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First in a series: The Chronicle reviewed more than 1,000 jail disciplinary reports and found guards used excessive force against inmates or abused their authority over 120 times.

Norman Hicks, a retired butcher, had been in the Harris County Jail about 10 days when other inmates pleaded with jailers to have him transferred to the mental health unit.

Hicks, 72, had been placed in general population for violating probation in a family violence case even though intake workers determined he suffered from a combination of severe mental problems: bipolar disorder and schizophrenia. The inmates worried Hicks might be killed by others he annoyed, according to a federal lawsuit filed by Hicks' children.

Instead, Hicks died after being punched by a jail guard involved in 11 previous use-of-force incidents. The guard hit Hicks with a closed fist, breaking bones in his face. He fell and hit his head, and the guard left him bleeding on the floor of an interview room. The Harris County medical examiner ruled the 2011 death a homicide.

What happened to Hicks in one of the nation's largest county correctional facilities underscored its most glaring weaknesses.

He did not receive the care he needed in what sheriff's officials describe as the county's largest de facto mental health institution.

He found himself trapped in a violent milieu riven by thousands of fights each year.

He was struck by a guard who failed to seek medical care or report the incident.

Over the past nine months, the Houston Chronicle has reviewed more than 1,000 disciplinary reports provided by the Harris County Sheriff's Office. Nearly half of those internal affairs investigations from 2010 through May 2015 resulted in discipline against jail staff who often brutalize inmates and attempt to cover up wrongdoing but rarely lose their jobs. Court records show jailers seldom faced criminal charges even in cases where they used excessive force.

"It was like an animal shelter," said Jamarcus Hill, who was jailed in 2013 as a 19-year-old on an auto theft charge. "You do anything - you get punished, you get pepper sprayed. You got to fight for your food, you even have to fight for your shoes."

In June 2009, the Justice Department concluded after its own yearlong investigation that inmates' constitutional protections had been violated by excessive violence and by substandard medical care that led to an "alarming" number of prisoner deaths. The Justice Department has taken no public action since then despite what records show are similar instances of unreported beatings, inmate deaths and medical neglect. Officials provided a letter indicating that the Civil Rights Division has an "ongoing law enforcement proceeding," but provided no specifics.

Adrian Garcia took over management of the jail in January 2009 as Harris County sheriff and promised reforms. He resigned in May to run for mayor of Houston. In a recent interview, he said that hundreds of disciplinary cases reviewed by the Chronicle resulted from his "commitment to transparency and accountability." He said he put systems in place that addressed Justice Department findings and notes that the average number of annual deaths dropped from about 16 per year from 2001-2006 to roughly 11 during his administration. Still, the jail has become more violent in recent years, with fights, assaults and attacks on staff escalating, the Chronicle's investigation has found, based on the sheriff's own statistics as well as custodial death reports, autopsies, lawsuits and interviews with current and former jail officials, former inmates and attorneys.

Among the findings:

Harris County jailers were disciplined more than 120 times for misconduct involving abuse of authority or misuse of force, including beating, kicking and choking inmates. At least 15 were handcuffed at the time. In 84 of those 120 cases, jailers or supervisors failed to file required reports, lied or falsified documents. Stephen LaBoy, 25, was beaten by six jailers in his cell after flashing a mirror at a guard station. Drissa Pickens, 28, was assaulted by an accused murderer after a jailer unlocked a cell door and allowed the attack.

At least 70 inmates have died in custody since 2009. Three, including Hicks, died after guards used force. Other elderly or ill inmates were unable to make bond and died while awaiting trial. Latoshia Clark, 36, died pre-trial, of AIDS, after six weeks in jail for drug possession. Ten who died committed suicide, including Alex Guzman, 28, who hanged himself while two jailers ate a Domino's pizza and missed required cell checks. Guzman's case was among 35 documented instances where jailers skipped required cell checks, or faked records to hide skipping them.

