Derrick Howard was tough — prison tough.
Howard grew up in the St. Louis suburb of Normandy. In his late teens, before his first stretch in prison, he acquired the street name of "The Black Italian Snake."
Proud of the moniker, Howard wore it through his long and ultimately deadly journey through the nation's prison system.
In January 2007, a jury in St. Louis convicted Howard of orchestrating an elaborate murder-for-hire scheme while he was locked up in jail awaiting trial on a gun charge. The federal judge presiding over Howard's case sentenced him to 60 years in prison.
By late 2019, Howard had racked up a string of disciplinary violations while incarcerated, landing him at one of the Federal Bureau of Prisons' toughest lockups, the high-security U.S. Penitentiary Tucson in Arizona.
Then COVID-19 hit. The coronavirus surged through the densely packed prison like wildfire, turning it into a world haunted by sickness and death.
Howard feared for his life.
The 51-year-old suffered from a series of underlying conditions, including obesity, hypertension, asthma and a chronic lung disease.
Inside the prison, face masks and hand sanitizer were in short supply, and social distancing was nearly impossible to maintain. Howard knew he had little chance of survival if he caught the coronavirus, according to Diane Dragan, his St. Louis-based federal public defender.
"He did say if he got COVID he'd die because he had lung issues," Dragan says. On October 22, Howard tested positive for the coronavirus.
Four days later, an ambulance took him to a nearby Tucson hospital for further treatment. On October 31, hospital staff placed him on a ventilator, according to BOP reports.
But the chain of events of the following weeks, culminating in Howard's death on December 3, remains a mystery to his family.
Did he die from COVID-19? The death certificate issued by Pima County, Arizona, indicates that he did.
Or did his death stem from something else, such as the fall he suffered — as medical records show — while recuperating at a Tucson rehab facility shortly after he was taken off the ventilator?
Medical records also indicate he was conscious but hallucinating, writing notes to hospital staff until shortly before he stopped breathing early on the morning of December 3.
"We don't know why our brother died," says Pam Howard, his older sister. "He was able to fight his way off the ventilator, and he's conscious, and the next day he's dead? We just want to know why."
What's more, Howard's family could not contact him during the six weeks between when he tested positive and when he died, his sister says.
"I just don't understand why we couldn't see him, or get any information from the hospital," Pam Howard says, adding that she feels "very angry and heartbroken because our brother was in the hospital that long, and we didn't get a chance to contact him, to write him a letter."
It was not until this past Halloween, nearly a week after Howard was sent to the hospital, that Howard's family was even notified that he was seriously sick with COVID-19.
Soon after that initial notification, a hospital staff member called Howard's family to ask if they wanted to say goodbye to him before he died. But Pam Howard says the offer came with a condition — they could only talk to him if they agreed to take him off the ventilator.
The family refused the deal.
The next day, Derrick Howard was taken off the ventilator anyway. Medical records indicate he took a turn for the better and was sent to a nearby rehabilitation center to recover.
The improvement in his condition was fleeting. A few days later, without explanation, Howard's heart stopped beating. An ambulance took him to a nearby hospital emergency room, where he was pronounced dead.