Nurse charged with involuntary manslaughter in 2019 jail death

A nurse at the Las Colinas women’s jail was charged criminally Thursday in the 2019 in-custody death of Elisa Serna, who died after being left alone slumped on the floor of her cell.

District Attorney Summer Stephan announced charges against Danalee Pascua, 36, who faces one count of involuntary manslaughter, a felony that could result in a sentence of up to four years in prison.

“There is nothing more serious than the sanctity of life and when that life is in the custody and care of the government, it must be safeguarded and provided with the appropriate medical care,” Stephan said in a statement.

“The evidence in the in-custody death of Elisa Serna demonstrates criminal negligence that contributed to her death,” the district attorney said.

Serna, who was 24 when she died, was arrested in November 2019 after being stopped by San Diego County sheriff’s deputies. She was transported to the Las Colinas jail in Santee and told officials during her booking process that she had recently used heroin.

Serna suffered serious dehydration and other medical issues for several days — but was never on the department’s withdrawal protocols — before dying on Nov. 11, 2019, according to a lawsuit filed by the family.

Days after the death, Serna’s parents contacted The San Diego Union-Tribune, which profiled the case later that week. The family’s lawsuit against San Diego County, filed one year ago, is pending in U.S. District Court.

Paloma Serna, Elisa’s mother, said Thursday that she is grateful to the District Attorney’s Office for holding someone responsible for her daughter’s death. She also did not skirt from the fact that her daughter had a substance-abuse problem she was working to overcome.

“I believe that with time and enough patience, she would have won that fight,” Serna said of her daughter. “We will never know that now, because she was denied basic medical care, and the humane treatment that we would expect would be accorded any person.”

The Sheriff’s Department issued a statement Thursday saying it supported the District Attorney’s Office decision to pursue a criminal charge in the case and offered condolences to the Serna family.

The statement said Pascua had been hired as a detentions nurse in 2017. She was placed on paid administrative assignment soon after Serna died and was no longer treating patients at the Las Colinas jail.

On Thursday, the department said Pascua has been suspended without pay.

“This was based on sustained findings of misconduct following a Sheriff’s Department Internal Affairs investigation,” the statement said.

Earlier this year, the Citizens’ Law Enforcement Review Board, which independently reviews allegations of misconduct within the Probation and Sheriff’s departments, issued a report stating that Serna had been left alone in her cell after striking her head as she collapsed to the floor.

She was found dead an hour later in the same position.

Despite the findings, the review board investigators found no violations in Sheriff’s Department policies and issued a recommendation that a complaint was “not sustained.”

However, days later the board overruled that recommendation and sustained a misconduct violation against a sheriff’s deputy who was with the nurse when they both left Serna alone.

“Serna’s condition was one that deserved attention,” the review board wrote in an amended report. “... Deputy 1 had a responsibility to respond to Serna’s emergency medical needs. This did not occur and therefore Deputy 1 mistreated Serna.”

The Citizens’ Law Enforcement Review Board has no jurisdiction over jail nurses or medical staff — a situation the panel’s executive officer is working to change.

The review board was limited to issuing findings against the deputy who accompanied Pascua, concluding the deputy “failed to meet standards in recognizing, reporting, or responding to Serna’s emergency medical needs.”

Only after the oversight panel issued its findings did Serna’s family learn that no one came to her aid after she had suffered a seizure and collapsed in her cell.

Michael Serna waits inside a Kearny Mesa crematory while his wife says her last goodbye to their oldest daughter. Elisa Serna was 24 when she died in San Diego County jail.

(Jeff McDonald/The San Diego Union-Tribune)

Paul Parker, executive officer of the citizens’ review board, said Serna’s death underscores the need for his investigators to be able to examine whether medical treatment or decisions made by jail medical personnel contributed to a person’s death.

“Without the ability to investigate the actions of medical personnel, we are unable to determine whether a death is preventable and recommend changes that may save the life of another person under (Sheriff’s Department) care,” he said Thursday.

Sheriff’s Department officials said the homicide unit referred its investigation to the District Attorney’s Special Operations Division, which reviews deaths that occur in law enforcement custody to determine whether criminal charges should be filed.

“The San Diego Sheriff’s Department is committed to providing compassionate medical services for the safety, health, and well-being of everyone entrusted in our care,” the department statement said.

But from the beginning, Serna’s family questioned the circumstances surrounding her death.

They got conflicting information from detectives they spoke to when they were first informed that Serna had died. Then, medical records they obtained from the Sheriff’s Department raised questions about the course of treatment Serna received in custody.

“No one provided medical care,” the civil lawsuit filed last year states.

“At the time of Elisa Serna’s death, there had been a long-standing custom and practice of improper and inadequate investigations; cover up of misconduct; and failure to discipline and train deputies and medical staff,” the complaint also said.

The medical examiner’s report noted that Serna was dehydrated and had acute pneumonia. Redacted medical records obtained by Serna’s mother showed that staff thought Serna was lying about not feeling well.

Marc Stern, a University of Washington School of Public Health professor and a national expert in correctional medicine, reviewed Serna’s autopsy for the Union-Tribune last year and found the report to be lacking information.

Criminal charges against county law enforcement have been all but unheard of in recent years. Former Deputy Aaron Russell was charged with murder last year after shooting a suspect on the street as he ran away just before he was about to be booked into the Central Jail.

According to a six-month investigation published by the Union-Tribune in 2019, the Sheriff’s Department had the highest mortality rate among California’s six largest counties, averaging more than one death every month for more than a decade.

So far this year, 12 inmates have died in San Diego County jails. More than 160 people have died in local custody since Sheriff Bill Gore was first appointed in 2009.

The District Attorney’s Office said in a statement that investigators and prosecutors examined the situation and only pursued charges against Pascua.

“Our analysis in this case as in any case follows the law, is independent and objective,” the statement said. “In this particular incident, we can only file charges against the individuals involved if it is determined there is criminal negligence beyond a reasonable doubt.”

But prosecutors did not rule out additional criminal charges.

“There is an ongoing investigation in this case reviewing other parties who may also be criminally responsible,” the office said.

Pascua, who could not be reached for comment, is scheduled to be arraigned Nov. 18 in El Cajon Superior Court.

The Serna family, who lives in Montana, is in San Diego this week to attend anniversary remembrances for their deceased daughter. Among other events, they plan to attend a protest outside the Las Colinas jail on Tuesday night.

Elisa Serna is survived by a daughter, Serenity, who is now 6 years old.