Jack Glenn Woolverton

CUSTODIAL DEATH REPORT Agency Information ORIGINAL CDR Number: 19-1039-C Version Type: VERSION 10/14/2019 10:04 Report Date: Status: Submitted AM Agency/Facility Information Henderson County Agency Name: Agency Address: 206-A N. Murchison Sheriff's Dept. Agency City: Athens Agency State: TX Agency Zip: 75751 Director Information Director Salutation: Sheriff Director First Name: Botie Director Middle Name: Director Last Name: Hillhouse Reporter Name: David Faught Reporter Email: [email protected] Decedent Information Custodial Death Report :: Page 1 of 7 --- PAGE BREAK --- Identity of Deceased First Name: Jack Middle Name: Glenn Last Name: Woolverton Suffix: Date of Birth: 10/11/1971 Sex: Male Race: Anglo or White Age At Time Of Death: 47 Date/Time of Custody (arrest, incarceration) (mm/dd/yyyy hh:mm AM/PM): Date/Time of Custody or 6/4/2019 3:33 PM Incident: Date/Time of Death (mm/dd/yyyy hh:mm AM/PM): Death Date and Time: 6/5/2019 4:21 PM Manner / Cause of Death Has a medical examiner or coroner conducted an evaluation to determine a cause of death? Medical Examiner/Coroner Yes, results Evaluation?: pending What was the manner of death? (select only one) Pending autopsy Manner of Death: results Custodial Death Report :: Page 2 of 7 --- PAGE BREAK --- Medical Cause of Death: Medical Cause of Death: Unknown cause Had the decedent been receiving treatment for the medical condition that caused the death after admission to your jail's jurisdiction? Medical Treatment: No If death was an accident, homicide or suicide, who caused the death? Who caused the death?: Not applicable If a weapon caused the death, what type of weapon caused the death? (Hold CTRL to select all that apply) Type of weapon that caused Not Applicable death?: Was the cause of death the result of a pre-existing medical condition or did the decedent develop the condition after admission? Pre existing medical Could not be condition?: determined If death was an accident, homicide or suicide, what was the means of death? Means of Death: Unknown Location / Custody Information Where did the event causing the death occur? Custodial Death Report :: Page 3 of 7 --- PAGE BREAK --- Street Address: 203 FM 315 South City: Chandler County: Henderson Zip: 75758 What location category best describes where the event causing the death occurred? Location Category: Residence/Home What type of custody/facility was the Decedent in at the time of death: Police Custody Type of Custody: (pre-booking) Specific type of custody/facility: Specific Type of Custody/Facility: N/A What was the time and date of the deceased's entry into the law enforcement facility where the death occurred (mm/dd/yyyy hh:mm AM/PM): Entry Date Time: Entry Date Time N/A: Where did the death occur? Death Location: Medical facility General Information Did any other law enforcement agencies respond to calls for service related to this incident? Other Agencies Respond?: Yes Custodial Death Report :: Page 4 of 7 --- PAGE BREAK --- What were the most serious offense(s) with which the deceased was (or would have been) charged with at the time of death? Offense 1: Assault Offense 2: Offense 3: Not filed at time of Were the Charges:: death What were the types of charges or reason for contact? (Hold CTRL to select all that apply) Medical / Mental Type of Offense: Health assistance call At any time during the incident and/or entry into the law enforcement facility, did the decedent display or use a weapon? Decedent display/use of No weapons: At any time during the incident and/or entry into the law enforcement facility, did the decedent: Yes (select all that Attempt to Injure Others?: apply) Injured law enforcement Ways Decedent Attempted To personnel; Injure Others: Attempted to injure civilian(s) or other inmate(s) At any time during the incident and/or entry into the law enforcement facility, did the decedent: Appear intoxicated (alcohol or Custodial Death Report :: Page 5 of 7 --- PAGE BREAK --- drugs): Yes Make suicidal statements?: Unknown Exhibit any mental health Yes Exhibit any medical problems?: Yes problems?: At any time during the incident and/or entry into the law enforcement facility, did the decedent: Barricade self or initiate Resist being handcuffed or No Yes standoff?: arrested?: Physically attempt/assault Gain possession of officer's Yes No officer(s): weapon: Verbally threaten other(s) Escape or attempt to No No including law: escape/flee custody: Attempt gain possession No officer's weapon: Was the deceased under restraint in the time leading up to the death or the events causing the death? Yes, mark which Under Restraint: restraint devices were used Type of restraint Handcuffs; Leg Type of Restraint: Shackles Summary of Incident Summary of How the Death Occurred: (max. 30,000 characters) Summary: Deputies responded to an address in reference to a call for service placed by the deceased persons mother. Deceased person would at times be screaming and yelling and then would completely calm down momentarily until he would begin screaming again. Deputies called for EMS to come to the scene. EMS arrived at the residence and the deceased agreed to go to the hospital to be checked out by medical professionals. Deputies and EMT personnel walked the deceased to the back of the ambulance to transport to UT Health in Tyler, Texas. as the deceased was near the ambulance to board he attempted to strike one of the EMT personnel. Deputy stepped between the deceased and the EMT and was struck in the nose. Deceased was placed on the ground and hand restraints were applied. The deceased began kicking at Deputies and leg restraints were applied. Deputies reported the deceased began banging his head on the Custodial Death Report :: Page 6 of 7 --- PAGE BREAK --- ground while the restraints were being applied. Immediately after the leg restraints were applied Deputies told EMT personnel that deceased did not appear to be breathing. Deputies removed the restraints and CPR was started. Deceased was transported to UT Health in Tyler, Texas. Texas Ranger Michael Adcock was called to the scene to investigate this incident. Henderson County Sheriff's Office was notified of the death on June 5, 2019 at 16:21 hrs. An autopsy was performed by American Forensics in Mesquite, Texas. the results of the autopsy are pending due to the wait for toxicology results. Custodial Death Report :: Page 7 of 7