U.S. District judge Aubrey E. Robinson Jr. ruled yesterday that it is unconstitutional for D.C. General Hospital to use metal restraints such as handcuffs and leg irons to control jail inmates sent there for medical treatment.

Instead, he said, the hospital should use medical restraints made of cloth and leather to control the inmates.

Robinson's ruling come in a case involving an inmate who was sent to the hospital and was found to have a high temperature and diarrhea. After orally threatening the staff and tampering with an intravenous device, he was manacled to his bed with handcuffs and leg irons for four to five days.

Robinson said the use of the metal restraints was an attempt to punish the inmate, who was constitutionally entitled to "medical care and humane treatment."

"Metal restraints are medically inferior, provide no greater security, and are more expensive than medical restraints," Robinson said. "The only possible reason to use metal restraints is to punish the patient."

Inmates sent to D.C. General are normally kept in a special ward. However, the hospital can lock troublesome inmates in individual rooms -- as it did in this case -- or restrain them.

The hospital's own regulations call for the use of cloth or leather restraints, and previous court rulings provide detailed procedures involving their use.