Kimberly Phillips didn't like to show when she was hurting, her daughter Maranda Mills said. But Mills could see her mother's pain when she visited her at the Tarrant County Jail.
“I could tell she was holding back her tears,” Mills said. “And she just looked at me, and she said, ‘Baby, I need to eat.’”
Phillips kept telling her daughter how hungry she was, Mills said. She was trying to eat the food the jail gave her, but she couldn’t keep it down.
Phillips died in custody on February 18. Her cause of death: complications of malnutrition and dehydration. She was 56 years old.
Phillips is at least the fourth person whose death in Tarrant County Jail custody has been linked to dehydration since 2020. She appears to be the first linked to starvation, at least since 2017, when Republican Sheriff Bill Waybourn took office.
And this was not the first time Phillips stopped eating in the Tarrant County Jail, according to notes from an incarceration dated 2023 – a fact that medical staff noted when she was booked into jail again in January.
By the time she was transferred to John Peter Smith Hospital (JPS) three weeks later, on February 15, Phillips had severe hypernatremia — a sodium imbalance usually caused by dehydration — and her kidneys were failing, records show.
Now, Mills is left wondering how this happened, leaving her without her mother and her kids without their grandmother.
“She was my best friend,” Mills said, crying. “I didn't have friends, because I always felt my mom was enough.”
'Please don’t let me die’
The Tarrant County Jail has been under scrutiny for years for deaths and allegations of mistreatment behind bars. At least 71 Tarrant County prisoners have died since Waybourn took office in 2017, including an alleged murder by guards last year. The county has also paid more than $4.3 million in jail-related lawsuits since 2022.
That includes a $750,000 payout to the family of Georgia Kay Baldwin, a woman with severe mental illness who died in 2021 from hypernatremia. That's despite having a water fountain in her cell.
Abdullahi Mohamed and Edgar Villatoro Alvarez also died of dehydration in jail custody, in 2020 and 2022, respectively. Both men also had a documented history of serious mental illness, WFAA reported.
A recent investigation in The New Yorker found dozens of starvation and dehydration deaths in jails across the country. Often, the people who died struggled with mental illness, were arrested for low-level crimes and couldn’t make bail.
Mills suspects her mother’s food intolerances led to her death, she said. In the medical records she shared with KERA News, providers at JPS wrote they thought Phillips’ mental health played a role. She had previously been treated for psychosis and seemed to have paranoia around food, medical staff wrote. “Severe allergies” are also listed elsewhere in her medical history.
Whatever led to Phillips’ death, Mills' lawyer Chidi Anunobi said he suspects her death was preventable.
“Our working theory is that Tarrant County Sheriff's Office, that they were grossly negligent, and that their negligence caused Kimberly's death,” he said.
The Tarrant County Sheriff’s Office declined to answer specific questions about Phillips’ treatment in jail, citing an ongoing investigation. When asked if the jail has made changes to prevent more dehydration deaths, spokesperson Laurie Passman responded in an email, “No changes.”
“Inmates have always had access to water 24/7. They have a water fountain in each cell,” she wrote.
Phillips was booked into jail on January 25 for outstanding warrants, according to a press release from the sheriff’s office. The release noted Phillips was “placed in medical housing under medical observation, where there is access to 24/7 medical care.”
Mills visited her mom multiple times during the three weeks she was behind bars. Phillips was a vegan, and she wasn’t getting vegan food, Mills said. She tried to eat the food they gave her, but she told Mills she kept vomiting it up.
"She said, ‘Please don't let me die here, Maranda. Please don't let me die,’” Mills recalled.
Two years earlier, when Phillips was in the Tarrant County Jail, a staff member checked on her after she hadn’t eaten for three days, according to her medical records.
“When asked about reason of referral, patient stated ‘the food is not good, it makes me sick, I’m not going to be forced to eat something that it’s [sic] going to kill me, I’m supposed to get a special diet, and they have not given me anything,’” the provider noted.
Phillips expressed the same concerns during her incarceration this year. When medical providers visited Phillips, she declined to let them take her vitals, but she told them she could not eat the food she was given, records show. She made multiple requests for vegan food and nutrition drinks. She also told a mental health provider she “starved” the last time she was in the jail, according to one note dated January 25.
Special meals are available in the Tarrant County Jail through an order from a doctor or the chaplain, Passman said. But JPS records show a nurse told Phillips on February 6 she could only get vegetarian meals for religious reasons.
Mills tried to get her mother some food, too. She called jail medical staff with her concerns about her mother’s diet, but she was told the jail is not a hotel or a restaurant, she said.
The Tarrant County Sheriff’s Office declined to comment on this allegation, citing the ongoing investigation. JPS also declined to comment, citing patient privacy.
That’s a “crass, ridiculous” response to Mills’ request, jail and prison consultant Lenard Vare said. He spent about 26 years working in corrections, including a decade as jail commander in Napa County, California.
“Sometimes they say stuff like that, but the reality is this: We do have vegetarian meals in jails. We have kosher meals in jails. We have halal meals in jail,” he said. “We have special dietary meals in jail for people with high cholesterol or high blood pressure, or diabetic meals, and those kinds of things. So there are various types of meals that most jails will accommodate.”
Sometimes, jails have to get creative to help incarcerated people do what they need to do, Vare said. He remembered bribing one man with apples and oranges to get him to stop fighting the guards escorting him to court dates.
