A seriously ill inmate in a San Francisco jail begged to go to a hospital three hours before he died but was instead ordered into an isolation cell by a nurse who told sheriff's deputies, "There is nothing we can really do for him,'' reports of the incident show.

The July 1 death of Edwin Macon Jr., 44, raises questions about how San Francisco jail authorities treat inmates who complain of illness but are suspected of malingering.

The jail's medical staff never sent Macon to the hospital, even though he had collapsed in court on consecutive days, repeatedly complained of pain in his chest and legs and was so weak he could barely walk.

Instead, despite Macon's repeated demands for hospital treatment, nurses said he was "carrying on and on'' about heart problems, according to jail medical records provided to The Chronicle by Macon's family. One nurse wrote that Macon wasn't even a "high risk" patient who would need intensive monitoring.

Macon's death at the Hall of Justice jail is being investigated by San Francisco police, the medical examiner, the Sheriff's Department and the jail medical services.

Investigators said Macon, who had been jailed on a domestic violence charge, suffered from an enlarged heart, kidney disease and pneumonia at the time of his death.

Macon's family said the death shows breakdowns in the medical care that inmates receive from the city.

"They don't let a dog die like that,'' said Macon's mother, Jessie Macon of Daly City, a former nurse who said her son had a history of heart problems and should have been hospitalized.

Macon was the only son of Jessie and Eddie Macon. Eddie Macon was a longtime professional football player who was the Chicago Bears' first African American player and was once a defensive back for the Oakland Raiders.

Macon's mother said her son, a onetime electrician who also had done gardening, had been on disability for two years and had used crack cocaine.

Still, she said, her son needed help.

"Whether they believed him or not, they could have taken him to the hospital to find out if he was sick,'' she said.

"Even if they didn't believe him, they didn't have to throw him into the hole,'' she said. "They just threw him in there to die, is what I figure they did.''

Dr. Joe Goldenson, head of jail medical services, said he is awaiting the final autopsy report to make conclusions about the handling of the incident.

"It appeared he received appropriate care, but we won't know for sure until we have all the information,'' Goldenson said. "We just don't know what he died from. Even if it was related to his enlarged heart, it could have been something that wasn't preventable.''

Eileen Hirst, spokeswoman for the Sheriff's Department, which runs the jail, said: "We consider every death in custody to be a tragedy. We extend our condolences to Mr. Macon's family.''

Macon, who had a history of drug use as well as heart problems, had been brought to the jail on Father's Day, June 19, after being arrested on domestic violence charges. Macon told his jailers he had quit illegal drugs, and he was being treated by the jail with various medications, including children's aspirin to prevent a heart attack.

"He had an enlarged heart. He was at certain risk for complications from that,'' Goldenson said.

On June 27, nurses responded to a "man down'' when Macon complained of pain and collapsed in a San Francisco courtroom where he had been brought for his domestic violence case. He complained of kidney pain and chest pain.

"He's carrying on and on about his medical problems from him having a heart problem that he needs to be sent to SFGH or to be seen by his own doctor bec(ause) he needs a heart transplant,'' nurse Nimfa Punzalan said in a log entry on the afternoon of June 28 about the incident the day before.

Macon said he had vomited blood, but when the nurse said she didn't see any evidence of that, he became angry and loud and complained "that nothing has been done for him,'' the nurse said.

"He's not even on the hi(gh) risk board,'' she said, referring to a list of inmates who require intensive medical monitoring.

On the morning of June 28, another registered nurse responded to a man- down call for Macon, who had been sent back to the same courtroom. According to the jail medical records, Macon accused medical officials who responded to the courtroom of not providing him with proper care and demanded again to go to the hospital. But he was taken back to county jail in a wheelchair and sent to a jail clinic for observation.

On that same day, records show, nurses decided to confiscate his medicine, as they believed he had not been taking it. This forced Macon to take medication under observation.

On June 29, Macon was labeled a "high risk'' patient after he again went to the jail sick bay. It was noted that he had been back on his medications and that his blood pressure had improved.

"Leg pain but consider malingering,'' nurse practitioner John Poh said in a report made the next day, June 30. At the time, Macon told Poh that he had made bail and was awaiting release. He also denied having pain in his chest, according to records.

But at 12:39 a.m. on July 1, sheriff's Sgt. B. Bloom reported that he found Macon on a mattress in his cell, with feces and urine rubbed on his body. "Macon was moving and saying he needs to go to Seton Hospital,'' Bloom said.

Nurse Evangeline Anacleto and another nurse arrived and told Bloom to put Macon in an isolation cell instead. His vital signs seemed normal, and his blood pressure was measured at 120/60, in the normal range, the records suggest. Anacleto said Macon had been seen by a nurse practitioner earlier that day.

"There is nothing we can really do for him,'' she said, adding that he should be placed in the safety cell as "gravely disabled'' with "no obvious physical injury,'' according to records.

Macon had trouble moving and could not walk on his own. His pants dropped to his ankles as he was moved and was left standing naked in the cell, according to Bloom.

At 3:15 a.m., Macon appeared to be sleeping to a deputy who was checking on him, but about 10 minutes later, the deputy looked again and saw that he did not respond to the deputy and appeared lifeless. Efforts to revive him failed, and he was pronounced dead at 4:08 a.m.