The stories are numerous, graphic and troubling.
A health care worker at a Los Angeles County jail recounts a recent incident in which a detainee “started smearing feces [on the walls] and dancing in this very slow and odd way.” That worker says the man had to wait in an unmonitored cell before he was transferred to an emergency room. He spent several weeks in the hospital.
That same health care worker recalls another incident in which staff members called attention to a detainee who had a hole in his scrotum. According to this worker, jail medical staff said there was nothing acutely wrong with him. The medical worker says the wound was oozing pus and obviously a health concern.
Earlier this year, LAist reported on conditions at the L.A. County jails, where more than 12,000 people are incarcerated on any given day — with roughly 40% of them classified as having mental health care needs.
LAist’s reporting found that sheriff’s deputies regularly ignored COVID-19 safety protocols and have allegedly discouraged detainees from getting vaccinated.
But it’s not just deputies who are allegedly failing some of the county’s most vulnerable wards.
Some current and former medical staff members describe a working environment that is dysfunctional, abusive and detrimental to providing health care. One county health care worker calls the situation in the jails a daily “human rights disaster.”
Much of the criticism is leveled at the jails’ Chief Medical Officer, Dr. Sean Henderson, who previously held several positions at Los Angeles County+USC Medical Center.
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Last September, after a female doctor who formerly worked under Henderson at the jails filed a complaint about his verbal abuse, the county responded to her saying it found there had been “inappropriate conduct” on the basis of gender. The same doctor who filed that complaint has filed a separate grievance against Henderson that is pending. In addition, Henderson is named in two lawsuits that are still active.
LAist has obtained a copy of a letter, dated June 9, 2021, written anonymously by a staff physician. The letter was addressed and sent to County Supervisor Hilda Solis, whose district includes the county jails, and Sheriff Alex Villanueva. The letter said Henderson is “well known for being abusive of his authority and power.”
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The letter writer claims Henderson “brought with him [from LAC+USC hospital] his tradition and history of hostility and dysfunction.”
Another county physician, who worked in the jail system for some 13 years, described Henderson’s interactions with coworkers as “sadistic” in an interview with LAist.
During Henderson’s previous tenure as Chair of the Department of Emergency Medicine at USC, the L.A. County+USC hospital’s resident program accreditation was temporarily put on probation for about six months.
One former USC emergency medicine resident, who asked to remain anonymous, told LAist: “You wouldn’t catch me dead working for him again."
Henderson declined three interview requests for this story, via the Department of Health Services media department. Henderson was also directly emailed allegations made by medical staffers and did not respond.
“Ensuring patients who are currently incarcerated have access to medical services is critical and a top priority,” the Department of Health Services said in an emailed statement. “We continually strive to improve care for patients as providing care in the jails present unique challenges for health care providers and the County.”
‘It Can Only Get Worse From Here’
For many years, medical care at the county jails was the responsibility of the Sheriff’s Department. The downtown Los Angeles jail system consists of Men’s Central Jail, Twin Towers Correctional Facility and the Inmate Reception Center. The Sheriff’s network of jails also includes the Century Regional Detention Facility, the North County Correctional Facility and the Pitchess Detention Center.
In 2015, more than 15 years after L.A. County was cited by the U.S. Department of Justice for mistreating and abusing incarcerated people who have a mental illness, the DOJ entered into a settlement agreement with the county. The agreement, which is still in effect, requires enhanced training for jail staff, more out-of-cell time for incarcerated people living with a mental illness, and enhanced grievance procedures, among other reforms.
“The medical care in the jail was terrible,” says Peter Eliasberg, chief counsel at the ACLU of Southern California.
In 2016, the L.A. County Board of Supervisors made a critical change regarding medical care in the nation’s largest jail system. They removed the responsibility from the Sheriff’s Department and created a new Department of Correctional Health Services.
“There was a concern that ... what should have been clinical decisions could be compromised by law enforcement,” Eliasberg says.
Six years after the department was created, some staff members say the problem of serious health care deficiencies within the jail system has not been solved.
LAist spoke with several current or former employees of the jails’ medical department. One current employee describes an environment in which patients are regularly denied care because deputies or medical staff members say they’re too dirty, might be lying about needing care, or are too difficult to remove from their cell.
One county employee, whom we will refer to as Health Care Worker One, asked not to be named for fear of retaliation. That employee provided the accounts of feces being smeared on walls and a wound to a detainee’s scrotum being discounted.
Says that worker: “It can only get worse from here.”
‘It’s A Fight, Every Time, To Get Anybody Seen’
Health Care Worker One described a reluctance inside L.A. County’s jail system to deal with difficult situations. It’s not uncommon for detainees with a serious mental illness to be uncooperative, and they are often held in so-called “high observation” cells, which become filthy. In early April, there were roughly 1,300 people in such cells, according to Sheriff’s Department reports.
