San Diego County and one of its health care contractors have agreed to pay $15 million to the family of a woman who died at the Las Colinas jail in Santee nearly five years ago.
The settlement reached late last week stems from a wrongful death lawsuit filed in connection with Elisa Serna's Nov. 11, 2019, death, which alleged jail staff failed to properly treat Serna despite knowing she was suffering from symptoms of drug and alcohol withdrawal, including frequent vomiting and seizures.
Along with the monetary terms -- which will have San Diego County paying $14 million and Coast Correctional Medical Group paying $1 million -- the settlement mandates that the county institute a series of reforms aimed at improving training for county jail personnel and revise protocols for inmates receiving medical care.
One of the terms insists county jails consistently implement specific medical protocols for the incarcerated who suffer from drug and/or alcohol withdrawal, something Serna's mother, Paloma Serna, says would have saved her daughter's life.
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Other non-monetary terms will require jail staff to receive training regarding inmate falls, continuity of care during jail employee shift changes, and compassionate care.
Jail staff will also be required to check inmate vitals once per shift.
The sheriff's department will also explore the feasibility of providing medical staff with access to video monitors capturing what's happening inside the cells of the jail's medical observation unit, such as the one where Serna was held. Currently, medical staff may only view those monitors with permission from jail deputies.
The judge who oversaw the settlement will monitor the sheriff's department over the next year to ensure compliance with the terms.
At a Tuesday morning news conference, attorneys credited Paloma Serna for pushing for those reforms to be included in the settlement.
One of Serna's attorneys, Eugene Iredale, said she was "responsible in large part for the best parts of this settlement by insisting that this case was more about change and the prevention of harm than it was about the money."
San Diego County's jails have been under scrutiny for their high rate of in-custody deaths, drawing criticism from the public and a scathing report from the California State Auditor that pointed to deficiencies in the San Diego County Sheriff's Department's practices and polices.
In a statement regarding the settlement, Sheriff Kelly Martinez touted changes to jail policies instituted since she took over for former Sheriff Bill Gore in 2022.
"Elisa Serna deserved better. My sympathy goes to the Serna family and everyone who has been affected by this case, and I am glad that the county of San Diego and the family have reached a settlement," Martinez said.
Martinez's statement noted "many changes and an incredible shift in priorities, approach, and processes in our jails since 2019" and stated that she is "committed to improving our jail system and ensuring the jails are safe for everyone who is incarcerated and for all our employees."
But Paloma Serna and her attorneys assert that these stated changes, such as implementation of withdrawal protocols, have not been consistently applied.
Grace Jun, another attorney who represented the Serna family throughout the case, cited another in-custody death from 2022 in which an inmate suffering from withdrawal symptoms was allegedly not provided withdrawal medication and later died. The family of that woman, Vianna Granillo, filed a wrongful death lawsuit earlier this year against the county.
Serna's family says Elisa Serna was not placed on withdrawal protocols despite her stating she was going through withdrawal upon being booked into the jail. The family's attorneys says jail staff frequently accused Serna of faking her symptoms and ignored her.
"A lot of these deaths were preventable if they would have done their job," Paloma Serna said.
Serna died shortly after she collapsed in her cell in the jail's medical observation unit, five days after she was booked into the jail.
Iredale said that in the hours leading up to Serna's death, she fell 18 times in her cell, suffered nearly a dozen seizures, and vomited at least 64 separate times.
Serna's death also sparked a criminal prosecution against a doctor and nurse who worked at the jail, who were each charged with involuntary manslaughter. The nurse, Danalee Pascua, was acquitted by an El Cajon jury earlier this year, while the case against the physician on duty the day Serna died, Friederike Von Lintig, was dismissed shortly after jurors deadlocked 9-3 in favor of acquitting her.
Serna's father, Michael Serna, said in a statement that he remained frustrated by what he said were efforts by the county to conceal the facts regarding in-custody deaths.
"I'm supposed to be feeling closure right now, but there is none because the county continues to act like they've done no wrong. This is a systematic failure from top to bottom," he said.
