Jail personnel no longer just have to worry about suicide while watching inmates. Drugs, medical issues and mental health also have led to increased jail deaths. A record four inmate deaths took place at the Kitsap County Jail in 2023.

Suicide — the most common cause of in-custody deaths in jails nationally — was not responsible for any of last year’s incidents. Instead, natural causes and a narcotics overdose led to the inmate deaths, the county medical examiner’s office reported.

“The traditional worries have been suicide and police use of force. Those are the things that we have been addressing really well. But last year was totally different. We saw more serious medical issues come up and overdoses,” said Sheriff John Gese, who oversees the 92 correction officers who run the jail. “The question is, was last year an anomaly or is this what we are going to have to deal with in the future,” he said.

There were no deaths in 2022, one in 2021 (due to a medical condition), two in 2020 (suicide and restraint asphyxia) and two in 2019 (suicide and accidental overdose).

2023 jail deaths

—Rhonda Lee McKelvy, 46, of Bremerton died July 3. Cause of death was a subarachnoid hemorrhage, due to a ruptured cerebral aneurysm; a weak artery in her brain ruptured.

McKelvy died just hours before her scheduled release. The night before she said she wasn’t feeling well and complained of “flu-like symptoms.” She cried about hip pain to another inmate. McKelvy had thrown up and had been given anti-nausea medication. The next morning, she skipped breakfast. Officers reported doing several routine cell checks and observed McKelvy lying on her side and seeing her chest rise and fall. A public address announcement was made listing McKelvy and others who were going to be released that day. She did not respond. An inmate unsuccessfully tried to rouse McKelvy. At 8 a.m., officers were notified; they tried lifesaving measures until medical staff responded. CPR and AED were administered. Narcan was given; it is a drug designed to reverse the effects of a narcotic overdose. Death was pronounced at 8:31 a.m. Later, an autopsy found no signs of injury to the skull to cause the hemorrhage, a Port Orchard police officer said.

—Karl Edwin Kanekkeberg, 58, of Port Orchard died Aug. 6. Cause of death: Ketoacidosis due to poorly controlled diabetes and alcohol abuse. Kanekkeberg died just hours after being booked. When brought in at approximately 3:30 p.m, Kanekkeberg told officers he drinks 15 beers a day and shoots dope. His blood pressure was slightly elevated. Another inmate told officials he heard Kanekkeberg babbling. “He was diabetic and needed food and sugar.” The sack lunch he was provided was found in his cell uneaten. Officers made numerous routine checks and observed the inmate lying on the floor breathing in a holding cell. At 11 p.m. he was found face up on the floor and non-responsive. Correction officers started CPR, utilized AED and as a precaution administered three doses of Narcan. Medics almost immediately pronounced Kanekkeberg dead. Officers, upon examination, found no evidence of IV drug use nor signs of strangulation or recent lacerations. A preliminary urinalysis found the presence of alcohol.

—Dana Lynn McGranahan, 43, of Renton, died Nov. 8. Cause of death: acute combined fentanyl and methamphetamine intoxication. Manner of death: accident [verses intentional overdose].

McGranahan died just hours before her release. She had been brought to the jail the day before. She had been arrested for entering a residence and claiming there was an “alien invasion,” and they were having a baby. She was arrested with methamphetamine.

The morning McGranahan died, she attended court and was notified she was going to be released. Upon returning to her cell, she told officers she was going take a nap. During a routine check, an officer found her lying down covered by a blanket. Upon removing the blanket McGranahan was cold and non-responsive. Lifesaving efforts followed, which included CPR and administering five doses of Narcan. No physical evidence of narcotic use or signs of injury were found by officers. Later, a urinalysis by the medical examiner was positive for multiple narcotics, a Port Orchard police officer said.

—Jerry Salupan Cadena, 48, of Port Orchard, died Dec. 11. Cause of death: atherosclerotic and hypertensive cardiovascular disease. He had an enlarged heart and suffered plaque build-up in his arteries.

Cadena died six days after being booked into the jail. A corrections officer had checked in on Cadena at 4 p.m. and observed no issues. At 4:21 p.m., Cadena was found in an awkward position on the floor and non-responsive. Lifesaving efforts, which included Narcan, were made by staff and later South Kitsap fire but they were unable to revive him. Staff found no injuries or drug paraphernalia or narcotics in his cell. A review of jail video – which did not show the inside of the cell – revealed no assaultive actions had been made against Cadena.

Jail population

Today’s jail population is described by Gese as “fragile.”

“We know that our jail population has a great number of people who are suffering from addiction. The majority are coming in on or addicted to fentanyl. A great number of our folks have mental illness too. In addition, we are seeing a lot more people coming in with serious medical issues – probably from the lifestyle they have lived for years where they haven’t received much medical attention,” Gese said. “I don’t think we have ever had to deal with so many chronically sick folks and people who are addicted or have mental illness. A lot of them have a combination of all three.”

Complexities associated with many of the inmates place a tremendous responsibility and burden on officers, Gese said. “Our jail, like other ones, end up kind of almost like a dumping ground for people who are addicted or have mental illness.”

