Pottawattamie County sheriff says jail changes made after ‘tragic’ 2018 case

COUNCIL BLUFFS, IOWA — Pottawattamie County Sheriff Andy Brown said this week that reviewing and improving jail medical care has been a top priority following a 2018 incident in which a county inmate had to have both legs amputated.

Brown said the case of inmate Kevin Pittillo was tragic and that since he took office in 2020, he has restructured county jail leadership, putting it under a sworn sheriff’s captain, rather than a civilian.

He added that the quality of medical care at the jail has been reviewed and will continue to be examined so “it meets all appropriate standards going forward.”

‘Feel horrible’

“I obviously feel horrible about what happened to him,” Brown said of Pittillo. “I ran for sheriff in 2020 because I want to help the people of Pottawattamie County.”

“I certainly do not want anyone to come out of our jail worse off than when they went in,” he said.

He issued the comments after the Nebraska Examiner revealed that Pottawattamie County had reached an out-of-court settlement with Pittillo and his court-appointed Nebraska public guardian last November. The county agreed to pay $4.5 million to settle claims that were part of a negligence lawsuit alleging lack of proper medical care.

County officials had not previously revealed the monetary settlement, saying that it could have prejudiced trial jurors who were hearing testimony in lawsuits aimed at other parties in the case.

The jail’s supervising doctor, Dr. Jon Thomas, also agreed to an out-of-court settlement, but the amount awarded was not disclosed in court records.

On Wednesday, a jury of six men and two women deliberated for about two hours and found the jail psychiatrist, Dr. Ivan Delgado. not liable for the injuries suffered by Pistillo.

Delgado’s legal team, led by the Omaha firm of Lamson, Dugan & Murray, said it appeared the jury agreed the incident “was a physical medicine issue and not a psychiatric issue” and that Dr. Delgado had met the reasonable standard of care for psychiatrists.

Delirious, almost naked

Pittillo, now 66, was brought to the Pottawattamie Jail in July 2018 on suspicion of disturbing the peace. He was reported to be delirious and paranoid, was nearly naked and was talking about being a former Russian KGB agent or a current member of the U.S. military.

He was examined by the medical staff and by Delgado, who prescribed a psychotropic drug, Seroquel, commonly given to treat schizophrenia and other mental illnesses, to address his strange behavior.

While in jail, Pittillo regularly refused to take the drug and refused to take showers. He lay naked on the floor of his cell and was mostly nonverbal. Guards had to pick him up and clean him, and told others that Pittillo needed to go to a hospital or a mental facility.

One leg appeared dead

Nine days Pittillo entered the jail, guards sensed that he was physically deteriorating and called for an ambulance.

Eventually, Pittillo was transferred to Bergan Mercy Hospital in Omaha, where he was diagnosed with “profound ischemia,” a clotting of blood vessels that had blocked the flow of blood to his legs. A surgeon testified that one leg appeared dead.

Both his legs had to be amputated. He now lives in an Omaha independent living facility that provides 24-hour assistance to help him get in and out of bed. He spends most of the day watching television, Michelle Chaffee of the Nebraska Office of Public Guardian Chaffee said.

Pittillo’s attorneys had argued his legs could have been spared, or his amputations could have been less extensive, had Delgado recognized his physical and mental deterioration earlier and ordered him sent to a hospital.

But Delgado’s lawyers said it was the jail nurse’s job to ensure that Pittillo was taking his medication and that they had failed to alert the psychiatrist that he wasn’t doing so until a week had passed.

Like a sudden heart attack

Pittillo’s physical ailments, Delgado’s attorneys also insisted, came on suddenly and were caused by lifelong poor health and smoking. They maintained that the clotting occurred like a sudden, surprise heart attack.

While Delgado’s attorneys accused Pittillo’s lawyers of seeking “Cadillac” care for their client, Pittillo’s attorneys said it was about human dignity and getting their clients diapers changed without his having to wait hours in his wheelchair.

Chaffee said she filed the lawsuit — a first for her eight-year-old office — after Pittillo became a state ward and she learned what had happened.

Public guardians are appointed to manage the affairs of people with disabilities or elderly individuals who cannot manage their affairs on their own and have no family or friends to do so.

The Nebraska office, established in 2014 through the Nebraska Supreme Court, manages about 300 state wards. The office’s stated missions is to protect “Nebraska’s most vulnerable” and it often intervenes in instances of financial exploitation or medical mistreatment.

Pittillo testified during the six-day trial, but he wasn’t present for closing arguments Tuesday. Chaffee said that was because it’s painful for Pittillo to be in his wheelchair too long.

Chaffee said she was disappointed by the verdict, but not surprised, given that the system of treating those with mental illness is “broken.”

“This whole situation is a horrible example of how individuals with mental illness are blamed, ignored and treated differently compared to individuals with physical illnesses,” she said.

“If a person was found lying on the sidewalk, with beginning signs of a potential heart attack, I do not think they would be taken to jail for loitering,” Chaffee added. “And, most assuredly, if the individual was in jail and physical symptoms progressed to heart failure, they immediately would be sent to a hospital.”