After 21-year-old Tamario Smith died in Santa Cruz County Jail in 2020, family and supporters rallied at the jail. (Mat Weir — Santa Cruz Local file)

At least 13 people have died in Santa Cruz County Jail since 2012, according to county records. The payout in Smith’s case follows a $3.25 million county settlement in 2022 related to the death of inmate German Carillo in the jail, according to records obtained by Santa Cruz Local. 

Tamario Smith died on May 10, 2020 of a heart attack brought on by hyponatremia, or low sodium in the blood, according to a coroner’s report. The Sheriff’s Office said at the time that his organs failed from drinking too much water, but that wasn’t the whole story. 

Smith — who was awaiting adjudication of a domestic violence charge for three months — suffered from schizophrenia and was on medication, according to court records. His family’s wrongful death lawsuit alleged weeks of medical and psychiatric missteps, inadequate care from jail health providers and broken intercom buttons in a segregated cell.

Smith’s death contributed to a push for independent oversight of the Sheriff’s Office, several sources said, and in 2022 the county established an Office of Inspector General. The jail now has a different health provider. Upgrades to jail communication systems including intercom repairs are due “hopefully by January or February,” said Santa Cruz County Sheriff Chris Clark, who was sworn in last week. 

“In terms of just our general operating situation, we’re always looking to do things better” at the jail, Clark said. 

A life cut short

Tamario Smith’s mother described her son as generous, kind and protective of his family. She said he was also very thoughtful and mature.

Tamario Smith. (Warren-Smith family)

The lighthouse on West Cliff Drive was one of his favorite places, she said. “‘Mom, it’s time for us to go to the beach, I need to go clear my mind,’” Warren-Smith recalled him saying. “I would drive over there and he would go down to the beach, him and his sisters. He would sit there on the beach and meditate or whatever he was doing.” 

Smith was born in Stockton and was in foster care when Warren-Smith and her husband adopted him at 2 years old. He had six brothers and six sisters between his adoptive and biological siblings.

Smith attended Live Oak Elementary, Shoreline Middle and London Nelson Community schools. He was a member of the Word of Life church on the Westside. 

Warren-Smith said her son became passionate about helping homeless people and had thought about becoming a social worker and child advocate. 

She said her family likes to honor Tamario by donating to Word of Life’s annual Thanksgiving meal for people without housing at the London Nelson Community Center in Santa Cruz. The family volunteered there for years before Tamario died. Warren-Smith said Thanksgiving was his favorite holiday, possibly because of how much he loved the candied yams she makes. 

“I miss him terribly. Every time I make candied yams I think about him,” she said.

Lawsuit allegations

From 2018 to 2020, Smith’s undiagnosed mental health problems helped land him in county jail a few times, his family said. Smith was booked into the main jail on Feb. 3, 2020 after failing to appear in court twice for a domestic violence charge. While incarcerated, Smith was experiencing psychosis and was found unfit to stand trial, according to court records. But he was not transferred to a hospital because of the COVID pandemic, according to the January 2021 civil suit.

Gerald Lazar, a psychiatrist who worked in the jail, prescribed Smith several antipsychotic medications but did not order blood tests, the Smith family lawsuit alleged. Several of the medications Lazar prescribed Smith have a well-documented risk of hyponatremia. The lawsuit said that after seeing Smith on March 11, Lazar made a note to follow up with him in one week, but neither he nor any other mental health practitioner saw Smith again.

Still in jail in April, Smith was experiencing symptoms of overhydration, including headaches and neurological weakness in his arm, the lawsuit stated. He saw Wellpath medical staff several times. The lawsuit alleged the employees mistook the symptoms for dehydration and instructed him to drink more water.

On April 29, without seeing Smith, Lazar renewed his prescriptions and was not informed of Smith’s visits with Wellpath staff or his medical complaints because only Wellpath staff had access to those records, the lawsuit stated. A Wellpath representative declined to comment for this story.

Several weeks before he died, Smith was transferred to a maximum-security part of the jail where he was alone for 21 to 23 hours daily. Officers were tasked with checking on him hourly, the lawsuit stated. The Sheriff’s Office provided no explanation for his transfer, according to a June 2024 amended complaint. 