Most jailers disciplined for abuse of authority or unnecessary force received only short suspensions. Since 2010, 33 of those jailers were fired for use of excessive force, unprofessional conduct, neglect of duties and lying or falsifying reports. Criminal charges were pursued against guards in only six of those cases. Jailer Brandon Whitaker grabbed inmate Tommy Maiden around the throat during a shouting match and squeezed so hard that he left bruises in the shape of handprints, jail photos show. Whitaker got a five-day suspension without being charged.

Dozens of jail employees were disciplined after they fraternized or had sex with inmates, brought in contraband or concealed relationships with prisoners and gang members. A training academy was disbanded and guards as young as 18 until recently completed only online courses as a cost-cutting measure. Former Deputy Tony G. Richards was prosecuted for having sex with an inmate in the jail laundry. His lawyer declined comment.

"It's thugs guarding thugs over there," said state Sen. Rodney Ellis, D-Houston.

He expressed frustration with jail management and said he has encouraged civil rights attorneys to sue Harris County over jail conditions.

Amin Alehashem, a lawyer for the Texas Civil Rights Project office in Houston, called for an intensive federal investigation of violence and neglect in the jail. "Looking at the issues we have seen come out of there, it completely warrants a Department of Justice probe to see where things are slipping through the cracks," he said.

***

The Harris County Jail is an extremely violent place. Fights among inmates break out an average of 11 times a day. Assaults between inmates are reported about four times daily. Inmates assault staff about once each day. And guards report using force against inmates almost daily, according to official jail statistics.

But what often goes unreported is the use of excessive force against inmates. The jail holds up to 9,434 inmates and sprawls across five buildings along the Buffalo Bayou in downtown Houston.

Robert VanHorn cursed jailers for not bringing him a blanket, then stopped up his toilet and flooded his cell in protest in August 2013. He was taken to a holding cell, handcuffed and shackled. Then jailer Terryl Stoddard entered the cell and threw VanHorn against a metal bunk, opening a deep gash in his head that took nine staples to close. Stoddard's superior, Sgt. Kent Matthews, reported the injury, but he did not mention Stoddard's role. Instead, he wrote that VanHorn slipped on the wet floor.

An initial review cleared both officers, but when VanHorn filed a follow-up complaint Matthews received a three-day suspension for covering up the incident. Matthews still works at the jail, but could not be reached for comment.

Stoddard was fired, a tougher penalty than most guards received in cases related to excessive force. Investigators later determined that he had allegedly used unnecessary force on yet another inmate. He's awaiting trial on misdemeanor charges for official oppression in both cases. His attorney, Vivian King, said her client is innocent and jail officials did not consider all available evidence in a rush to judgment

Like VanHorn, about half of Harris County jail inmates on any given day haven't been convicted but are awaiting adjudication. VanHorn was in the jail on pending charges for allegedly stealing a DVD player.

Civil rights attorneys and other critics of the Harris County criminal justice system say jail violence and chronic overcrowding are symptoms of the deeper problem of local judges' strict bond practices Few accused offenders get released unless they can pay a non-refundable 10 percent commission charged by a Harris County-approved bondsman - a group that collectively makes millions from the county's tough lockup policies.

Hundreds of others are serving sentences of less than a year for minor crimes. Steven Laboy was serving a 60-day sentence for a possession of a switchblade when he was attacked in his cell by six jailers in March 2013, disciplinary records show. The onslaught began after he had flashed a mirror from his cell, hoping to signal a companion for a visit to the jail barbershop, he said.

Laboy remembered one jail guard saying: "I got something for you. I'm going to come back and bring some people." The first of six guards who burst into his cell hit him in the face with a blast of pepper spray, an internal affairs investigation shows. Then they pushed the inmate into the corridor and slammed him against a wall. Laboy fell facedown, where he was pummeled and kicked.

"I thought I was going to black out, get my nose broken, or get a concussion. And at the same time, I couldn't breathe," Laboy said.

One jailer later took Laboy to a clinic with unexplained bumps and bruises, but no one reported the incident. An internal investigation began only because the beating was captured on a security camera.

The jailers were suspended, but none were fired or charged with any crime.

