Last month, a federal judge in New Jersey rejected the plea of a man who claimed his kidney problems made COVID-19 especially dangerous for him. Maurice McPhatter, 49, was one of more than 20,000 federal prisoners who have sought early release during the pandemic. Thousands have been freed. McPhatter, serving a 10-year sentence for drug trafficking, explained in a handwritten letter that he was born with only one kidney and now had a large kidney stone. Judge Kevin McNulty did something that sank McPhatter’s chances of early release. Prison medical records contained instructions that kidney test scores for African Americans should be adjusted, using a decades-old formula that drew a distinction between races. McPhatter is Black, and the resulting “race adjustment” put his score on the healthy side of a commonly used threshold for chronic kidney disease. “He is at no particular risk of a dangerous COVID infection,” the judge concluded.
The formula McNulty used to make his decision has been discarded by a growing number of health care institutions and experts who say it can lead to misdiagnoses and inequitable care for Blacks. The American Society of Nephrology recommended that it be replaced with a race-blind formula. LabCorp, the diagnostic laboratory company, has already made the switch, as has the Department of Veterans Affairs and numerous major hospital systems. During the pandemic, the older formula took on importance in at least one setting: federal courtrooms where the race-adjusted kidney score is still employed to help judges decide whether to grant medical release to Black prisoners. It is unclear how many cases have been decided on the basis of the old formula. Last week, lawyers for a Black inmate at the Hazelton federal prison complex in West Virginia, Jonte Robinson, filed a lawsuit in federal court in Washington, D.C., demanding that the Bureau of Prisons stop adjusting the kidney function scores of Black inmates. It demands that the bureau re-evaluate the scores of thousands of Black prisoners using a newer race-free formula.