The family of a Colorado man who died while in custody in Boulder County Jail after a near month-long staph infection filed suit against the counties and medical provider in federal district court Friday.

Avery Borkovec, 22, died Nov. 3, 2022 at the jail, where the suit alleges the staff knew of the staph infection he contracted prior to his arrest for trespassing and other previously issued warrants.

"They simply handed off this known-to-be be seriously ill patient without any regard for his future care needs, despite knowing that without antibiotics he was likely to develop sepsis and die," Rachel Kennedy, an attorney representing Borkovec's estate said in a press release. "All they had to do was write a prescription or make a phone call, but they cared so little about this young man they didn’t even do the bare minimum."

Borkovec was held at Broomfield County Detention Center prior to being moved to Boulder County Jail where − according to the suit − the private medical provider, Turn Key Health LLC, failed to inform the jail that he was suffering from a severe infection.

"He was so thin and pale that other inmates referred to him as 'Casper,'" the press release said.

"I have been in law enforcement for the past 28 years where we must be held accountable for our actions," Chris Borkovec, Avery's great-uncle and a representative for the estate, said in a statement to USA TODAY. "In this case, there were multiple failures by various parties who were responsible for Avery's well-being ... It is my hope this matter leads to change and higher standards so another family does not have to experience this."

Defendants named in the suit include the City and County of Broomfield, the Boulder County Board of Supervisors, Boulder County Sheriff Curtis Johnson, Turn Key Health LLC and 13 individuals involved in Borkovec's care.

The County of Broomfield declined comment. The Boulder County Board of Supervisors referred USA TODAY to the Sheriff's Office, who said "the Sheriff’s Office will review and take any legal allegations seriously and respond in any timeframe determined by the court," in a statement to USA TODAY made before the filing.

Turn Key did not immediately respond to a request for comment.

The suit seeks unspecified compensatory and putative damages.

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Borkovec ill before arrest

Borkovec was taken to Good Samaritan Hospital in Lafayette on Sept. 26, 2022 complaining of abdominal pain and persistent vomiting, according to the lawsuit.

There he was diagnosed with a likely bacterial infection, but was discharged before a blood culture revealed the staph infection.

Borkovec was arrested on Sept. 29 and taken to the Detention Center where a Turn Key nurse received a detailed summary of the hospital visit, including blood tests and the culture showing the infection.

Dr. Bryan Reichert, the doctor at the jail, began Borkovec on an opiate withdrawal therapy after a drug test but did not order antibiotics, according to the complaint.

"Either (Nely) Moreno-Santacruz recklessly chose not to relay Mr. Borkovec’s abnormal vital signs and alarming lab results, or Dr. Reichert recklessly concluded that Mr. Borkovec’s extremely elevated pulse and blood pressure had a benign cause without any hands on assessment or even a chart review," the lawsuit alleges.

Moreno-Santacruz is a Turn Key nurse named as one of the defendants in the lawsuit.

Reichert conducted a chronic care exam on Borkovec on Oct. 3 that included a review of the hospital chart. Reichert concluded that the hospital cultures were contaminated and that Borkovec was not experiencing an actual infection, the lawsuit alleges. The lawsuit further accuses Reichert of denying emergency care and only ordering monitoring and a repeat blood culture for the inmate.

USA TODAY attempted to reach out to Reichert through a publicly listed phone number but did not receive a response.

Borkovec continued to register high blood pressures, a sign of infection, throughout his detainment at Bloomfield. The appointment for the ordered repeat blood culture was rescheduled and was never completed, as the inmate was transferred the day after the original appointment, according to the complaint. The lawsuit alleges that a Turn Key nurse charted that the culture had been completed.

Borkovec moved to Boulder, jail not informed of infection

Borkovec was moved to Boulder County Jail on Oct. 7, where the lawsuit alleges that Turn Key did not inform the jail of his infection.

"Turn Key workers’ conscious choice not to convey this information to Boulder was a complete and total dereliction of their gatekeeping duties," the lawsuit alleges. "They simply handed off this known-to-be seriously ill patient without any regard for his future care needs, despite knowing that without antibiotic treatment he was likely to develop sepsis and suffer serious injury or death."

Borkovec relayed his symptoms as well as his hospital visit and admitted to recent heroin use during a medical intake at the jail.

The lawsuit alleges that the jail did not take any steps to retrieve medical records from either the hospital or the detention center.

Borkovec made dozens requests for medications for body pain, digestive issues as well as newly onset dental pain. The lawsuit alleges that multiple nurses in the jail considered Borkovec to be faking the pain without examining the inmate.

"None of the Boulder nursing staff referred Mr. Borkovec to a provider capable of diagnosing the cause of his concerning symptoms," the lawsuit alleges. "Rather, they each independently and baselessly concluded that the cause of his symptoms was benign or faked, and continued to blindly administer an ever-growing cocktail of ineffectual over-the-counter drugs that did nothing to treat the underlying cause."

Borkovec moved for being too ill, condition deteriorates

On Oct. 24 Borkovec was moved from the so-called "inmate worker pod" at the jail to "Medium-B Module" as he was too sick to work. The

Inmates in the module repeatedly notified jail staff to Borkovec's deteriorating state, according to the complaint.

On Oct. 27 Borkovec called his great-grandmother and told her he felt fluid building up in his lungs. When a nurse took Borkovec's vital signs that night his pulse was 137 beats per minute and his oxygen saturation was 93%.

Borkovec's condition continued to deteriorate over the next four days, according to the lawsuit. He was losing weight, couldn't eat and was spitting up blood.

Around 11:30 p.m. on Nov. 2 Borkovec was so ill that inmates called jail deputies for help. Deputies called for medical assistance where a nurse entered the cell and said she needed a second opinion from another nurse. She never returned, according to the lawsuit.

A second nurse responded and recorded an oxygen saturation of 88% but took no further vital statistics. The nurse concluded that the cause of the low oxygen was asthma and provided an inhaler.

"Any reasonably trained health care worker knows that a patient with an oxygen saturation of 88% and an unknown cause must immediately be transported to an emergency room for higher level assessment and care than can be provided at the Boulder County Jail," the lawsuit states.

The nurse referred her recommendation to a jail physician who accepted her asthma determination without conducting his own examination, the lawsuit alleges.

Borkovec was then moved to cell 5 where he would spend the remainder of his life.

Borkovec's final hours

At 9:03 a.m. on Nov. 3, Borkovec stumbled into the threshold of his cell where a passing inmate called for jail deputies. Borkovec told deputies that he was short of breath. The deputies called for medical attention but did not deem it worthy of an emergency response, according to the lawsuit.

His mouth was covered in coffee-ground like vomit, and he was unable to talk.

When other security personnel arrived, they told the medical team to "step it up" and bring Narcan, believing that Borkovec had overdosed. The lawsuit alleges that deputies mocked the situation, quoting one deputy as saying, "is this just…you used chew and now you’re all messed up?"

Jail nurses administered four doses of Narcan as Borkovec's oxygen saturation hit 70%. Borkovec lost consciousness and began to vomit black blood. Nurses and deputies attempted to perform CPR. When first responders arrived, they were unable to regain a pulse, according to the lawsuit.

An autopsy conducted by the Boulder County Coroner found staph bacteria in his blood and lungs, lesions on the heart caused by infectious vegetative endocarditis and an acute upper gastrointestinal hemorrhage, according to the lawsuit. Borkovec's lungs were so full of fluid that they weighed more than twice of what a healthy pair lungs measure.

"Mr. Borkovec was just 22 years old when he suffered an entirely preventable, protracted, and excruciatingly painful death," the lawsuit alleges.

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