Many detainees suffer from chronic health conditions that have been untreated for years.
According to Health Care Worker One: “We send them down to get examined by a primary care physician and the primary care person will say, 'Oh, this isn’t that impressive to me, I didn’t see anything, send them back to their cell.'” When a health concern is flagged, incarcerated people will often be taken to the urgent care facility within Twin Towers for assessment, the worker said.
The health care worker described another incident, having observed a detainee turning blue inside his cell: “The deputies would not open the door, even for a nurse to take his vital signs, because they claimed he was going to be hostile and aggressive.”
The worker believes the health care system within the jail is “critically short-staffed,” adding that the situation is exacerbated by deeply ineffective and abusive management.
“It’s a fight, every time, to get anybody seen, just taken out of their cell,” Health Care Worker One remarked.
People can't receive care in a timely manner.
A pending lawsuit against L.A. County, which also names Henderson as a defendant, claims Correctional Health Services failed to provide dialysis treatment for an incarcerated patient. The complaint alleges this was after an L.A. Superior Court judge ordered a medical examination citing the patient’s severe chronic kidney disease and a possible need for dialysis. The suit alleges the catheter area became infected and the individual had to later undergo surgery.
Lawyers representing the county claim medical staff were “not deliberately indifferent to” the medical needs of the formerly incarcerated patient. According to court documents filed by the defendants’ attorneys, the patient received “constant, appropriate, and prompt medical attention and treatment.”
Melissa Camacho-Cheung, senior staff attorney at the local ACLU, says her office regularly gets calls reporting that detainees are waiting for months to see a dentist or to get follow-up on a broken limb.
Camacho-Cheung says it plainly: “People can't receive care in a timely manner.”
An ‘Authoritarian Leader’
In discussing what they believe is a broken system, six workers who currently provide or formerly provided medical care at county facilities told LAist they have serious concerns about working conditions — and patient care — under the leadership of Chief Medical Officer Sean Henderson, who assumed his current role in 2020 after holding the position on an interim basis since 2018.
Henderson reports to Dr. Timothy Belavich, director of Correctional Health Services for L.A. County. He, in turn, reports to Dr. Christina Ghaly, director of the county Department of Health Services. Saying it was a personnel matter, a DHS spokesperson would not confirm whether Belavich or Ghaly received any letters or are aware of letters sent to County Supervisor Solis complaining about Henderson’s behavior and temperament.
Dr. Laura Doan began her second stint providing healthcare at L.A. County Jail in 2019, when she was hired as a Physician Specialist to work in the urgent care facility at Twin Towers. She says she previously worked there from the fall of 2017 to the summer of 2018. Having most recently worked as a health care provider inside Chicago’s Cook County jail — the nation’s second largest — Doan has plenty of experience working in jails.
Doan says working conditions under Henderson were an alarming contrast to the ones she experienced in Illinois. She called Henderson a very authoritarian leader and says he threatened to fire her on multiple occasions, because she questioned some of his directives.
“The verbal abuse and mistreatment of me because I was a female ... led to me also deciding that for my wellbeing I needed to leave this environment,” Doan says.
In text messages from March 2020 shared with LAist, Doan described to a colleague an incident in which she says Henderson yelled at and belittled her behind closed doors. “I’m on the wrong side of him too often,” Doan texted her coworker. Doan remembers regularly being in tears after sessions with Henderson, who she says also discouraged her from taking notes during their meetings.
Doan says she has also experienced Henderson mistreat her and others on the basis of gender. She recalls Henderson telling her she should act like she’s “castrated” and follow his orders without questioning. According to Doan, Henderson has asked her and other female staffers: “‘Why do you guys always have to touch your hair when you're nervous?’”
Doan recalls a conversation she had with Henderson during which he referenced a female colleague who had left her job: “He's like, ‘She wouldn't stay in the box that I put her in and she kept trying to punch out at the walls of the box. Are you going to stay in the box? If you're not, then I'm gonna move you.’”
Doan filed a County Policy of Equity Complaint against Henderson. In September of last year, after investigating her claims, the county’s Equity Investigations Unit sent Doan a letter stating that her complaint of Henderson’s inappropriate conduct towards others on the basis of gender had been substantiated. The letter does not state if Henderson was reprimanded or punished.
Screaming And Public Humiliation
One person with complaints about Henderson’s conduct during his time at LAC+USC hospital — which are similar to Doan’s allegations — worries about Henderson operating within the black box of the county’s jail system.
“When you’re able to display that kind of behavior in such a public place [as LAC+USC], what makes you think that he won’t continue to do that even more ... in a setting such as Twin Towers,” a provider who wished to remain anonymous and we’ll call Physician One, told LAist.
