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(Washington, DC) – Poor medical treatment contributed to more than half the deaths reported by US Immigration and Customs Enforcement (ICE) during a 16-month period, Human Rights Watch, the American Civil Liberties Union, Detention Watch Network, and National Immigrant Justice Center said in a report released today.

Based on the analysis of independent medical experts, the 72-page report, “Code Red: The Fatal Consequences of Dangerously Substandard Medical Care in Immigration Detention,” examines the 15 “Detainee Death Reviews” ICE released from December 2015 through April 2017. ICE has yet to publish reviews for one other death in that period. Eight of the 15 public death reviews show that inadequate medical care contributed or led to the person’s death. The physicians conducting the analysis also found evidence of substandard medical practices in all but one of the remaining reviews.

“ICE has proven unable or unwilling to provide adequately for the health and safety of the people it detains,” said Clara Long, a senior US researcher at Human Rights Watch. “The Trump administration’s efforts to drastically expand the already-bloated immigration detention system will only put more people at risk.”

12 people died in immigration detention in fiscal year 2017, more than any year since 2009. Since March 2010, 74 people have died in immigration detention, but ICE has released death reviews in full or in part in only 52 of the cases.

An illustration of detainees and beds in immigration detention. © 2018 Mitch Blunt for Human Rights Watch

Based on the death reviews, the groups prepared timelines of the symptoms shown by people who died in detention and the treatment they received from medical staff, along with medical experts’ commentary on the care documented by ICE and its deviations from common medical practice. The deaths detailed in the report include:

  • Moises Tino-Lopez, 23, had two seizures within nine days, each observed by staff and reported to the nurses on duty in the Hall County Correctional Center in Nebraska. He was not evaluated by a physician or sent to the hospital after the first seizure. During his second seizure, staff moved him to a mattress in a new cell, but he was not evaluated by a medical practitioner. About four hours after that seizure, he was found to be unresponsive, with his lips turning blue. He was sent to the hospital but never regained consciousness and died on September 19, 2016.
  • Rafael Barcenas-Padilla, 51, had been ill with cold symptoms for six days in the Otero County Processing Center in New Mexico when his fever reached 104, and nurses recorded dangerously low levels of oxygen saturation in his blood. A doctor, consulted by phone, prescribed a medication for upper respiratory infections. The ICE detention center didn’t have the nebulizer needed to administer one of the medicines, so he did not receive it, and he showed dangerously low oxygen readings that should have prompted his hospitalization. Three days later, he was sent to the hospital, where he died from bronchopneumonia on April 7, 2016.
  • Jose Azurdia, 54, became ill and started vomiting at the Adelanto Detention Facility in California. A guard told a nurse about Azurdia’s condition, but she said that “she did not want to see Azurdia because she did not want to get sick.” Within minutes, his arm was numb, he was having difficulty breathing, and he had pain in his shoulder and neck – all symptoms of a heart attack. Due to additional delays by the medical staff, two hours passed before he was sent to the hospital, with his heart by then too damaged to respond to treatment. He died in the hospital four days later, on December 23, 2015.

“Immigrant detention centers are dangerous places where lives are at risk and people are dying,” said Silky Shah, executive director of Detention Watch Network, a national coalition that exposes the injustices of the US’ immigration detention and deportation system. “The death toll amassed by ICE is unacceptable and has proven that they cannot be trusted to care for immigrants in their custody.” 

In fiscal year 2017, ICE held a daily average of nearly 40,500 people, an increase of nearly 500 percent since 1994. The Trump administration has asked Congress to allocate $2.7 billion for fiscal year 2019 to lock up a daily average of 52,000 immigrants in immigration detention facilities, a record number that would represent a 30 percent expansion from fiscal year 2017.

“To the extent that Congress continues to fund this system, they are complicit in its abuses,” said Heidi Altman, policy director at the National Immigrant Justice Center, a nongovernmental group dedicated to ensuring human rights protections and access to justice for all immigrants, refugees, and asylum seekers. “Congress should immediately act to decrease rather than expand detention and demand robust health, safety, and human rights standards in immigration detention.”

The new report is an update of a 2017 Human Rights Watch report that examined deaths in detention between 2012 and 2015, as well as a 2016 report by the American Civil Liberties Union, the Detention Watch Network, and the National Immigrant Justice Center that examined deaths in detention between 2010 and 2012.

The medical experts who analyzed the death reviews for the groups include Dr. Marc Stern, the former health services director for the Washington State Department of Corrections; Dr. Robert Cohen, the former director of Montefiore Rikers Island Health Services; and Dr. Palav Babaria, the chief administrative officer of Ambulatory Services at Alameda Health System in Oakland, California, and assistant clinical professor in Internal Medicine at the University of California, San Francisco.

Six of the new deaths examined occurred at facilities operated by the following private companies under contract with ICE: CoreCivic, Emerald Correctional Management, the GEO Group, and the Management and Training Corporation (MTC).

“ICE puts thousands of people’s health and lives at risk by failing to provide adequate medical care to the people it detains for weeks, months, and even years,” said Victoria Lopez, senior staff attorney at the American Civil Liberties Union.

 

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