Saying that the conditions in Baltimore's jails pose a danger to inmates' health, two watchdog groups contend in court papers that state officials have violated the terms of a 1993 legal order that required them to clean up the facilities and revamp the way medical services are provided.
The American Civil Liberties Union and the Public Justice Center asked a federal judge last week for a hearing, alleging that people who are jailed awaiting trial in Baltimore have inadequate access to medical care and are forced to live in unsanitary conditions.
Attorneys for the groups say that detainees at the city jails - which house an average of about 4,000 people - routinely wash their clothes in toilets, eat food prepared in kitchens where mice and cockroaches run free, and go days without receiving medicine they need.
The allegations go hand-in-hand with a U.S. Department of Justice investigation's findings last year that the Baltimore City Detention Center violated the constitutional rights of detainees and was responsible for a pattern of preventable deaths - at least six of which were due to chronic health neglect.
Rosa Cruz, deputy director of public information for the state Department of Public Safety and Correctional Services, said Friday, "Our counsel has received the motion, and we are reviewing it. The department has been working with the Justice Department on the issues in the report."
Lawyers for the ACLU contend that medical neglect has reached crisis proportions. Of particular concern, they say, are heroin addicts who are undergoing treatment and who face excruciating withdrawal symptoms while awaiting methadone treatment in jail.
Elizabeth Alexander, director of the ACLU's national prison project, said medication for psychiatric illnesses, HIV, hypertension and even asthma is scarce and sometimes unavailable. She said the state facility - parts of which date back 200 years - can't handle the number of inmates.
"When you overcrowd a jail, it makes the job of the staff impossible," she said. "Jails should be seen as a scarce resource and used only to protect the community's safety."
Frank Dunbaugh, lead lawyer on the consent decree, said Friday that state officials "seem to be operating as if the decree is not in effect, so we are asking the court to reinstate enforcement efforts to insure health care and sanitation is kept up to snuff, up to standards."
Under the 1993 federal consent decree, which has the force of law, state officials running the jail were ordered - and agreed - to abide by health, safety and sanitation standards and practices. Among the long list of requirements are adequate plumbing, windows, lighting, ventilation and water systems; health screenings; and food preparation that complies with state health codes.
If a federal judge finds that those standards are not being met, the state could be found in contempt of court.
One female detainee, Tanisha Keith, 28, suffered a spider bite in her ear this year and waited several days before she received medical treatment, according to court papers filed with U.S. District Judge J. Frederick Motz.
Keith, an East Baltimore resident who was being held on an assault charge, lived in a basement dormitory where, she said, she and 32 women were confined near the rodent- and insect-infested boiler room.
"I pulled a piece of a spider out of my ear, which was swollen and red," she said. "I lost my hearing."
With medical treatment, her hearing was restored, she said.
Nicole Sesker, 34, of Northwest Baltimore said she was pregnant while being held on drug charges in 2001 and waited several weeks before being assigned to the maternity ward. She said she suffered from heroin withdrawal during her incarceration and received no treatment.
The medical screening and "sick call" systems for detainees came under criticism in last week's legal motion and the Justice Department report. Both documents state that the system is too slow to respond to emergency medical needs - including broken bones and throbbing teeth.
"Sick call is not actually available to detainees within a reasonable period of time," the legal motion says.
Court papers also allege poor sanitation in the detention center's plumbing, showers, kitchens and cells.
A sewage flood, dirty and mildewed showers, insect and mice infestation in the food preparation area, and confinement in cells with broken toilets were alleged in the legal papers.
In the summer of 2002, the ACLU filed a similar motion alleging that the women's jail has poor ventilation and becomes overheated in the summer. State officials say they have obtained funding to install more air conditioning in the women's jail this summer.