Born behind bars

Alexa Angel Garza was born behind bars in the Yuma County jail. Her life started on a bloody mattress in a jail cell around 1:10 a.m. on Sept. 10, 2006.

No doctors or nurses were present. No medical equipment was available - not even a towel or running water. The only medication given to her mother was Tylenol.

The Sun received a copy of an official internal investigation detailing the 12 hours leading up to Garza's premature birth at roughly five months gestation.

Conflicting reports try to explain if the 22-year-old mentally ill mother, Ashley Ingraham, wanted the child. And pages of the report attempt to verify if Ingraham intentionally fell on her stomach in her jail cell, and if jail and medical staff followed the correct procedure when they gave her sanitary napkins for her vaginal bleeding, had a nurse visit her for the first time more than three hours after the bleeding began, took her vitals and doubted that she was in labor.

The Sun recently obtained the Yuma County Sheriff's Office report from Michael McGregor, the jail administrator who is currently on paid leave - in part - due to this incident.

According to the report, Ingraham was alerting jail staff that she was having "slow-timing contractions" since her booking in jail on Sept. 7.

"(I told them that) I need to see an emergency room doctor immediately," she stated in the report. "(They) tried to tell me that I was faking it, that I'm not contracting."

She was arrested on charges of disorderly conduct and domestic violence for allegedly hitting her then-boyfriend and the father of the baby, Alex Garza, 31.

The report states that a local mental health hospital had treated her for bipolar disorder, a manic-depressive illness that causes sudden mood changes, but did not specify when.

Inmates - who couldn't see into Ingraham's cell - first alerted jail staff that Ingraham was allegedly jumping off her bed and onto her stomach prior to 12:30 p.m. on Sept. 9. The report does not state what her exact actions were that day in her cell and what time they began. In the report, it states that a jail investigator told Ingraham that he had reviewed a DVD which "shows her intentionally falling on her stomach."

Ingraham admitted in the report that she resorted to the tactic to convince jail officials to take her to the hospital because she felt the medical staff was ignoring her and that this was the only way to get to the emergency room.

Ingraham told the investigator, "I might have accidentally fallen off my bed a few times ... I wasn't trying to fall on my stomach, I was trying to actually do exercise and stuff so I could try to ignore my pain and everything because (they were) not going to do nothing."

According to Ingraham, "My belly only hit the floor only amount of once ’cause I kind of slipped."

When the jail staff was first alerted of her actions at 12:30 p.m. Sept. 9, Ingraham had vaginal bleeding. The officer gave her a sanitary napkin so that medical staff could monitor the situation.

After leaving messages with seven local obstetricians, The Sun was unable to interview one to determine the possible impact of Ingraham's actions on her pregnancy.

Ingraham told a sergeant around 3:34 p.m. that she did not want to have the baby and that she was a bad mother for being in jail.

The first nurse to see Ingraham that day was nurse Radu Timis at 4:15 p.m. According to the report, Ingraham told Timis that she did not want to be pregnant. Timis said Ingraham was "faking it" and "there was nothing wrong with her, she was not in labor" and advised her to rest, according to the investigation.

However, also according to the report, Ingraham's midwife, Anette Casey, who cared for her during her pregnancy, said Ingraham "made her appointments on a regular basis and was excited about her pregnancy."

From 12:30 p.m. Sept. 9 until 1:10 a.m. Sept. 10, there are at least 11 instances where jail or medical staff either checked on Ingraham, noticed blood in her cell, gave her sanitary napkins, took her vitals, told her to rest, told her she was not in labor or reported her pleas for help to a higher jail official.

A security control officer stated in the report that "It angered me, the way (nurse) Timis handled the situation. He should have been more tuned in and gotten her butt downstairs (to go to the hospital)."

The second nurse to treat Ingraham that evening, Irene Naputi, told a shift supervisor sergeant that "I bleed more on my period than she's bleeding. She's OK," the report stated.

A unit manager for Ingraham's unit also said in the report that Ingraham's bleeding had alarmed him.

