Steve J. Martin Testimony Day 2

Steve J. Martin, expert witness for the plaintiffs in the Mental Health for Inmates trial, returned to the stand for more direct testimony on Monday, Feb. 13, 2012. Martin outlined the various ways SCDC failed to meet standards of response to inmates, particularly in terms of use of force policies on mentally ill inmates.

He reiterated that according to national standards and the state’s own corrections policy, restraint chair use is for control only; punishment uses are strictly prohibited. Policy limits its use to imminent danger, risk of harm to self or others, or damage to state property. Martin said “restraints should not be applied in a way to cause pain, and no inmate should be forced to stay in them for a prolonged period of time.”

National guidelines he quoted say that restraints should use the least restrictive form; and only for as long as necessary; and never for a prescribed period of time. Additionally a person should not be held in unnatural positions, such as hog-tied face down or spread-eagled.

When asked about particular uses of restraints, Martin testified that Warden McCall at Perry Correctional said in his deposition that standard use of the restraint chair is four hours, and is rarely, if ever less than four hours because it is the standard procedure and practice in place.

Multiple instances were described in which an inmate was kept in the restraint chair for several four-hour sessions in a row, despite being logged as quiet.

Martin noted that logs “are suspect” when the required 15-minute notations are all made at exact 15-minute intervals. When asked why that was unusual, Martin said, “As officers attempt to make rounds as required, it is unusual that they would make a series of 16 rounds precisely at quarter-hour intervals. I don’t recall ever being able to accomplish that.”

Martin cited case after case of logs for inmates indicating compliance but continuing to be restrained for four or more hours. He stated that “at some point a judgment could and should have been rendered that control was established and he should be released or transferred to a more appropriate setting than the restraint chair.”

He said the practice suggests that the four-hour period they set in place is a minimum irrespective of whether or not control has been established. He cited several cases where inmates were kept for eight hours, and one, whose log entries indicated he had been quiet, was restrained from 6:30 at night until 6:30 the next morning for a total of 12 hours.

When asked if he found that use of restraint chairs involved unnatural positions, Martin stated, “It was apparent that inmates were restrained on occasion in a spread-eagle or crucifix position for hours at a time.”

Martin said he had never seen this practice used in the U.S. as a routine practice during his 40 years of experience in corrections administration.

He said, “It was demonstrated for me at Perry Correctional, and I was unable to determine what tactical or restraint advantage was opposed to the proper use of the restraint chair.”

When asked to describe the technique of restraint staff had demonstrated to him, he said, “the inmate is placed in the chair in the nude in a spread eagle position – arms stretched back and down and cuffed to the bedpost or bars.”

He said, “The chair immobilizes the body, so having some minimal garment does not compromise security. That has to be rigged. No manufacturer of a restraint chair provides a way to cuff to the bed or cell.”

One case involved an inmate who was self-mutilating. He was put in the restraint chair for at least eight hours in the crucifix position and cuffed to the bed with his arms behind him. That inmate lost feeling and circulation in his limbs; and had been restrained in the chair 13 times in a seven month period. 

Martin was asked why that would be done. He replied, “I have not been able to determine what use that would have other than to cause pain – and it does seem to do that. It should be used in a logical fashion. The basis for use of the restraint chair must be related to the need for control, per national standards.”

Martin detailed the difference between appropriate use of the chair to regain control of an inmate versus other avenues of control that can be attempted. He emphasized that the use of the chair is viable when other options have been exhausted and danger exists.

During a recitation of numbers of cases of what Martin considers misuse of the restraint chair he reiterated a point made by Jeffrey Metzner, M.D. who had testified last week about the need for constant observation of someone in a restraint chair. Martin said, “The fifteen minute observation [intervals] are problematic. If you place someone in a restraint chair they need to be constantly watched. Too much can happen quickly if the inmate is not being observed.”

National standards call for constant observation when inmates are in full immobilization restraints.

Plaintiffs showed a video of one inmate who, after four hours in the crucifix position in the chair, asked “who said I don’t want to come out?” multiple times calmly in response to a guard telling the camera that the inmate wanted to stay in the chair for four more hours. The inmate was strapped back in. 

Martin described him as being, “rather casually engaged in dialogue about what the staff was doing” “What’s going on, I thought I was coming out?” the inmate inquired. Martin described the inmate’s behavior:  "He was no trouble.”

Another video showed an extremely thin and pale inmate in the chair for four hours and who remained quiet. Upon release he appears weak, seems to be in some pain, and had to be helped by several officers out of the chair to his cell. When told he is being returned, he quietly pleads and cries almost inaudibly, begging them, “please don’t put me back in that chair.”  He asked, “If you put me back in the chair please don’t put my hands behind my back,” and “don’t put my arms behind the chair like that, please,” followed by a plaintive, “please, it hurts.” His begging continued for several minutes, finally saying, “Please I can’t move…”

When asked why Mr. Martin selected that particular video, he responded that “The need to restrain is a situational control event; if there is a need, restrain them, incapacitate them until you have control, and then get them out of there. This violates all five elements in a blatant disregard of sound practice in regard to immobilization restraints.”

