By Jeremy M. Lazarus

Terry A. Riggleman went to prison as a convicted robber.

But 11 years into his 20-year sentence, he is working to change an alleged state practice of withholding life-saving medicine from Virginia prison inmates like him who are afflicted with the liver-destroying viral infection known as Hepatitis C.

Backed by a new pro-bono civil rights law firm, Nexus Caridades Attorneys Inc., Mr. Riggleman, 42, at Augusta Correctional Center has filed a federal class action lawsuit against the Virginia Department of Corrections seeking to overturn current policy and make treatment available.

“Defendants have a constitutional mandate to treat Mr. Riggleman’s infection,” the suit states, “but instead of curing Hepatitis C, defendants have permitted Mr. Riggleman and other inmates to be infected — without treatment — until they reach their deathbed.”

The suit represents a major embarrassment for the administration of Gov. Terry McAuliffe, which has pushed continually against General Assembly opposition to expand health insurance to low-income Virginians but is now accused of withholding treatment for one of the state’s poorest groups — prisoners.

The governor’s office has not responded to a request for comment on the suit. It alleges the state policy amounts to a bureaucratically imposed death sentence for the untold number of inmates with Hepatitis C.

The case could become a potential budget-buster if Mr. Riggleman prevails in the suit filed June 26 in Harrisonburg in U.S. District Court for the Western District of Virginia.

According to Mario Williams, lead attorney for Nexus Caridades, which is based in Augusta County, 30 percent to 40 percent of inmates are believed to be infected with Hepatitis C. That’s an estimated 10,000 of the 30,000 men and women locked up in state facilities, making it one of the most widespread diseases in the prisons.

New medications have been developed since Mr. Riggleman was first diagnosed with the chronic disease in 2005, but they are hugely expensive. A 12-week course of medication costs a minimum of $50,000 per person, according to the drug manufacturer.

Virginia would need to spend $500 million or more should the federal court find the state has violated the U.S. Constitution’s Eighth Amendment ban on cruel and unusual punishment by withholding such medicines as Mr. Riggleman’s suit alleges.

The suit names Harold Clarke, director of the state Corrections Department, and Dr. Mark Amonette, the corrections department’s chief medical officer.

Both men, who are represented legally through the Virginia Attorney General’s Office, are keeping mum about the suit.

“Any response on behalf of our clients will be made in court filings,” a spokesman for Attorney General Mark Herring stated.

Mr. Riggleman suffers excruciating stomach, nerve, joint and liver pain, as well as constant fatigue from the disease. He turned to Nexus Caridades after his requests for treatment were rebuffed in November and March.

Despite his symptoms, the state Corrections Department notified him that his disease had not progressed far enough to justify treatment. Medical staff also were instructed not to treat him or others with the disease, the suit states.

Michael Donovan, president and CEO of the GPS equipment maker Nexus Services Inc. that funds Nexus Caridades, said his company “is proud to fund this class action suit so we can bring an end to the DOC course of conduct which literally condemns inmates like Mr. Riggleman to die.”

Mr. Williams, the attorney, said Nexus Caridades is hopeful the state will not fight the suit and, instead, will agree to a settlement, although he said that DOC officials have been unwilling to entertain an agreement to change the policy.

According to the suit, the federal Bureau of Prisons started prescribing the new Hepatitis C medication, as have correctional systems in California, New York, Illinois and three other states.

That stands in contrast to Virginia prisons, which have refused to use the new class of direct-acting antiviral drugs and have ceased providing older medications, including a combination therapy of interferon ribavirin or a triple therapy that adds another drug.

Mr. Williams said Virginia inmates are at the mercy of the policies because they automatically are ineligible for Medicaid while in prison. They are only eligible for Medicaid coverage when they are transferred to a hospital for treatment. Inmates also are banned by DOC policy from being added to a relative’s health insurance policy or buying their own.

Instead, they are required to receive treatment from medical staff at the prison where they are housed.

“They are absolute wards of the state when it comes to health care,” Mr. Williams said.

DOC’s detailed medical guidelines allow for treatment of Hepatitis C when the disease is advanced, but the decision is made on a case-by-case basis.

“The treatment will be based on the severity of the disease,” the guidelines state, as well as the willingness of the patient to abstain from risky behavior that can create a risk of re-infection and has enough time left on a sentence to complete treatment.

According to Nexus Caridades, the policy was created because DOC does not want to the absorb the cost.

State corrections officials declined to release to the Free Press any information about the number of inmates who are infected or are in treatment for Hepatitis C.

Mr. Donovan said the department also has not responded to Nexus Caridades’ requests for the information..

Hepatitis C is generally spread like HIV/AIDS — through fluid transfer between an infected party and another person. For example, shared needles used to create prison tattoos can result in the transfer. So can sexual activity.

While Hepatitis C can go undetected for years, the disease can result in liver cancer or cirrhosis, or scarring of the liver, and render the organ that filters poison from the blood inoperative.

According to the Centers for Disease Control and Prevention, Hepatitis C causes the deaths of nearly 20,000 Americans yearly, surpassing deaths from other infectious diseases, including HIV/AIDS, and is the most common cause for liver transplants.

“Each day without treatment increases the likelihood of permanent damage or death,” Mr. Donovan said.

Because the disease is epidemic in Virginia’s prisons, the lack of treatment means hundreds of people will die each year from a disease that is absolutely curable, he said.

“The issue for DOC and the state is cost. But that is not our concern,” Mr. Donovan said. “Our concern is saving lives and preventing unelected officials from deciding who will live and who will die based on policies regarding the treatment of disease for people who are in their care and absolutely dependent on them.”