PORTSMOUTH, Va. -- Arrested for stealing $5.05 of sweets and soda, a 24-year-old who doctors repeatedly diagnosed as psychotic and delusional was left to essentially starve to death over four months in a squalid Virginia jail cell, Jamycheal Mitchell's aunt alleged in a federal lawsuit.
By the time Mitchell died in August -- officially, of a heart condition "accompanying wasting syndrome of unknown etiology" -- jail staff had allegedly denied him many meals, cut off the water to his cell and left him naked with no bedding or shoes as he smeared feces on the window of his urine-covered cell, the lawsuit states, citing numerous inmates who served time with Mitchell.
Mitchell lost about 40 pounds during his time in jail, documents say. A medical examiner said he was "nearly cachectic," meaning his weight loss could not be reversed via nutrition.
Wasting syndrome and cachectic are terms most often used with sufferers of chronic disease such as cancer and AIDS.
"He was unrecognizable -- that's how bad it was. He was unrecognizable. There's something that has to be done," his aunt, Roxanne Adams, told CNN affiliate WTKR. "[He was] probably about 90 pounds and looked 70 years old."
Inmates said they pleaded with guards to help Mitchell during his stay, but their pleas were ignored or disregarded, according to the lawsuit.
"As long as he doesn't die on my watch," one inmate recalled being told.
The 112-page lawsuit filed last week outlines the litany of allegations against 39 defendants, including the Hampton Roads Regional Jail, the state Department of Behavioral Health & Developmental Services and the private prison health care firm, NaphCare.
Click here to read the lawsuit. Warning: some of the details may be considered disturbing.
Adams is demanding a jury trial and at least $60 million in a lawsuit that alleges willful and wanton negligence and five counts of civil rights deprivation.
"Their beloved Jamycheal, despite his struggles with mental illness, had been a vibrant young man who loved music and always made people laugh. In his place was a withered figure the family could hardly recognize," the lawsuit says.
A spokeswoman for the state Department of Behavioral Health & Developmental Services could not be immediately reached for comment; a call and email to the department were not returned Monday.
Jail spokesman Lt. Col Eugene Taylor said, "We really can't speak about the Jamycheal Mitchell case at all," citing advice from counsel.
Jeff Rosen, an attorney representing the jail, could not be reached for comment.
A statement from an attorney for Birmingham, Alabama-based NaphCare, which no longer provides health care at the jail, called Mitchell's death a tragedy and said NaphCare's employees "took appropriate steps" to have him transferred to a state mental health facility.
"The investigative reports of his death suggest gaps and failures within the state's mental health system prevented Mr. Mitchell from receiving the inpatient care he needed," it said. "The allegations of indifference and neglect against NaphCare's providers are false and unfounded. NaphCare will vigorously defend these false allegations."
The story of Mitchell's demise begins April 22, 2015, when the Portsmouth man was arrested for stealing a 2-liter bottle of Mountain Dew, a Snickers and a Little Debbie Zebra Cake from a 7-Eleven.
At the time, he falsely claimed his father owned the store, and the treats were his, the lawsuit states. He was held on a theft charge, as well as a count of trespassing because he had been banned from the store.
At the time of his arrest, the 6-foot-1 Mitchell weighed 180 pounds. He had just turned 24 two days before.
Mitchell had a history of mental illness. He was diagnosed as mildly intellectually disabled in fourth grade, and in the next year as bipolar schizophrenic. Well behind his classmates in his studies, he dropped out of school in the 10th grade, according to the lawsuit.
After his arrest, Mitchell was sent for a medical screening at Portsmouth City Jail, which determined Mitchell's "thought process does not make sense." On April 24, he was said to have "delusion," the lawsuit states.
On April 29, he was labeled "very psychotic -- delusional" and those charged with screening him said he "rambles from subject to subject" and asked where tech icon Bill Gates and Steve Jobs were. A judge the next day ordered a psychological evaluation, the lawsuit states.
The Portsmouth Department of Behavioral Healthcare Services said Mitchell was a candidate for a jail diversion program, but he wouldn't accept services. The same day, the city jail documented again that the "inmate continues to be psychotic," according to the suit.
