ROCHESTER, Minn. Victor Artola and Paul Harris didn’t have much in common. Artola spoke Spanish, Harris spoke English. Artola was 63, Harris was 21. Yet, when the two moved into prison cell 217 of Faribault’s K3B wing in early March 2021 after testing positive for COVID-19, they formed an unexpected bond.

Artola offered Harris food off his plate. Harris — who was asymptomatic — tried to get medical help for Artola when he couldn't stop vomiting.

On the night of March 12, they both fell asleep in their bunks looking at the same white walls and stainless steel toilet surrounded by vomit-soaked towels.

ALSO READ: 'It’s dead man walking': Newspaper investigation reveals mistreatment of Minnesota inmates during pandemic

The next morning, only one man woke up.

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“Victor, get up!” Harris recalled saying as he jerked Artola’s shoulders, noticing blood caked around his mouth. Correctional officers shone a light through their narrow cell window and told him to check on Artola, who hadn't stirred in hours. “I shook him real hard, but he was already gone,” Harris said.

Artola died in his cell, 10 days after being diagnosed with COVID-19. He was never brought to a hospital, even as he vomited up food and water for 72 hours.

The vital signs medical staff recorded in the day before his death were within the normal range, with oxygen saturations nearing perfect levels. Yet a translator was not present for the Spanish-speaker during these checks, where staff recorded that Victor "stated he felt fine," just hours before he died.

His case is full of uncertainty, but those around Artola say one thing is clear: His calls for help were ignored until it was too late.

'I'm not good': A timeline of Artola's final days

Using interviews with inmates, family members and medical records provided by the Department of Corrections, the Rochester Post Bulletin reconstructed Artola’s final 10 days.

On March 3, 2021, Victor Artola’s COVID-19 sample returned positive.

He was informed of his test result on March 4 and moved into a quarantine cell with Harris. A red tag was placed on their door, a sign that one or both of the individuals inside had tested positive or were symptomatic for COVID-19. According to surveillance footage and photos from the prison, some of the surrounding cells were dotted with yellow tags, indicating inmates were potentially exposed to COVID-19.

A row of cells in Faribault prison's K3B wing show yellow and red tags.  A red tag signifies that one or both of the individuals inside had tested positive or were symptomatic for COVID-19. A yellow tag indicates an inmate was potentially exposed to COVID-19. (Courtesy of Minnesota Department of Corrections)
A row of cells in Faribault prison's K3B wing show yellow and red tags. A red tag signifies that one or both of the individuals inside had tested positive or were symptomatic for COVID-19. A yellow tag indicates an inmate was potentially exposed to COVID-19. (Courtesy of Minnesota Department of Corrections)

For the next four days, Artola’s condition remained relatively stable, aside from a slight cough, according to Harris. Two other inmates in the unit and a family member who Artola regularly called also confirmed this.

There are no medical check-ins recorded from March 5 through 11. DOC policy dictates that an inmate who tests positive for COVID-19 should undergo twice daily symptom monitoring. Commissioner Paul Schnell said he believes those check-ins occurred, and could not say why they weren't reflected on Artola's medical records. He believed dramatic symptom changes would be noted in the records, but perhaps not routine check-ins.

However, Artola did get dramatically worse during that timeframe, according to four people who saw or spoke with him.

He lost his appetite and began to feel ill about March 7, according his nephew Balmore Artola, who talked with him on the phone Tuesday, March 9.

Victor soon began to vomit, unable to keep water or food down, according to Harris and Manuel Muro-Martinez, another inmate who advocated on Victor's behalf. The Centers for Disease Control and Prevention lists vomiting as one of the symptoms of COVID-19.

Prison staff offered cloths and germicide to clean up the mess. Fearing for his cellmate's life, Harris implored staff to take Victor's symptoms more seriously.

“I’m constantly begging them to take him to the hospital,” Harris said. “(Victor) just kept holding his stomach. … He told the (correctional officers) ‘Me no good. I'm not good. Am I going to be taken to the hospital?’ And they kept saying there was nothing we could do."

At 3 p.m. March 12, after Artola had been vomiting for at least two days, correctional officers grew more concerned with his condition. Officer Leilani Bang called an available registered nurse to check on Artola and take his vital signs, according to an investigation from a DOC forensic pathology specialist.

The medical professional taking Victor Artola’s vitals on 3/12/21 recorded his oxygen saturation to be at 99%, temperature at 97.7 degrees, and blood pressure at 116/60. All of these readings were considered normal for a man of his age and condition. (Courtesy of Minnesota Department of Corrections)
The medical professional taking Victor Artola’s vitals on 3/12/21 recorded his oxygen saturation to be at 99%, temperature at 97.7 degrees, and blood pressure at 116/60. All of these readings were considered normal for a man of his age and condition. (Courtesy of Minnesota Department of Corrections)

Medical staff recorded Artola’s oxygen saturation at 99 percent and temperature at 97.7 degrees. For a diabetic man in his condition, his vitals were considered in the normal range, according to Dr. Susan Hasti — a family medicine doctor currently on the faculty of the Hennepin Healthcare Family Medicine residency program. Hasti has previously worked in outpatient and inpatient medicine. She reviewed these records at the request of The Post Bulletin and was not involved in Artola’s care.