"It sounds childish, but it worked,” Vare said. “It was fine, because we got him to where we needed to get him. Nobody got hurt, and sometimes you have to think outside the box.”
Jails’ responsibility
There are plenty of medical and psychiatric reasons someone might not be able to eat, according to Dr. Marc Robinson, a Texas physician who cares for incarcerated people.
In some cases, people have the right to starve themselves, Robinson explained. Prisoners have used hunger strikes to protest conditions, but it's different when someone isn’t eating or drinking due to mental illness, he said.
"For someone to make that decision, they have to have the capacity to do so,” Robinson said.
Whenever someone isn’t eating or drinking in jail, medical staff needs to determine whether they’re doing it for a reason that makes sense, that they’re not depressed, and they understand the risks, Robinson said.
"If somebody doesn't meet that capacity assessment — for example, if they have a mental illness and they're not eating — well, then it does become incumbent on the jail to make sure that somebody's eating,” he said.
He acknowledged that can be an “impossible task” for jails, where most prisoners may have a mental illness. Texas jails have been called the biggest mental health providers in the state.
That's why sometimes, what people require is hospitalization, because it's easy for one person who’s not eating to slip through the cracks, Robinson said.
“If that person was in a psychiatric hospital or any other facility, they would have someone checking in on their meal tray and saying, ‘Oh, how much did you eat? Oh, they didn't eat. Well, let me talk to the doctor, because this has been two days now,’” he said.
The last time Mills saw her mother, she remembered Phillips’ voice sounded hoarse and weak. Phillips told her daughter not to worry about her anymore, because “they don’t want to help her,” Mills said.
“I said, mom, you need to ask them to take you to the hospital. You don't sound right,” she said. “She said, ‘I did, baby. I asked a lot of times. And they won't let me go to the hospital.’"
KERA News asked the sheriff’s office about the allegation that Phillips’ request to go to the hospital was ignored. JPS jail medical staff decide when someone needs to go to the hospital, Passman said, adding that the sheriff’s office will “refrain from commenting until the investigation is completed.”
KERA News also asked JPS what was done to help Phillips, and who is responsible for making sure that people in jail are eating and drinking.
“Any inmate requiring medical attention or treatment receives individualized care in accordance with his or her unique circumstances,” JPS spokesperson Dawn Fernald wrote in an emailed statement. “While we are unable to comment on specific patient matters, we do take all inmates’ health needs seriously and strive to deliver the most appropriate care in every instance."
Jails need to have a protocol in place when detention officers notice someone isn’t eating or drinking, Vare said. Some agencies require officers to refer a prisoner to mental health if they’ve gone 24 or 48 hours without eating.
If someone doesn’t eat for a couple days, Robinson recommended they should be sent to a hospital.
Phillips was transferred to the hospital on February 15, three weeks after she was booked. One jail record noted she had not eaten since January 27, according to her medical file. A detention officer reported Phillips had accepted a meal tray on February 11 but didn’t know how much she ate.
People in jail have a right to medical care, and it’s the jail’s responsibility to provide it, Robinson said.
“If they have a medical crisis, they can't just walk out and go to a clinic,” he said. “They can’t check themselves into the hospital. They're fully dependent on the jail or prison."
Suing for answers
The day Phillips was transferred to the hospital, medical staff noted she was weak, uncooperative and agitated. Her face was sunken, her lips were dry, and her ribcage was protruding.
Phillips tried to refuse care, but JPS staff decided she wasn’t able to do that.
“Given her inability to articulate an understanding of the risks associated with refusing medical care, we are determining that she does not have decision-making capacity at this time,” a doctor wrote.
So JPS moved forward with treatment, noting her dire condition put her at “overall high risk of mortality.” They started dialysis for Phillips’ failing kidneys and started tube feeding her.
They had to be careful to avoid refeeding syndrome, according to the notes. That’s a dangerous medical complication that can arise when a starving person starts eating again.
But the doctors could not save Phillips. In the hospital, she was disoriented, confused as to the month and year and her situation, according to medical records. She refused dialysis and asked medical staff to remove her feeding tube. On her third day in the hospital, doctors responded to a Code Blue — a cardiac arrest — and CPR and compressions failed. Phillips was dead.
In May, Mills sued Tarrant County for information about her mother’s death. The county has moved to withhold those records, according to the lawsuit.
Phillips’ family has had to rely on media reports to learn about what happened, her lawyer, Chidi Anunobi, said in an interview.
“These are human beings. These are human beings who have families who care about them, who love them,” he said of people in jail. “And regardless of what they did, they're still entitled to basic human decency."
Anunobi submitted an official public records request to the county, asking for files like intake logs, custody records, medical charts and surveillance footage, according to the lawsuit.
The county appealed that request to the Texas Office of the Attorney General, the decision-maker in open records disputes, arguing the release of those records would threaten the ongoing investigation into Phillips’ death. The AG’s office agreed and allowed the county to keep the records secret.
If he gets access to the documents, and they indicate wrongdoing, Anunobi plans to file a federal lawsuit, he said.
“We want to see the record so we can make that determination and go where the facts lead us,” he said. “They are blocking us from even getting to that stage.”
The lack of information, and the lack of closure about her mother’s death, make it hard for Mills to sleep, she said.
"She was scared. She didn't want to die,” Mills said. “She just wanted out. She wanted to be out and eat."
Got a tip? Email Miranda Suarez at msuarez@kera.org.
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