PHOENIX (AP) — For more than five years, Arizona has been dogged by a federal lawsuit that alleges the state provides shoddy medical care for its prisoners.

Now, the state is facing the prospect of millions of dollars in fines over its failure to carry out reforms of its medical system.

Arizona Corrections Director Charles Ryan was berated in court Tuesday by a judge who described the state's efforts to overhaul prison health care as an "abject failure," two years after it agreed to make such changes as part of a settlement of the lawsuit.

U.S. Magistrate David Duncan grilled the prisons direc...