Justin Daniel Dominguez

CUSTODIAL DEATH REPORT Agency Information ORIGINAL CDR Number: PA16263CJ Version Type: VERSION Report Date: 6/22/2016 9:02 AM Status: Submitted Agency/Facility Information Travis County Agency Name: Agency Address: P. O. Box 1748 Sheriff's Office Agency City: Austin Agency State: TX Agency Zip: 78767 Director Information Director Salutation: Sheriff Director First Name: Greg Director Middle Name: Director Last Name: Hamilton Reporter Name: Inocencio Flores Reporter Email: [email protected] Decedent Information Custodial Death Report :: Page 1 of 6 --- PAGE BREAK --- Identity of Deceased First Name: Justin Middle Name: Daniel Last Name: Dominguez Suffix: Date of Birth: 5/22/1992 Sex: Male Race: Age At Time Of Death: 24 Date/Time of Custody (arrest, incarceration) (mm/dd/yyyy hh:mm AM/PM): Date/Time of Custody or 6/10/2016 7:05 PM Incident: Date/Time of Death (mm/dd/yyyy hh:mm AM/PM): 6/11/2016 10:56 Death Date and Time: AM Manner / Cause of Death Has a medical examiner or coroner conducted an evaluation to determine a cause of death? Medical Examiner/Coroner Yes, results are Evaluation?: available What was the manner of death? (select only one) Alcohol/Drug Manner of Death: Intoxication Custodial Death Report :: Page 2 of 6 --- PAGE BREAK --- Medical Cause of Death: Medical Cause of Death: Cocaine and Methadone Toxicity Had the decedent been receiving treatment for the medical condition that caused the death after admission to your jail's jurisdiction? Medical Treatment: Not Applicable If death was an accident, homicide or suicide, who caused the death? Not applicable; cause of death was Who caused the death?: suicide, intoxication or illness/natural causes 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? Not Applicable; cause of death was Pre existing medical accidental injury, condition?: intoxication, suicide or homicide If death was an accident, homicide or suicide, what was the means of death? Not applicable; cause of death was Means of Death: intoxication or illness/natural causes Custodial Death Report :: Page 3 of 6 --- PAGE BREAK --- Location / Custody Information Where did the event causing the death occur? Street Address: 500 W. 10th St City: Austin County: Travis Zip: What location category best describes where the event causing the death occurred? Location Category: What type of custody/facility was the Decedent in at the time of death: Type of Custody: County Jail Specific type of custody/facility: Specific Type of Custody/Facility: Jail - single cell 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: At medical facility Custodial Death Report :: Page 4 of 6 --- PAGE BREAK --- General Information Did any other law enforcement agencies respond to calls for service related to this incident? Other Agencies Respond?: 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 B/I F V Misdemeanor A Offense 2: Offense 3: Were the Charges:: Filed What were the types of charges or reason for contact? (Hold CTRL to select all that apply) Type of Offense: 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 weapons: At any time during the incident and/or entry into the law enforcement facility, did the decedent: Attempt to Injure Others?: 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 6 --- PAGE BREAK --- drugs): No Make suicidal statements?: Exhibit any mental health Exhibit any medical problems?: 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 standoff?: arrested?: Physically attempt/assault Gain possession of officer's officer(s): weapon: Verbally threaten other(s) Escape or attempt to including law: escape/flee custody: Attempt gain possession officer's weapon: Was the deceased under restraint in the time leading up to the death or the events causing the death? Under Restraint: No Summary of Incident Summary of How the Death Occurred: (max. 30,000 characters) Summary: Inmate was booked into jail on 06-10-16 at 8:00 PM. Inmate did not complain or claim any medical conditions or problems at the time of booking. He was placed in a one person cell at approximately 11:23 PM on 06-10-16. The post officer did not receive a response from the inmate while serving lunch at approximately 10:14 AM. Corrections officers, jail nursing staff and paramedics performed CPR on the imate for several minutes. Inmate was transported by EMS to a medical facility. A death pronouncement was given by a doctor at the medical facility at 10:56 AM on 06-11-16. Custodial Death Report :: Page 6 of 6