased funding, including a $1.8 million annual medical contract with new provider Richmond, Virginia-based Mediko, which started in 2020 andincludesthe medication-assisted treatment.
"Our role is to ensure the funding is in place to support 21st century policing in our detention center," said Newman, a Democrat who has served nine years on the board, with five as chair.
Medical care for the incarcerated
Miller said he would also"continue to work with the judiciary system to ensure we hold folks with high-risk factors to public safety."
The sheriff said he would also work with Mediko "to provide additional screening and staff to address folks with substance abuse and mental health disorders earlier upon entering our facility."
"We will continue to seek the latest in technology and practice best practices to achieve the quality of service consistent in treating people with dignity and respect while providing the best possible care while in our custody," he said.
But relatives of detainees said the jail failed in its medical care of their family members.
Devon Biddix, whose brother's death was officially assigned to a year-old blow to the headcomplicated by refusal to take seizure medication, said the jail was negligent in the care it provided.
"They noticed something was wrong and didn't do anything," said Biddix, who saw video of the incident.
More: Bodycam footage: 7-minute delay before jail guards begin CPR on Jacob Biddix
It took seven minutes from the time detention center personnel saw something amissto when they started chest compressions, she said. Then, whenan automated external defibrillator told a medical staffer to administer shocks, the stafferdid not, Biddix said.
Guffey's stepfather McClureblames medical stafffor prematurely ending hersuicide watch and says video he sawshowed personnel stopping chest compressions and"waiting a minute and a half" before trying to restart her heart with a defibrillator.
He and late wife Jewell McClure, who died in June, had looked to sue but were told by their attorney they had little chance of winning.
The Citizen Times has not seen any of the videos, which by state law arenot public record. As relatives, McClure and Devon Biddix were allowed to view the footage. In December, aBuncombe Superior Court judge ordered a copybe givento Devon Biddix, though a protective order prevents the public or media from seeing it.
Shade, who said she risked deathafter being denied insulin, said medical staff checked her blood sugar when she was put in her cell. It came back at 350 milligrams per deciliter, well over normal levels of 100-120 and dangerously high, she said.
"I told them they could kill me," Shade said. "After 10 hours of this,I really thought they were going to."
Sarver declined to comment on allegations of poor care for Biddixor Shade, citing federal medical privacy laws. He did not respond to a Jan. 4 question about McClure's criticisms. The sheriff's office received a demand letter in December from Shade for a $200,000 settlement, he said.
Candace Edwards, human resources director withMediko, did not respond toa message seeking comment.
Asked about his satisfaction with Mediko, Miller said he would continue to evaluate the company's performance.
The prior medical contract was with Southeast Medical Correctional Group, starting in 2014 and ending in 2019, the year the county paid the family of detainee Michele Smiley $2 million after she died of a methamphetamine overdose.
Booked on a probation violation, the 34-year-old mother of sixswallowed the drugs to avoid prosecution. When she alerted jail personnel, she was told by one staffer not to worry and that she was "just going to get really high."
Southeast, which is now part of the Nashville-based Wellpath, settled with the family for an undisclosed amount. Smiley's family and Wellpath did not respond to requests for comment.
Former Sheriff Van Duncan, who served in the position for 13 yearsincluding the time of Smiley's 2017 overdose, acknowledged mistakes in her deathbut defended the jail'spractices then and now as some of the most proactive in the state.
Duncan said any failures by jail staff are not from lack of empathy but from dealing with a "tremendously difficult population."
After seeing deaths and other problems, Duncanstarted an intake assessment process in which well over half of those booked self-reported drug and mental health issues, he said.
"I think we have becomea countyand a town, for good, bad or for whatever, that has attractedalot of folks who are homeless and with dual problems of mental health issues and substance use," he said.
"I think Sheriff Miller is probably following best practicesand doing everything he can do in that jail. I think that it is a reflection of our widerpopulation."
Of the six most recent detainees who died, threewere known to have been homeless, Biddix, Austin and Cox.
District attorney, SBI
After a jail death, the SBIcan be called in to look for potential criminal wrongdoing.
As top county prosecutor, Williams has asked that to be a regular occurrence. But in the deaths of Guffey and Biddix, Williams said that did not happen.
More:'Unique' officer misconduct agreement: All Buncombe law enforcement agencies sign
With what information the SBI did provide on Guffey's death, Williams said he found no reason to prosecute.
Williams has held the elected position of Buncombe County DA since 2014. He said he will run for reelection this year.