LAist also spoke with a physician who was a resident at USC in 2012 when Henderson was Chair of the Department of Emergency Medicine at USC. This person, who we will refer to as Physician Two, does not work in Los Angeles but asked to remain anonymous to protect his career.
Saying Henderson’s caustic leadership was at least partly responsible, Physician Two claims the resident program “lost faculty in droves.”
In 2013, a group of resident physicians at USC sent an email to the L.A. County Department of Health Services, the dean of the Keck School of Medicine and several others, raising numerous concerns about Henderson.
The letter reads, in part: “Our greatly valued public institution has become a place where Dr. Henderson can walk into a clinical area at any time in full view of suffering patients to scream and publicly humiliate and demote a faculty member without repercussions, acting with the authoritarian belief and entitlement to do so. This does not take into consideration the countless times that he has disrupted direct patient care to publicly disparage and intimidate faculty members, hospital staff, and Residents.”
The letter called on officials to “collect more information on the destructive and disruptive events described in this letter, along with scores of others throughout the past and recent years involving Dr. Henderson.”
About nine months after the letter from USC residents to county and medical school officials, the Accreditation Council for Graduate Medical Education (ACGME) put the LAC+USC Medical Center Program on probation for several months.
The Accreditation Council confirmed the probation to LAist, saying that it delivered a letter to USC outlining its concerns with the program, but declined to provide us the document, stating confidentiality concerns. USC did not provide comment after LAist requested information concerning the program’s probation history.
During his nearly 40-year career working in the emergency room at LAC+USC hospital, former physician assistant Joe Baltrushes says he worked with Henderson in some capacity for more than two decades.
In March 2009, Baltrushes was one of 13 LAC+USC physician assistant staff members who signed a letter sent to the hospital’s Chief Medical Officer. The subject line reads: “Hostile Work Environment and Retaliation.”
It reads, in part: “The many transgression[s] by Dr. Henderson are too numerous to document in this letter.”
The staff members call out Henderson for displaying “intimidating and disruptive behavior” and “demeaning comments, threats and name calling in the clinical areas.” The letter also expresses frustration at what the signatories believed was long unchecked bad behavior from Henderson.
“He’s an evil guy that does terrible things to people,” Baltrushes told LAist. “And there’s been no accountability at all as far as I can see.”
‘Filth Spread On The Walls’
The letter sent to Supervisor Solis and Sheriff Villanueva last summer by an anonymous Correctional Treatment Center physician asks county officials to investigate Henderson’s “hostile,” “temperamental” and “unprofessional” behavior.
“I personally have witnessed him talking to patients referring to them as ‘you animals,’ ‘you black people, there’s nothing wrong with you, you just want drugs,’” the letter reads.
Solis’ office declined an interview request from LAist.
L.A. County denied our public records request for complaints referencing Henderson, citing privacy concerns that sometimes can protect personnel records.
The allegations against CHS management and Henderson come at a time when disturbing problems remain within L.A. County’s jail system. The jails continue to be out of compliance with the 2015 federal settlement agreement that required the county to rectify several serious concerns about patient care, according to an Oct. 2021 report from a court-appointed monitor who observes conditions in the jails.
The monitor’s report cites an insufficient amount of out-of-cell time for people in high observation housing. The report noted poorly-lit cells “nearly overflowing with garbage,” as well as “filth spread on the walls near various inmate tiers” at Men’s Central Jail.
The report also points out a sharp increase in the number of deaths by suicide within the jail system. There were four suicides in all of 2020, according to the court monitor. “In 2021, however, there were five completed suicides in the First Quarter alone,” the report points out.
The court monitor’s report also states that “the higher suicide numbers should be a call-to-action for the County to redouble its efforts to improve jail conditions for inmates with mental illness.”
More recent records from the L.A. County Coroner show there were double the number of in-custody suicides in 2021, with seven occurring at the jail complex downtown and one at the Sheriff’s station in Palmdale.
‘I Don’t Know If [There] Were Any Consequences’
L.A. County has committed to closing Men’s Central Jail in the coming years. As the county explores what that will take, some current and former medical providers at the jail told LAist that issues with management and patient care cannot wait.
Dr. Nick Teophilov, a physician who works in the county’s ambulatory care division, said in an interview with LAist that when he worked at Twin Towers, he regularly experienced abuse from Henderson. Teophilov transferred out of the jail in 2020 after working there since 2007. He said the main reason for his departure was because of daily harassment by Henderson.
“His sadistic interactions with coworkers ... has just completely eradicated any energy, any enthusiasm, any desire to really perform at the top of our skills and abilities,” Teophilov says.
For his part, Teophilov says he presented a letter to Supervisor Solis’s office in 2019, outlining “examples of harassment and intimidation which endanger patient safety.”
In the letter, Teophilov described a meeting he attended in 2012 during which Henderson yelled at an employee in front of several USC and correctional health managers. “The color of his skin turned dark red. Droplets of saliva were flying out of his mouth. I was shocked and dismayed,” Teophilov wrote.
