Jorge Macay with his son, circa 2001. Photo courtesy of Karina Macay

Jorge Macay, 41, died while purportedly under medical observation at a San Francisco jail on Wednesday. His family thinks the jail — and the city — failed to care for the man who was in their charge. 

Macay, according to the Sheriff’s Department, was brought into County Jail 2 in San Francisco on Sunday, Feb. 12, after he was arrested following a  domestic dispute call by neighbors. By Wednesday, he was dead in his cell. 

Sheriff’s spokesperson Tara Moriarty confirmed Macay was under observation. Macay was “assessed at intake and was offered medical care and treatment appropriate to the medical issues identified at their intake assessment,” Moriarty said.  

Macay’s girlfriend, Ileana Velez, said this meant he was put in solitary confinement. Velez, 31, said she spoke with Macay on the phone on Monday, the day after he was taken into custody. 

“He just kept saying he was so cold,” said Velez. Around midday on Wednesday, Maccay was found unresponsive in his cell. 

Velez said the recent times that Macay had been jailed, he was given Librium, a drug used to treat alcoholism and anxiety. Librium is also known to slow or stop breathing and heart rates. 

“They gave him that. But that was messing with his emotions … he’s already unstable, as far as that goes,” Velez said, adding that while Macay used methamphetamine, he was not a drinker and had no need for alcohol withdrawal medication.

The last time Macay was jailed and given Librium, Velez said he told her that “he felt like somebody was sitting on his chest.” The guards wouldn’t come to the cell when he called for help, Macay told Velez, so he got their attention by picking a fight with his cellmate. 

Macay’s son, Jorge Macay, Jr., remembered his father telling him the same story.

Regardless of what caused Macay’s death, Velez said that, in her experience, the cells would have had camera surveillance. And Velez, Macay, Jr. and Macay’s sister, Karina Macay, said whoever was in charge should have been watching more closely. 

“He didn’t die from being injured, he died because somebody dropped the ball and was not monitoring him the way they should have been,” Karina said. 

Karina, Macay’s older sister, said she received a call from the medical examiner’s office later on Wednesday, and was given preliminary information about her brother’s sudden death. 

“He was in, I guess, the detox unit,” Karina said. She was told by the medical examiner that her brother was “under medical observation” and seen at 11:30 that morning. “He was fine, supposedly.” 

Then when officers checked his cell at noon, Karina said, “They said that he was found unresponsive and with a faint pulse.” Medical personnel tried to resuscitate Macay, but Karina was told that he was pronounced dead around 12:45 p.m. 

This left Macay’s sister with many unanswered questions. 

“I want to know: What drugs was he on, first of all? What were you guys giving him to mitigate his withdrawal, or whatever was going on? What kind of medical monitoring were you doing?” Karina asked. “Why did my brother walk into that jail and leave in a body bag?” 

Jorge Macay with his girlfriend and two younger children. Photo courtesy of Ileana Velez.

The sheriff’s department, Karina said, still had not contacted her about her brother’s death, two days later.

“They should be on top of that type of stuff,” said Jorge Macay, Jr., who wasn’t sure whether his father was given medication, acquired drugs in jail, or died from withdrawal symptoms. “That’s their whole job, to babysit you.”

Macay isn’t the only person to die in county jail in recent years. According to Sheriff’s Department records, one county jail inmate died by suicide in late 2022, and another died of suicide in January, 2021.

Macay was no stranger to jail; he had been on parole for many years, and was in and out of custody several times. 

Growing up in San Francisco in the 1980s, Karina Macay said that she and her two brothers “grew up rough” with two parents who struggled with drug addiction, and their mother landing in prison. Their father, battling his own substance abuse issues, left the children with their grandmother in Daly City. 

When their mother got out of prison, Karina said she and her siblings were reunited with her and lived together again. But after their mother died in 2001, when Jorge Macay was 20, Karina said her brother was never the same. 

“Sometimes you become a product of your environment,” she said. “It was hard for him, especially after my mom died. It seemed like drugs is what helped him get through it. He didn’t know how to cope with it, you know? And then after that, he was just kind of lost, and in and out of prison … and I just tried to love him through it.” 

