At a tribal jail in Washington state, an inmate with a broken leg banged on his cell door, screaming for pain medication, only to be denied. Hundreds of miles away, a diabetic man jailed on the Wind River Indian Reservation in Wyoming needed insulin, yet government records say authorities were unable to get any for him. And jail staff at other reservation lockups on several occasions mistakenly gave inmates the wrong medication. These episodes, and dozens of others noted in limited detail in 2016 jail incident reports collected by the federal government, underscore what health professionals and jail administrators describe as a deep-seated problem: Scores of federally funded jails on reservations have no in-house nurses or other medical staff, often leaving corrections officers to scramble in emergencies to determine whether to send an inmate to the hospital, or provide basic care themselves — sometimes with unfortunate consequences. Jail data collected by the U.S. Bureau of Indian Affairs from 2017 was not yet available.