Records show MDC stopped doing mouth checks prior to inmate's overdose

On July 8, the Metropolitan Detention Center medical team received an email advising the team that the warden wanted them to stop conducting mouth checks during drug distribution in the hopes of saving time and getting more inmates on detox medications. 

Fifteen days later, within hours of inmate Thomas Acee dying of a methadone overdose — the drug having been sneaked to him from a detox patient — another email was sent that read: "Effective immediately, we will be returning to the former process ... with the medical team doing mouth checks."

The email, recently obtained by the Journal, continued: "Our team was comfortable allowing security staff to perform the mouth checks... However, the confusion created around this appears to have nobody doing mouth checks."

An investigation by the Bernalillo County Sheriff's Office found another inmate sneaked his prescribed methadone to Acee — a murder suspect and the son of a noted FBI agent — hours before the 21-year-old was found dead in his cell. The Journal is not identifying the inmate as he has not been charged.

Attorney Laura Schauer Ives has been retained for a possible wrongful death suit, representing Acee's estate on behalf of his young son. Schauer Ives told the Journal the firm is still reviewing the case but called it "extremely discouraging" that MDC changed the mouth-check policy right before Acee's death.

Furthermore, she called it “concerning” that Acee overdosed while under monitoring by jail staff.

Both MDC and the University of New Mexico Hospital — which handles health care at the facility — declined to comment and answer questions. Instead, a statement was sent from Warden Kai Smith: "The Bernalillo County Metropolitan Detention Center (MDC) does not comment on pending litigation. This incident remains under investigation by the MDC Office of Professional Standards.”

UNMH spokesperson Chris Ramirez said in a statement, "At this time, it would be inappropriate to comment on this case, pending possible litigation. In general, UNM Hospital is committed to providing the highest quality health care to all patients housed at the MDC."

In a late-November correspondence, Ramirez said the policy was for UNMH staff to conduct mouth checks to be sure inmates have swallowed the medicine and aren’t giving it to other inmates. 

At that time, MDC spokesperson Candace Hopkins said the medical provider has historically conducted mouth checks.

Seven people have died at MDC or died after being injured or falling ill at the facility since January. Since 2020, 39 inmates have died, with the majority of those deaths involving people who were detoxing at the time and the causes often being drug-related.

'A good last night together'

On July 23, deputies responded around 5:30 a.m. to the jail and found Acee lying on his back outside his cell. MDC staff last saw Acee alive at 3:45 a.m., and just before 4:30 a.m., he was found unconscious, according to BCSO reports obtained through an Inspection of Public Records Act request. An autopsy determined Acee died from a methadone overdose, with the death being ruled an "accident."

The reports state Acee's cellmate at the time told deputies he was getting sent to prison the next day and he and Acee "wanted to party." The cellmate said Acee got the methadone in a styrofoam cup.

"They thought getting methadone was going to be a good way of having a good last night together," according to the report. The cellmate told deputies Acee initially took half the methadone and he never took his half, telling Acee he could "do whatever he wanted with it."

The reports state the cellmate told deputies to "look at" the jail's methadone program to find where Acee got the drug. Deputies learned that MDC normally conducted mouth checks of inmates prescribed methadone.

"This meant before leaving, the inmate would have to show their mouth to ensure they had swallowed methadone. However, recently MDC had switched to not doing mouth checks," according to the reports. Deputies reviewed footage of the inmates receiving methadone and found Acee met with one of them afterward, with the inmate handing him a white cup. 

Deputies determined the inmate "obtained methadone that was meant for him but provided it to" Acee, "which ultimately... caused his death," according to the reports. BCSO forwarded the case to the U.S. Attorney's Office for possible federal prosecution.

That inmate remains in custody at MDC.

Policy change

In a July 8 email, UNMH alerted staff that the warden asked them to "stop doing mouth checks" for inmates receiving methadone or Suboxone "so that we can eventually reduce the amount of time we take giving out these meds with the hopes of increasing how many patients we can get on (medications for opioid use disorder, or MOUD).”

As the number of inmates coming into MDC detoxing from drugs has increased, the facility — which is under a decadeslong settlement agreement to improve inmate care — has previously said it was trying to ramp up providing medications such as methadone and Suboxone.

On July 23 at 1 p.m., hours after Acee's death, an email was sent with the subject line "MOUD Mouth Checks Please read Effective immediately." The email detailed that the policy change had spurred confusion and an absence of the checks being done at all — "allowing for the possibility of diversion leading to patient safety concerns."

"All MOUD nurses are being asked to go back to doing mouth checks ... effective immediately and until further notice," according to the email.