Lessons from Nassau jail health verdict

There came a moment, during the trial in a wrongful-death lawsuit against Nassau’s jail medical vendor and the county itself, when the family of Bartholomew Ryan gasped audibly in the courtroom.

That was during testimony from Dr. Vincent Manetti, the psychiatrist who examined Ryan hours before the Iraq War veteran — who was in jail after he couldn’t make bail on a charge of driving while under the influence of drugs — killed himself.

Manetti testified that Ryan told the doctor during an exam that previously he had been diagnosed with post-traumatic stress disorder, bipolar disorder and anxiety.

But, Manetti said, he diagnosed Ryan only with a drug dependency problem. Manetti said Ryan told him, “I don’t want to play the psych card.”

With that, members of Ryan’s family gasped, and looked toward each other, with anger and disbelief on some of their faces.

A few days later, the reason for their muted outburst would become clear. Ryan’s mother, Lilyann, testified that the veteran left a drug treatment program because he felt he did not belong.

“He felt it was a PTSD problem, and drugs were secondary to that problem,” she testified.

While Manetti testified that Ryan — who killed himself six hours after talking to the doctor — thought his issues were rooted in drug abuse, not other disorders, Ryan’s mother testified that Ryan believed it was the other way around.

Either way, the jury put more stock in the plaintiff’s case than they did in that of Nassau County, and its jail medical provider, Armor Correctional Health Services. The jury last week awarded Ryan’s family almost $8 million after finding both the county, and the medical provider, negligent in the case.

Afterward, a spokeswoman for Armor said the company intended to “pursue all available post-trial remedies,” while Nassau on Monday repeated that it was reviewing the verdict to determine “options available going forward.”

Ryan’s was the first of four federal lawsuits against Armor and Nassau over jail inmate deaths to go to trial.

His death also came under review by the state Commission of Correction — which determined that an Armor psychiatrist did an inadequate assessment of Ryan’s mental health on Feb. 24, 2012, hours before he killed himself in his cell. The report didn’t name the doctor.

Was Ryan a casualty of Nassau’s decision to significantly cut costs at the jail by retaining an outside medical provider on a contract that paid the same rate per month no matter how much — or as the state Attorney General initially contended in a civil suit it ultimately settled with Armor — how little care the vendor provided?

The trial didn’t address that question. Still, it’s one worth pondering — by County Executive Edward Mangano and legislators — as Nassau seeks to replace Armor with a new jail medical care provider.

The county still is seeking proposals — even though Armor, which aggressively has defended its quality of care, has said it plans to leave once its contract expires next month. On Monday, a spokesman for Mangano said the county is discussing a “contingency plan” with Nassau University Medical Center, which is next door to the jail.

Even as the search for a more permanent solution continues, however, Nassau would do well to consider more than savings.