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FILE - In this Aug. 22, 2013 file photo, former El Salvadoran military Col. Inocente Orlando Montano departs federal court, in Boston. Defense attorneys say medical care for Montano accused of helping to plot five killings is declining since his transfer to a new facility to await a final decision on his extradition. A lawyer for Morales said in a filing Tuesday, May 23, 2017, that routine blood sugar checks were missed and he has had a fever and other symptoms indicating that he could have a new infection. (AP Photo/Steven Senne, File)
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Attorneys: Salvadoran Colonel’s health declining in new jail

FILE - In this Aug. 22, 2013 file photo, former El Salvadoran military Col. Inocente Orlando Montano departs federal court, in Boston. Defense attorneys say medical care for Montano accused of helping to plot five killings is declining since his transfer to a new facility to await a final decision on his extradition. A lawyer for Morales said in a filing Tuesday, May 23, 2017, that routine blood sugar checks were missed and he has had a fever and other symptoms indicating that he could have a new infection. (AP Photo/Steven Senne, File)

RALEIGH, N.C. (AP) — After a judge sought to send an ailing Salvadoran colonel to a prison hospital, the U.S. Marshals Service instead moved him to a different jail that boasts “the lowest cost-per-day for inmate incarceration” in Virginia.

Now lawyers for the man accused of plotting notorious war crimes say he’s being denied the medical care he needs, leaving him too weak to help himself to the bathroom. On Thursday, the judge demanded an update from federal prosecutors on medical care for Inocente Orlando Montano Morales.

Montano’s diabetes and susceptibility to infection after bladder cancer raise questions about whether he will live long enough to face trial on charges he helped plot the 1989 killings of six Jesuit priests during El Salvador’s civil war. The federal judge reviewing Spain’s efforts to extradite Montano has described his conditions as “life-threatening,” even though he previously denied his request to live with family members while his case unfolds.

James Todd, an attorney for the 75-year-old Montano, wrote in a court filing that his daily blood sugar readings weren’t completed for five days straight earlier this month, with Piedmont Regional Jail classifying them as “overdue tasks.” Todd says records also show he wasn’t receiving physical therapy for back pain after a fall at a North Carolina jail.

Then, this week, Montano began having fevers and chills similar to those he’s had due to infections after his cancer treatment.

“These symptoms, combined with the extreme weakness in his extremities, made it difficult for him to go to the bathroom to change his colostomy bag,” Todd wrote Tuesday in the affidavit to federal Judge Terrence Boyle. “Yesterday, despite repeated requests for assistance, nobody came. The colostomy bag exploded and soiled his uniform.”

Boyle issued an order requiring federal prosecutors to respond to the inadequate care allegations by noon Friday.

The U.S. Marshals Service issued a statement Thursday saying it was aware of Montano’s allegations about the Virginia jail.

“Both the facility and the U.S. Marshals Service have policies and procedures for handling such prisoner allegations, and those are being followed,” the statement said, declining to offer further specifics.

Jail officials didn’t return messages seeking comment.

In April, Boyle had sought to send Montano to a federal prison hospital in North Carolina, but the Marshals Service said the transfer couldn’t be done. Federal prosecutor Eric Goulian said at a hearing that it would be unusual to send a Marshals Service extradition inmate to a Board of Prisons facility, and the hospital had a waiting list for beds.

In his order denying Montano’s request to live with family, Boyle wrote that the Marshals Service medical director contacted jails around the region and selected the Virginia lockup because of its around-the-clock care. Montano was transferred there in recent weeks from a Greenville, North Carolina, jail where he had been held for about two years. Todd wrote that the North Carolina jail measured his blood sugar six days a week.

Piedmont Regional Jail in Farmville, Virginia, serves six counties and houses over 700 local, state and U.S. Marshals Service inmates, according to its website. It’s operated by a regional authority overseen by officials from those counties. The website says: “Fiscally, Piedmont Regional Jail has been recognized as the Virginia facility with the lowest cost-per-day for inmate incarceration.”

The jail’s health care has come under scrutiny. In 2013, the federal government reached a settlement agreement requiring the jail to improve medical care after a Justice Department investigation found problems. Separately, the jail agreed in 2012 to pay $350,000 to settle a wrongful death lawsuit by the family of an immigration inmate who died in 2008 of a staph infection.

Montano’s lawyers say he’s susceptible to jail bacteria because of his colostomy bag.

Montano, who once served as El Salvador’s vice minister of public security, has been incarcerated in the U.S. for about four years, first on an immigration fraud conviction and then while his extradition case unfolds. A federal magistrate judge last year approved his extradition to Spain to face charges of helping plot the killings of the priests, five of whom were Spanish natives. But Boyle is reviewing a challenge filed by Montano’s attorneys.

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