Andra Adkins died hours after he was medically cleared to be booked in to the Dallas County jail.
Suicide had been initially suggested as the cause of his death. But six weeks later, the cause of his death is still unknown.
Texas Jail Project director Krish Gundu pointed to two recent cases in Texas of inmate’s being cleared for detention — one for mental health, one physical — then dying in custody shortly after.
She said jail deaths following medical release are not unusual — but there should be an effort to determine the cause.
"I would think that, 'hey, somebody came in from the jail within hours of being cleared by the hospital with this tube out. I wonder if somebody did that to him?' No matter what happened, as an ME, you would want to err on side of the caution. you would do the autopsy and not rely on law enforcement to tell you whether they should do it or not."
No autopsy?
The medical examiner did not perform a full autopsy, citing several existing medical conditions, according to a state report.
Deaths that happen while in jail custody must be reported to the Texas Attorney General's Office.
The Attorney General's custodial death report says Dallas County Medical Examiner would not perform an autopsy on Adkins because he had several medical conditions, including "a history of cirrhosis of the liver, heart disease, and several other medical health conditions."
Gundu said concerning questions remain because there are no autopsy results to explain what happened.
"How do you go from clearing him for detention to now saying that his death was due to a medical condition?" she said.
"You gain a lot from calling it natural because then you don't have to do anything" Gundu said. "Especially if it's natural pronounced in the hospital under a physician's care, then the law allows you to not investigate."
When an inmate dies of natural causes while in custody, and an investigation leaves no doubt about the circumstance, an autopsy is not required.
But, according to Texas statute, if someone in custody dies of natural causes while attended by a doctor, an autopsy must be ordered after next of kin is notified.
Initial medical concerns
DART police had taken the 50-year-old Adkins to the jail just before 9 p.m. March 10.
Sheriff's office spokesperson Doug Sisk said DART police initially had medical concerns transporting him, so they took him to Parkland first.
"They checked him out, and they gave him the clearance to be booked in the jail," he said. "He was found in the holding area messing with this medical device."
Jail staff had said Adkins pulled a tracheotomy tube out of his throat.
His mother Berlinda Martin later corrected them.
Her son had been picking at a dialysis port line in his chest often bothered him.
Video shows he then suddenly shot upright.
Adkins died just before 4 a.m. March 11 — about one hour after being rushed to Parkland Hospital soaked in blood.
The next day, Commissioner John Wiley Price had said that based on conversations with staff, the death seemed self-inflicted.
"I inquired about a jail death and, more appropriately, what we call a suicide," he said.
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