They’re not stylish and they’re prone to false alarms, but jail officials across the country are turning to biometric bracelets to keep people from dying in custody.
A company called 4Sight Labs has created medical monitors that measure vital signs like heart rate and breathing. When locked onto the wrist, the device is designed to alert the jail’s staff of a medical emergency.
“Our goal is to not miss a health crisis,” 4Sight Lab’s CEO David Sanders said.
Across the U.S., Sanders said 61 local jurisdictions are using the technology or are in training to implement it in their jails.
People are often taken into custody in fragile health. Many are withdrawing from opioids, experiencing a mental health crisis, or suffering from other untreated chronic conditions.
According to a federal database of in-custody deaths obtained by The Marshall Project, nearly 4,000 people died in jails over a four-year period between 2019 and 2023. The database is incomplete and likely an undercount, making it difficult to draw conclusions about larger patterns in the data.
The most common cause of death is listed as “unavailable.”
Inside Philadelphia’s jail complex
In Philadelphia, people booked into jail wear biometric wristbands during the first five days of custody.
“My goal is to have zero in-custody deaths,” Michael Resnick, commissioner of the Philadelphia Department of Prisons, said. “I know that’s unrealistic, but I want to implement as many protocols as we can to get as close to zero as possible.”
So far this year, two people have died in Philadelphia jails. The complex of razor-wired buildings situated along the Delaware River has averaged 11 deaths annually in recent years, officials said.
“The Philadelphia jails have a long, checkered history,” said Noah Barth, prison monitoring director for the Pennsylvania Prison Society.
Over the years, Barth has surveyed conditions inside the city’s jail and he said the complaints have run the gamut: dirty housing units, people stuck in cells for too long, meals that are too small.
“The majority of people we talk to say they have to wait over a week, sometimes over a month, to receive medical care,” Barth said. “Now that’s not every instance, but it seems to be a pretty regular experience for folks.”
In 2020, a group of people incarcerated there filed a class-action lawsuit over inhumane conditions — and they won.
Last year, a judge ordered the city to pay $25 million to improve the jail, and Barth said things are slowly getting better.
There’s finally air-conditioning in every housing unit. Though there still aren’t enough guards, new recruits have been hired, the commissioner said. Earlier this year, the jail population dropped to a 33-year low.
“Material conditions of life are improving in a lot of places,” Barth said. “Just the basic function of the jail.”
Testing the wristbands
Inside a medical unit at the Philadelphia jail complex, nurse Lynda Witkowski stood in front of a computer screen that showed 137 people actively using the wristband monitors.
“There’s little lights underneath blinking that measure heart rate, respirations, skin temperature, excessive movement,” said Witkowski.
To demonstrate what happens when someone’s breathing suddenly slows or their heart rate spikes, Witkowski started banging the device against her hand. When it didn’t alert, she banged it against the wall. It still didn’t register an alarm.
David Sanders, the CEO of 4Sight, later said the alarm failed to trigger because that wristband had been tested in the same way earlier in the day. When the medical staff had cleared the alert, the bracelet learned not to respond to that kind of excessive movement, Sanders said.
However, during Witkowski’s demonstration, an alarm on a different bracelet somewhere in the building did go off. A nurse investigated and confirmed it was a false alarm. Someone had rolled over on the device.
Philadelphia started using these monitors in April, and false alarms are common.
Jail officials said they don’t mind the false alarms because the bracelets have alerted medical staff to two life-threatening emergencies, including one for a woman in her 30s.
“We got a critical alert from the monitor, and sent her to the hospital. She was diagnosed with a serious infection in her neck,” said Dr. Lalitha Trivikram, who works for YesCare, the company responsible for health care inside Philadelphia’s jails.
Not all jails are satisfied with the monitors. Last year, in Albuquerque, New Mexico, the Metropolitan Detention Center canceled a contract with 4Sight Labs because the bracelet battery only lasted two hours, and it didn’t work with the jail’s technology infrastructure.
The company said the jail was using an older version of the product that didn’t work as well.
People in custody weigh in
How do the people wearing these wristbands feel about them?
Commissioner Resnick made several people incarcerated in the Philadelphia jail available for an interview. Some complained the bands were uncomfortable or cinched too tightly around their wrists. George Beckett, whose eye was still swollen and bloodshot three days after getting booked into jail, said it bothered him while trying to sleep.
But he said the discomfort was worth it because the bracelet helps to “take that weight off your mind.”
Beckett said he has a seizure disorder.
“I’ve got a really bad risk of falling,” he said as a team of jail officials looked on. “Whether it even honestly is or isn’t working, just the fact that people are coming in, actually, to check on you when you do have disabilities is a plus. It gives you hope when you’re feeling like you’re in a hopeless state.”
Anyone getting booked into jail can opt out of the bracelet. But Erikson Barrios, who wore a bracelet along with the jail’s bright orange jumpsuit, said he didn’t feel like he had a choice.
“In jail, it’s not a question if you want it or not. You got to,” Barrios said. “It’s jail. You got control over nothing.”
After five days in custody, the bracelets come off. That’s when Philadelphia jail officials said the risk of a medical emergency becomes less likely.
But people also die in jails from illnesses that occur after the first five days.
Prison monitor Noah Barth is cautiously optimistic. He said the technology is promising, “but I think it’s going to be something to keep a close eye on. Are they going to stay vigilant? With any technology, it’s only as good as the user.”
Wilder Fleming and Ilica Mahajan, a reporter for The Marshall Project, contributed reporting.
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Peter O’Dowd produced and edited this segment for broadcast with Catherine Welch. Allison Hagan produced it for the web.
This article was originally published on WBUR.org.
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