County ignored FDA warning, inmate died 3 months later


For several months before a 60-year-old man died in the San Luis Obispo County Jail, a doctor at the jail prescribed the inmate high doses of a medication the FDA warned that taken regularly could lead to heart attacks in patients with high blood pressure.

On the evening of April 14, Kevin Lee McLaughlin complained of chest pain, shoulder pain and numbness in his arm that had started a day earlier, according to jail records. McLaughlin also complained of increasing arm pain and heart palpitations.

“I’m clammy,” McLaughlin said. “I need to go to the hospital.”

The nurse denied McLaughlin’s request, and gave him Tylenol before sending him back to bed. Less than an hour later, jail staff discovered McLaughlin was not breathing and had no pulse, according to jail records.

McLaughlin had been in custody since his arrest on Jan. 23 for assault with a deadly weapon after he lashed out at a family member after learning about the death of his brother earlier that day. Agitated over the loss, Mclaughlin pushed a chair towards his mother, and even though the chair did not make contact, a visitor at the house called 9-1-1.

At the time of his death, McLaughlin had already been convicted of the charge and was due to be sentenced to180 days in jail on May 11. With credit for time served and good behavior he was expecting to be released from jail in May.

Shortly after his arrest, doctors at the jail prescribed McLauglin, who had asked to be given the same medications he took on the outside, medications for high blood pressure, depression and pain, according to jail medical records.

After he was jailed, McLaughlin asked for the same medications he took for high blood pressure, depression and pain, according to jail medical records. County doctors prescribed him some of the same medications.

But, three days after his arrest Dr. Kristopher Howalt prescribed McLaughlin 1,200 mg of Ibuprofen a day. On Feb. 14, Howalt increased McLaughlin’s dose to 1,600 mg a day. At the time of his death, McLaughlin was still taking 1,600 mg of Ibuprofen a day, according to jail records.

In 2005, the FDA issued a warning that Ibuprofen increases the risk of heart attacks and should be used only for short term in small doses for people with heart disease? That warning was strengthened in July 2015 saying that it is best for people with high blood pressure to avoid taking Ibuprofen at all.

“There is no period of use shown to be without risk,” said Judy Racoosin, M.D., M.P.H., and deputy director of the FDA’s division of anesthesia, analgesia, and addiction products.

The FDA suggests anyone taking a NSAID, a non steroidal anti-inflammatory drug, including Ibuprofen, seek medical attention if they experience symptoms of a heart attack or stroke.

“Stop taking NSAIDs and seek medical help if you experience symptoms that might signal heart problems or stroke, such as chest pain, trouble breathing, sudden weakness in one part or side of the body, or sudden slurred speech,” the FDA says in its warning.

Since 2012, 11 men have died and many others have been injured while in jail custody. A handful of county workers say the deaths and injuries could have been prevented if San Luis Obispo County provided adequate health and mental health care.

For years, inspection reports provided documentation that the county has failed to comply with state requirements regarding adequate staffing and medical policies and procedures. In 2015, inspectors found that “the workload capacity of meeting the needs of the inmate medication administration program as it currently exists is prohibitive.”

County employees, who requested anonymity because they fear retaliation, said that the county jail continues to be understaffed having a doctor on site only several hours in the morning three to five days a week. As a result, doctors regularly continue high doses of Ibuprofen and other medications without having time to examine the patient, sources said.