Dialysis technician forgot appointment at Utah prison; inmate missed treatment, later died

SALT LAKE CITY – A dialysis technician forgot about an appointment at Utah’s prison, where an inmate later died after going without treatment, the University of Utah’s health care system said Wednesday.

Two technicians at one of its dialysis clinics switched shifts in early April, University of Utah Health Care spokeswoman Kathy Wilets said in a statement. The technician who was supposed to show up at the prison forgot about the switch and missed appointments on a Friday and Saturday, Wilets said.

On Sunday afternoon, a nurse at the prison phoned the dialysis clinic, but the clinic was closed for the day, she said.

Inmate Ramon C. Estrada died that night. Autopsy results have not yet been released, but the Utah Department of Corrections said it appeared Estrada died of a heart attack related to kidney failure.

Estrada was 62 and was set to be paroled less than three weeks later.

The University of Utah Health Care’s internal investigation was ongoing Wednesday, Wilets said. She said the disciplinary process regarding the employees was ongoing but couldn’t say Wednesday whether that meant the employees would be disciplined.

The health system is also improving its scheduling alert system and trying to communicate more clearly with prison staff, Wilets said.

The prison’s own investigation was also ongoing Wednesday, Utah Department of Corrections spokeswoman Brooke Adams said.

Salt Lake County District Attorney Sim Gill said he didn’t know Wednesday if his office would consider filing criminal charges because of Estrada’s death. He said the investigations were ongoing and his office had not reviewed the matter.

Estrada had been in prison since August 2005 on a rape conviction. He was believed to have been in the country illegally, the prison said. He would have been turned over to the U.S. Marshals Service when his sentence was complete.