MOORHEAD — Abby Rudolph died in 2016 at the age of 19 when she was an inmate in the Clay County Jail.

The circumstances of her death are the subject of a civil lawsuit that's making its way through U.S. District Court. The lawsuit asserts that after nearly four days in jail Rudolph died on Nov. 3, 2016, from a lack of medical care that surpassed "mere negligence" to something that shocks "the conscience."

By contrast, a state agency's review of the Clay County Jail after Rudolph's death determined that the jail had displayed professionalism and treated Rudolph with compassion.

Rudolph's mother, Jill Rudolph, who filed the wrongful death lawsuit in early 2018, died in December 2018 at the age of 52. Jill Rudolph's obituary lists her mother and two children — a son and a daughter — among her survivors, as well as a brother, Craig Casler.

In an interview with The Forum, Casler said it's believed his sister, Abby's mother, likely died of a medical condition after lying down to take a nap, but he suspects there was more to it than that.

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"She died of grief. She could not go on," said Casler, who feels his sister simply could not endure another Christmas without Abby.

The wrongful death lawsuit states that at the time of her death Abby Rudolph was struggling with an addiction that started when she became hooked on pain medication while recovering from a broken hip she suffered during her junior year in high school.

It was that addiction that led to her arrest the afternoon of Oct. 30, 2016, in connection with a shoplifting incident, according to the suit, which says Rudolph began experiencing withdrawal symptoms shortly after her arrival at the jail.

The suit claims Rudolph's symptoms were brought to the attention of jail officials the evening of Oct. 31, 2016, by fellow inmates concerned about her health.

The inmates wrote a note to jail officials stating Rudolph had not been eating or drinking, and they urged that she be monitored because of her deteriorating condition, according to the suit.

The suit states Rudolph informed a jail officer at 5 a.m. on Nov. 1, 2016, that she could not eat her breakfast, and jail records indicate it was at about that time jail officials became aware of sporadic bouts of vomiting that would continue until about 2 p.m. on Nov. 3, 2016.

At that time, the suit states, a jail officer and a nurse noted that Rudolph appeared sluggish and was cool to the touch.

The nurse and jail staff decided to take Rudolph to the shower, but once there Rudolph became unsteady and sat on the floor, where her body began to jerk and she appeared "catatonic," according to the suit.

Rudolph lost control of her bodily functions about the time an ambulance arrived and medics began working on her, according to the suit, which says Rudolph was moved to the ambulance in the parking lot and shortly afterward resuscitation efforts were discontinued at 2:52 p.m. on Nov. 3, 2016.

The suit states that during her stay in the jail Rudolph received no treatment, other than being put on a liquid diet and did not see a doctor at any point while incarcerated.

Defendants named in the suit include MEnD Correctional Care, a company that provided the jail with health care services; the jail nurse; and Clay County, including a number of county employees.

Claims made in the suit include allegations Rudolph was denied access to adequate medical care and that the county failed to adequately train employees.

Rudolph Amended Complaint by Dave Olson on Scribd

Defendants respond

Court papers filed by Clay County say that when Rudolph was brought into the jail she denied using drugs or alcohol and denied having any medical problems.

The county's court filings also state that on the evening of Nov. 1, 2016, Rudolph told a jail officer she was detoxing from heroin, and Rudolph was moved to a high-risk holding cell and placed on medical watch. From Nov. 2 to Nov. 3, 2016, the filings say, jail officers "continued to address Rudolph's needs" while regularly checking on her condition.

The county's answer to the civil complaint describes in some detail the incident for which Rudolph was arrested.

According to the court document, Rudolph took a toaster out of a box at Menards in Moorhead and filled the box with about $200 worth of items she later acknowledged she was planning to shoplift.

Rudolph also had a magnetic bar code security scanner, a common tool used by thieves, and she was arrested on suspicion of felony possession of theft tools, according to the court document.

The county's answer to the lawsuit also states that at about 12:30 a.m. on Nov. 3, 2016, the day Abby Rudolph died, a jail officer provided her with Gatorade, a glass of water, and a new vomit bag.

At about 4:30 a.m. that morning, a jail officer gave Rudolph a new vomit bag and 30 minutes later she was given juice, milk and Gatorade for her breakfast. Around noon that day, a jail officer offered Rudolph her hour out of her cell, but she declined, according to papers filed by the county.

Then, at about 2:07 p.m., a jail officer requested that a nurse come to the shower area because Rudolph was possibly having a seizure. And about seven minutes later, the Moorhead Fire Department and an ambulance crew arrived and began providing medical care to Rudolph, according to the county's answer to the suit.

The document says paramedics continued life support for Rudolph until a doctor at a local hospital gave them the order to discontinue such efforts at 2:52 p.m.

In its answer to the suit, MEnD lists a number of affirmative defenses, including the assertion that any damages Rudolph suffered were the result of pre-existing and/or subsequent conditions and that any action or inaction on the part of MEnD employees was not a direct cause of any injury Rudolph suffered.

A death certificate on file with the Minnesota Department of Health's Office of Vital Records says Rudolph died from acute bronchopneumonia, a medical condition affecting the lungs. The certificate lists the manner of Rudolph's death as natural and indicates neither injury nor trauma contributed to her death.

A trial date in the suit has yet to be scheduled, though court documents say the case is to be ready for trial no later than March 10, 2020.

Documents filed in federal court hint that a settlement is in the works involving at least one defendant in the case, but no details were available. Casler said a settlement with MEnD was possibly near, though the suit is still pending.

State review

The Minnesota Department of Corrections investigated Rudolph's death, and in June 2017 the agency sent a report to then Clay County Sheriff Bill Bergquist.

The report, signed by Timothy Thompson, manager of the state Inspection and Enforcement Unit, says jail staff "appear to have been very compassionate and treated Ms. Rudolph very professionally." The report also says staff appeared to take appropriate action based on knowledge of the situation.

The report notes that after Rudolph was placed on "seclusion checks," video footage from the jail showed she was checked more frequently than every 15 minutes, though staff only logged checks at 15-minute intervals.

The report says corrective action was required, including a directive that jail staff be retrained to stress the importance of proper well-being checks and proper documentation of well-being checks.

Abby Rudolph's death was just one of several deaths in the region in recent years involving drug use and withdrawal.

In North Dakota in 2018, a father and son died as jail inmates in separate incidents within months of each other. In both cases, drugs or drug withdrawal was thought to have played a role.

National experts on addiction and safe withdrawal in jails say there are ways to prevent such tragedies. The National Center on Addiction and Substance Abuse has found that 85 percent of incarcerated adults are substance involved, though just 10 percent of those incarcerated with addiction receive care.

Casler said he hopes his niece's death might lead to changes that will prevent others from suffering a similar fate.

He said after his niece was arrested, his sister could have bailed her daughter out of jail, but thought she would be safer in jail than on the street.

That decision led to his sister carrying a crippling amount of guilt on her shoulders, Casler said, adding that he believes there should be better options than jail for people battling addiction.

If people are placed behind bars, he said it is the responsibility of the facility to make sure they remain safe and free from harm.

"This should be a learning experience," he said.