It all ended in a simple letter.
Last fall, an out-of-state contracting firm, and the Morehouse School of Medicine -- which was providing the doctors and nurses -- were both fired. Their contract to provide medical services to Fulton County and its jail were canceled.
There were five deaths within a three month period, and all on the watch of medical personnel from Morehouse.
"When the system becomes overwhelmed, that's when people start to get hurt, people start to die," says Sarah Geraghty, an attorney with the Southern Center for Human Rights.
Three of the deaths were suicides, with opioid withdrawal suspected as a contributing factor. The other two deaths were medical emergencies, with the response being questioned.
"We will put together a case file," says Bahan Rich with the Georgia Bureau of Investigation.
The GBI, which previously announced a criminal probe of one of the deaths, has expanded its investigation to include the four others. It's too early to say if criminality will be found in the other cases.
"The findings will be turned over to the Fulton County Sheriff's Office and [the] district attorney's office," adds Rich.
But advocates say, while a contract has been canceled and a new one awarded, accountability is still hard to find.
"The last contract the jail had was not appropriately managed. An independent auditor needs to go in and make sure people are receiving adequate care," says Geraghty.
Nearly 3,000 inmates depend on it.
"We will learn from what happened," said Robb Pitts, Chair of the Fulton County Board of Commissioners.
He says once the investigation into the deaths is complete, those results will be handed over to the new contractor to implement real solutions.
We've also learned that a new policy has been put into place to house all inmates undergoing drug withdrawal in a medical observation unit.
A new contractor is a start, but one can't forget what happened prior. The county has said publicly and bluntly that Morehouse was not qualified to handle the job.
We thought it was time they answered to that.
After requests for an interview, which were declined, we visited the Morehouse School of Medicine. But before we could even sign in, security asked us to leave.
In later written statements, the school told us the accusations are "unproven assertions," and when asked directly if the school feels responsibility for the deaths, Morehouse replied, "We are always saddened by the unfortunate loss of life...MSM stands by the services we provide."
In short, they aren't taking the blame here. And without a chance to question leadership, it's hard to push back against their denials.
In the meantime, families of the dead still wait and wonder who is to blame.
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