A 101-page investigation released Friday concludes that corrections officers who locked a schizophrenic inmate in a hot shower at Dade Correctional Institution and left him there for nearly two hours — until realizing he was dead — committed no crime.
The report, issued by Miami-Dade State Attorney Katherine Fernández Rundle, said the death of 50-year-old prisoner Darren Rainey was an accident, the result of complications from his mental illness, a heart condition and "confinement in a shower."
At least six inmates claimed that the shower was specially rigged so that corrections officers controlled the temperature and were able to crank it up to scalding — or down to an uncomfortably frigid spray, thereby using it as punishment to control unruly inmates, most of whom suffered from mental illnesses.
But the state attorney's two-year probe decided that the inmates' statements were not credible.
While the report cited significant inconsistencies in the accounts of inmates, it acknowledged the same was true to a lesser degree of the accounts of staffers, although there was "general agreement on a core set of salient facts."
Sgt. John Fan Fan, and officers Cornelius Thompson, Ronald Clarke and Edwina Williams — the staffers involved in putting Rainey into the shower — did not act with premeditation, malice, recklessness, ill-will, hatred or evil intent, the state attorney said.
The report includes photographs, videos, dozens of witness statements, the medical examiner's summary, prison housing logs, timelines and other documents.
Milton Grimes, the attorney representing Rainey's siblings, suggested the report's release, late on a Friday, on St. Patrick's Day, was meant to limit public scrutiny of the clear "inadequacies" of the investigation.
"We are appalled that the state attorney did not look deeper into this case and see the criminality of the people who were involved," Grimes said. He said the family is disappointed, but remains hopeful that federal investigators still probing possible civil rights abuses will find justice.
Grimes suggested that police and state attorney investigators gave too much weight to corrections officers' testimony and not enough to the broader context — news reports and inmate grievances suggesting prison staff has been abusing inmates at the prison for years.
Others also questioned whether the case was thorough.
"A lot of evidence was tampered with because the people there who had an interest did not want it to come out," said Harriet Krzykowski, a former mental health counselor at the prison who was not interviewed as part of the probe.
Among the most controversial portions of the state inquiry is the temperature of the shower. The report gives no indication that crime scene investigators turned on the water to see how hot it ran. A prison captain, assigned as the environmental health and safety officer, tested it two days after Rainey's death and found it to be 160 degrees, far greater than the 120-degree limit set by the state.
But her reading was dismissed as not indicative of the temperature when Rainey was inside.
Other than two prison officers, a nurse and a paramedic, no one was interviewed by police — including multiple inmate witnesses who had reached out to various law enforcement authorities — until two years later, when the Miami Herald began raising questions about the case as part of what would become a three-year probe into corruption in Florida prisons.
The final report does not address why the case was put on hold, or why, nearly five years later, the autopsy has never been released.
Dr. Emma Lew, Miami-Dade's medical examiner, was emphatic, however, that Rainey did not suffer burns of any kind, and there was no evidence of any trauma on his body, according to the state attorney's report issued Friday.
However, a never-released preliminary report written the day of the autopsy refers to "visible trauma … throughout the decedent's body."
A nurse told the Herald early on that Rainey's body temperature that night was so high it could not be measured on a thermometer.
One fact is undisputed: Rainey's skin was peeling off his body when he was pulled out of the shower.
Since 2014, police detectives spoke with 26 inmates who were in the mental ward, called the transitional care unit (TCU) at the time of Rainey's death. At least six inmates said that the shower had been used to punish inmates who misbehaved. And three reported that they themselves had been subjected to punishing showers. Some say the shower was used by inmates without any problem. Fourteen inmates were either too mentally ill to say anything credible — or they refused to talk to police altogether.
Lew also discounted what the prisoners said because the prison nurses police interviewed claimed they had never treated — nor heard about — any inmates who had burns as a result of the shower.
But Krzykowski and others medical workers at the prison have told the Herald that they were pressured to keep quiet by both their employer, a private contractor, and by corrections officers who threatened to leave them unprotected when dealing with unstable inmates.
David Weinstein, a former federal prosecutor who reviewed the report for the Herald, said it's clear that the evidence did not meet the legal standard required to charge any of the officers with a crime.