Martin’s opinions were read into the record that the restraint chair should not be used:

  • For periods longer than necessary to gain control.
  • In absence of immediate need to immobilize.
  • In a manner that creates pain or discomfort.

Martin stated that the mentally ill inmate population at SCDC is subjected to use of force at a rate nearly five times greater than the general population. Despite standards set in the 1960s, mentally ill inmates are much more likely to be segregated, which he says should be for the shortest period to accomplish the goal; and not over 30 days. Martin reviewed over 100 cases of segregation and said that sanctions involving wholesale imposition of loss of privileges were also used to excess and that inmates are about twice as likely to be in lockup status if they have a mental illness than if they don’t. In addition, they are more likely to lose “good time” if you have a mental illness.

Even when an inmate has been deemed not accountable for his actions that led to disciplinary infractions, the corrections hearing officers have been instructed to impose sanctions as normal.

Individual cases of mistreatment were reviewed, including that of one inmate with schizophrenia and mental retardation. That inmate was left for days until a nurse visited and noted a terrible smell from the cell, which contained partially rotting food.

The report said she noted his breathing was labored; he was face down with no clothing or security blanket, and was covered in vomit and feces, which had been there for some time. She reported that the stench was the worst smell she had ever encountered. The inmate had been observed having been thrown onto the bare concrete with his hands cuffed.

Martin was asked, “How would you rate someone being thrown into a cell handcuffed?

He said “It raises the risk of injury exponentially because he cannot break his fall.”

The officers would not comply with the nurse’s request to transport the inmate to the hospital. Inmates were rounded up to move him. He was brought in at 2:20 p.m. with a body temperature of 80.6F indicating hypothermia and pronounced dead at 5 p.m.

Martin testified, “One thing I want to make clear to the court is that during the course of this investigation the investigator sought to establish the supervising official who placed the inmate in the status that started this series of events, but could not find nary an official – as remarkable as that can be – who would admit authorizing putting the inmate in this status.

“There is a requirement for frequent supervision,” he continued. “This is driven by active supervision – in order to allow an inmate out at the earliest possible point. Clearly supervision was not provided after he was in the position; and we could not find anyone who would say they had authorized it. What precipitated it? Who observed it? Who supervised it? The investigator asked everyone – no one would acknowledge it.  The placement officer would have had to assume responsibility to assure supervision would be approved; pretty weighty responsibility and decision for someone of that rank.”

Another case involved the case of an inmate who had been dead for at least 12 hours, however, Martin said during that time “officers made the rounds and entered logs that he was alright; he was found dead on the floor; but officers did not make a report that he was unresponsive.”

Yet another case involved a cell check log that indicated the prisoner was “checked in bed” – that is very suspect since he was found on the floor of the cell and the cell checks were at time the medical examiner determined that the inmate was already dead.

When asked if the officers were consulted, Martin testified that they admitted “they were false entries.”

Another suicide investigation focused on the cell check log as well, which Martin stated was “clearly a false log with an entry made at 6:30, which was after the inmate was found dead.”

Martin testified that the entire system of documentation is suspect based on false entries. 

On cross-examination, counsel for the defense (SC Dept. of Corrections) challenged Martin about treatment based programs, which he called a care-giving model. Martin cited New York, California and Minnesota systems as being systems heavily dominated by treatment services and counseling and programming and therapeutic environments.

Martin was asked how many deaths resulted from use of chemical spray or restraint chairs, to which he replied, “None.”

Defense counsel brought up other state’s records of abuse and asked if Martin had encountered any cases of officials rounding up inmates with horses or hitting them with bats? Martin said no.

He was asked if he had seen instances of hog-tying, firearms use on inmates, to which Martin answered no.

Martin agreed that an inmates’ history can affect the way an officer deals with him and that inmates with a history of assault are more likely to be put in segregation.

Counsel proposed multiple hypothetical situations. Martin criticized the system saying, “One pervasive thing in your system is your administrators assume the worst.”

Counsel for SCDC asked, “Should they not assume the worst?”

Martin emphasized that the state’s own standards and rules stipulate that it is not what about what the inmate might be capable of; it is not about a license to abandon or abdicate sound correctional standards for a perceived threat.

Martin testified that “No one, not even your own expert would suggest you could step into the cell and hit an inmate with a closed fist to the head. But this chemical spray is no less the impact.”

Martin agreed that there are times when use of chemical sprays is warranted, and that a limited application of spray can be more humane than hands-on treatment, adding, “It’s less risk of injury but I’m not comfortable with counsel terming it mild.”

He later advised defense counsel to “do your research,” adding, “you do not have to hit the inmate in the face for it to work; it is designed to be used in open spaces. MK4 streamer in an 8x10 cell will affect him whether you hit him in the eye or not.”

Counsel asked, “Don’t you have to be in a position to reach him?” to which Martin replied, “Yes, but the cell is small.”

The court recessed for the day.  Cross-examination will continue Tuesday morning at 9 a.m.