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Brain Injuries from Head Trauma and Metabolic Insult

$12,617,674 – Negligence, Civil Rights, Medical Negligence


A 32-year-old suffers a brain injury due to negligence by sheriff’s deputies and jail nurses.

A San Diego Superior Court jury awarded $12,617,674 to David Collins, a 32-year-old Encinitas man who alleged negligence by Sheriff’s Deputies and Vista Detention Center nurses for failing to identify and treat his low sodium and his traumatic brain injury that he suffered while detained.

Plaintiff Collins sued the County of San Diego, its Sheriff’s Deputies Matthew Chavez and David Sanchez, along with Vista Detention Center nurses Roela Carolino and Johnathan Symmonds for negligence related to his arrest on November 18, 2016. At the time, he had a condition called hyponatremia caused by low sodium, chronic illness, and dehydration. His symptoms included slurred speech, trouble walking, and hallucinations.

Collins was found outside his home by a Good Samaritan, who called for paramedics at his request. The paramedics arrived and before they could perform an assessment, the deputies hauled Collins off to jail for “drunk in public” under Penal Code section 647(f).

During his detention, Collins fell twice, striking his head. In addition to his hyponatremia, he had a traumatic brain injury. He was not transported to the hospital right away. By the time he reached the hospital, his sodium levels were critical, and he had brain bleeding and contusions.

When the hospital physicians tried to raise his sodium for fear of the consequences from the head trauma, he developed a further brain injury called osmotic demyelination syndrome or ODS.


This case really is the “tip of the iceberg” of a larger problem, which is the apparent abuse of Penal Code section 647(f) by the Sheriff’s Department, particularly in North County. The case also highlights the appalling level of care offered in the San Diego County jail system.

The jury found that the deputies were negligent when they pulled Collins away from the paramedics and transported him to the Vista Detention Center. The jury found that the jail nurses committed medical negligence for failing to get Collins proper medical care for his hyponatremia and brain injury.

Throughout the trial and to the media, the County portrayed Collins as a binge drinker and alcoholic who did this to himself. His blood tests were negative for alcohol and drugs. The jury considered whether Collins was partially responsible for his injuries and found that none of his actions were the cause of his brain injuries.


The brain injury to the frontal lobe caused by striking his head in jail permanently affects Collins’ judgment and insight, and the ODS affects his mobility and speech. Both were preventable had Collins been transported to the hospital by the sheriff’s deputies or the paramedics either before his arrest or booking, or right after he fell in the jail.

Special Notes

Before trial, the County asked to go to a mediation with retired Judge Herb Hoffman. Judge Hoffman recommended $3 million both to the County and to Collins to settle the case. Plaintiff accepted the number, but the County Board of Supervisors refused it and only offered $500,000.

The jury awarded Collins $8,000,000 in pain and suffering and $4,617,674 in past and future income loss and medical costs. Because part of the verdict related to the jail nurses involved medical negligence, the verdict was reduced by the trial judge per the provisions of MICRA (Medical Injury Compensation Reform Act), which caps non-economic damages. The $5,600,000 non-economic verdict against the two nurses was reduced to $250,000. The verdict was also reduced by an offset for a prior confidential settlement with the physicians and hospital involved in treating Collins’ hyponatremia. The final judgment was for $6,417,990.56.

The County appealed the judgment and on February 7, 2021, the Fourth District Court of Appeal affirmed the judgment and certified the opinion for publication. Read the entire opinion here. It appears the County will next appeal the judgment to the California Supreme Court.




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