Nancy Lynn Nielsen

CUSTODIAL DEATH REPORT Agency Information ORIGINAL CDR Number: 20-1747-CJ Version Type: VERSION Report Date: 12/7/2020 2:31 PM Status: Submitted Agency/Facility Information 200 Taylor St., Tarrant County Agency Name: Agency Address: Plaza Bldg. 7th Sheriff's Dept. Floor Agency City: Fort Worth Agency State: TX Agency Zip: 76196 Director Information Director Salutation: Sheriff Director First Name: Bill Director Middle Name: Director Last Name: Waybourn Reporter Name: Charles Brogdon Reporter Email: [email protected] Decedent Information Custodial Death Report :: Page 1 of 7 --- PAGE BREAK --- Identity of Deceased First Name: Nancy Middle Name: Lynn Last Name: Nielsen Suffix: Date of Birth: 5/11/1964 Sex: Female Race: Anglo or White Age At Time Of Death: 56 Date/Time of Custody (arrest, incarceration) (mm/dd/yyyy hh:mm AM/PM): Date/Time of Custody or 11/16/2020 12:45 Incident: PM Date/Time of Death (mm/dd/yyyy hh:mm AM/PM): 12/7/2020 10:10 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 No, evaluation not Evaluation?: planned What was the manner of death? (select only one) Manner of Death: Natural Custodial Death Report :: Page 2 of 7 --- PAGE BREAK --- Medical Cause of Death: Medical Cause of Death: Stage IV Cancer Had the decedent been receiving treatment for the medical condition that caused the death after admission to your jail's jurisdiction? Medical Treatment: Yes 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 Pre-existing medical condition?: condition If death was an accident, homicide or suicide, what was the means of death? Not applicable, cause of death was Means of Death: illness/natural cause Location / Custody Information Custodial Death Report :: Page 3 of 7 --- PAGE BREAK --- Where did the event causing the death occur? Street Address: 1500 S. Main Street City: Fort Worth County: Tarrant Zip: 76104 What location category best describes where the event causing the death occurred? Location Category: Other, specify Other Location Category: County Hospital, John Peter Smith Hospital 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: Hospital/Infirmary 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): 11/16/2020 12:45 Entry Date Time: PM Where did the death occur? Death Location: Medical facility General Information Custodial Death Report :: Page 4 of 7 --- PAGE BREAK --- Did any other law enforcement agencies respond to calls for service related to this incident? Other Agencies Respond?: No 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: Violation of Bond Conditions Offense 2: Offense 3: A probation/parole Were the Charges:: violation What were the types of charges or reason for contact? (Hold CTRL to select all that apply) Type of Offense: Other, specify Type of Offense, Other: Violation of court ordered bond conditions 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: Attempt to Injure Others?: No At any time during the incident and/or entry into the law enforcement facility, did the decedent: Appear intoxicated (alcohol or No Make suicidal statements?: No drugs): Custodial Death Report :: Page 5 of 7 --- PAGE BREAK --- Exhibit any mental health No 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 No standoff?: arrested?: Physically attempt/assault Gain possession of officer's No 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 Type of Restraint: Leg Shackles Summary of Incident Summary of How the Death Occurred: (max. 30,000 characters) Summary: Inmate Nielsen, Nancy L. (White Female, DOB 05-11-1964, SS# 002-62-7703, TX ID# 18947665) was booked into custody on November 16, 2020 at 12:45 pm on a Violation of Bond Conditions warrant issued by Tarrant County Criminal Court #5. On November 24, 2020, Nielsen was transferred to John Peter Smith (JPS) Hospital for stage IV cancer treatment. Dr. Gohar at JPS pronounced Nielsen deceased at 10:10 am on Monday, December 7, 2020. Dr. Gohar advised TCSO that he would be signing the death certificate which means there will be no autopsy by the T.C.M.E. The death investigation is being assigned to Detective R. Garcia, 817-884-1272 and [email protected], for the in-house investigation (#2020-14026) and Texas Ranger McDonald will be conducting his investigation. Custodial Death Report :: Page 6 of 7 --- PAGE BREAK --- Custodial Death Report :: Page 7 of 7