The next month, the jail would again report problems with Mitchell, and again it invoked the words psychotic and delusional. A May 2015 report said Mitchell was disoriented, speaking loudly and having hallucinations.
"Inmate continues to present as acutely psychotic -- deputies report that he goes for hours just yelling," the report said, according to the lawsuit.
Transfer to Hampton Roads
On May 11, Mitchell was transferred to the Hampton Roads Regional Jail in Portsmouth. His file noted he needed medical treatment, including psychotropic medications, and advised he should be monitored as a suicide precaution.
He weighed 178 pounds.
A doctor conducted a May 20 psychological evaluation, in which he documented that Mitchell had "psychotic and grandiose ideas," according to the lawsuit. He was unable to coherently discuss his case and during a break in the evaluation, the doctor heard Mitchell "singing and yelling incomprehensibly."
Mitchell "LACKED," the doctor wrote in all-capital letters for emphasis, "the capacity to assist counsel in preparing a defense."
The judge issued a competency restoration order, which required Mitchell to be transferred to Eastern State Hospital, a mental health facility in Williamsburg, roughly 50 miles north of Norfolk.
The order was reportedly sent May 27, but the lawsuit says there is no proof it was mailed, and an investigation conducted by the Virginia Department of Behavioral Health & Developmental Services showed no record of the hospital receiving it.
On numerous occasions during his incarceration, Mitchell was denied his medications, the lawsuit alleges. Sometimes he refused them outright, other times he became aggressive, cursing and at least once spitting on a nurse and corrections officer. In other instances, jail staff noted that he would dip his finger in the drugs and put them in his nose as if he was using cocaine, the lawsuit states.
Before Mitchell went to jail, a Portsmouth Department of Behavioral Healthcare Services employee would take Mitchell to a clinic every two weeks for an injection of psychotropic drugs.
In jail, Mitchell received "virtually no psychotropic medication," and a month before his death, all his medication was discontinued, the lawsuit alleges.
Though jail officials said Mitchell refused the drugs, "those statements suggest an informed and conscious decision, which Mitchell was incapable of making," the lawsuit says, adding that guards would encourage nurses to ignore him because he was "crazy."
On June 11, according to the lawsuit, Mitchell asked a health care provider, whom he thought was the U.S. President, to touch his eye and give him a kiss, prompting a report that the "patient appears to remain psychotic."
About six weeks later, after doctors were unable to conduct a mental status exam because Mitchell was so aggressive, the jail discontinued his medication because he refused to take it, the lawsuit states.
Trip to hospital
Mitchell continued to be uncooperative when he was taken to Bon Secours Maryview Medical Center in Portsmouth on July 30 to have the swelling in his feet and legs -- which one fellow inmate described as "elephant like" -- examined.
Doctors diagnosed him with edema, hypoalbuminemia, which is low levels of a blood protein possibly resulting from malnutrition, and elevated transaminase, a possible indicator of liver damage.
No cause was determined. Mitchell now weighed 145 pounds.
He was given a consultation with a gastrointestinal doctor, but in the almost three weeks between the hospital visit and Mitchell's death, he had no followup visits, according to the lawsuit.
Mitchell's family, including Adams, his aunt, were shocked by his gaunt appearance. Adams estimated that she called more than 40 times to express her concerns. Jail staff, the lawsuit states, told Adams and Mitchell's mother, Sonia Adams, that they weren't on the visitor's list, and therefore were unable to see him.
Fellow inmates, too, were shocked, not only by Mitchell's appearance, but also by his behavior and the jailors' treatment of their counterpart, the lawsuit says.
In his cell with the Plexiglass window, Mitchell would whistle and talk to other inmates through the gap between the doorjamb and door.
The two-person confinement reeked of feces and urine, and "indicative of the depth of his mental illness, and/or out of an effort by him to simply be noticed and helped, Mitchell smeared feces on the Plexiglass window to his cell," the lawsuit says.
After Mitchell tried to flush his clothing down the toilet, guards took his clothes, mattress, sheet and blankets, leaving him to sleep on a "metal sheet," according to the lawsuit.