Now, Jorge Macay, Jr., Macay’s eldest son, is 22, around the same age that Macay was when his mother died from drug complications. His two younger children are 12 and 7. 

“Addiction doesn’t get fixed with jail time. It doesn’t get fixed going to prison. It doesn’t get fixed by being picked up on a violation and just being put back in that pod,” Karina said. “They failed him. And not only did they fail him, he died under their care this time.” 

In 2011, Macay sued the sheriff’s department, accusing a deputy of beating him up while in custody. His attorney, John Burris, said he reached a settlement with the department. Velez, Macay’s girlfriend, worried that bad blood between Macay and San Francisco law enforcement could mean that he didn’t receive adequate care while in custody. 

Jorge Macay (left) with his father, Carlos Macay (center) and sister, Karina Macay (right).

But even those who meant to help Macay along the way may not have done enough. Karina remembered attending her brother’s graduation from a Walden House drug program, and realizing her brother was high during the ceremony. 

“I couldn’t believe it, I looked at that place and it was just like, ‘The fuck is wrong with you people?’” Karina asked. “I know he has to want it, but he wasn’t even given the tools to be able to … try to do it.” 

Though she took care of her younger brother for a long time, Karina said their relationship grew rocky in recent years, and she hadn’t seen him in a while. 

On Monday, having heard that he was in jail again, Karina went to visit Macay; it was their late mother’s birthday. She was told she couldn’t see her brother because of the Covid-19 protocols, even though the sheriff’s deputies she saw working there apparently took few covid precautions and were unmasked. 

In the past year, Velez said Macay had been trying to turn things around. He would proactively go see his parole officer instead of being arrested, and he would test clean. 

Jorge Macay, Jr. said his father struggled his whole life, but unlike the “typical drug abuser,” always did his best to take care of his children.

Doria Torres, a longtime friend of Macay’s, said she recently noticed Macay’s efforts and had just started working with him to help find him a job. Torres works for Hunters Point Family, a nonprofit that helps formerly incarcerated or homeless people find employment. 

“I was waiting for him to start doing that … Working with Jorge, you gotta do one thing at a time with him,” Torres said. “He still had his downfalls, but he was trying.”  

Now, Macay’s family hopes to change the system. 

“My brother’s death is not going to be in vain,” Karina said, her voice trembling. “And if he died so that we could do this, and we can change some things and bring it to light, and save other people’s lives and make the system a little bit better? Then I’m okay with that.” 

The family has started a fundraiser to support Jorge Macay’s children, pay for funeral services, and hire an attorney to investigate his death.

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REPORTER. Eleni is our reporter focused on policing in San Francisco. She first moved to the city on a whim nearly 10 years ago, and the Mission has become her home. Follow her on Twitter @miss_elenius.

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  1. I grew up with George and his sister I lived across the street since the day he moved to Daly city he had always been a good friend to me always willing to help a person in need a man with a big heart even kept his doors open for friends sad to say he had to deal with drama at times some fights to protect his close friends I seen him get arrested after he was trying protect a female who was pregnant and was getting beat up bye boy friend . good man I will miss him rip Jorge.

  2. My name is Shanna Washington I been a unrelated “Blood Sister” with Jorge Macay for over 20 years, And his death really mind boggles me, because I as well have been incarcerated in San Francisco County Jail on warrant charges ect. And I to had been a person to self medicate myself using Methamphetamine, I too am not too much of a drinker as well, but whenever I was brought into custody I was also given that drug Librium by the medical staff at the SF County jail at booking , I also became extremely cold after taking the drug Librium , I was extremely cold ,colder then normal, and I had shortness of breath and I would pass out cold. I believe that Librium can possibly kill a person who is under the influence of Methamphetamine . It’s possible that the drugs and the medication mixture lowered blood pressure the heart rate and possibly give someone immediate sickle cell anemia. Or Mr. Macay had a allergic reaction to this medication or he was give something else by accident and could of had a allergy to the medication. It was the police responsibility to listen and observe Jorge medical status, Also it was the jail responsibility to take Jorge Macay to the local hospital, he needed professional medical assistance and SF County jail turned a deaf ear to Jorge Macay and now he has lost his life. So very sad . God has Jorge and whatever happened to this young man God dose not like ugly .

