RALEIGH, N.C. (AP) - A North Carolina inmate with mental illness who had been held in solitary confinement died of thirst, according to an autopsy report released Thursday.
Michael Anthony Kerr, 54, was found unresponsive in the back of the van March 12 after being driven roughly three hours from Alexander Correctional Institution in Taylorsville to a mental hospital at Central Prison in Raleigh.
The North Carolina Department of Public Safety subsequently fired a captain and four nurses at Alexander. A nurse and a staff psychologist resigned.
At the time, Public Safety Secretary Frank L. Perry pledged "an aggressive, yet thorough internal investigation" into Kerr's death. However, nearly nine months later the agency has not made public any results of that probe.
In the North Carolina Medical Examiner's Office report, pathologist Dr. Susan E. Venuti says a senior prison official allowed a "witnessed review" of an internal report into Kerr's death, though the medical examiner's office was not permitted to keep a copy. Venuti wrote that the report left unanswered key details about the circumstances leading to Kerr's death, including when the inmate last had access to food and water.
Because of the lack of information, the pathologist wrote that she was unable to make a determination about whether Kerr's death should be classified as natural, accidental or homicide.
"Mr. Kerr's psychiatric history was significant for schizoaffective disorder for which he was not receiving any treatment at the time of his death," Venuti wrote. "It was not possible to make any firm conclusions regarding the inmate's nutrition and fluid intake, and whether or not his mental health and/or external factors played a role in the dehydration."
Venuti noted abrasions on Kerr's forearms were "consistent with restraint devices."
Records show that before being driven to the hospital, Kerr was being held in "disciplinary segregation," the term North Carolina's prison system uses to describe being confined to a solitary cell. Inmates commonly refer to it as being in "The Hole."
The agency did not respond to a request filed Thursday for information about why Kerr was being punished or how long he had been held in isolation prior to his death.
In a statement, the agency said the investigation into Kerr's death is ongoing and that the autopsy's findings are being reviewed.
"From the start, we have been committed to finding out exactly what happened in this case and in taking appropriate administrative and operational actions," said David Guice, the state commissioner of Adult Correction and Juvenile Justice, according to the statement.
A request to interview Venuti was not approved by the state Department of Health and Human Services, which includes the medical examiner's office.
In an interview earlier this year, Kerr's sister, Brenda Liles, told The Associated Press she had repeatedly called prison officials in the days before her brother's death trying to get him help after hearing from another inmate that he was in danger. She said her brother had been struggling with mental issues since two of his sons were shot to death in separate incidents in recent years.
Records show Kerr, whose criminal record includes several convictions for larceny, was sentenced in 2011 to serve 31 years as a habitual felon after being charged with illegally possessing and discharging a firearm.
North Carolina's prison system has long faced criticism for its treatment of inmates with chronic mental illnesses.
In 1997, a federal audit of Central Prison prompted by the death of an inmate found he died from dehydration after being held in solitary confinement for four days. Water to the inmate's cell had been cut off after he'd stopped up and repeatedly flushed his toilet to cause flooding.
In 2006, Alexander Correctional came under scrutiny after a report that prison staff there routinely used a nylon strap similar to a dog leash to tether inmates whom administrators considered dangerous.
Two years after that, Alexander inmate Timothy E. Helms was left paralyzed after he said he was clubbed by correctional officers after setting a fire in his locked cell. Medical records indicated Helm's skull had been smashed.
A subsequent state investigation failed to determine precisely how Helms received his injuries, and prison officials denied any wrongdoing. Helms, who had been previously diagnosed with multiple psychiatric disorders, later died.
Some states have moved to curb the long-term isolation of inmates, which can greatly exacerbate such psychiatric symptoms as paranoia, anxiety and depression.
The longstanding policy in North Carolina's prison system says no inmate should be housed in isolation for more than 60 days in a stretch. However, Helms' prison records showed he was kept in isolation 571 consecutive days before the fire.