The widow of a diabetic man who died in San Diego's Central Jail last year after being denied insulin has sued the county, Sheriff Kelly Martinez and the jail's medical provider, NaphCare.

Cecilia Bach spoke briefly at a news conference Thursday morning in front of the downtown jail about her husband, Keith, a 20-year Navy veteran who went on to work as a heating and air technician for the city of San Diego for more than two decades.

Last month, the county Medical Examiner took the unusual step of ruling Bach's death a homicide, citing neglect.

"They took away the love of my life," Cecilia Bach said through tears before becoming too overwhelmed to continue.

The Bachs had been married for 35 years.

Keith Bach, 63, was arrested Sept. 25, 2023, by Chula Vista police for vandalism and making a criminal threat, according to jail records.

Bach managed his diabetes with an insulin pump but on occasion would experience mood swings if his blood sugar level peaked or fell outside the normal range -- not uncommon for diabetics, said attorney John Gomez, whose law firm is representing Cecilia Bach.

In the past, Cecilia had called 911, and paramedics would help stabilize Keith, Gomez said. But on Sept. 25, 2023, Chula Vista police officers showed up instead.

"The police arrived and arrested Keith because he had thrown a remote control -- his own remote control, inside of his own home," Gomez said. "That's what got him arrested that day."

The Chula Vista Police Department is also named as a defendant in the lawsuit.

Police took Bach to Scripps Mercy Hospital, where he was treated for elevated blood sugar and medically cleared for jail.

During the booking process, Bach fainted and was rushed back to the emergency room for further treatment. He was returned to the jail early on Sept. 26, with orders for medical staff to monitor his blood sugar.

Jail nurses checked Bach's glucose levels at least six times that day, his autopsy report notes, and he was given 10 units of insulin.

Just after 1 a.m. on Sept. 27, Bach's blood glucose level hit a dangerous high of 322 mg/dL.

According to the autopsy report, he initially refused an offer of 10 units of insulin because he knew the dose was too low, but then changed his mind.

"[T]his was the last documentation of insulin administration," the autopsy report says.

A nurse requested an increased dosage, the report says, but the approval was "pending review" at the time of Bach's death. There is no record of Bach receiving any additional medical care.

As the 10 units of insulin started to run out, the warning alarm on Bach's insulin pump started sounding.

He repeatedly asked jail deputies for help, the lawsuit and autopsy report both note. Fellow inmates, hearing the alarm, also tried to get deputies' attention, to no avail.

"Keith is asking for help," Gomez said. "The other prisoners are saying, 'This man needs his diabetic medicine. Give him his insulin.' Despite all of this, Keith received no insulin and no medical visits for more than 24 hours straight."

During this time, Cecilia Bach was receiving alerts via a cellphone app that her husband's insulin pump needed to be refilled.

"She was frantically going to the jail, trying to bring more insulin to Keith, but was told he would be taken care of by the jail's medical staff and deputies," the lawsuit says.

Early on Sept. 28, Bach was found unresponsive in his cell and not breathing. He was declared dead just after 4 a.m.

The medical examiner found he died from diabetic ketoacidosis and ruled the death a homicide due to inadequate medical care.

Until last month, only once in at least two decades had the Medical Examiner's Office ruled the death of a person in sheriff's custody a homicide when they were not killed by another inmate or at the hands of deputies.

The other homicide ruling was made last year for the March 2022 death of Lonnie Rupard, also in the Central Jail. Rupard, who had been diagnosed with schizophrenia and other mental health disorders, died from malnutrition, dehydration and pneumonia.

"While elements of self-neglect were present," Deputy Medical Examiner Bethann Schaber wrote of Rupard's death, "ultimately this decedent was dependent upon others for his care; therefore, the manner of death is classified as homicide."

A sheriff's spokesperson said via email Thursday that the Sheriff's Office "continues to extend our sympathies to Mr. Bach's family, and everyone affected by his death."

"The Sheriff's Office takes all cases involving the death of an individual in our custody very seriously," Lt. David LaDieu wrote. "Every case is thoroughly investigated by the Sheriff's Homicide unit."

LaDieu said the homicide investigation was sent to both the district attorney and the U.S. Attorney for review regarding potential criminal liability.

The Sheriff's Office is conducting a separate inquiry into the matter in addition to the homicide investigation, LaDieu said.

Cecilia Bach's lawsuit joins at least 18 others currently being litigated in federal court over San Diego County jail deaths.

Over the last five years, the county has paid roughly $75 million in settlements and jury verdicts to the families of people who have died in jail, as well as individuals seriously injured in jail custody.