  3. For the people who believe that addiction is a personal, moral bankruptcy, or a sign of weak will or inferior genetics, I encourage you to gain perspective by learning about the SCIENCE of addiction. Drugs like meth, coke, heroin, hijack the brain’s dopamine-based reward system, rewire the brain’s neural pathways and make the addiction even stronger. Cocaine triples normal dopamine levels, meth can multiply normal dopamine levels 10-fold. The same rewiring happens with nicotine, alcohol, sugar, and gambling. Surely you’ve known people who have quit smoking 3 or more times, people in AA who fall off the wagon during rough patches, or diabetics who can’t resist a piece of chocolate cake. People who cold-turkey off heroin or meth can and do die from physical withdrawal; In addition, with natural dopamine completely depleted from their brains, they can sink into a depression so profound that they commit suicide. Please refrain from judging others unless you have been through this yourself (then you will never judge another) or you have taken the 15 minutes to educate yourself about the science of addiction.
    Making snarky comments about a person’s relapse that ,through whatever means, causes them to lose their life, is heartless and inhumane. (I bet you don’t see yourself that way at all.) If it isn’t in you to be compassionate or empathetic with the pain this family is going through, try to remember, Silence is Golden.

    1. Nice of you to summarize the most generic research… but like diabetes, using drugs is a choice and avoidable. Yes genetics play a role but it is still a person’s choice to use. Alcoholism runs in my family so get this, I chose to not ever drink.

      Heroine withdrawal isn’t life threatening, sure it’s uncomfortable but not dangerous like baclofen, benzodiazepines or alcohol withdrawal.

      Meth and other hard drugs do cause brain damage overtime. If you have so much sympathy you will stop blindly defending drug use and promote forced treatment because many of these people suffering no longer have the cognition to do it along. Thankfully Sam Quinones is writing more about this now.

  4. I didn’t know the man but from what I read he had a hard, painful life. May his family find comfort knowing that he is no longer suffering. Ppl talking shit about his struggles have no idea of the devil that is meth. The crashes, the paranoia, the malnutrition, the physical and psychological pain. Unless u been on the shit and now u clean don’t judge.
    Meth IS the devil.

  5. How many people die of fentanyl overdoses every year, that we don’t see stories about?

    This is just another drug-user death. It happened to happen in jail, but that doesn’t make the sheriff’s department responsible. Macay chose his path in life.

    1. There is not enough info available to make the determination of whether or not the Sheriff’s Department is liable. You seem upset the family wants to retain a lawyer, which they have every right to do. They will need help through the process and would be remiss in not doing so.

      Your comments are crass. Your expressed sympathy is hollow.

  6. One thing for certain no one is perfect, and if you’re perfect and your life has always been congratulations to you. These comments clearly lack empathy for his children and family. All we want to know is what happened and why it happened!!! Let’s keep in mind he died under the watch of the law, not on the streets , not his home , he was all alone. Yes we know he may have not been perfect in none of your eyes but understand that in his children eyes he always did his best. Though he may have been a product or his environment him and his siblings have raised their children to do and be better than them!!! I can testify that because I am his niece a college graduate, working on receiving a second degree to help to better the system!!! Yet, if I would not state what I’m doing you would just assume that I in fact would more than likely be a victim of drug abuse or who knows. Please show compassion to his family who just wants answers not to be ridiculed for what he did or did not do just based upon an article. While we actually know him, his struggles and pain and so forth!!! I’m sick of you people in these comments, that’s typing on your phone’s computers whatever. It’s easy for you to type harsh words, but yet if the roles reversed you would just be a grieving family seeing your loved one that’s no longer here get bashed , stating it’s karma, or oh wells. Stop and think about how you would feel and if you’re that remorseless , I’ll continue to pray that none of you ever go through anything like this because some of you would not survive through a storm!!

    1. Keana, I’m sorry for your loss. I am.

      I think many of us are cynical because we expect the next thing will be a multi-million dollar lawsuit against the city, and that does affect us.

      Also, you probably don’t want to hear this either, but more than 1 million Americans died in the pandemic. Every human life is precious to someone: Macay is someone’s relative and friend. But the pandemic — and people’s resistance to wearing masks — clearly showed that every human life is not precious to everyone.