He wrote that another doctor interrupted Henderson’s “tirade” and the meeting “continued as if this was business as usual.”
The letter sent to Solis’ office also expresses Teophilov’s concern with Henderson’s basic medical knowledge. He described an event in 2018 in which an incarcerated patient was sent to LAC+USC hospital because of an untreated alcohol withdrawal syndrome called delirium tremens that causes hallucinations and can prove fatal.
According to Teophilov’s letter, Henderson questioned the decision to hospitalize the patient: “In [Henderson’s opinion] the patient’s untreated schizophrenia was the cause of his bizarre behavior. Dr. Henderson lacked basic knowledge about the clinical manifestations of delirium tremens. He could not distinguish the symptoms of untreated schizophrenia from the symptoms of delirium tremens. Dr. Henderson’s poor clinical skills would have endangered the patient’s life if he was his treating physician.”
Additionally in the letter, Teophilov claims Henderson “was angry at the CHS staff for correctly diagnosing the patient’s condition and saving his life.”
Teophilov told LAist that he’s not aware of any action taken to rectify the concerns he laid out in the letter. Teophilov says he met with two Solis aides in June 2019, but never received a response to his complaints.
(Dr. Teophilov is also named as a defendant, along with Dr. Henderson and others, in the lawsuit noted in this story from a former detainee who alleges he received inadequate care for his chronic kidney disease. Teophilov, formerly a chief physician at the jails, says he believes adequate care was provided.)
Additional Harassment Allegations
Henderson is named in a lawsuit filed against L.A. County in Dec. 2021 by physical therapist Dr. Sutiono Togi, in which Togi, who worked under him in the jails, alleges workplace violations.
Attorney Alan Romero, who filed the lawsuit on behalf of Togi, called Henderson “a harasser.” Romero described Henderson as “someone that’s gone out of his way to needlessly abuse [Dr. Togi] and refuse to even address him as ‘doctor.’” That lawsuit is still pending.
In a document filed with the court, attorneys representing Henderson and L.A. County said that the defendants “deny each and every allegation of the Complaint.”
Meanwhile, Dr. Laura Doan awaits arbitration of a grievance she filed in July 2020, with the help of the Union of American Physicians and Dentists, against the county and Henderson.
The grievance alleges Doan suffered a number of “fierce verbal assaults” by Henderson. It asks that the county “Hold Dr. Henderson accountable for his misconduct, including removing him from leadership positions in [the Department of Health Services].”
As for her Policy of Equity complaint that was substantiated on gender-based inappropriate conduct, Doan says she doesn’t know if there were ever any consequences for Henderson.
Doan believes she was subsequently the victim of retaliation from Henderson because she says her supervisor duties were eliminated after making a complaint about him during her time at Twin Towers. This allegation is included in her pending grievance against Henderson.
Doan, who still works for the county as a physician specialist in the ambulatory care division, says she chose to be interviewed on the record about her experience because she feels a sense of responsibility for her colleagues and patients still inside the jails.
Doan also questions how much progress has been made towards equity in the workplace for women, even after the “Me Too” movement. She says her infant daughter inspired her to illuminate injustices she believes are ongoing.
“I worry about her,” Doan says, “because [I wonder], will things change in 20 years? I just hope that she doesn't have to experience the things that I had to go through.”
‘Get A Lot Of Them Out Of There’
As the outcry from jail medical staffers continues, L.A. County promises significant changes to the jail system.
Last year, a report prepared by the county’s Department of Diversion and Reentry and the Sheriff’s Department estimated it would take up to two years to close Men’s Central Jail. The report described the nearly 60-year-old facility as "unsafe, crowded and crumbling."
The proposal cites a 2020 RAND study, which found that “an estimated 61% of the jail mental health population were likely appropriate candidates for diversion.”
One year after the Board of Supervisors received the report on closing Men’s Central, it said in a statement that while it’s committed to closing the jail “as swiftly as possible … it is difficult to project an exact timeline.”
In March, the JusticeLA Coalition rallied outside of the Hall of Justice on the one-year anniversary of the report to push the county to close the jail by March of next year.
The overall jail population has been reduced by 12% since last September, according to county officials.
“You got to get a lot of them out of there,” says the ACLU’s Eliasberg, referring to incarcerated people with mental health issues. “And then the ones who remain will probably do better also, because they're not so crowded and jammed in there.”
But Eliasberg doesn’t believe the jail system, as it stands, could be fixed by anyone.
“I just don't see a world where they're going to provide adequate medical and mental health care,” Eliasberg says. “As long as they have a jail population they have as sick as it is, and particularly when 40% of the population has serious mental illness.”
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Lead illustration by Dan Carino/LAist