"There was a lot. There was pad, upon pad, upon pad, toilet paper and just anything you can think of in there," according to the unit manager, who was referred to as Officer B. Wilson in the report. Wilson said he spoke to his sergeant about his concern, but the sergeant told him they needed to follow the nurse's instructions.

"Regardless if she may be complaining of contractions, or whatever, she's bleeding," Wilson stated. "I can still see the toilet perfectly, and it's just like, how could somebody walk in the unit and not see that as like WOW."

Wilson added that he did not think medical personnel took Ingraham seriously.

An inmate in a cell near Ingraham's, Michele Inman, agreed. She told the investigator: "I think in the beginning ... nobody believed her, and nobody did anything ..."

Inman stated in the investigation that it "was ’round lockdown" near 9 p.m. (on Sept. 9) when "(a) person came and said they were going to get medical, but medical didn't come for a long time."

For Ingraham, the only people who could hear her cries for help that night could do nothing to help her - inmates locked in cells next to her.

Inman said she awoke because she heard Ingraham make "a cry I haven't heard" and "panicking banging."

"She was screaming and crying, but there was no officer. Nobody would come, and I swear I heard that probably a half-hour," Inman said in the report.

By the time a jail official did respond to Ingraham's cell, it was too late.

"The contractions were minutes apart, and I kept on calling for the detention officers, and they wouldn't do nothing, and then I just laid on my bed, and the baby came out," Ingraham stated.

"I began to yell and told them the baby was here. I had to put my mouth over the baby's mouth and suck out the fluid and spit it out and make sure the baby was moving," Ingraham told the investigator.

The crying stopped before 1:21 a.m., when a jail manager found Ingraham standing in her cell, holding a baby, with the umbilical cord still attached.

The Sun contacted Northend Health Associates, the former medical contractor for Yuma County jail, but officials there said nurses Timis and Naputi were no longer employed by Northend. Northend Health Associates' contract ended with the jail on June 18. The county did not renew its contract.

In the report, nurse Timis told the investigator, "I did not consider that is (sic) necessary to go to the hospital, because clinical signs were not showing me an emergency situation to send her to the hospital."

Numerous calls to YCSO spokesman Capt. Eben Bratcher for comment were not returned to The Sun by press time.

According to the report, Emergency Medical Services arrived at the jail around 1:21 a.m., about 11 minutes after the detention officer discovered the birth of the baby.

Around 1:42 a.m. the baby was transported to Yuma Regional Medical Center, where the newborn was placed into the Neo-Natal Intensive Care Unit in critical condition, due to "extreme prematurity," "respiratory failure" and brain hemorrhaging, and she was not expected to live.

She was transported to the University Medical Center in Tucson on Sept. 12, according to the report.

The Sun was unable to confirm when Alexa Garza was released from Tucson.

The child is now under Child Protective Services and residing with a nurse in Lake Havasu City, according to the father.

Ingraham was released from Yuma County jail on bond on Oct. 13. On Nov. 30, she was again booked into Yuma County jail and was released on Jan. 22. The Sun was unable to confirm the most recent charges that landed Ingraham in the local jail.

According to the baby's father, Ingraham is in a halfway house in Phoenix. The Sun was unable to confirm her location.

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TIMELINE OF EVENTS LEADING TO THE BIRTH OF ALEXA ANGEL GARZA:

SEPT. 9, 2006

- 12:30 p.m. - An inmate alerts a detention officer that Ashley Ingraham is jumping off her bed and landing on her stomach. Ingraham tells the officer she was bleeding in her toilet. The officer gives her a sanitary pad so medical personnel can monitor the bleeding. Ingraham tells the officer she was jumping off her bed. The officer notifies a sergeant about the situation, who tells the officer to call if anything else happens.

- 3:34 p.m. - A sergeant speaks to Ingraham, who cries and says she does not want to have the baby and that she is a bad mother for being in jail and having mental issues.

