Rollin Cook, the executive director of Utah's Department of Corrections, told The Associated Press that it's too early to say if someone will be fired. Depending "upon the investigation, if that's one of the corrective actions that needs to happen, of course we will take that," Cook said.
Cook said the prison has Spanish-speaking staff available to inmates, but he doesn't know if any were on hand when 62-year-old Ramon C. Estrada didn't get dialysis treatment on Friday and Saturday.
Estrada was from Mexico and relied on translators while in court on rape charges and at a 2008 parole hearing.
He died Sunday at the prison from an apparent heart attack related to kidney failure. He would have been paroled on April 21.
Cook said he was notified of the death Monday morning. As executive director, he wouldn't expect to be notified if a medical provider didn't show up to give a scheduled treatment, Cook said. He would expect a head nurse or the director of the medical services to be notified, he said.
Cook said still he didn't know Thursday if that had happened in Estrada's case.
Several advocacy groups called for answers this week, and Gov. Gary Herbert's office said the situation is tragic.
"It is unacceptable the inmates did not receive the medical care they needed when they needed it," Herbert spokesman Marty Carpenter said in a statement.
Tony Yapias, who directs the advocacy group Proyecto Latino De Utah, said he has called the governor's office to ask for a full investigation. Yapias told The Associated Press it is an issue of concern to his group if a Latino dies as a result of inadequate medical attention or supervision.
A medical examiner will autopsy Estrada's body, but it appeared he died Sunday of an apparent heart attack related to kidney failure, the Utah Department of Corrections said.
Officials on Wednesday were still trying to figure out if anyone tried to contact the missing dialysis providers and when they might have done so. Cook said he had no more information to release Thursday. He said he wanted to be transparent and was frustrated that he couldn't offer more details until they investigate.
"The key thing that I want the public to know is that we're going to do everything we can to try and fix the problem," he said.
As part of the investigation, Cook said his department would consider whether to keep their contract with the University of Utah health care system, which provides dialysis and other medical services to the prison.
Cook also said the Department of Corrections has "a tremendous relationship" with the university system and he didn't expect it to end.
Kathy Wilets, a spokeswoman for the University of Utah's health care system, said the system has provided dialysis to the prison for about 14 years, the last seven involving on-site treatment at the prison.
The prison made the switch after an inmate escaped and fatally shot a prison guard in 2007 while being escorted to a doctor's appointment.
Technicians with Sandy-based South Valley Dialysis, a University of Utah medical clinic, were scheduled to arrive at the prison Friday and Saturday but did not show up. South Valley is one of 17 dialysis clinics the hospital system operates in Utah, Idaho and Nevada.
The prison's medical director has been put on leave while the department investigates, corrections department spokeswoman Brooke Adams said this week.
Estrada had been in prison since August 2005 on a rape conviction. He was believed to have been in the country illegally, Adams said. He would have been turned over to the U.S. Marshals Service when his sentence was complete, she said.
At a 2008 parole hearing, Estrada said he was grateful for his dialysis treatment. An audio recording of the hearing shows that the Spanish-speaking Estrada told the board through an interpreter that he had been very sick and without the program, he probably wouldn't have be alive and appearing before the parole board.
Randall W. Richards, a lawyer who represented Estrada in 2005, did not return messages seeking comment. It was unclear if Estrada had an attorney at the time of his death.
Six other male inmates had been waiting for dialysis treatment and were taken to a hospital for evaluation. Four of them were treated and returned to their cells Tuesday, Adams said.
Adams did not have details about how long the four admitted to the hospital went without dialysis treatment. The other inmates' identities were being withheld for privacy reasons, she said.
Associated Press writers Kelly Catalfamo and Brady McCombs contributed to this report.