Handcuffed in a cell for six days, covered in his own feces, without food and water: That is how Michael Anthony Kerr spent the final days of his life, according to a letter written by a former Alexander Correctional Institution inmate who shared a cell block in solitary confinement with the now-deceased prisoner.

This month, the INDY reported that Kerr, a 53-year-old Sampson County man with a long criminal record and a history of mental illness, died during the two-and-a-half-hour trip from Alexander Correctional in Taylorsville to Central Prison in Raleigh on March 12. Prior to his death, Kerr had spent more than a month in solitary confinement.

The letter, dated April 1, from an inmate, whose identity is being withheld by the INDY to protect his safety, offers new details on Kerr’s death. (The inmate’s letter has been edited by the INDY for clarity.)

The INDY wrote to the prisoner but received no response. The inmate, who has a lengthy criminal history as well as dozens of prison infractions for fighting and disobeying orders, had recently been transferred to another prison.

“When I came onto the block with Mr. Kerr, he was not eating,” the inmate wrote. “He was using the bathroom on himself, laying in feces. … Sergeant was saying, ‘Look at his pants halfway down. His butt is out. Look at his crusty feet.’”

On March 7five days before his transferprison workers called out a “code blue,” according to the letter. Code blue is a medical term typically used to report a patient in need of immediate medical attention.

“Sergeant and officers go in his cell and put him in handcuffs and the nurses go in,” the inmate wrote. “They were saying how bad he smelled but was doing nothing to help him.”

The letter said prison workers handcuffed Kerr during the March 7 examination. In the days that followed, prison workers took Kerr’s unresponsiveness as a sign that he was refusing to have the handcuffs removed, the letter said. “But he never talked, so how did he refuse?” the inmate wrote.

The inmate goes on to write that a prison guard even taunted Kerr as they prepped him for transfer to Central Prison on March 12, stating, “You too dumb to stand up and put your clothes on.” According to the letter, the sergeant also said aloud that the handcuffs would have to be cut off, although it’s unclear why.

“They brought Mr. Kerr out in a wheelchair and was pushing him out,” the inmate wrote. “His face was blank and his eyes had a far-off stare to them, and they was wide open but seeing nothing and he had something white coming out of his mouth and he died some hours later. Now look, because they thought he was faking, now he’s dead because of staff and the superintendent and the medical staff didn’t do their jobs and get Mr. Kerr the mental health help that he needed.”

Disability Rights N.C. Executive Director Vicki Smith says the letter seems to be accurate. “It lines up with what we understand to have happened, but we can’t say that it’s 100 percent accurate at this time,” said Smith.

DPS Spokeswoman Pam Walker declined to comment on the inmate’s claims, although she said investigators are reviewing multiple prisoners’ accounts of what they saw prior to Kerr’s death. “All of those will be taken seriously,” she said.

Investigators from the N.C. Department of Public Safety, the State Bureau of Investigation and the nonprofit Disability Rights N.C. have launched investigations into Kerr’s death.

No cause of death has been released and state officials are awaiting a medical examiner’s report, which could take months to complete. Meanwhile, Kerr family members have publicly blamed prison officials for his death.

According to DPS, five workersnurses Brenda Sigman, Wanda St. Clair and Kimberly Towery; nurse supervisor Jacqueline Clark and Captain Shawn Blackburnhave been fired. Nurse Lisa Kemp and staff psychologist Christine Butler have also resigned during the course of the investigation.

Of the five dismissals, Walker said three are officially appealing. Walker said DPS officials would fire more prison employees and may request criminal prosecution if it is “deemed appropriate.”

North Carolina prison officials have been under scrutiny for their treatment of mentally ill inmates since 2011, when a blistering internal report detailed prisoners left isolated in squalid conditions inside segregated cells at Central Prison, the state prison system’s primary mental health and medical facility for male inmates.