San Diego County will pay $3 million to the widow of a diabetic man who died in jail when his insulin pump ran dry and medical workers failed to resupply it for more than 19 hours.
Cecilia Bach’s lawsuit over the death of Keith Bach, her husband of 35 years, in the men’s Central Jail in 2023 has been resolved with a settlement.
San Diego County officials did not immediately respond to a request for comment on the latest payout over a death in local jails.
The Sheriff’s Office said in a statement Friday that it continually evaluates its medical practices and makes improvements where opportunities are identified.
Among other new practices, the office said diabetes patients in jail are flagged for immediate care; safety alerts for insulin pumps have been implemented and detainees who need more insulin are housed in a jail medical unit, a department spokesman said.
“These enhancements reflect the Sheriff’s Office’s commitment to continuous quality improvement and patient safety,” spokesperson Lt. David Collins said in an email.
Attorney John Gomez, who represented Bach’s widow in the federal lawsuit, said his client was pleased with the settlement but remains concerned that people keep dying in sheriff’s custody.
“When it comes to change, money talks loudest,” Gomez said Friday. “We are hopeful that this result and others will continue to lead to meaningful reform.”
Bach, who was 63, had been working as a heating and air technician when he was arrested by Chula Vista police on Sept. 25, 2023, on suspicion of vandalism and making a criminal threat. He was not charged by prosecutors.
A longtime diabetes patient, Bach was too sick to be booked into custody at the time of his arrest, so he was transported to Scripps Mercy Hospital for treatment.
Later, he was medically cleared for booking and taken to the Central Jail in downtown San Diego. But Bach fainted during the booking process and was returned to the emergency room until he stabilized. He then was returned to jail.
“Orders were to continue using the insulin pump, confirm metformin dose and add blood sugar checks,” the autopsy findings said.
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Court records show jail staff were told to monitor Bach’s insulin after he was released from the hospital and placed back into their custody, and he was given 10 units of insulin on Sept. 26.
But hours later, his blood glucose level hit a dangerous high, and he warned jail staff that such an insulin dose was too low. A nurse requested a higher dose, but approval of the order was “pending review.”
Bach wasn’t seen by any medical staff for nearly one full day. Even after the alarm on his insulin pump went off, they did not refill the prescription.
Bach died early on the morning of Sept. 28, 2023. He had not been evaluated for at least 19 hours at the time of his death. The pump alarm was still beeping when a coroner’s investigator arrived.
“Following insufficient insulin administration while in custody, Mr. Bach developed diabetic ketoacidosis and died,” the autopsy findings noted.
“This occurred despite medical records containing documentation of his medical condition, insulin requirements, when his pump would be depleted of insulin and multiple unanswered requests for insulin by Mr. Bach and fellow inmates,” the report said.
The medical examiner’s office classified the manner of death as a homicide due to neglect, but no charges were ever filed against any Sheriff’s Office staff.
San Diego County jails have a history of in-custody deaths, although their frequency has dipped in recent years due to reforms imposed by Sheriff Kelly A. Martinez. Five people have died in custody so far this year, a notable decline from the 19 deaths recorded in 2022.
Lawsuits over many of those deaths have cost San Diego County taxpayers tens of millions of dollars in settlements in recent years, including $16 million paid to the family of Hayden Schuck last year and $14 million paid to the family of Elisa Serna in 2024.
More legal payouts are likely in coming months, as currently pending lawsuits make their way through the courts.
Gomez said the $3 million settlement he reached with the county does not include a confidential agreement he reached with private medical providers.
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