By A.C. Thompson

A cocaine overdose. That's how the San Francisco Medical Examiner's office says county jail inmate Edwin Macon Jr. died during the early morning hours of July 1. The medical examiner's report, which cites "acute cocaine intoxication" as the cause of death, was released to the public Aug. 4 after stories about Macon ran in both this paper (see "Deadly Delay," 8/3/05) and the San Francisco Chronicle.

The results of the autopsy would seem to let the San Francisco Sheriff's Department (which runs the jails) and the San Francisco Department of Public Health (which provides medical care to jail inmates) off the hook.

Actually, though, a close reading of the report brings up new questions about the treatment Macon received. In addition to pinpointing a cocaine overdose as the cause of death, the medical examiner found Macon was suffering from two "other conditions" that escaped the scrutiny of the health care professionals who checked him out.

At the time of his death, Macon was besieged by "acute pylenonephritis" – a severe kidney infection – as well as pneumonia. His medical records show jailhouse doctors and nurses failed to identify either affliction in the days leading up to his death, though both ailments are common and potentially lethal.

Notes taken by a nurse June 27 indicate Macon was complaining of "kidney pain" and had experienced chest pain for two days. On June 28 he continued to tell nurses he was plagued by pains in his kidneys and chest.

"He did receive the appropriate medical care in the days before he died," Dr. Joe Goldenson, head of Jail Medical Services for the health department, told the Bay Guardian, adding that on June 30, Macon told a nurse practitioner his aches had dissipated. "The complaints he had were not related to the cause of death."

Macon's mother, Jessie Macon, is still furious. "I'm so angry I could blow up," she said. "They didn't look for what was wrong with him. They didn't listen to him."

One more question lingers: Hours before he died, Macon was moved to a "safety cell," a padded room for prisoners in psychiatric crisis. At that time a nurse examined him, discovered "no physical injury," and phoned Jail Psychiatric Services, leaving a message for the psych team. In the nurse's notes, there's no indication she was aware that he was in the process of overdosing on coke. Is there anything she could've done at that point to save Macon's life?

"We're still investigating the circumstances of that night," Goldenson told us.

E-mail A.C. Thompson at acthompson{at}hushmail{dot}com.