LOS ANGELES -- It was well after dark, but Tawana Hunter lingered in the hospital parking lot, watching the minutes tick by on her phone. As midnight drew closer, she ran through all the things she wished had been different.

She wished her father had been in better health. She wished he hadn't gotten arrested. She wished he hadn't spent the last few months of his life in jail. And she wished that, right now, he wasn't dying alone, handcuffed to a hospital bed.

After almost two hours of wishing and waiting, her phone rang.

"I'm sorry," the woman began. Tawana knew what came next.

Jubal Hunter, 60, was one of 45 Los Angeles County inmates who died in custody last year, one of the deadliest years in recent history. Though the number of people in the county's lockups is roughly a third less today than what it was a decade ago, the number of fatalities has risen so much that the annual death rate has more than doubled in that time frame. Suicides are slightly down after a sharp spike in 2021, but natural deaths are up, killings are up, and overdoses are way up compared to 10 years ago.

Yet no one seems to agree on why. Jail leaders, oversight officials and inmate advocates have cited various causes including fentanyl, COVID-19 and overcrowding. Sheriff Robert Luna, whose department runs the jails, has blamed the poor health of the inmates leading up to their arrest. Many, he told The Times, receive the "best healthcare" of their lives while incarcerated.

But a Times review of thousands of pages of autopsies, lawsuits, medical records and oversight reports found another common thread stretching across all causes of death: neglect, by both guards and medical staff.

In recent years, records show, inmates have died from jumping off railings, banging their heads against a wall and injecting drugs with makeshift needles — all in view of jail surveillance cameras that no one watched until later. At least three inmates died after stuffing paper, sanitary napkins or other items down their throats, asphyxiating before anyone intervened.

Last year, one man died after he was beaten and left bleeding for four hours before guards noticed. And last month, one man's family filed a lawsuit alleging he was neglected for so long that his body was "cool to the touch" by the time staff found him dead from an "easily treated" medical condition.

"We think about people dying in interactions with the justice system when they're saying, 'I can't breathe,' with a knee on their neck," said Nicholas Shapiro, a UCLA researcher who studies Los Angeles jail deaths. "But a lot of these deaths are happening in 'I can't breathe' scenarios due to neglect and a lack of access to healthcare."

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