In the months since his death, Umana's family has been frustrated by a lack of answers.
"Something happened in there," said Umana's mother, Tammy Martinez.
Salt Lake County jail Lt. Mike DeNiro, citing federal laws governing medical privacy, discussed few details of Umana's decline. But DeNiro did say jail staff tried to assist Umana and encouraged him to eat and drink. DeNiro would not say if the jail attempted to force feed the man.
"They were attempting to deal with it," DeNiro said.
Umana's mental illness appears to have contributed to his death. Martinez said Umana, who was diagnosed with schizophrenia and bipolar disorder as a teenager, stopped taking his medication in the fall.
"Then he started hearing voices and thinking people was poisoning him," Martinez said.
Umana was so concerned about people poisoning him, she said, that he started preparing all his own food. On Oct. 26, Martinez's boyfriend, William Honeycutt, was preparing a meal in her kitchen.
Umana picked up a folding knife and stabbed Honeycutt in the lower back. The injury was not severe and Honeycutt survived.
Umana fled after the stabbing. The Salt Lake County Metro Gang Unit was called to find him. Although Martinez denies Umana was a gang member, Umana had many tattoos, including a prominently displayed "14" on his chest and neck, often used to symbolize members of the Nortenos street gang.
The gang unit arrested Umana the day after the stabbing. Court documents say he told a police officer he stabbed Honeycutt "before William killed him."
Umana was booked into the jail in lieu of $100,000. Prosecutors charged him with first-degree felony attempted murder. Martinez said within a few days of Umana's arrest, she took the jail his medications. Jail staff wouldn't take the pills, but did write down the prescriptions, she said.
It's not clear when Umana stopped consuming food and water. DeNiro said Umana had been in the jail's health unit but was removed for bad behavior. DeNiro declined to elaborate.
Jail staff moved Umana to the administrative segregation unit. The unit has a higher level of security and each inmate there has a cell to himself. Each cell has a drinking fountain and meals are provided to the inmates.
Martinez said she saw her son a few days after Christmas. Then Umana lost his visiting privileges due to misbehavior. Martinez said she has never been told what her son did wrong.
On Jan. 20, staff decided to return Umana to the health unit. DeNiro said Umana's refusal to consume food or water was just one reason for the move. DeNiro again declined to elaborate, but he did say that prior to 2008, a patient with Umana's problems would have been moved to a hospital. In 2008, the jail opened an acute care unit in its own health ward.
"One of the challenges we're facing right now is because we opened the acute unit to save money, we're dealing with sicker inmates than we were dealing with in the past," DeNiro said.
On Feb. 8, Martinez said, a female jail employee called her to say Umana was refusing to eat and had taken only two showers since his arrival at the jail. According to Martinez, the woman said jail staff were having a meeting that day to decide what to do.
Martinez was allowed to see her son three days later. From the other side of the protective glass, Martinez said she could tell Umana was in trouble. He was thin, his eyes were sunken and he had trouble holding up his head. He said something about the water in the jail being too hot.
"He says, 'Mom, I need to get out of here. I won't make it in here,' " Martinez recalled.
The woman jail employee called Martinez the next day to ask how the visit went. Martinez told her Umana was not well. Martinez said she assumed the jail would take care of the problem. Meanwhile, Umana's court case was delayed while the judge and the attorneys waited for results from a mental health professional about whether Umana was competent to stand trial. The results of that review have not been made public.
The last time Carlos Umana was seen with food was five days before his death, and even then he was only "picking" at his meal, according to a medical examiner's report Martinez's family shared with The Tribune. About 6 a.m. on Feb. 27, a guard performing a regular check found Umana kneeling over the toilet in his cell.
Umana did not respond to the guard's calls. When staff entered the cell, Umana was unconscious. An IV was started, he was placed on a stretcher and staff began performing CPR.
At 6:42 a.m., as staff were preparing to wheel him to an ambulance, Umana was pronounced dead.
Martinez received a telephone message from someone on the jail staff telling her to call back right away to discuss her son. Martinez believed the message would be news that Umana had made a turn for the better. When Martinez called, she couldn't believe what she was hearing when a jail employee said Umana was dead.
Postmortem tests did not find the presence of any drugs an indication Umana was not taking medications for his mental illness. In his report, the medical examiner ruled the manner of death was natural causes due to starvation and dehydration, but the medical examiner listed Umana's mental illness as a likely contributing factor.
DeNiro said the jail is continuing to investigate Umana's death. DeNiro did not know when that investigation would be complete. Martinez and her family have consulted with an attorney but no legal action has been taken.
Martinez cremated Umana. A brown rectangular urn with the ashes now sits on her living room table. She doesn't know what she'll do with her son's remains.
"He always wanted to come home," she said, "so I figure he's home now."
Editor's note: The Tribune has taken still images from the video produced by Umana's family to show the difference between when Umana entered the jail and what he looked like at his funeral. The video itself is no longer linked to in this story.