JACKSONVILLE, Fla. — A Florida man’s death in custody after allegedly being denied critical medical care underscores broader concerns about privatized jail healthcare and systemic failures in treating people behind bars.
On Dec. 15, 2023, Brian Tracey, a person in custody at the St. Johns County Detention Center, failed to receive the medical attention he needed to survive from Armor Health of St. Johns County LLC.
“Brian Tracey lay naked and unable to breathe on the floor of the medical ward at the St. Johns County Detention Center,” reports ProPublica.
Tracey’s girlfriend waited outside for him, anticipating his release. Instead, she was told by a deputy and chaplain that he had died.
The medical staff of Armor Health of St. Johns County LLC, the jail’s health provider, said Tracey “was showing flu-like symptoms and suffered from chronic obstructive pulmonary disease, a lung condition that makes it difficult to breathe,” according to ProPublica.
The county sheriff’s office described Tracey’s behavior during the days and hours leading up to his death, stating that “Tracey had passed out and appeared confused.”
Two retired jail commanders and two medical doctors with “extensive knowledge of jail treatment,” according to ProPublica, “determined that Tracey should have been hospitalized based on the symptoms he showed at the jail, which were later determined by an autopsy to be caused by pneumonia with COVID-19.”
Tracey was never hospitalized.
Jails can often be dangerous places for individuals who arrive in poor health. In recent years, the Bureau of Justice Statistics has reported that deaths in custody have been rising in the United States, according to ProPublica, but healthcare in jails has not improved at the same rate.
Former Republican state Sen. Jedd Brandes said, “Healthcare overall in Florida prisons and jails is a difficult and frankly ignored issue that’s put on the back burner.”
Armor Health Management LLC, as well as its predecessor, Armor Correctional Health Services Inc., has previously faced allegations that it “failed to hospitalize patients who needed more intensive care,” according to court records reviewed by The Florida Trident and ProPublica.
Armor Correctional Health Services was sued more than 450 times from 2014 to 2021. Two-thirds of those cases involved allegations of substandard jail healthcare and were filed and later dismissed.
According to court documents, in 2020, a medical expert hired to review internal company reports of deaths in custody within Armor facilities claimed “the company failed to hospitalize patients in more than 70 instances,” ProPublica reported. Armor denied those claims.
Florida is not the only state to take action against Armor. In New York, where the company provided healthcare at two county jails, 14 people in custody died. The state sued Armor in 2016 for breach of contract and fraud.
Seven of the deaths were found to involve “egregious lapses in medical care,” according to the New York State Commission of Correction’s Medical Review Board. Although the agreement barred the company from operating in the state for three years, it has since resumed operations there.
After a verdict was issued against Armor Correctional Health Services, several LLCs were created, including Armor Health Management LLC. Seven Florida jails signed contracts with Armor Health under these new entities.
“Within three years of the company’s conviction, six of the seven Florida jails using an Armor entity stopped contracting with those companies,” according to ProPublica. “St. Johns County, where Tracey died, holds the only known remaining contract with an Armor entity in Florida.”
Pensacola attorney Joe Zarzaur argued in a 2021 wrongful death lawsuit that “those contracts incentivize Armor entities to keep sick [people in custody] in the jails because Armor is paid a flat fee to provide healthcare; that means, he argued, there’s no billable benefit for adding additional services, such as hospitalization,” according to ProPublica.
Zarzaur added, “This is why Armor’s contractual partners, [people in custody], and families see this repetitive conduct of delaying or outright denying [people in custody] medical care, which leads to their deaths.”
“They told us he died of a heart issue, that it was sudden, he just fell over and died,” said Tracey Letourneau, a relative.
Tracey was taken into custody on Dec. 6, 2023, where he was placed in the infirmary to be monitored for a dog bite wound that had been recently treated.
Medical staff soon observed Tracey having difficulty breathing and prescribed him an oxygen mask. One nurse, according to the police report, noted that he was sweaty and complained of shortness of breath. Another nurse recorded that his blood oxygen level had dropped to 89%, a level at which the Cleveland Clinic recommends individuals seek immediate medical treatment.
The next day, the sheriff’s incident report stated that Tracey had passed out in his cell.
After Tracey’s girlfriend posted bond, a deputy went to his cell to process his release and found him lying in his bed, naked.
Investigators later reviewed video footage showing Tracey struggling to dress himself and visibly struggling to breathe.
Sheriff’s deputies reported that they had checked on Tracey and that he was OK in a custody log entry recorded three minutes later.
“At 8:35, Tracey appeared to stop breathing,” according to investigators. ProPublica reported that “no one gave Tracey CPR until 9 p.m.”
When Lillian Scharf, Tracey’s sister, requested his full medical records, she was denied because she was not his legal next of kin.
It was not until this year that Scharf learned the full details of her younger brother’s death through reporting by The Florida Trident and ProPublica. “By then, the two-year statute of limitations to sue for a wrongful death or neglect had passed,” ProPublica reported.
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