On May 10, 2020, officers found Smith unconscious in his cell, “with his face smashed against the wall right under” the nonfunctional intercom button, according to the lawsuit. The suit alleged the officers noted a “weak pulse” and a “gurgling sound” but did not render aid, instead waiting for medical staff to arrive. Smith was declared dead about 20 minutes after the officers found him, the lawsuit alleged. County authorities said it was 30 minutes.

Wellpath, the county’s jail medical provider in 2020, was also named in Smith’s parents’  complaint and has not settled. Wellpath filed for bankruptcy last month, halting legal proceedings in the case. 

Smith’s parents settled separately with Lazar, but the terms of that settlement are confidential. Attorneys for Lazar did not respond to requests for comment.

Changes at the jail

Sheriff Clark said the aging jail’s facilities weren’t designed for the needs of the current inmates. 

“Our population now is mostly mental health, and it’s a cross between substance use disorder and mental health,” Clark said. “We provide, with our medical providers, the best medical care and mental health care we absolutely could with the facility we have.”

Asked whether the Sheriff’s Office learned anything from Smith’s death, Clark said, “I’m not going to go into specifics necessarily about litigation, but we’ve had people that experienced medical emergencies that despite anything we could have done, that death couldn’t have been prevented.”

Twelve people have died in Santa Cruz County Jail since California Forensic Medical Group, later purchased by Wellpath, took over care in the jail in late 2012. 

Earlier this year, the Sheriff’s Office chose not to renew its contract with Wellpath. A new contractor, NaphCare, has provided medical care in the jail since July 1. Asked whether Smith’s death was a factor in the change, Clark said, “The timing just felt right for a change in vendor.”

Complaints about medical care have notably decreased in the months since NaphCare took over, said Julie Ruhlin of the Santa Cruz County Office of Inspector General at an October community meeting.

“Based on the number of complaints that we’ve seen coming in, it seems like that was a positive switch,” Ruhlin said. 

Family and supporters of Tamario Smith rally outside Santa Cruz County Jail in June 2020. (Mat Weir — Santa Cruz Local file)

Protests and new transparency

Tamario Smith’s name was often evoked at protests that erupted in Santa Cruz County during the nationwide unrest that followed the May 2020 murder of George Floyd. “What happened to Tamario Smith?” asked a hand-painted banner at some of the protests. The banner was sometimes part of the “community ofrenda” that decorated the Town Clock on-and-off for months.

A vigil and protest was held at the Town Clock on June 18, 2020 to demand answers about Smith’s death. A Sheriff’s Office press release earlier that day identified Smith’s cause of death as “acute water intoxication, due to the over consumption of water in a short period.” Water consumption led to an electrolyte imbalance which caused his organs to fail, according to the statement. This explanation did not quell the concerns of those at the vigil.

After the protests of 2020 petered out, activists continued to evoke Tamario’s name in the calls to establish independent oversight of the Sheriff’s Office. The Santa Cruz County Office of Inspector General was established in 2022 and is tasked with ensuring the Sheriff’s Office is transparent and accountable. 

In its first public report, released in October, the Office of Inspector General recommended that once the lawsuits are settled, the Sheriff’s Office should release detailed reports about the jail deaths of Smith and others who “the public has not forgotten about.” Reports from the Sheriff’s Office about each in-custody death should identify “performance, structural, or other issues that were not optimal” and make a plan to address the shortcomings, the recommendation states.

“We have evidence on our side in terms of what transpired there. Sometimes those facts can be disputed, and that’s just the process of litigation,” Clark said. Clark did not commit to releasing information about Smith’s or other jail deaths, but said “it’s something I’d take a look at.”

Prior to his retirement as Sheriff, Hart said in an October interview that whether the Sheriff’s Office would release more information depends on the circumstances surrounding each case. Hart also said the Office of Inspector General could make the reports. “They have access to everything in our office, if that’s something they want to do, we’ll certainly honor that,” Hart said.

Mike Gennaco of the Office of Inspector General said in-custody deaths that occurred prior to the establishment of the office are not within their scope of work.

“We could do it if there was a special request to do it,” Gennaco said, and that request would likely come from county supervisors. “Our scope is such that it is more forward-thinking, and that is also kind of why we recommended that the sheriff put out some information.”

Read more

• ‘Concerning’ use of force described in Santa Cruz County Inspector General report — Oct. 28, 2024
• Santa Cruz County leaders explore potential new jail — Sept. 15, 2023

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