In her opinion, U.S. District Judge Shelly Dick excoriated the state for its “callous and wanton disregard” for the health of those in its custody. “Rather than receiving medical ‘care,’ the inmates are instead subjected to cruel and unusual punishment,” Dick said in her November opinion. The “human cost,” she said, is “unspeakable.”

She then ordered the appointment of three independent monitors to devise and implement a plan to reform the system.

That plan, however, may never come to fruition. Before those monitors could even be chosen, the state appealed the ruling, invoking a federal law — the Prison Litigation Reform Act — that hobbled a similar lawsuit over Angola’s health care nearly 26 years ago. The current case could suffer a similar fate.