Former inmate Marchello McCaster wants several million dollars from the county to compensate for the debilitating holes in his lungs because of what he claims was deliberate indifference as he wasted away from tuberculosis while he was in the Ramsey County workhouse.

McCaster's U.S. District Court lawsuit filed in November 2009 heads into a St. Paul courtroom Thursday with a hearing before Judge Richard Kyle. Ramsey County is seeking to get the case dismissed.

The former inmate claims the county violated his Eighth Amendment right against cruel and unusual treatment by failing to recognize and treat his tuberculosis. McCaster's lawsuit said the jail's medical staff "utterly failed" to help him as he dropped 44 pounds off his 200 pound frame, shuffled weakly through the halls and his eyes took on a look of death. The lawsuit claims the signs should have been obvious to nurses, but the county had "constitutionally deficient protocols and procedures" for health care.

The county denies mistreating McCaster, arguing that he failed to prove the jail nurses acted with "deliberate indifference" to his health. Phil Carruthers, head of the Ramsey County attorney's civil division, said he couldn't comment beyond saying, "We'll tell our story in court."

Kyle has set the case for a settlement conference Aug. 3 and trial Sept 1.

Attorney Bob Bennett said his client, now 28, is pursuing his GED, but is unable to work and has at least $700,000 in medical bills. "You can't wreck a guy much more than they wrecked him," Bennett said. "His lungs don't work. His heart doesn't work."

McCaster had TB when he went to the workhouse, leading to an outbreak that already has cost the county millions in the settlement of a class-action lawsuit by inmates last fall. Depending on how infected inmates fare over time, the settlement will cost somewhere between $17 million and $20 million. At least 100 inmates tested positive for latent or active tuberculosis.

The disease can affect any part of the body but is most common in the lungs. TB spreads through coughing, sneezing and talking. In January, the Ramsey County Board approved a $1.5 million overhaul of the airflow system in the workhouse. Work is to be completed by August.

McCaster checked in to the workhouse April 17, 2008, on a fifth-degree assault conviction. His stay was to conclude June 11, 2008. Although he had recently dropped 15 pounds down to 200, a nurse didn't diagnose his condition at an entrance health screening. The county's motion to dismiss the case notes that a person can have active tuberculosis without showing symptoms and the nurse observed none.

Minnesota law requires that inmates be screened for TB within the first 14 days of detention or confinement. McCaster claims jail nurses failed to properly administer and read his TB tests so the disease wasn't caught. "If you give him the drugs right away, he gets better," Bennett said.

The county contends the Constitution doesn't require the government to treat TB. The "goal of screening for TB represents a laudable public health goal," but doesn't guarantee the discovery of TB at intake or other stage of incarceration, the county argued in its motion.

On June 9, 2008, McCaster was taken to the hospital after a corrections officer aggressively complained that he saw "death" in McCaster's eyes, according to the plaintiff's memo to the court in which he argues his case should go forward.

By the time he checked into Regions Hospital, McCaster was told he was no more than 48 hours from death, Bennett's memo said.

The county and Bennett agree on the legal question that must be answered: It "is not, in hindsight, whether [McCaster] had a serious medical condition, but rather, whether the condition was so obvious that a layperson would have easily recognized the need for medical treatment."

Rochelle Olson • 612-673-1747