On the day he was arrested for a misdemeanor, Dexter Barry warned Florida police that if he did not take his anti-rejection medication, his heart would fail.

"I take rejection medicine for my heart transplant. I can't miss those doses," he said, according to body camera footage obtained by NPR.

Barry, 54, pleaded with the arresting officer seven times back in November. He alerted the jail nurse and a court judge about his condition too. But in the two days that Barry was held at Duval County Jail in Jacksonville, Fla., no one allowed him access to the medication he desperately asked for.

Three days after he was released from jail, Barry died from cardiac arrest that was caused by an acute rejection of the heart, Dr. Jose SuarezHoyos, a Florida pathologist who conducted a private autopsy of Barry on behalf of Barry's family, told NPR.

Barry's family insists that their loved one's death was entirely preventable had the jail staff taken Barry's pleas for his medication more seriously. His death, which was first reported by The Tributary, has sparked major questions about the quality of health care overseen by the Jacksonville Sheriff's Office.

"Dexter Barry's disturbing, preventable death from medical neglect highlights a major flaw in how America treats its carceral system," ACLU Florida told NPR in a statement. "We urge state officials to investigate Mr. Barry's killing and pursue justice for his loved ones."

Attorney Andrew Bonderud, who is representing Barry's family, told NPR they plan to file a lawsuit against the Jacksonville Sheriff's Office soon.

"There were so many people who could have prevented Dexter Barry's death," Bonderud said. "It seems to me that one phone call to the right person from the right person would've made a difference."

The sheriff's office declined to comment on Barry's death due to pending litigation.

A jokester who was ecstatic to watch his grandchildren grow up

Barry, a car salesman with roots in the West Indies, loved traveling to the Caribbean, talking about cars and making his children laugh.

"He was stern but fun," his daughter, Janelle King, told NPR. "He was a jokester, always cracking jokes and fun to be around."

After experiencing a near-stroke in 2008, Barry waited for a new heart for 12 years, and even moved to Florida to increase his chances of getting the procedure, King said. Barry was determined to receive the treatment because he wanted to watch his son's children grow up, as well as see King have a child of her own. In 2020, the opportunity to possibly live a longer, healthier life came true.

"He thought he was going to die before he could receive one," King said. "So, to hear that they had a heart for him, it was amazing news to everyone."

Successful heart transplant recipients can live on average 10 years longer

Some people wait months or years for donated hearts.

"Usually for every possible organ that comes up, there's a long list of recipients that would potentially be compatible with it," Dr. Juan Vilaro, a heart transplant cardiologist at the University of Florida in Gainesville, told NPR.

The process is highly selective — blood type, body size, how sick the patient is and the distance between the donor and candidate are all factors that determine who will receive the lifesaving transplant.

But once the procedure goes through, it can be transformative for ailing patients. With proper treatment and recovery, heart transplant recipients can add on average 10 years to their life span, Vilaro said.

Anti-rejection drugs play a critical role for that to come true. These medications help prevent a recipient's immune system from attacking their new heart. Therefore, they have to be taken every day for the rest of their lives. Missing several days of medication can be deadly.

"What we explain to patients, in no uncertain terms that, these medications are your lifeline," he said.

Vilaro added that in his experience, when a transplant patient ends up incarcerated, hospital staff coordinate with the jail or prison to ensure the patient continues to take their medication.

"They go through a lot of work and trouble to call the jails and make sure they get what they need," he said.

Barry's multiple pleas for his medication were ignored

On Nov. 18, Barry got into a heated argument with his neighbor, who had been using his internet in exchange for some cash to help pay the internet bill. Barry accused his neighbor of missing some payments and at one point, threatened to beat up his neighbor, who is disabled and blind. Before the fight turned physical, Barry walked away to cool off, King said.

Later that day, Barry was charged with simple assault. While in the police car, Barry alerted the police multiple times about his transplant, as well as the drugs he relied on to stay alive.

"The jail can get your medication," said J.J. McKeon, the arresting officer.

During a health intake, a jail nurse noted that Barry had a heart transplant and needed medication for it. "Urgent Referral," the nurse wrote down, as well as the location of Barry's pharmacy, according to medical documents.

The next day, at a bond hearing, Barry sounded the alarm again.

"I just had a heart transplant and I haven't took my medicine all day since I have been locked up, and I take rejection medicines for my heart so my heart won't reject it," Barry said, according to court transcripts.

Judge Gilbert Feltel responded "OK," adding that Barry could be released if he paid a bond of $503.

"Hopefully you are able to make bond here and get your medication," the judge said.

He suffered from an acute rejection of his heart, only 2 years after the surgery

Barry did not tell his family that he went to jail until he was released on Nov. 20. That evening, Barry called his son, who immediately noticed his father did not sound well and urged to him see a physician, King said.

On Nov. 23, Barry went to the hospital. There, he asked if he should double up on his anti-rejection drugs given that he had missed some doses. The nurse told him to continue taking the drugs as usual to prevent the risk of overdosing, according to King.

Later that day, Barry, feeling weak, called his home health aide to visit him. Upon arrival, the nurse phoned 911. When first responders arrived, the aide stepped outside to escort them to the apartment. But by the time they returned to his apartment, Barry was unresponsive. He was taken to a local hospital, where he was pronounced dead.

King said she is most disturbed by how many authorities knew of her father's condition.

"The officer, the judge, the jail, the nurses, the medical team, nobody did their job," she said. "As a result, my father who waited 12 years for a transplant is not here."