A second medical examiner's report into the death of Ralph Madison Stockton IV raises more questions about the level of observation provided by Wake County jail staff in the hours leading up to his fatal drug overdose.
The report released to the News & Observer this week represents the initial investigation into Stockton's death by the state medical examiner's office. It says Stockton, 19, of Raleigh, was last known to be alive at 11:30 p.m., Nov. 5. That is the same time he was evaluated by a jail nurse, according to an autopsy report.
Stockton entered the jail at roughly 3 p.m. that day. He was found unresponsive on a jail mat at 6:31 a.m. the following day, and pronounced dead less than an hour later. If the report is accurate, he would not have been properly checked on for roughly six hours before he was found unresponsive.
That information in the report was provided by Wake County sheriff's investigators, said Dr. Clay Nichols, a deputy medical examiner.
Last week, state officials said the jail had violated a regulation requiring that all inmates be observed at least twice an hour. That observation requirement means making sure they are alive and OK, according to Steven Lewis, the state Department of Health and Human Services official who oversees the jail regulations.
The state report found the jail staff had last seen Stockton, the grandson of a prominent Winston-Salem lawyer, at 5:29 a.m., or 62 minutes before he was found unresponsive.
Phyllis Stephens, a spokeswoman for Wake County Sheriff Donnie Harrison, who is in charge of the jail, said staff did not violate the observation standards. But she declined to provide documentation, saying it is not a public record for security reasons.
UPDATE: This afternoon she said the death is under an "on-going internal administrative investigation into the actions of specific personnel regarding the supervision of the inmate."
Jim Jones, a DHHS spokesman, said the state investigation did not look into the entire time Stockton was in jail to determine whether the observation standard had been followed through the night. He added the state is not required to do further investigation into the death.
The medical examiner's report, and a subsequent autopsy, also suggest that jail staff had indications that Stockton needed closer observation. The state regulation requires those who are suspected of being intoxicated to be observed four times an hour.
Both reports say that Stockton was observed by numerous people to be intoxicated. Stephens said she could not confirm such observations because that would be protected "medical" information regarding Stockton.
The medical examiner's report also indicates that Stockton had been caught using "a number of illicit drugs" at his mother's home and that he had a past history of depression and drug use.
The autopsy report contains one apparent error, and the medical examiner report contains two.
The autopsy report says that Stockton had been picked up on Nov. 5 after being drunk and disorderly at a football game. Arrest reports indicates he had been picked up in his car on a misdemeanor marijuana possession charge, and subsequently charged with failure to appear on a prior underage drinking charge issued by police in Watauga County.
The medical examiner's report says Stockton was caught using drugs at his mother's home the night of Nov. 5, but Stockton was in the jail by then. It also says the death was reported to the medical examiner at 7:30 p.m. on Nov. 6; it was actually reported at 9:30 a.m. that day. Nichols said he has corrected that error.
Stockton's family declined to comment on the additional information. The medical examiner's report, autopsy and DHHS report are all attached below.