Editor’s note: An earlier version of this story incorrectly identified the medical examiner’s role. Florida has employed medical examiners rather than coroners since 1970.
A medical examiner’s report has revealed that 20-year-old Alia Wardell died of natural causes Nov. 28 while in custody at Escambia County Jail.
Wardell’s cause of death was a pulmonary embolism due to deep vein thrombosis, the report said. The cause was listed as natural, and as a result of the finding, the Escambia County Sheriff’s Office has closed any investigation of Wardell’s death being a possible homicide by negligence.
However, Wardell’s mother, Melania Smith, believes her daughter would still be alive if the jail had listened to her pleas to ensure her daughter received “life sustaining” medications.
“I told them (the jail) that, and they didn’t seem to care,” Smith said. “If they had given her the pills, she would have been OK.”
The horror began for Smith’s family when she placed a 911 call on Nov. 17 to get her daughter emergency mental health treatment through Florida’s Baker Act. It’s a call Smith had made at least 30 times before because Wardell was left with permanent cognitive impairments from multiple benign brain tumors and subsequent surgeries. This time, Wardell had refused to take vital medications.
Wardell was transported to West Florida Hospital, where she became so combative with hospital staff that several of them pressed felony battery charges. Wardell was discharged into the custody of a deputy and booked into Escambia County Jail on Nov. 22. Six days later, Wardell was discovered unresponsive in her jail cell.
Dr. Shanedelle Norford, the medical examiner who performed Wardell’s autopsy, said Wardell most likely experienced shortness of breath in her final moments as it is the most common sign that a pulmonary embolism is occurring.
“Unfortunately, most of the interventions are performed at a hospital,” Norford said. “They can try to oxygenate you in that moment, but the lungs are blocked.”
Norford said it varies greatly from one person to the next how quickly someone declines once the first signs of a pulmonary embolism appear and when they might go unresponsive. Smith was told her daughter still had a faint heartbeat when she was transported to Baptist Hospital with a core body temperature of 82 degrees but she was pronounced dead after attempts to revive her.
“The fact that her body temperature is going down means that she’s already declining,” Norford said.
The medical examiner’s report states Wardell’s pulmonary arteries were obstructed by multiple blood clots that traveled from the deep veins in her legs.
Smith said her daughter did not have a history of blood clots and believes they could have been prevented if the jail staff had administered the medications she was supposed to be on, particularly Desmopressin.
Wardell was diagnosed with diabetes insipidus, a disorder causing an imbalance of fluids and sodium in the body. The condition was a side effect of the tumors and treatment that left her without a functioning pituitary gland.
Smith said her daughter needed Desmopressin to help her body reabsorb water, thus regulating her electrolytes and body temperature.
The autopsy report revealed Wardell was extremely dehydrated at the time of her death and had a high sodium level of 180. Smith believes this is why her daughter formed blood clots.
The medical examiner has a different take.
“I don’t think the two are related,” Norford said. “She had a long history of electrolyte imbalances. Going through her medical records, it’s not unusual to have this high sodium.”
Wardell was prone to feeling cold as her body struggled to regulate a normal temperature, something Smith saw as problematic as correctional facilities are known to maintain a cold environment for a litany of reasons.
Smith is bothered that Wardell’s toxicology report shows none of the medications her daughter was supposed to be on were in her system. Smith believes the last time her daughter received Desmopressin, which she took twice daily, was before she was taken to West Florida Hospital following the Baker Act call.
The unknown circumstances around Wardell’s death caused the county to launch an internal investigation of what transpired while Wardell was in the jail’s custody. The final report has not yet been released.
Amber Southard, public information officer for the Escambia County Sheriff’s Office, said any investigation of Wardell’s death being a possible homicide by negligence has been closed by law enforcement since her death was determined to be of natural causes.
For now, Smith is waiting for the headstone to arrive for her daughter’s final resting place. The family is in contact with an attorney who is collecting medical records and facts in pursuit of possible legal action.
Smith hopes her daughter’s death will lead to reform that prevents patients in mental health crisis from being charged as criminals while obtaining care under the Baker Act.
“I’m still going for Alia’s Law to get an amendment to the Baker Act,” Smith said. “That’s pretty much my goal. Some change needs to come from this.”
This article originally appeared on Pensacola News Journal: Alia Wardell died of natural causes in Escambia jail, report says