Over a 16-month inquiry, investigators discovered that inmates were subjected to "inhumane, violent and hazardous conditions," posing severe threats to their safety. Among several alarming findings were housing units riddled with infestations, broken and flooding toilets, exposed wiring, and inconsistent food and medical care. The use of excessive force by staff, including Tasers, was also documented without adequate justification.

The investigation highlighted significant lapses in protection for inmates, leading to repeated episodes of violence, including stabbings, sexual abuse, and even murders. "Detention in the Fulton County Jail has amounted to a death sentence for dozens of people," Kristen Clarke, Assistant US Attorney General for the Civil Rights Division, stated during a news conference in Atlanta. The probe, initiated partly in response to the 2022 death of Lashawn Thompson, uncovered shocking instances of neglect and abuse especially in the jail's mental health unit.

Within weeks of the investigation’s start in July 2023, six men had already died in the jail. One of them perished during a spate of violent assaults that resulted in seven inmates being stabbed across five jail units within 24 hours. Cases such as Thompson's, who was found covered in lice and filth, only serve to underscore the grave humanitarian crisis within the facility. Thompson was among four Black men with serious mental health needs who died in the mental health unit in under a year.

The Justice Department's 105-page report suggested measures to rectify the dire situation, emphasizing inmate safety, protection from excessive force, addressing environmental hazards, and improving health care. The document also claimed that should state officials fail to remedy the issues within 49 days, the US Attorney General might consider legal action.

Assistant US Attorney Ryan Buchanan noted the high rates of violence at the jail, pointing out that more than 1,000 assaults and 300-plus stabbings had been reported in 2023, nearly double the rates seen in other major city jails. Clarke reiterated this, underscoring disparities by comparing the Fulton County Jail's monthly stabbings to yearly figures from larger facilities like the Miami-Dade County Jail.

The report additionally revealed an elevated risk of sexual abuse among inmates, facilitated by inadequate supervision, the presence of weapons, and poor classification practices that placed violent and gang-affiliated inmates alongside vulnerable individuals. This investigation paints a grim picture of systemic failings and pervasive human rights abuses at the Fulton County Jail. The report has been shared with the Fulton County Sheriff's Office and Thompson's family for their comments.