Samuel Ervin

CUSTODIAL DEATH REPORT Agency Information ORIGINAL CDR Number: 22-119-C Version Type: VERSION Report Date: 2/1/2022 10:40 AM Status: Submitted Agency/Facility Information Brownwood Police Agency Name: Agency Address: 1050 W. Commerce Dept. Agency City: Brownwood Agency State: TX Agency Zip: 76801 Director Information Director Salutation: Other Director First Name: James Director Middle Name: Director Last Name: Fuller Reporter Name: James Fuller Reporter Email: [email protected] Decedent Information Custodial Death Report :: Page 1 of 6 --- PAGE BREAK --- Identity of Deceased First Name: Samuel Middle Name: Last Name: Ervin Suffix: Jr Date of Birth: 7/3/1976 Sex: Male Black or African Race: American Age At Time Of Death: 45 Date/Time of Custody (arrest, incarceration) (mm/dd/yyyy hh:mm AM/PM): Date/Time of Custody or 1/31/2022 4:44 AM Incident: Date/Time of Death (mm/dd/yyyy hh:mm AM/PM): Death Date and Time: 1/31/2022 8:00 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) Could not be Manner of Death: determined Custodial Death Report :: Page 2 of 6 --- PAGE BREAK --- Medical Cause of Death: Medical Cause of Death: Cause of Death is pending autopsy which is being scheduled to take place in Lubbock, Texas Had the decedent been receiving treatment for the medical condition that caused the death after admission to your jail's jurisdiction? Medical Treatment: Unknown 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 6 --- PAGE BREAK --- Street Address: 2601 Crockett Dr. City: Brownwood County: Brown Zip: 76801 What location category best describes where the event causing the death occurred? Location Category: Other, specify Other Location Category: Hendricks Medical Center - Brownwood ER 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: 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): Entry Date Time: Entry Date Time N/A: Where did the death occur? Death Location: Medical facility General Information Custodial Death Report :: Page 4 of 6 --- 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: Public Intoxication 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: 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 Yes Make suicidal statements?: No drugs): Exhibit any mental health Unknown Exhibit any medical problems?: Yes problems?: Custodial Death Report :: Page 5 of 6 --- PAGE BREAK --- 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: Handcuffs Summary of Incident Summary of How the Death Occurred: (max. 30,000 characters) Summary: Deceased was discharged from the emergency room and caused a scene in the parking lot. ER staff phoned the PD and arriving officers evaluated and arrested the deceased for public intoxication as it appeared he was under the influence of an unknown type of narcotic. Deceased was handcuffed behind his back and escorted back into the ER per policy to ensure he was medically cleared for admittance into the Brown County Jail. While lying on the gurney, the deceased became unresponsive and attempts to revive him were unsuccessful. Custodial Death Report :: Page 6 of 6