- 4:15 p.m. - Nurse Radu Timis checks on Ingraham, who says she does not want to be pregnant and that is why she is behaving that way. Timis advises her to rest and decides Ingraham is not in labor.

- 7:15 p.m. - A unit manager reports to a sergeant that Ingraham has begun bleeding again. Timis returns and again says she is not in labor. Timis places Ingraham on bed rest and a feminine pad count to be collected at the end of each shift. The sergeant asks Timis if she should be taken to the hospital, and Timis says "no."

- 9 p.m. - Ingraham reports her mucus plug came out. Timis again responds and says that was not the case. The sergeant places her in a dry cell, with no flushing toilet or running water. According to the American Pregnancy Association, a mucus plug remains in front of the cervix to prevent bacteria from entering the uterus. Typically, close to birth, the plug is expelled to allow the fetus to pass through the birthing canal.

- 10:30 p.m. - Ingraham's vital signs are taken by medical personnel and appear to be normal.

- 10:45 p.m. - The sergeant passes Ingraham's information to the sergeant taking over the shift.

SEPT. 10, 2006

- 12:15 a.m. - An officer tells the sergeant that Ingraham has been yelling and complaining she is in labor. Ingraham tells the sergeant she is in labor and needs to go to the hospital and is in a lot of pain. The sergeant tells Ingraham to relax, and he will try to see a nurse about her problems.

- 12:20 a.m. - The sergeant speaks with nurse Irene Naputi, who says she has been monitoring the situation. Naputi states she "bleeds more on her period" than what Ingraham had bled onto feminine pads.

- 12:30 a.m. - A sergeant takes a medic to Ingraham to check her vitals, which Naputi says are fine.

- 1:10 a.m. - An officer tells medical personnel Ingraham has prematurely given birth to a baby girl in her cell.

- 1:21 a.m. - Emergency Medical Services arrives at the jail.

- 1:42 a.m. - The baby is transported to Yuma Regional Medical Center.

- 2 a.m. - A call is placed to jail administrator Michael McGregor. It was the first call placed to McGregor about Ingraham.

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FATHER GIVES UPDATE ON BABY'S CONDITION

"She's doing as well as a premature baby can do. She still has a lot of problems we're gonna be facing in the future," Alex Garza, father of Alexa Angel Garza, told The Sun recently.

Garza said Alexa has respiratory and developmental problems, and although she is almost 11 months old, she is only at the developmental stage of an average 4-month-old baby. He said doctors have told him her motor skills and mentality are not going to keep up with her age.

Garza said Alexa is in the care of Child Protective Services. She is residing with a nurse at a home in Lake Havasu City and he sees her twice a month. He was unable to provide The Sun with phone numbers or names of the baby's doctors and nurses.

He said he is not dating the baby's mother anymore, and he believes Ashley Ingraham is on parole and living in a half-way house in Phoenix. He said he has not spoken to her in eight months.

Garza said he hopes to share custody of Alexa with Ingraham, unless she is not interested in custody, in which case he will try to gain full custody of their child. He is hoping Alexa will be able to come home to Yuma within the next four to five months.

"I'm trying to get an apartment of my own with a bedroom for the baby," he said.

Garza said the baby was named after him, and her middle name, Angel, was added from "the circumstances she was born under."

"Every time I talk about her, I start to get a little teary-eyed. Not only did they (Yuma County jail officials and medical personnel) mess up my child's life, but I was unable to be there in the hospital when she was born. They took that from me and from her.

"It's totally wrong what they did. Whoever's decision it was not to send her to the hospital, I hope he loses his job."

Garza said he has retained an attorney from Tucson, James Steadwell, and has filed a lawsuit against Yuma County and the jail's medical personnel.

Steadwell confirmed he made a claim to Yuma County and to Northend Health Associates "many months ago" and that the claim status was "pending," meaning it would either be resolved or go to formal litigation.

Yuma County Sheriff's Office Capt. David Reyes said the county did receive notice of a claim filed by Steadwell.