NO CHARGES TO BE FILED IN DEATH OF INMATE

Jose Santiago-Perez Was A Diabetic Who Died After Begging For Help. The
System, The D.A. Said, Failed Him.

His pleas for help were ignored, so Jose Santiago-Perez, a diabetic and a
heroin addict, spent the last day of his life vomiting and writhing in a
Philadelphia prison cell - becoming so thirsty that at one point, other
inmates say, he drank from a toilet.

His death, on Sept. 16, 2000, was the result of "a systemic failure" and
was evidence of prison medical care "in chaos," District Attorney Lynne M.
Abraham said yesterday. But she said no one would be criminally charged for
the inaction that allowed Santiago-Perez, 28, to die.

His death will cost the taxpayers, though. His family's lawsuit against the
city and a company that provides prison health care was settled Tuesday for
an undisclosed sum, a lawyer for the family said.

"The entire system failed to look after this prisoner's condition," Abraham
said at a news conference. "There was a callous indifference to [his] health."

After a two-month investigation, she said, her office could not pin blame
for the death of Santiago-Perez on any one person. Rather, she said,
"systemic failure to provide a standard duty of care was the real culprit
in this case."

According to prison internal-affairs investigators, corrections officers at
Curran-Fromhold prison in Northeast Philadelphia failed to summon medical
help for Santiago-Perez because they believed he was suffering from drug
withdrawal. When fellow inmates tried to summon help, the report says, they
were repeatedly told that Santiago-Perez was "dope sick" and would have to
wait for his symptoms to pass.

Santiago-Perez, of North Philadelphia, who was awaiting trial on
drug-possession charges, would have survived if he had gotten the insulin
he needed that day, according to a report prepared by Assistant Medical
Examiner Gregory McDonald.

Abraham said her investigators did not find evidence of criminal conduct on
the part of any corrections officers or nurses - or by the doctor who
treated Santiago-Perez about an hour before his death and ordered water and
insulin.

While the district attorney said she empathized with the pain his family
must feel, she added: "There is no relief that we can offer them in the law
that we could in good conscience sustain... . We can't prove gross
negligence, nor can we prove that there was any deliberateness."

She criticized Arnold Berkowitz, the prison physician who saw
Santiago-Perez shortly before he died and ordered insulin but did not stay
to monitor his condition - even, the prosecutor said, as the prisoner lay
curled up on the floor.

"He abandoned his patient," said Abraham. "No doctor, I think, who has any
even rudimentary information about diabetes would leave him in a fetal
position on the floor, order insulin, and leave. A doctor's oath requires
more."

Berkowitz was removed from his job at Curran-Fromhold soon after the
episode. Through his lawyer, he declined to comment yesterday.

The family of Santiago-Perez sued the city and Prison Health Services Inc.,
which has provided medical services in Philadelphia jails, and reached a
financial settlement Tuesday, their lawyers said yesterday. All parties are
barred from disclosing the dollar amount.

"There was an institutional failure" at the prison, Dennis J. Cogan, the
family's lead lawyer, said yesterday in an interview. "A lot of people
messed up. There was a lot of negligence here, and there's a lot of blame
to go around... . It's absolutely inexcusable."

While relatives of Santiago-Perez said they were pleased with the
settlement, his sister, Rosangela Cesario, appeared startled to learn that
no criminal charges would be filed.

"Oh, my God, that's horrible," Cesario said of Abraham's decision. "You're
supposed to trust in the law. They're leaving those people free for what
they did to my brother? What we really wanted was for them to be charged."

A lawyer for the city referred a reporter's questions to Mayor Street's
office yesterday, where spokesman Frank Keel declined comment. Lawyers for
Prison Health Services, too, declined to discuss the settlement, citing the
confidentiality agreement.

In the aftermath of Santiago-Perez's death, prison officials disciplined
seven nurses and two corrections officers. They also put in place new rules
that require medical personnel at the police administration building, where
many prisoners are processed, to call ahead to the jail and alert them if
someone with medical problems is on the way, said prisons spokesman Robert
Eskind. By all accounts, Santiago-Perez had told medical aides at the
administration building that he needed insulin, and he received two doses
while he was in custody there.

At Curran-Fromhold, however, his pleas for a doctor went unheeded for more
than 24 hours, investigators determined.

In March 2001, a prison internal-affairs investigation recommended that the
case be referred to the District Attorney's Office. For reasons that are
not clear, this did not happen. Abraham said her investigation began in May
at the request of Councilman Angel Ortiz, who has decried the quality of
health care in city prisons.

The city announced last month that it was ending its contract with Prison
Health Services.