  7. To the family of my good friend Grimey my condolences goes out to you and for you Ileana v sis I’m so sorry that this happened I know your really going threw it as well as family especially his kids for his sister yes stay on top of that he was a good guy to many I called him my brother too he is fasholly going to be missed

  8. Bud !!!!! All I can say is… this was not the way things were supposed to end… Rest in peace my friend…. Our memories together will never fade from my heart…
    You and I have shared some of the greatest times …. Gonna miss you my friend…..

  9. Drug addicts kill themselves slowly everyday. The family insinuating that the jail staff did anything to cause this man’s death is lashing out while placing no responsibility on their relative. He was a grown man who chose his pleasure over the love of others.

  10. “Macay was no stranger to jail — he had been on parole for many years and was in and out of custody several times”.

  11. Looks like deserved karma to me. Karma is real. And not just for other people. But YOU too. Meth is real bad karma.

    1. Sir or madam —

      For whatever reason, you have seen fit to belittle a dead man via multiple comments on this article posted under multiple names. I don’t know about “karma,” but the result is that you can find a new hobby and cease commenting on this site.



    2. As is what nasty, I’ll willed words your displaying towards a family in mourning, shame on you and I honestly can’t condone you and your opinion and apaled that I. Almost fell weak to your contagious words of hate to almost basically lower myself to the level of which are displaying.

  12. I am praying for Jorge’s journey home to God — safety, peace and resolution for his loving family.

  13. Unfortunately long term meth use is incredibly stressful on the heart and other systems. He was 41 going on 71 as we say in the hospital. People Lay down and don’t get up. Others go from wildlings to wilting. Family is state of grieving and looking to point the finger. My guess hoping for a payout too. At the end of the day Jorge had to want to get better himself and even with all the resources in the world many addicts don’t escape.

      1. That part he is so out of pocket like somebody trying to get paid no justice fa sho cause sfpd ain’t right the fuck money gone come n go shit we can’t have him back and that’s what matter

    1. May I ask do you know my uncle and our family personally?? Because we just wanna know what happened, why it happened, what could have stopped it from happening!!! Insensitive people like you are the reason why many families dread about coming fort about getting answers ! Why not just show some compassion and keep your so called theories and comments to yourself!

    2. People go into hospitals every day with what they think is a minor condition and die. Addicts die in jail and prison every day. And guess what, bad health is the cause, not some imaginary bad behavior by staff.

    3. Fuck all those that dont know jorge and got somthing stupid to say.all of you are a bunch of pickle sniffin marks……R.I.P GRIMEY.

    4. I I really hope I misread your comment which I felt insinuated you work in the hospital as a public servant. God help us if you do.

  14. George was my friend; he had a heart of gold. He loved his children very much. He even loved my daughter, Elizabeth, who turned one today on the 17th. I feel that the Sheriffs Department definitely had neglected him.

    1. This is still unrealistic to me. I can’t believe a great friend, father, significant other, son and sibling he was … I pray 🙏🏾 your answers for the truth is revealed. This is hitting all of us where it hurts because he had a effect on all of us . We had fun times, funny times, angered, and intimate. Just picture and remember the great experience that was brought into our lives and think positive. Love you Lulu and my condolences sister for your loss, as well as Minnie Poo Puff, And Jr.

  15. Rest In Peace Jorge. I met you as a child. You were so cute and sweet.
    The Angels have you now. You are related to my kids the Macay’s. My
    heart is breaking right now.

    Dalin Govea

  16. While in custody, the Sheriff’s department is responsible for prisoner safety.
    Now, the SFSD oversight board can investigate this incident. Oh wait, they can’t even find a Chief Investigator in a timely manner or allow themselves to speak to the press. Perhaps President Wechter can use his vast investigator and treasure hunt experience to determine what happened OR just write a big settlement check to the family asap. At least Wechter has some actual oversight investigative experience, not sure about the others though

  17. Very insightful & well written article. Thank you for ur extensive research along with appreciated attention to important details, both for public safety concerns and the family’s legitimate right to answers. Compassionate &factual journalist, thank you.

    1. I agree. The perspective and detail provided in this piece, along with the compassion with which it is written, made me wish I knew this gentleman. This story-telling journalism is what sets Mission Local apart from the others.