A report filed on August 26 in a federal lawsuit against the Alabama Department of Corrections and Birmingham-based Naphcare Inc. alleges that conditions at Alabama's Limestone prison's HIV unit are unsafe for prisoners and staff. Naphcare Inc. is the prison's medical contractor.

Dr. Stephen Tabet, an infectious disease specialist at the University of Washington, visited Limestone in February 2003 and reviewed 38 deaths that have occurred in the HIV unit since 1999. "The most egregious medical failure at Limestone is the number of preventable deaths," he wrote in his report. "Patients at Limestone are treated like they are nuisances."

Tabet found Limestone's HIV-positive prisoners housed separately in a sheet-metal warehouse with insects and little protection from the elements. He found cases where inexpensive, preventative care -- such as dispensing Bactrim to halt pneumonia deaths -- is not readily given. He cited patients dying from starvation because they had not been treated for weight loss or vomiting. Prisoners stand in an outside line, the report stated, at 3 a.m. for HIV medications. Since no food is available at that time, they take the pills on empty stomachs -- against FDA guidelines -- leading to vomiting and further deterioration. Tabet found cases of prisoners dying from AIDS wasting syndrome because no one prescribed medicine to increase muscle mass, and instances of nurses illegally prescribing medicine.

Dr. Colette Simon, who has overseen medical care for Limestone since 2000, said that many of the deaths in Tabet's report occurred before her arrival. Since Naphcare has had the contract, only 14 people have died. Naphcare spokesperson David Davis blamed the DOC for the conditions, and said the company disagreed with many of Tabet's findings.

This marks the second time a medical expert has cited inadequate care at Limestone. A 2002 audit by Jacqueline Moore and Associates said the prison's death rate from AIDS was more than twice the national average in prisons. Naphcare has sued, claiming the audit contains inaccuracies.

Last year, the Southern Center for Human Rights in Atlanta filed the lawsuit for which Tabet wrote his report.

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