A federal judge on Friday dealt the state of Maryland two setbacks in its efforts to extricate itself from a decades-long federal lawsuit over health care and mental health services in Baltimore’s jails.

U.S. Judge Matthew J. Maddox rejected the state’s preferred choices for an “independent medical monitor,” or a doctor who will gauge its compliance with the terms of an 8-year-old settlement agreement in the case. Maddox also ordered the state to turn over contested records that could shed light on how often people with severe mental illness are getting out of their cells.

The pair of losses for the Maryland Office of Attorney General and its private law firm, Butler Snow LLP, came as the state has spent nearly half a million dollars on ratcheting up its legal defense in an attempt to untangle its corrections department from a federal lawsuit over health care and mental health services in Baltimore jails that dates back to the 1970s.

As of June, the state had spent nearly $407,000 on the law firm’s services. The attorney general’s office said last week it has received one additional invoice from the law firm and has now spent nearly $423,000.

Friday’s hearing capped off two escalating and increasingly contentious fights between the state and a team of advocacy groups led by the ACLU’s National Prison Project, deflating the legal maneuvers by Butler Snow, which had recommended three doctors who had no experience monitoring correctional healthcare lawsuits.

In rejecting the state’s nominees, Maddox cited that lack of experience as well as a history of “adverse judicial findings” that called the doctors’ credibility and expertise into question, both arguments outlined in a recent brief by the ACLU.

Instead, Maddox appointed Dr. Muthusamy Anandkumar, who was one of two doctors put forward by the ACLU. In issuing his decision, Maddox said he found Anandkumar to be the “most qualified and suitable” candidate.

That decision is sure to be a consequential one for the Maryland state government. State leaders have made exiting the lawsuit a top priority for its beleaguered corrections department, which has run city jails for decades. Despite staffing shortages in the facilities and a rotating cast of oft-criticized private medical vendors hired under questionable contracts, the state had placed much of the blame for its lack of progress in coming into compliance with the jail health care settlement on what it described as ever-shifting and ambiguous standards set by the prior medical monitor, Dr. Michael Puisis.

The incoming medical monitor, Anandkumar, is already monitoring a case in the U.S. Virgin Islands in which the government is being represented by Butler Snow, which has made a name for itself by defending correctional systems, largely in Deep South states such as Alabama, Georgia and Louisiana.

Assistant Attorney General Laura Mullally told Maddox that the timing of Anandkumar’s start date at the helm of the Baltimore case will depend on whether his contract has to go before the state’s spending board or not.

How often are Baltimore’s most mentally ill jail detainees getting out of their cells?

The hearing also handed a partial victory to the ACLU in its quest to further scrutinize records from the Baltimore Central Booking and Intake Center’s inpatient mental health unit, a wing of the jail that houses the detainees with the most serious mental illnesses. The unit became notorious in recent years for what the advocacy groups, who routinely tour Baltimore jail facilities, described as “extremely harsh living conditions.”

Recent evaluations by the independent doctor monitoring mental health services in Baltimore jails have showed those conditions beginning to improve, thanks to efforts by the state corrections department. But the ACLU has zeroed in on the question of “out of cell time,” citing conflicting information in the records provided by the state’s private health care vendor, Centurion, and the handwritten jail logs kept by custody staff. The group’s attorneys accused the state of effectively destroying evidence by refusing to turn over the handwritten logs for nearly a year.

The state pushed back on Friday, contending that “count sheets” sought by the ACLU did not reflect what the advocacy group asserted it did. Rather than showing “out of cell” time, the records actually show how much time each detainee spends “off the unit,” said Butler Snow attorney William Lunsford. He also contended that the state has no responsibility to turn over what he described as “personal notes” etched onto the count sheets by custody staff.

Maddox appeared to be sympathetic to that argument in Friday’s hearing, which lasted nearly three hours, pointing out that the debate was stretching on due to Lunsford making several arguments that appeared nowhere in the state’s legal briefs. He ordered that the state turn over the count sheets from a three-month period to allow the ACLU to determine whether they are relevant to the question of out- of-cell time.ed since it is not mentioned anywhere in the settlement agreement.

Meanwhile, David Fathi, head of the ACLU’s National Prison Project, repeatedly criticized Lunsford and his colleagues for making arguments in court that were not outlined in any legal briefs or sworn affidavits, suggesting that his statements could be factually misleading.

“Mr. Lunsford’s assertions about other cases, conversations — none of this is evidence,” Fathi shot back in court.

Maddox appeared to be sympathetic to that argument in Friday’s hearing, which lasted nearly three hours, pointing out that the debate was stretching on due to Lunsford making several arguments that appeared nowhere in the state’s legal briefs. He ordered that the state turn over the count sheets from a three-month period to allow the ACLU to determine whether they are relevant to the question of outof cell time.