Translator services were not used during these medical visits, and the records note "lang. barrier was a difficulty," as staff interacted with Artola, who family members and friends confirmed did not speak much English.

This was a flaw in the medical care Artola received, according to the department's commissioner. He said that he will likely push for department policy changes to ensure translators are consistently present in the future.

"In general, we would want to have a translator there, to make sure there is not just an assessment of more clinical features presented in any person, but also what's being described," Schnell said.

The absence of a translator for someone who can barely speak English is an alarming oversight, said Hasti.

"There is a federal right for language access in health care settings. This was clearly not done. This is a terrible medical ethics violation, as critical information from the patient was knowingly left out of the assessment," she wrote.

A second medical check-in, timestamped at 11:20 (investigators later noted they believed it was erroneously recorded as a.m. instead of p.m.) also stated that Artola appeared to be in poor condition. His vitals remained in the normal range, according to records.

 In a second check-in on March 12, a medical professional recorded Victor Artola’s vital signs to be in the normal range, with oxygen saturation at 99% and temperature at 97.3 degrees. (Courtesy of Minnesota Department of Corrections)
In a second check-in on March 12, a medical professional recorded Victor Artola’s vital signs to be in the normal range, with oxygen saturation at 99% and temperature at 97.3 degrees. (Courtesy of Minnesota Department of Corrections)

Medical staff noted that Artola “stated that he felt fine” and “appeared to understand and was stable," once again, without the assistance of a translator.

Muro-Martinez grew so desperate to get Victor help that he called the Artola family on his friend's behalf, asking them to contact the prison and see if they could urge for Victor to be transported to the hospital. Balmore called Faribault and offered to help however he could. He drifted into a restless sleep in the early hours of March 13. At 4 a.m., he jolted awake with a horrible feeling in his body and knew something was wrong.

Victor was declared dead at 5:33 a.m.

Was emergency care warranted?

Artola’s death certificate stated he died from natural causes. The document was filed March 16 with the state registrar and completed by Rice County Coroner Randolph Reister. COVID-19 was not listed as a cause of death or under “other contributing conditions.” When reached by phone, Reister said this was likely a clerical error which he would submit amendment paperwork to correct.

An autopsy conducted by Ramsey County Assistant Medical Examiner Victor Froloff on March 14 came to a much different conclusion, finding that Artola died from COVID-19 and “consolidations and pulmonary edema of both lungs” — meaning his lungs filled with fluid. The medical examiner’s office declined to comment.

If the autopsy's conclusions are correct and Artola died after fluid collected in his lungs, the medical entries recorded in his final hours are puzzling. They don't appear to show a man hours from death.

"Given the medical information in this case, and that on autopsy he died with lungs full of fluid, I would not expect such normal vital signs,” Hasti wrote. “Why would he have such a high oxygen level of 99% when he is clearly so ill? It causes me to question the validity of that measurement.”

Even if the vital signs were correctly recorded, Hasti said medical staff should have transported Artola to the emergency department after he vomited for several days.

"If a nursing or group home called me about a patient of mine, vomiting and unable to keep even water down and with diabetes in their mid-60s in age, I would ask to have that patient transported to the (emergency department) for evaluation. In fact, I would have made that decision far sooner than three days,” Hasti wrote, adding that those concerns are amplified for patients who have diabetes, such as Artola.

Speaking generally about the care of COVID-19 patients, Olmsted Medical Center Chief Medical Officer Randy Hemann said oxygen saturation readings can be deceiving. He recalls a patient who seemed healthy during exams and had a normal oxygen saturation level, but a chest X-ray caught that their lungs were filling with fluid.

Because these signs don’t always show the complete picture, Hemann said it’s essential to listen to the patient and have them update on how they’re feeling.

“Although it seems non high-tech or highly diagnostic, it often ends up to be just that: If you feel worse, let us know,” Hemann said.

Inmates who observed Artola’s care in his final days said prison and medical staff ignored those telling cries for help when his condition worsened.

Denied medical release

Balmore Artola used to see his uncle frequently when the two lived just miles from each other in Eagan and Richfield. After Victor was incarcerated, Balmore tried to help his uncle however he could, keeping up with weekly phone calls and updating him about any news from his home country of El Salvador.

When the pandemic surged, Balmore grew concerned for how his uncle's underlying health conditions might affect him if he contracted COVID-19. So, he helped with an application for conditional medical release.

