The inmate who died at St. Louis' Medium Security Institution (MSI) in August died of an accidental fentanyl overdose, the autopsy report shows.

Louis L. Payton, 48, was the latest inmate to die at the facility known as the Workhouse this year. He was the fifth inmate to die in custody at a city jail this year, according to records St. Louis Public Radio received in August from the city.

“We are here because there must be no more. No more death and dying in a place that claims to be for the purpose of rehabilitation,” said Close the Workhouse campaign leader Michelle Higgins this summer.

Close the Workhouse campaign advocates say they want to end the cash-bail system that they say detains low-level offenders who can not afford to be released. Court records show Payton had been in jail since January on charges of unlawful firearm and marijuana possession. His court date would have been in October. Many inmates at MSI are detained before trial because they cannot afford bail.

Credit Ashley Lisenby | St. Louis Public Radio St. Louis Public Radio and other local news outlets took a guided tour of the Medium Security Institution, also known as the Workhouse, in March 2018.

Back in August, Payton’s family called for answers at a media event organized by Close the Workhouse.

“What happened to him, we don’t know. We don’t know,” a relative of the Payton’s told the news media this summer.

There is a lawsuit pending against the jail alleging inhumane conditions and treatment. The city has denied those allegations in the past.

What happened?

Police reported that Payton collapsed at the jail at 12:15 a.m. on Thursday, Aug. 2. The autopsy record reports the time of death as a little over an hour later. There was evidence of medical care including defibrillator and EKG stickers, according to the medical examiner’s report.

Payton’s family members told the news media this summer they did not know of any medical conditions that would have caused his death. The medical examiner's report describes many of Payton’s organs as “normal,” “intact” or “not remarkable.” Payton did not have any apparent injuries, according to the report.

However, one particular finding stands out: “Acute fentanyl and acetyl fentanyl intoxication.” Fentanyl is a synthetic opioid pain reliever 50 to 100 times more powerful than morphine.

A spokesman for the city said months ago that officials are working to make city jails safer. But Payton died of an opioid overdose. How did fentanyl get in the jail in the first place? City officials who oversee the jail would not address Payton's death specifically, citing HIPAA laws and an active investigation into the jail.

"The smuggling of drugs and other contraband into jails and other secure facilities is a problem law enforcement stuggles with across the country," city spokesman Koran Addo said in an emailed statement on Friday. "The St. Louis Corrections Division works diligently to address the issue and provide a safe environment to the jail population."

A blind eye?

Close the Workhouse has lobbied the city on behalf of ex-Workhouse inmates to have the facility closed, for much of the year. Member Montague Simmons said in addition to allegations of subpar medical attention, people the campaign has talked to allege drug trafficking happens at the jail.

“I’ve definitely heard rumors of drug trafficking. I haven’t heard much in support of rehabilitation,” Simmons said. Jail Commissioner Dale Glass has talked in the past about drug-rehab programs at the institution.

“Unfortunately, even some of the allegations around drug trafficking made allegations against staff who were complicit or turned a blind eye,” Simmons said. “And if that’s the case, it means that folks are not safe.”

Ashley Lisenby is part of the public radio collaborative Sharing America, covering the intersection of race, identity and culture. This new initiative, funded by the Corporation for Public Broadcasting, includes reporters in Hartford, St. Louis, Kansas City, and Portland (Oregon). Follow Ashley on Twitter @aadlisenby.