More menacing was what happened to Drissa Pickens, a soft-spoken woman with almond-shaped eyes who is now beginning college classes to become a drug counselor.

Jailed a year ago for violating probation in a domestic violence case, Pickens said she got angry when she wasn't given lunch and began shouting at jail guard Vanessa L. Salazar. The guard told Pickens "that if she did not 'shut up' or words to that effect," she would "allow the other inmates to attack her," according to disciplinary records.

Harris County Jail by the numbers 70 in-custody deaths since 2009. 1,441 incidents where staff used force on inmates 2009-13. 14,588 fights from 2012-July 2015. 5,367 inmate-on-inmate assaults 2012-July 2015. 1,106 inmate assaults on staff 2012-July 2015.

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Salazar then unlocked the electronic door to Pickens' cell. Within seconds, Khaundrica Williams, accused of murder, barreled toward Pickens, knocking her down, hitting her in the face and yanking handfuls of hair from her scalp. Pickens fought back as hard as she could.

Somehow, Pickens managed to escape her cell as the fight continued. She remembers looking up at Salazar, who stood in a control center, watching.

"I really couldn't believe it," she said. "I expect that kind of stuff from inmates, but not from the guards. They are supposed to protect us, and I did not feel protected."

Disciplinary records show that Salazar did not report the fight to a supervisor, as required. She admitted to unlocking the cell to allow Williams to fight Pickens.

"I have no explanation as to why I did not write a report, except that I know I did wrong and there was no way for me to explain why I did what I did," Salazar said in a sworn statement to the department's internal affairs division.

In February 2015, a little more than four months later, the sheriff fired Salazar and another guard found complicit in the attack. Salazar could not be reached for comment.

Pickens still suffers from anxiety attacks. "I feel like the guards let the inmates do their dirty work for them," she said. "They abuse their authority."

***

In one of his first acts as Harris County sheriff in 2009, Garcia consolidated two separate internal affairs operations - one that policed the jail and the other that investigated complaints against patrol officers. He formed an Office of Inspector General with a staff of nearly 50. Garcia said he needed to take action to show the Justice Department that his office would address alleged abuses. He also had inherited a "tremendous" backlog of 160 uninvestigated complaints that had piled up during the previous administration, he said. The deputies organization supported the move.

The OIG he created had a reputation for conducting thorough investigations.

In one of his final acts as sheriff before resigning to run for mayor, Garcia fired six supervisors, suspended 29 jailers and demoted a major for a neglect case involving a mentally disturbed inmate, Terry Goodwin. Initially jailed for marijuana possession, he was laterfound incompetent to stand trial.

A state jail compliance team discovered in 2013 that after he had assaulted a county psychiatric worker, Goodwin had been left unattended for weeks, surrounded by bug-infested food containers in a cell with a feces-clogged toilet. A grand jury in April indicted two of the six fired supervisors for falsifying jail logs to indicate that Goodwin was in good condition, despite essentially abandoning his care.

Garcia said he first learned about the case in 2014 when a whistleblower made it public and an internal investigation began. In a recent interview, Garcia said he was furious after learning of the long-term neglect.

"The framework was there, the system was there to protect the inmates," he said. "Had they followed those policies, we wouldn't be having this conversation."

Harris County recently settled a legal claim filed on Goodwin's behalf for $400,000. He is currently serving a three-year sentence in a Dallas-area prison for assaulting the jail employee.

***

The indictments spawned by Goodwin's high-profile neglect case were unusual. The official response was far different after the 2014 death of inmate Kenneth Lucas.

Lucas, 38, a boilermaker at a refinery, was arrested in February 2014 for violating a child visitation order. He had spent four days in jail when guards came to believe he had broken a smoke alarm, possibly to fashion a shank, Garcia later said. Six jailers dressed in riot gear stormed his tiny segregation cell, pinning him to the ground. Video footage showed just a swath of Lucas' orange jumpsuit, while he lay under a pile of jailers clad inbody armor, helmets and combat boots.

