A judge in a class-action lawsuit that protests the quality of health care in Arizona’s prisons has ordered the state to improve medical and mental health services for inmates after attorneys who won a settlement in the case complained that officials were dragging their feet in making required changes.

The order Friday from U.S. Magistrate Judge David Duncan requires the state to come up with a plan for meeting settlement requirements that set deadlines for when inmates are given medications and seen by health providers.

Attorneys who represented the prisoners contend that the state’s prisons haven’t improved since the October 2014 settlement, saying Arizona has dramatically inflated its compliance figures and failed to carry out many requirements called for by the agreement.

They cited a medical expert who said a 59-year-old man at a Yuma prison with end-stage liver disease had died from complications from a massive infection. The expert said the prisoner’s requests for medical attention weren’t heeded despite his claim that he was bleeding in his legs and that his lesions were swarmed by flies.

“My best hope is that the state acknowledges the gravity of the problem and also acknowledges that the solution to the problem is more clinical staff,” said Don Specter, one of the attorneys for the inmates. “They are way understaffed and can’t provide adequate care until they get more staff.”

The Arizona Department of Corrections didn’t immediately respond to a request for comment Friday afternoon.

The settlement was won on behalf of 33,000 Arizona inmates after some complained that their cancer went undetected or they were told to pray to be cured after begging for treatment.

As part of the settlement, state officials agreed to seek more money from the Legislature to increase health care staffing, offer cancer screenings to certain prisoners, follow requirements in treating patients with chronic diseases and provide more out-of-cell time to prisoners kept in isolation cells.

Lawmakers gave the Department of Corrections an additional $6.6 million in health care funding last year in response to the settlement.

The lawsuit against Arizona Corrections Director Charles Ryan and another prison official alleged the failure of medical staff at one prison to diagnose the metastasized cancer of one inmate resulted in his liver enlarging to the belly size of a pregnant woman at full term.

It said another inmate with a history of prostate cancer had to wait more than two years for a biopsy, and nothing was done for a prisoner who suffered from depression and told staff members he was suicidal before he killed himself.

Prison officials have denied the allegations and didn’t acknowledge any wrongdoing when making the settlement.

The prisoners weren’t seeking money damages and instead asked for a court order declaring that Arizona’s prisons violated constitutional guarantees against cruel and unusual punishment.

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