Family with display

Joanne and Scot Sacco of Manchester comfort each other at their Manchester home on April 13. On display is a memorial for their late son, Nicholas.

LAST MONTH, the New Hampshire House voted by a close margin to tighten up laws from 2018 that reformed bail.

Even though the rate of violent crime is down in Manchester, the lawmakers were cheered on by Mayor Joyce Craig and Police Chief Allen Aldenberg, who apparently believe locking up people is the way to deal with crime.

But it is a drastic way to deal with the petty crimes of Nicholas Sacco.

Sacco grew up in a two-parent, middle-class family in the Rosecliff neighborhood of south Manchester. His dad was retired military, his mom a Manchester school teacher.

He had lots of love and opportunity in his early years, but like thousands in New Hampshire, he entered adulthood addicted to heroin. If drug addiction is a disease, then one of the symptoms is crime, and Nicholas accumulated a record of theft, forgery and drug possession.

There is no hint of violent crime in his felony record. But he landed in the Valley Street jail on May 16, 2019.

Two days later, he told his jailers that he was withdrawing from his five-bag-a-day heroin habit and needed to go to the hospital.

They put him on detox watch. Over the next three days, nurses dutifully recorded his vital signs (nausea, vomiting, cramping, heart rates of 100 or more). They never contacted the jail’s on-call doctor. They gave Sacco a Styrofoam cup and urged him to hydrate.

By May 21, Sacco was rushed to the Elliot Hospital. The following day, his parents told doctors to remove him from life support. He was 24.

“They treated him worse than a dog,” his mother, Joanne, said last week in the dining room of her house. “They just think he was a druggie. They were judge, jury and executioner.” Joanne is the third mother I have written about whose child died in connection to the jail.

The Saccos have sued the jail, the nurses who tended to Nicholas and the two-person practice the jail hires to provide medical care to inmates.

The jail’s position can be summed up like this: Care can’t just be bad to prove a claim, it’s got to be really bad. The legal term is “deliberately indifferent,” and there has to be a widespread policy or practice that condones such care.

The physician practice, American Institutional Medical Group, claims qualified immunity.

(In a heartbreaking turn of events, the AIMG physician assistant who tried to revive Sacco shot and killed himself in front of his wife earlier this year at a shopping center parking lot.)

Both sides have hired experts to interpret Sacco’s death and treatment. AIMG lawyers hired two people who work in the prison-medical industry. One, a physician assistant from Idaho, wrote that AIMG did no wrong. A doctor for a Utah company said the nurses at Valley Street did a better job than nurses in other jails.

This is an expert report submitted in U.S. District Court on behalf of American Institutional Medical Group, which provides physician services to the Valley Street jail.

The Saccos have their own experts. Dr. Thomas Andrew, the former chief medical examiner for the state of New Hampshire, wrote that the death was entirely preventable.

Another expert, Dr. Jonathan Giftos, ran the substance abuse program at the infamous Rikers Island jail in New York City for three years without a withdrawal-related death.

“Reading the (Sacco) chart is like watching a train wreck happen in slow motion, with no interventions offered to prevent the outcome,” he wrote in his report.

This expert report, prepared for the family suing Valley Street jail after their son's death, was prepared by the physician who oversaw addition-related issues at Rikers Island in New York City.

Next month, U.S. District Court Judge Joseph Laplante will hear from both sides and decide if the case can go forward.

Mayor Craig doesn’t dispute that there are problems at Valley Street jail, she said in an email.

Hillsborough County government, the mayor said, should devote some of the $82 million in federal American Rescue Plan money to a pre-trial services and diversion program. (At least two New Hampshire counties, Merrimack and Strafford, offer such programs, which connect social workers to defendants to get them help while on bail.)

Regardless, Craig said bail practices should be tightened up.

“Releasing individuals who pose a serious threat to our community will not improve the conditions at Valley Street,” she said.

Technically, bail reform was in place when Sacco was at Valley Street. He was on probation, so when he was arrested for shoplifting he faced a 72-hour jail hold. His case, however, is an example of who will end up at Valley Street regularly if bail practices tighten up.

I emailed questions to jail Superintendent Willie Scurry. He said he can’t comment on Sacco because it is in the courts. He said the remaining person at AIMG, Dr. Christopher Braga, continues to provide physician care to the terms of the contract.

Why, I asked, has only a fraction of the dollars earmarked for medically assisted addiction treatment been spent? He said that’s up to Braga.

Although they didn’t like to see Sacco in jail, his family said they thought he’d be safe. Now they struggle with his loss.

Sacco’s father, Scot, wonders what he could have done differently. Quit his job? Move him and his son to the middle of nowhere to keep him out of trouble?

Joanne lives with the last conversation she had with her son, words relayed over a telephone call from the jail.

“He told me he loved me,” she said. “That was the last thing he said to me: ‘I love you Mom.’”