The pathologist who performed an autopsy on the body of Erie County Holding Center inmate India Cummings says he's not inclined to rule her death a homicide, even though a state agency says it should be called a homicide due to medical neglect.
The pathologist, Dr. Scott F. LaPoint of Monroe County, said he will make no changes unless the state Commission of Correction's Medical Review Board shows him "substantial information, of which I was previously unaware."
LaPoint was helping Erie County with its backlog of cases when he examined Cummings' body in 2016. He emerged unable to say what killed her and whether her death was natural, accidental or at the hands of others – a homicide.
LaPoint's reluctance to change course makes it less likely a government agency will respond to the outrage expressed by the State Commission of Correction's Medical Review Board. The panel of doctors and lawyers said Cummings spent much of her final days laying on the floor of her cell in a puddle of urine, and the medical and mental health care given her "was so grossly incompetent and inadequate as to shock the conscience."
Cummings, the Medical Review Board said, died from acute renal failure, dehydration and a blood ailment stemming from a broken arm combined with a massive pulmonary embolism. The inmate, 27, would have survived had she received proper care, the review board said, citing a series of missed communications and policy failures by key employees working for Sheriff Timothy B. Howard and County Executive Mark C. Poloncarz.
Though LaPoint was working as a freelancer for Erie County, the officials who run the Medical Examiner's Office do not intend to intervene and change the cause and manner of death either, said Peter Anderson, a Poloncarz spokesman.
"The Medical Examiner’s Office is in agreement with Dr. LaPoint’s determination," Anderson told The News, "and will not be revisiting the case in the absence of substantial new information."
The Poloncarz team took the same stance with the death of Holding Center inmate Richard A. Metcalf Jr. in 2012. After examining Metcalf's death, the Medical Review Board said Metcalf died of asphyxia when poorly trained Holding Center deputies tied the strings of a spit mask tightly around his neck, covered his head with a pillow case and prevented ambulance medics from seeing his face for several crucial minutes. Metcalf did not die of a heart attack, as the medical examiner in 2012 determined, the review board said, and urged the county to change its report.
The Medical Examiner's Office responded at the time by saying autopsy determinations represent the medical opinion of the "certifier," or the physician or pathologist who signs off on the cause of death. Since "no new or additional information that was not available to the original certifier has been advanced," the cause of death would not be changed, county officials said.
In the Metcalf case, however, the original "certifier" – then-Medical Examiner Dianne R. Vertes – still ruled the death a homicide because of the stress and punishment the inmate went through while in the Holding Center. The Medical Review Board asked criminal prosecutors to take a new look, and the matter was handed to Cattaraugus County District Attorney Lori Pettit Rieman, because of a conflict with the Erie County DA's Office.
If the Medical Examiner's Office classified Cummings' death as a homicide due to medical neglect, it would be helping the plaintiffs in a lawsuit against the county and pointing an accusatory finger at other Poloncarz employees and appointees – in the county departments of Health and Mental Health. Those units, headed by Dr. Gale R. Burstein and Michael R. Ranney, respectively, had a hand in Cummings' care – or her lack of care, as the Medical Review Board alleges. Further, the Health Department umbrella extends over the Medical Examiner's Office.
County Legislator Thomas A. Loughran, D-Amherst, said he would like to ask a county attorney at a meeting set for Wednesday whether the Medical Examiner's Office has a conflict in determining whether to change the cause and manner of death of India Cummings.
"This is a legal question, but it's also an ethical question as to how we got here," Loughran said. "I want to hear from everyone involved, and that includes the county attorney."
Loughran is a member of the Public Safety Committee, whose chairwoman, April N.M. Baskin, D-Buffalo, called a special meeting for 10 a.m. Wednesday in Old County Hall to discuss the Medical Review Board's report about Cummings.
Baskin has invited the Sheriff's Office and officials with the departments of Health and Mental Health. But Baskin has acknowledged that their willingness to answer specific questions will likely be limited because of the Cummings family's lawsuit against the county.