In about four months in 2022, while Mary Faith Casey was held in the Pima County jail, she lost more than 50 pounds. In August of that year, when a Pima Superior Court judge saw Mary’s emaciated frame as she entered the courtroom in a wheelchair, he dropped her charges and ordered her to be taken to the emergency room.
Doctors at the hospital struggled to bring Mary back to health, but after almost a month, released her to hospice care. Her children took her to California where she died from protein calorie malnutrition, according to a recent article about Mary’s case and starvation in jails.
“Mary Faith Casey is among the list of people who died in 2022 in connection with their time in the Pima County Jail, and her death should be officially acknowledged as such,” Andrea Woods, an attorney representing Mary’s family in a lawsuit against Pima County and the jail’s medical provider, told Arizona Luminaria.
“Mary joins a list that is far too long, and emblematic of systemic shortcomings in the Pima County Jail’s delivery of medical and mental health care,” Woods added.
Mary’s story was first reported by journalist Sarah Stillman and published in the New Yorker magazine on April 14.
Medical care, including mental health care, has long been a controversial issue in the Pima County jail. Since 2021, medical care has been provided to people detained in the jail by NaphCare, a for-profit Alabama-based company. In 2023, reporting by Arizona Luminaria found that NaphCare was failing to meet contractual obligations by understaffing and not providing prescribed medications or basic medical screenings.
In a lengthy 2020 investigative report — prior to Pima County officials contracting with NaphCare for medical care — the Reuters news agency found that jails where NaphCare provided health care had the highest death rates in the nation over a three-year period.
Lawsuits, such as that on behalf of Mary’s family, have been filed against NaphCare in Pima County and in other parts of the nation, including a wrongful-death action involving a jail in Spokane, Wash. That case led to a $27 million jury verdict against the company in 2022.
NaphCare spokesperson Stephanie Coleman told Arizona Luminaria via email that they are limited in what they can say because of the ongoing lawsuit, but said that “correctional healthcare presents unique challenges — serving a diverse patient population with complex physical and mental health needs in a setting where custody and security can affect the timing and delivery of care.”
“Despite these challenges, our commitment remains the same: to provide compassionate and medically sound treatment within the constraints of the correctional environment,” she said.
Coleman also said that, in Mary’s case, she was “transferred to two separate hospitals on four different occasions — and was repeatedly returned to the facility by hospital staff.”
Deaths in Pima County jail
Arizona Luminaria began reporting on deaths in the jail in the fall of 2022, shortly after Mary died. Since 2017, the number of publicly known jail deaths in the county is at least 60. If you count Mary’s death, the number would be 61.
According to a December 2022 county memo, 12 people died in the jail in 2022, and Mary was not counted among them. According to Stillman and experts studying incarceration, underreporting jail deaths is common. “Sometimes the victims get transferred to a hospital after they lose consciousness in their cells; the resulting fatalities usually get left out of jail-death logs, as Mary’s was,” Stillman writes.
Beginning in 2023, Pima County’s medical examiner office started tracking deaths that occurred within 30 days after someone’s release from jail. For a brief period, the county made that information publicly available, calling the deaths “Custodial Related Agency Deaths,” on a dashboard. That dashboard is no longer publicly available, but the medical examiner still tracks such deaths internally.
According to a lawsuit filed by attorneys in April of 2024 in U.S. District Court on behalf of Mary’s family and against NaphCare, Pima County and Pima County Sheriff Chris Nanos, “Ms. Casey, a 65-year-old mother and grandmother, starved to death because she was confined for 110 days without access to desperately needed psychiatric medications and healthcare.” According to the New Yorker article, Mary had a long history of mental illness, which began in her adulthood.
“Ms. Casey was incarcerated because of her poverty and homelessness: a lack of residential address triggered a violation of her probation and a subsequent arrest,” the lawsuit continues. “But from the moment she entered the jail, and over the weeks and months that followed, Defendants unconstitutionally deprived Ms. Casey of necessary medical and mental health care.”
The lawsuit claims that as a result of those deprivations, Mary “suffered grievous and needless life-ending misery.”
In a response filed April 7, Pima County Attorney Laura Conover denied all allegations that Pima County or the sheriff’s department was responsible for Mary’s death. The county’s response denies that Mary “was released ‘to die.’”
NaphCare also denied allegations of neglectful care.
“The NaphCare Defendants affirmatively assert that their conduct, and that of NaphCare’s employees or agents, was at all times lawful and within the appropriate standard of care,” according to a filing from July 2024.
The Pima County Sheriff’s Department did not respond to questions about Mary’s death.
“We hope that our lawsuit and increased public awareness helps to shine a light on the inexcusable conditions in the Pima County Jail,” Mary’s son Carlin Casey told Arizona Luminaria through his attorney, Woods.
“My family and I are haunted by what happened to my mother, and hope other families are spared this nightmare,” Carlin added.
Whether or not Mary’s death should count as a jail death, the known circumstances about her last months make clear that she suffered and swiftly deteriorated during her time in the jail.
County response
“The story on Mary is a tragic one, and clearly not a stand-alone incident across the country,” Natasha Tully, forensic epidemiologist at the Pima County Office of the Medical Examiner, told Arizona Luminaria via email.
“Mary’s death is not counted in any of our statistics because she died in California,” Tully said.
She said there aren’t protections in place to keep track of these kinds of cases.
“We’re limited in what deaths are reported to us and are reliant on law enforcement to report information about recent incarceration releases to us during the death notification process, which also means that they need to have been informed by family/friends of the recent incarceration,” Tully said. “We simply can’t know of all deaths that occur in persons who are released from jail/prison.”
Pima County Supervisor Matt Heinz, of District 2 — and also a medical doctor — told Arizona Luminaria he was concerned with ongoing issues with medical care in the jail.
“I do not believe that the system as it currently exists is meeting the needs of those folks who are requiring social health and behavioral health care” in the jail, Heinz said.
Heinz added that it should be the “responsibility of the jurisdiction” to keep people safe who are in jail.
Heinz did not comment about the particulars of Mary’s death or whether or not it should be counted as a jail death.
Karina Kepler, surviving daughter of Mary Faith Casey, told Arizona Luminaria through her attorney that her mother was shut off from her family and outside world while in jail.
“We depended on jail guards and medical staff to care for her,” Kepler said.
“We had no idea that she was receiving virtually no mental health care and deteriorating. By the time we learned of her suffering and decline, she looked like a prisoner of war and it was too late to save her.”
Republish our articles for free, online or in print.