In Biddix's case, the SBI initially declined an investigation, saying the request from the sheriff's office came too late, according to an Aug. 18, 2020, email released by Williams. But hemade a special appeal to the bureau, and staff agreed to proceed.
SBI investigationsare not public record, but a timeline on Biddix's death released by Williams differed with his sister's characterization, including the seven-minute gap in response.
Williams also did not mention a defibrillator in the timeline or other parts of thepublic report, which said ajail employee responded at 1:39 a.m. with a medical bag, followed by Emergency Medical Services staff arriving with a stretcher at 1:51 a.m.Biddix was taken away at 1:55 a.m., it said.
Of the four 2021 fatalities, Williams said he has received a full SBI report on one, Shepherd's April 10death. A preliminary review of the report"indicated that criminal charges arenot expected," Williamssaid. A final review is pending.
The SBI has not yet sent final reports on Austin, Owenbyor Cox, he said.
What the data says
The Citizen Times calculated death rates for the state's 10 biggest jail systems: Mecklenburg, Wake, Guilford, Forsyth, New Hanover, Gaston, Cumberland, Buncombe, Durham and Pitt.
That showed from 2008-18Buncombe had the second most jail fatalitiesin the state per 1,000 detainees, at 2. That was behind Durham at 2.4, with both well above the 1.5 national average.
But when 2019 to 2021 are taken into account, including Buncombe's eight deaths, the county's rate becomes the worst at 2.9, nearly twice the national average.The next highest is Durham at 2.3.
Over the 14 years, Buncombe had a total of 18 jail deaths. Seven were suicides, all hangings.
In 2021,five detention officers and a sergeant received life-saving awardsfor efforts to stop suicide attempts, Sarver said.
Of the other fatalities, sixwere assigned to diseases such as pneumonia, cirrhosis of the liver or to natural causes.
Three deaths were from drug overdoses. Two were said to have been caused by injuries, current or prior.
Three of the detainees who died were Black, and 15 were white.Menmade up most of those who died, at 14.
Such numbers, though,are likelynot known to those who could benefit most. While jail officials may be aware of what has happened in their own facilities, they have little reliable data for comparison with other places.
That is in part because unlike federal or state prisons — which house those who have been convicted and are serving relatively long sentences — jails regularly see large numbers of people churnthrough them. Often those arrested are able to post a bond and get out quickly. Others, without bonds or the ability to pay them, can wait weeks or longer for adjudication. Some convicted of lesser crimes serve their sentences in jail.
While prisons are managed by state and federal departments, jails are run by local sheriffs and funded by county commissioners.
Public records on N.C. jail deaths are kept by jails themselves and by DHHS, though the records do not appear to be combined in any way that makes it easy to see trends or compare experiences in different jails.
Asked about his reaction to Buncombe's death rate, Miller said he was "interested in how" the rate was obtained.
Jennie Lancaster, the former N.C. Adult Corrections Division chief deputy secretary, said being able to see and compare information like death rates could save lives.
"When you see your own operations change and you seespikes, then you look at those spikes and make sure your policies, your procedures, your safeguards are there."
It's not clear if DHHS, the state-level department assigned oversight of jails, does such analysis.Its inspectors are tasked with reviewing jails for compliance with safety and health rules.
If inspectors find problems and the sheriff does not fix them, the department secretary can move to shut down the facility, "if it seriously affects health and safety," saidWoollard, the DRNC attorney. But Woollard said he does not recall that ever happening.
A higher level of oversight is withthe Justice Department itself. But the department's Special Litigation Section, which enforces jail detainee civil rights, also does not have access to jail-level death data, despite the information being collected by its own statistics bureau.
Former special section attorney Julie Abbate said the group of federal litigators is stretched thin and has not brought actions involving any North Carolina jails. Death rates could help alert them to problems otherwise overlooked, Abbate said.
"Absolutely the more informationthe better. A higher death rate might be something to look into to see why. And maybe talk to folks inthe community."
Knowing the numbers can also help family members who now feel isolated.While focused on her brother's death, Devon Biddix said she now has questions about the larger trend of deaths in Buncombe's jail.
"Something needs to be done. It's not happening everywhere. Why is it happening here?" she said.
Andrew Jones contributed to this story.
Joel Burgess has lived in WNC for more than 20 years, covering politics, government and other news. He's written award-winning stories on topics ranging from gerrymandering to police use of force. Got a tip? Contact Burgess atjburgess@citizentimes.com, 828-713-1095 or on Twitter@AVLreporter. Please help support this type of journalism with asubscriptionto the Citizen Times.