"If you want to buy the government-conspiracy theory that the state attorney never charges corrections officers because they are part of the conspiracy, you are going to say they twisted the facts to support their theory," he said.
"But if you look at it objectively, I don't disagree with the results that were released. The only person that says that Rainey was burned and scalded was one inmate — and when you compare that to the rest of the evidence, it's not consistent."
That inmate, Harold Hempstead, was an orderly in the mental ward when Rainey died. It was Hempstead who first raised concerns about the episode, writing letters and filing complaints with police, the medical examiner and the state attorney about Rainey's death as well as other alleged abuses inside the TCU.
He and other inmates and mental health staff told the Herald that state prison guards used forms of torture, including dousing prisoners with buckets of chemicals, over-medicating them, forcing them to fight each other and starving them. A group of officers at the prison that served inmates empty food trays, known as "air trays," was known as the "diet squad'' and they often preyed on inmates who were too ill to coherently report what had happened, prisoners said.
Around the time of Rainey's death, another inmate hanged himself from an air conditioning vent, leaving a note sewn into his shorts detailing a litany of alleged abuses against inmates in the mental health unit.
"I'm in a mental health facility … I'm supposed to be getting help for my depression, suicidal tendencies and I was sexually assaulted," wrote Richard Mair, 40.
The Department of Corrections never investigated Mair's complaints, and the state attorney's investigation in the Rainey case was limited to the facts surrounding Rainey's death.
State investigators said they didn't find Hempstead to be credible because his timeline was at odds with events reflected on a video surveillance camera. Also, Hempstead could not have seen some of the things he claimed to have seen because his window was covered with paper for part of that time. The document suggests he pressured other inmates to report things that didn't happen, pointing out that many of the inmates' statements were "inconsistent with the testimony of correctional personnel, all of the nurses, as well as the physical evidence."
Hempstead was relocated to another state Friday, yet undisclosed, through a prisoner exchange, making him unavailable for comment. Prison officials said the timing was coincidental.
The report itself is inconsistent in some areas. On page 68, for example, the investigation says that only one inmate, Halden Casey, gave information about being placed in the shower with excessively hot water.
Earlier in the report, it mentions two other inmates: Lawrence Smith said he had been put in the hot shower about a month before Rainey died and that he had reported it to the nurses. Another inmate, Timothy Sliders, said he had been left in the hot shower for 30 minutes, but he managed to avoid injury by standing outside the spray. Another time, when he mentioned the water was comfortable, a guard went into the janitor's closet and turned it up hotter, he told police detectives according to the report.
Rainey, who grew up in Tampa, was serving a two-year sentence for cocaine possession and had been at Dade for about four months at the time of his death. He reportedly had soiled himself in his cell and refused to clean up, so the officers led him to the second-floor shower, despite other showers being closer to his cell.
Lew, the medical examiner, noted that people with schizophrenia have an impaired ability to compensate for "heat stress" and that this, combined with the powerful medication he was taking, could have contributed to hyperthermia and created a predisposition to cardiac arrest.
She attributed his skin slippage to as an event that happened post-mortem consistent with "exposure to a warm, moist environment" and the effects of changes during the early stages of body decomposition.
Six inmates claimed that Rainey yelled that he wanted out of the shower. No member of the prison staff reported hearing anything.
Julie Jones, secretary for the Department of Corrections, said she was appreciative of the effort by police and the state attorney. The agency remains focused on implementing reforms in the way it cares for mentally ill inmates.
"We will continue to integrate services which ensure these inmates successfully re-enter society and lead crime-free lives upon release,'' she said.
Following the Herald's stories, Dade Correctional's warden and assistant warden were forced out, and, later, then-Secretary Michael Crews stepped down amid political pressure. He was replaced by Jones. Other high-level prison officials have also left, including the prison agency's inspector general, Jeffery Beasley — the system's "watchdog" — who was accused by his own investigators of thwarting investigations.
Two of the guards identified as locking Rainey in the shower left their prison jobs, but were allowed to keep their law enforcement certifications. Roland Clarke is now a police officer in Miami Gardens and Cornelius Thompson works as a federal corrections officer.
Rainey's family filed a federal civil rights lawsuit against the Florida Department of Corrections in 2016. It is still pending.
The U.S. Department of Justice is still investigating possible civil rights abuses in Florida prisons.