Jail personnel have no idea who will be brought to the facility. A new inmate may arrive in top physical shape, be high on street drugs, undergoing a mental health crisis, or about to have a heart attack. So, officers have to be ready for any eventuality. The vast majority of inmates are not in the best condition, said Penelope Sapp, chief of corrections and head of the county jail. “About 90 percent of the people that come in are in some kind of altered state. Sometimes they are high on drugs or had a lot to drink. It could be a medical event, like a stroke. It could be a lot of things. We try to be predictive, but we don’t always catch everything,” Sapp said, adding officers have strategies to contend with various issues inmates may experience.

The Kitsap jail has an average daily population of 332, with a capacity of nearly 500. Inmates are facing misdemeanor or felony charges and serving sentences of less than a year. Defendants held on tribal charges and misdemeanors out of Gig Harbor are also held in the detention center. The facility — which occupies two floors in the building that houses the courthouse — is located on Division Street in Port Orchard.

Medical issues

When inmates are brought in, a nurse will ask about their medical history, take their vitals and will ask for a urinalysis test to determine if there are any drugs in their system, Sapp said. Medical staff check a database to learn what medications the person has been prescribed so health care personnel can ensure the person is able to remain on needed medication.

Regardless of preventative steps taken, not all medical issues can be avoided, Sapp said. “What we don’t know is what is going on internally, like a cardiac issue, because they may never had that before. You can be fine one day and pass away from a heart attack the next day,” she said.

During business hours medical staff include a medical doctor, an advanced registered nurse practitioner and nurses. After hours and on weekends there are two nurses who have access to on-call physicians.

Suicide

Everyone entering the jail goes through Columbia suicide screening, which involves being questioned about suicidal ideation. Staff keep a close eye on anyone believed to be suicidal. “We have to see them face-to-face every fifteen minutes. We have to lay eyes on them; to make sure there are signs of life — breathing, good color. The first 48-72 hours are very crucial.

“You try to find warning signs. I’ve been doing this job for almost 22 years. The people who have ended their life by suicide have not put out warning signs,” Sapp said.

Illicit drugs

Staff work to keep a step ahead of those seeking to bring drugs into the jail to guard against overdoses. That is particularly important given the serious consequences of increased fentanyl use. For example, in March an inmate in Santa Barbara jail was found guilty of smuggling fentanyl to another inmate who fatally overdosed. And seven Snohomish County inmates were taken to a hospital last May after apparent fentanyl overdoses from drugs smuggled into the jail.

Narcotics get into the jail several ways. The most common involves a person, prior to being booked, putting drugs in plastic baggy’s then swallowing the bag. After the contraband passes through the body, it is ready to use, officials said. To combat that practice, the Kitsap jail in 2022 installed a body scanning machine, similar to those used by TSA at airports.

“It’s like an x-ray where we can see the internal parts of individuals so we can see anything on them or in them,” Sapp said. When somebody tries to get drugs in or they are worried about getting in trouble for having them, they will swallow them. [The drugs] are usually in a baggie that can break up. If that happens, the person can overdose because of the drugs inside,” Sapp said.

When the scanner detects drugs, the inmate is escorted to a hospital to either have them removed or pass naturally.

Mailing controlled substances to inmates is another way drugs get inside a jail. A letter can be soaked in drugs. The inmate then chews the paper to ingest them, Sapp said. To guard against that, the jail has all incoming mail sent to a company in Florida to be screened for contraband.

Perhaps the most brazen way to get drugs into the jail is when a person goes next to it and tosses a bottle of 100 illicit pills over a wall into an inmate recreation yard. That has led to additional netting being added over the area, and soon more security cameras will be installed, Gese said.

Later this year, officials plan to get a pair of drug-sniffing canines to patrol the jail for hidden drugs. “If someone is able to get drugs past the body scanner, it will eventually get out of their body, and they will start using it. The canines will be able to go in housing units and find any drugs in there,” Sapp said.

Mental illness

Corrections personnel frequently deal with inmates who suffer from mental illness.

“Sometimes you are kind of putting a puzzle together, especially with individuals who are severely mentally ill. They are not very forthcoming with information [about their illness]. We have to try and put the pieces of the puzzle together to figure out what their diagnosis is and how we can treat them. Often, they haven’t been getting treatment in the community and now we have to try and help them,” Sapp said.

In appropriate cases, psychiatric medications are provided to inmates. Mental health professionals are also on hand to work with such individuals.

None of the jail deaths in 2023 were linked to mental illness but there are times staff has to deal with inmates undergoing a psychotic episode. To reduce the chance of such incidents leading to self-harm, officers undergo crisis intervention training and learn ways to de-escalate situations, Sapp said.

Editor’s note: The Kitsap Daily News used several sources to gather facts about each death. Interviews were conducted with jail administration and Jeffrey Wallis, program supervisor at the medical examiner’s office. Investigative reports by Port Orchard police were reviewed through a Public Records Request. POPD independently looked into the deaths because they occurred in the county jail. Those reports included interviews with correction officers and inmates present at the time of the deaths, video logs outlining times officers did checks of the inmates, and findings of the medical examiner’s office.

A shared open space area surrounded by numerous cells.

Recreation areas have an added screen over the top so people outside can’t toss drugs into inmates.