The Tragic Case of Keith Galen Bach: A Homicide by Neglect
Keith Galen Bach’s life came to a tragic end in September 2023, but the circumstances surrounding his death raise serious questions about the care provided to inmates in San Diego County jails. Bach, a 63-year-old man with Type 1 diabetes, was found unresponsive in his cell after hours of neglect, with the alarm on his insulin pump beeping incessantly, signaling a dire medical emergency.
The Alarm That Went Unheeded
Bach’s insulin pump had been alerting for nearly 24 hours, indicating that it had run out of insulin. This crucial medical device was not just a convenience; it was a lifeline for Bach, who relied on it to manage his diabetes. The beeping persisted during mealtimes, when Bach, aware of the risks of eating without insulin, gave his food to fellow detainees. Despite multiple alerts from Bach and other inmates to the deputies about the empty insulin pump, no action was taken to address his urgent medical needs.
Medical Examiner’s Findings
The Medical Examiner’s Office, upon reviewing the case, took the extraordinary step of ruling Bach’s death a homicide due to neglect. The autopsy report highlighted that Bach developed diabetic ketoacidosis—a life-threatening condition that arises from insufficient insulin—while in custody. The report pointed out that medical records clearly documented Bach’s condition, his insulin requirements, and the critical need for timely medical intervention.
The Response from Authorities
In a statement, the San Diego County Sheriff’s Office refrained from commenting on the findings, citing the ongoing investigation. They expressed condolences to Bach’s family but did not provide any details about potential accountability for the deputies involved. The District Attorney’s Office is currently reviewing the case, but no timeline has been established for any possible charges.
Advocacy and Outrage
The response from advocates and correctional health experts has been one of outrage. Aaron Fischer, a lawyer involved in lawsuits against the county for inadequate healthcare in jails, emphasized that no individual with diabetes should be denied access to insulin. He likened the denial of necessary medical care to suffocation, highlighting the severity of the situation.
A Troubling History
San Diego County has a troubling history regarding inmate deaths. A state audit released in early 2022 revealed that the county had the highest mortality rate among California’s largest jail systems, with 185 in-custody deaths recorded between 2006 and 2020. This alarming statistic has prompted calls for legislative reforms to improve conditions and healthcare services within the jails.
Bach’s Arrest and Medical History
Bach was arrested on September 25, 2023, on suspicion of vandalism and making a criminal threat. However, he was never formally charged. At the time of his arrest, he was too ill to be booked into jail and was taken to Sharp Mercy Hospital, where he was treated for elevated glucose levels. Hospital staff noted the beeping insulin pump and the need for it to be refilled. Despite this, Bach was cleared for booking just 40 minutes later and transported to the downtown central jail.
A Series of Medical Oversights
Shortly after arriving at the jail, Bach fainted during the booking process and was rushed back to the emergency room for further treatment. Medical orders were issued to continue using the insulin pump and monitor his blood sugar levels. While he cooperated with jail medical staff, allowing glucose checks and receiving some insulin, the situation deteriorated rapidly.
On September 27, Bach’s blood glucose level soared to a dangerous 322 mg/dL. Although he was offered insulin, he refused the dosage, believing it was insufficient. The last recorded administration of insulin occurred shortly after 1 a.m. on September 28, but after that, he was not seen by medical staff for 19 hours. The nurse’s request for an increased insulin dosage was left pending, and it remains unclear who was responsible for approving it.
The Final Hours
Bach was found unresponsive in his cell early on September 28 and was declared dead shortly after 4 a.m. The Medical Examiner’s report classified his death as a result of complications from a natural disease, but due to the neglect that characterized the events leading to his inadequate care, it was ruled a homicide.
A Rare Determination
The classification of Bach’s death as a homicide due to medical neglect is exceedingly rare. In the past two decades, only one other case in San Diego County has been ruled a homicide under similar circumstances. In 2022, Lonnie Rupard died in the same jail, and his death was attributed to neglect as well, highlighting a disturbing pattern of inadequate care for vulnerable inmates.
The Need for Reform
The tragic case of Keith Galen Bach underscores the urgent need for reform in the healthcare system within jails. As advocates continue to push for accountability and better medical care for inmates, the question remains: how many more lives must be lost before meaningful changes are made to protect those in custody?