ATLANTA — First he complained of a spider bite. Then he said he fell on the way to the shower and hurt his back. On Monday, he said he was feeling sick to his stomach because raw sewage seeped under his cell door.

Twice, the rape defendant accused of killing four people in a shooting spree that started in a courtroom asked to be excused from pretrial hearings in his murder case so he could return to the place he said he became ill. One time he came to court in a wheelchair.

Judge Hilton Fuller allowed Brian Nichols to miss Monday’s hearing, but said he wants Nichols in court Tuesday for another hearing unless he has a note from a doctor saying he should be excused again.

Nichols initially came to the hearing, wearing his orange jail jumpsuit instead of the civilian clothing he usually wears to court. His lawyers quickly asked that he be excused because they say he was feeling nauseous from sewage that flooded his cell on May 7.

Officials confirmed there had been some sewage flooding in the jail. Nichols’ attorneys said he is under a doctor’s care and taking medication for an intestinal condition.

It’s not the first time Nichols has complained of illness.

Last July, Nichols missed a hearing after complaining of a spider bite on his head. In November, he was escorted into a hearing in a wheelchair. His lawyer said at the time Nichols injured his back during a fall at the county jail while on his way to take a shower.

At Monday’s hearing, Fuller considered pretrial motions, including a defense request that the courtroom be improved to enable Nichols’ attorneys to better see witnesses and jurors. Tuesday’s hearing will address other defense motions.

Nichols was being retried on rape charges in March 2005 when he allegedly stole a deputy’s handgun at the Fulton County Courthouse after the deputy removed his handcuffs to allow him to change out of his jail clothes and prepare for court.

Authorities say Nichols fatally shot a judge, court reporter and sheriff’s deputy. He’s accused of killing a federal agent north of downtown before surrendering the next day in an Atlanta suburb.

Prosecutors are seeking the death penalty. Nichols’ murder trial is currently scheduled for Jan. 11.

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