The Siu Lam Psychiatric Centre is a maximum-security detention facility in Hong Kong. It holds nearly 250 inmates, many of whom require psychiatric observation and care. As American corrections providers well know, that’s a population that frequently has significant physical issues as well.
In July 2021, one of Siu Lam’s residents fainted and collapsed in their cell in what was thought to be a cardiac arrest. On-duty staff had just completed their regular check on the inmate – in many facilities that would mean they wouldn’t be seen again for 30 or 60 minutes. That interval, for any victim of cardiac arrest, would almost certainly prevent any possibility of successful resuscitation and likely be fatal.
But that’s not what happened to the inmate in Hong Kong. Siu Lam, not long before, had added remote inmate health monitoring technology that quicky tipped off staff to the victim’s emergency status.
“That sensor picked up changes in his vital signs,” said Jon Lloyd, president of Reassurance Solutions, a U.S.-based company that’s now bringing the technology to American correctional facilities, “and they were able to go in and resuscitate him and save his life.”
Developed by Xandar Kardian, a Canadian provider of advanced monitoring and detection technologies for multiple industries, the product – the XK300 sensor – is now protecting detainees at some 80 facilities in 20 U.S. states.
HOW CELL MONITORING WORKS
The XK300 uses highly sensitive ultrawideband radar technology to track four key things: heart rate, respiratory rate, motion and presence. It does this by capturing micro- and nanovibrational patterns throughout the cell, including those produced by the human body. If any of those standard patterns changes by as much as 0.1 millimeter, the XK300 alerts staff. It’s the first commercially available medical device approved by the FDA for such a purpose and includes 30 separate patents.
It requires no participation from inmates. There’s nothing they have to wear, and the XK300 operates 24/7 from a small housing on an upper wall or ceiling, largely out of reach of tampering and destruction. It can detect when the body is at rest or asleep and only captures vital signs when signal qualification requirements are met – no video or audio is collected. It also requires nothing of staff but a monitor with a web-based dashboard display – alerts are automatic when anomalies are detected. These can include configurable audio and visual signals to grab officers’ attention.
Networking and power for the sensors are provided by one or more hardwired gateways that can be located behind walls or in other secure places. These sustain signal strength even among the thick walls and solid materials used in building correctional facilities. The XK300’s radar is safe, with signals 40 times safer than typical home Wi-Fi. The sensor has a 130-degree field of detection and a range up to 33 feet.
While the XK300 was primarily designed for health care applications – and has obvious applicability in places like assisted living and long-term care facilities – its early successes in Hong Kong (where the opening case wasn’t the only save it produced) spurred rapid growth into corrections. An Australian pilot followed, then a U.S. meeting that led to the XK300’s introduction to America via Reassurance Solutions.
Its initial foothold came in the Midwest, where the founders of Reassurance also worked with Comprehensive Correctional Care (3C), a regional provider of correctional health services for around 70 facilities. The technology has also expanded to facilities from Georgia to Washington.
THREATS INCLUDE OVERDOSE, DETOX
One local jail that was an early adopter of the XK300 was the Kenton County Detention Center in Covington, Kentucky. Serving the commonwealth’s third-largest county, it’s on Kentucky’s northern border, part of the busy Cincinnati, Ohio metro area. It holds around 600 inmates. 3C provides the facility’s health care and has a nurse on site 24/7.
The Kenton County facility hadn’t seen a lot of major health problems, but it relied on traditional methods – i.e., rounds – to monitor inmate wellness. Leaders first saw the XK300 at a conference and liked what it offered; they ended up adding units to eight cells – four at intake and four in segregation cells for male inmates.
Intake is a dangerous time – if an inmate is on drugs, this can be when they begin to come down and detox or when an overdose manifests. Inmates facing arrest have also been known to swallow or conceal baggies of drugs that then rupture inside them.
“They come in sometimes in the worst states and aren’t always truthful about what they’ve ingested,” explained Colonel Trey Smith, the center’s chief of operations. “One of the challenges we face is that we don’t know what they’ve been doing prior to being detained – we have to be mindful of that.”
Prior to adding the XK300, emergencies were detected by staff during regular rounds, who’d notify medical personnel to respond immediately. They and supervisors would answer quickly and apply lifesaving measures – CPR, naloxone, etc. – and call EMS for more definitive care and transport.
The quick radar-driven notifications have their limits – they can’t detect overdoses before an inmate’s breathing or consciousness is affected, for example – but have nonetheless provided COs valuable early warnings and extra minutes when problems have occurred.
“We have determined the XK300 is a powerful tool for the early detection of abnormal vital signs in patients,” said Shawnee Ray, R.N., a nurse at the jail. “It allows us to quickly identify any fluctuations in a patient’s respiration and heart rate, whether they are increasing or decreasing. This device has already demonstrated its effectiveness on multiple occasions, notably in critical situations involving overdose and cardiac events.”
“In the 17 years I’ve worked here, we’ve had multiple overdoses and natural causes of death as well,” added Smith. “It’s unfortunate, but death is something that’s common in the corrections field, and we do everything we can to safeguard against it. Especially in this day and age, any time we can use technology to our benefit, we’re all for it.”
The jail had one recent prisoner who was thought to be under the influence of something when evaluated by medical. Stable at the moment, he was returned to his cell – but as the CO was walking away, an alert sounded.
“At that point he had overdosed,” recalled Smith. The deputy called for help, and medical responders administered Narcan and got him to the hospital. He survived. “But if the officer had just put him back in the cell and gone about his day and come back 10 minutes later to check on him, who knows?” Smith noted. “If that sensor hadn’t alerted, it could have been far worse for him and for us.”
EARLY WARNING SYSTEM
That alerting is designed to grab officers’ attention even in a noisy corrections environment. Kenton County has a dedicated XK300 monitor for its four booking cells at the deputies’ station and another for its isolation cells. “It’ll start blinking orange, then red, and beeping,” Smith said. “You can hear it all the way across the booking floor.” Medical staff get alerts from all eight cells.
Staff had to tinker a bit with the sensors’ locations to optimize their performance in the cells, but they’ve functioned reliably since those adjustments. Inmates being inmates, a few have been knocked down, but they’ve been easily reapplied, and none have needed replacement.
Jailers in Kentucky are uniquely accountable to the public: It’s the only state that elects them. Adding advanced health monitoring technology is a way to not only protect inmates’ lives but to demonstrate to citizens a focus on safety, humane care and responsible financial management through the reduction of unnecessary tragedies and legal repercussions.
“We regularly have members from our community tour the facility, and we always tell them about this technology we have to try to safeguard human life,” said Smith. “They’re always shocked – ‘Wow, we didn’t realize this type of technology even existed.’ It’s a great tool to have at our disposal.”
“What we try to be is an early warning system,” added Lloyd. “We’re not going to save every life. But what we do is provide a fighting chance to solve some of the problems faced by officers in this space.”
For more information, visit Reassurance Solutions.