One jailer straddled his back as four others cuffed his hands and shackled his legs behind him on the gurney. Lucas begged for help, his pleas echoing off concrete walls, the video shows.

"Right now, bro, I'm going to pass out," Lucas shouts. "Get off me: I'm not moving. … Help me please."

After a 30-minute struggle and the injection of a powerful depressant in the jail's clinic, Lucas stopped breathing. Clinic staff called 911, and Lucas was pronounced dead at a local hospital.

The medical examiner noted that Lucas suffered from extensive heart disease and said that the restraint used by jailers triggered a heart attack. The medical examiner nonetheless concluded that his death was a homicide. An autopsy describes more than a dozen cuts, bruises and abrasions from his head to ankles, including a broken finger from the struggle.

Garcia held a news conference at which he publicly defended officers whose actions had led to Lucas' death and released a video of the jailhouse struggle.

Despite the homicide ruling, not a single jailer was disciplined and a grand jury in March cleared all eight jail staff of any crime.

Widow Amber Lucas has watched the video of her husband's struggle so many times, she has it memorized. She says she can almost pinpoint the exact moment when he stopped breathing, the moment when she knew he wouldn't survive.

"I feel like it was a form of murder," she said. "They have him hog-tied, then you're sitting on him. Then you're smushing his face. He's screaming 'I can't breathe, I can't breathe, get off me! I feel like I'm going to pass out.' They heard that."

Along with Kenneth Lucas' four children from previous relationships, she filed a wrongful death suit on July 28 against the sheriff's office and the jailers.

Harris County is fighting the lawsuit, claiming its employees were not responsible.

One day later, it was Jacqueline Smith's turn to sue the jail in the death of her son, Danarian Hawkins, a mentally ill 27-year-old who hanged himself with a bed sheet wrapped around a smoke detector after making a previous suicide attempt with another jail-issued sheet. "Harris County jail staff left a suicidal Mr. Hawkins alone with the exact same instruments that he eventually used to kill himself," said Alehashem, of the Texas Civil Rights Project who is representing his family.

The family of another inmate who died in the jail, Herman Young, also sued the county for gross negligence and malice. That suit was dismissed after the county argued that its employees were immune from liability.

Young, 68, became incoherent and was taken to the jail clinic late one night in May 2010. After midnight, jailer Nikolaus Laliotitis yanked Young off a stretcher, punched him in the stomach and dragged him across the floor, according to other jailers who witnessed the unprovoked attack. A motive was never explained. Young died later that day at a local hospital due to what the medical examiner's office said were natural causes. Still, Laliotitis resigned and pleaded guilty to a misdemeanor charge of official oppression. He was sentenced to one day in jail and given a $1,000 fine, according to court records.

A jail sergeant was suspended for three days for failing to thoroughly investigate Young's assault.

***

When members of the sheriff's gang unit stopped a 2012 Kia Soul last year being driven by a member of the Tempted Young Goons, a street gang, they found ski masks and a loaded pistol in the car. But what surprised them most: the car's registration showed it was owned by a Harris County jailer, who later admitted she had a child with the gang member behind the wheel, and they were expecting another child.

The jailer was terminated last October, one of at least 30 documented incidents of jailhouse fraternization.

Some jailers have seduced or become infatuated with inmates. One young female jailer admitted giving an inmate, who was awaiting trial for using an armed robbery, photos of her, having daily conversations in the jail and even buying him a cellphone.

In her termination letter, she admitted: "I wrote to him that I could not wait to have sex with him."

Five other guards were fired and charged with smuggling contraband into the jail, including prescription drugs, vodka, tobacco, cellphones, even home-cooked meals. Another group was fired for having sex with inmates inside the jail laundry unit. One female jailer allowed an inmate to get on a county computer in the laundry unit to help her fix her home Internet service.

The effect that poor training and high turnover have had on the jail's workplace culture has been at the center of a debate Adrian Garcia and Ron Hickman-- the man who replaced him as sheriff -- have waged in the media since Garcia resigned in May.