"Day after day, he stood cold and naked at the doorway to his cell. He did not have any shoes to insulate his feet from the frigid cement floor," the lawsuit says, adding that Mitchell told another inmate he stood there for the warmth from an overhead light.
Days before death
Former inmate Justin Dillon has told media outlets, including The Washington Post and CNN affiliate WAVY, that the guards wouldn't feed Mitchell because he refused to return the trays from his previous meal through the "chuck hole" in the cell door.
When Mitchell was fed, Dillon said, he ate voraciously, often using the same hands he used to smear his feces on the window.
Dillon never saw Mitchell wearing clothes, he said, describing his fellow inmate during his finals days as "all skin and bones. He looked sick."
Inmate Dominique Vaughan backed Dillon's account that the guards withheld food from Mitchell and would sometimes deny him water, according to the lawsuit. Mitchell was sometimes so famished, he'd request extra food, which was also denied, Vaughan alleged.
Inmate Steven Gray said in a letter to Mitchell's family that Mitchell was sometimes denied food "for days at a time."
"I watched a physically healthy young man grow into a physically broken old man in a matter of months," Gray wrote.
Former inmate Reginald Morst recalled being ordered to clean Mitchell's cell, and he almost vomited upon entering.
"When you opened his slot, you smelled this horrific smell. It was like walking in the forest after something had died," Morst said, according to the lawsuit. "Everyone in the jail knew of (Mitchell). He was always in his cell screaming."
The prisoners said they also witnessed guards spraying a water bottle in Mitchell's face, kicking him, abusing him outside the range of prison surveillance cameras, taunting him by leaving food outside his cell, and punching and twisting his arm as he reached through the chuck hole for food.
He was also "forced to the ground, dragged, sprayed with mace, stood upon," and Mitchell could be heard weeping in his cell after the abuse, the lawsuit says.
On August 16, Mitchell told Dillon he was sick. Dillon told guards, "but they ignored Dillon's concerns," the lawsuit states.
Vaughan two days later saw Mitchell slumped over the sink in his cell, his legs sticking out.
"Get help. I can't move," Mitchell told Vaughan, but when Vaughan tried to get help, the guards ignored him, according to the lawsuit.
Later, Mitchell wouldn't get out of bed, wouldn't take his dinner tray and didn't respond when Vaughan called to him, the lawsuit states.
Mitchell was found in his cell not breathing and without a pulse August 19. He weighed 144 pounds.
When a guard tried to clean Mitchell's cell, it earned the howl of his fellow inmates, who accused the guard of "tampering with a crime scene," the lawsuit states.
Even after the cleaning, the chief medical examiner's office noted the cell's "foul odor."
Despite a state behavioral health official saying backlogs were responsible for the court order that Mitchell be moved to a hospital being found in a desk drawer, a report last month by the Office of the State Inspector General determined otherwise.
Not only were there no backlogs, according to the report, but between May 21, when the judge issued the order, and August 19, "there was only one day when all beds were full."
The lawsuit further says that between April and September, the waiting list for state mental health beds never topped 45, while the number of beds never sunk below 176.
A Virginia Department of Behavioral Health and Development Services investigation found at least 10 other similar orders in the same behavioral health official's drawer, the lawsuit states.
The office also slammed NaphCare for failing to respond to Mitchell's weight loss, his refusal to eat and his inability to care for himself, in addition to failing to treat his psychosis.
"As the individual was thought to lack capacity to assist an attorney in his own defense, expectations that the individual would have the ability to seek out medical treatment independently while acutely symptomatic seems unreasonable and likely to fail," the report said.
The lawsuit claims that NaphCare and corrections officers could have intervened on many occasions, either by informing the court that the hospital hadn't yet admitted Mitchell, or by advising the judge of his deterioration, his refusal to take medicine and "the danger to him absent court-ordered treatment."
His aunt said she didn't even recognize Mitchell when she saw his body. She asked if officials were sure they had the right person, she told WTKR.
"If he would've gone to Eastern State (mental health facility), we wouldn't be going through what we're going through now," she told the station.