Balmore Artola is pictured on Saturday, June 12, 2021, at his home in Eagan. (Traci Westcott / twestcott@postbulletin.com)
Balmore Artola is pictured on Saturday, June 12, 2021, at his home in Eagan. (Traci Westcott / twestcott@postbulletin.com)

The program predated the COVID-19 pandemic but was adapted to allow vulnerable inmates to be considered for release. A previous Post Bulletin analysis found that it was rarely used. Of the total 2,292 inmates who applied statewide during the pandemic, 157 were approved.

Applications were first reviewed by the Minnesota Department of Corrections’ medical examiner to determine if the individual fit the health criteria to be considered for release. If they did, they were passed on to a team of four reviewers who analyzed various aspects of public safety to decide if the inmate posed a potential threat.

Commissioner Paul Schnell reviewed notes from all reviewers and made the final call on if the candidate would be released. However, the Post Bulletin found that the commissioner denied 151 cases where reviewers unanimously recommended release.

“They may have come to a universal agreement. But when all is said and done, I'm the one who is charged with that responsibility,” Schnell said in an interview in March. State law grants the commissioner final authority to approve or deny medical release.

Artola’s medical vulnerabilities — diabetes and heart conditions — were deemed significant enough to possibly warrant a release. However, his application was ultimately denied on the basis of public safety.

An excerpt from Victor Artola’s conditional medical release application. Diabetes and heart conditions put Artola at higher risk of suffering a serious case of COVID-19. He became one of the four inmates who died after their applications were denied.
An excerpt from Victor Artola’s conditional medical release application. Diabetes and heart conditions put Artola at higher risk of suffering a serious case of COVID-19. He became one of the four inmates who died after their applications were denied. Document courtesy of Balmore Artola.

He was serving a 96-month sentence for criminal sexual conduct with a person under 13 years old, with an expected supervised release date in 2027. His MNSTARR score — a tool used to predict the potential of recidivism — was “low,” according to DOC documents. He was one of four inmates who died after their medical release application was denied.

"This is somebody's dad, friend, child, and that's the reality of it. As a system, we have an obligation to make sure that if things did not go as they should have gone clinically, and even beyond clinically, then we have an obligation to address that and to fix that," Schnell said.

Victor Artola (left) is pictured with his nephew Balmore Artola (right). Victor and Balmore talked at least once a week after he was incarcerated at Faribault prison. (Courtesy of Balmore Artola)
Victor Artola (left) is pictured with his nephew Balmore Artola (right). Victor and Balmore talked at least once a week after he was incarcerated at Faribault prison. (Courtesy of Balmore Artola)

'I wish I could have done more'

Inside and outside of prison, Artola had people fighting for him.

One of the people advocating inside the prison was Victor's own son, Jose. He pursued a volunteer position in health services, thinking he might cross paths with his father while he picked up his diabetes medications.

“All I wanted to do is just to say hi to him. Tell him that we're in this together. You're not by yourself,” Jose said, who added that he was particularly concerned for how the language barrier would affect his father in prison.

Shortly after Jose started the job, Victor was diagnosed with COVID-19. Within days, he was dead. Jose was not permitted to see his father before his body was transported back to El Salvador.

Several Faribault inmates who knew Victor reached out to the Post Bulletin to share what they witnessed during his final days.

One of them was David Basinger, who tutored Victor in English for years. He remembered Victor as someone who was always eager to learn and didn’t take shortcuts, whether learning the basics of math or English.

“It’s hard to process being that, you know, you saw him full of life and then (saw) it slowly leave him,” Basinger said, recalling how Victor used to savor radishes from his meals and collect coffee from men in the unit who would save it for him.

“We all did what we did to put ourselves in here. And for the most part, a lot of us are trying to better ourselves and become better people in order to go back to society. And having something like that happen, especially when someone was asking for help repeatedly, it just doesn't make any sense to me," Basinger said.

Harris, now 22 years old, still struggles with flashbacks of finding his cellmate’s dead body.

The inside of cell 217 in Faribault prison. Victor Artola slept on the bottom bunk, and Paul Harris on the top. (Courtesy of the Minnesota Department of Corrections)
The inside of cell 217 in Faribault prison. Victor Artola slept on the bottom bunk, and Paul Harris on the top. (Courtesy of the Minnesota Department of Corrections)

“I watched him suffer. It felt like I could see his dead body. I watched him being neglected,” Harris said in an interview two weeks after Artola’s death. “It’s just been bothering me because I wish I could have done more.”

Correctional officers placed Harris in solitary confinement after they removed him from cell 217. Staff told him it would last only a few hours. Hours stretched into days, and he remained in the segregated cell for two weeks.

“I’ve had a hard time sleeping. Thinking about it. I haven’t been eating much. It’s hard,” Harris said, just days after he was released from solitary confinement. “But at least I’m living.”