Both believe low pay is an issue. Detention officers' starting pay is $18 per hour, less than any other county worker except entry level clerks. The guards are forced to work mandatory overtime. Jailers need only 92 hours of training, which they must complete within a year.

In one cost-cutting effort as sheriff, Garcia closed the jail's training academy, saying the department wasted too much time and money on wanna-be jailers who flunked out. Instead, Garcia allowed new-hires to complete training online and slashed overtime pay for detention officers from $26 million in 2009 to $4 million in 2015, according to sheriff's records

Hickman said he believes that relying primarily on virtual training for newly hired jailers was a mistake. He immediately raised the detention officers' minimum hiring age from 18 to 21 and reopened the academy in August.

"The impact of hiring a young, immature work force will be felt for years to come," he said. "They do get on the job training, they do get senior people to work with. But when you're building the base of their value systems, proper training is absolutely essential. And relying primarily on virtual training does not establish that."

Garcia has touted many reforms he made that were designed to protect prisoners - including spending millions on additional security cameras inside the maximum security 1200 Baker Street facility. That building houses the jail's clinic, its mental health beds and inmates who might need protection, including teenagers, women and high profile prisoners. In a 2014 presentation, Garcia called the cameras an effective deterrent to inmate abuse. But Hickman said the security cameras inside Baker Street are ineffective since they do not archive videos

The two also have clashed over Garcia's hiring of a consultant, Port Arthur-based Griffith Moseley Johnson & Associates. The firm was paid $1.4 million from the jail's commissary fund to help address the Justice Department's 2009 findings. Garcia said the consultant helped him to reduce overcrowding by devising a credit system for "good time" for some inmates, and to develop suicide prevention strategies. Hickman said Garcia relied too heavily on consultants, noting the ex-sheriff hired another out-of-town firm to oversee jail chaplaincy services.

The one thing both men agree on is that the jail has far too few resources to deal with mental illness among its inmates. About 2,000 take psychotropic medications, while there are only 200 mental health beds.

***

By all accounts, Norman Hicks, the retired butcher, 72, was an annoying presence as he walked through his cellblock at the Harris County Jail, swinging a towel and popping other inmates, the kind of horseplay more common to a high school locker room.

With the only separation cell on his floor already occupied, jailers placed Hicks in an attorney interview room with no bathroom and left him. Jail policy requires checking on inmates in separation cells every 30 minutes.

Two hours later, jailers smelled a foul odor and realized Hicks had soiled himself. He cleaned up with his own jail-issued shirt and then was escorted to a second attorney booth, where jailers told him to throw his shirt out into the hallway.

Christopher Pool, one of the jail guards on duty, later claimed Hicks hit him in the face with the shirt and said the inmate punched him.

Other jailers disputed that account, according to disciplinary files.

What is not in dispute: Pool then slugged the elderly man in the face. Hicks fell and hit his head. Pool stared at Hicks, who was not speaking or moving, according to an account he gave investigators, then left for the jail clinic to clean himself.

Other jailers locked the door, and no one alerted supervisors or medical staff. When a jail sergeant noticed Hicks a half-hour later, he was not breathing.

Six days later, on Jan. 22, Hicks died in a hospital.

Pool's attorney, Carson Joachim, said Hicks was the aggressor.

"Christopher Pool and the other men involved acted appropriately, and within the parameters of how they were trained," he said. "Nor did their actions violate state or federal law.

"I want to make it clear that Mr. Hicks was the first aggressor in this incident, he struck Christopher Pool in the head with a closed fist. He threw a feces-laden shirt in Chris Pool's face and neck region, and simultaneously punched Chris Pool in the face."

A grand jury declined to indict Pool, though he was fired in August 2012 for failing to seek medical help and for failing to report the incident.

Pool later successfully appealed his firing, but by the time he was offered his jail job back by civil service commissioners, Pool had become a police officer in the Houston suburbs.

In a deposition Pool gave in a related civil lawsuit, he explained he didn't summon help because jail policy gave priority to cleaning up potentially hazardous bodily waste.

Pool described the blow delivered to Hicks as a routine event in the Harris County Jail.