Homeland Security memo exposes appalling medical mistreatment of immigrants in US custody

By Kate Randall
14 December 2019

Immigrants held in Immigration and Customs Enforcement (ICE) detention facilities across the United States receive medical care so poor that it has resulted in two preventable surgeries and contributed to four deaths. These allegations appear in a memo addressed to top ICE leadership by Cameron P. Quinn, Department of Homeland Security’s officer for Civil Rights and Civil Liberties.

The number of detainees in the US has soared to record levels under the Trump administration, reaching a peak of 55,000 this summer and decreasing to about 44,000 presently. In fiscal year 2019, eight people are known to have died in ICE custody, the highest number since the year ending the Obama administration, when 12 people died. Including those who have died or been killed shortly after being deported along with unreported in custody deaths, the real toll is likely much higher.

Detained immigrant children line up in the at detention center in Karnes City, Texas [Credit: AP Photo/Eric Gay]

The previously secret memo, obtained and analyzed by BuzzFeed News, exposes that immigrants detained have been subjected to appalling medical treatment in detention. The March 20, 2019, memo describes the complaints of a whistleblower within the ICE Health Service Corps (IHSC), which provides medical care for detainees in ICE custody. In the memo, the whistleblower alleges that IHSC “has systematically provided inadequate medical and mental health care and oversight to immigration detainees across the US.”

The internal memo to ICE leadership includes 17 complaints, involving both detainee medical and mental health care. The alleged consequences of this inadequate care have included a preventable surgery on an 8-year-old boy who had part of his forehead removed and a detainee who was allowed to become so mentally unstable that he lacerated his own penis.

The memo is one of a number of secret documents obtained by BuzzFeed News throughout 2019 exposing how the Trump administration’s criminal immigration policies were formed and executed and how these policies have affected those seeking to live in the US. The abuses have included lack of detainee access to showers, holding children in closed and crowded cells and delays in transferring ill detainees to hospitals, among other instances of mistreatment.

Medical care for detainees is handled by a patchwork of providers, including ICE itself, ICE employees assisting private or public contractors and care provided by a contractor under ICE’s supervision.

Delays in care, unnecessary surgeries

• The memo describes how on December 5, 2017, an 8-year-old boy’s mother informed officials at a Texas Family Residential Center that her son’s earache was getting worse. Medical personnel diagnosed him with swimmer’s ear and gave him eardrops.

On December 23, the boy began having seizures and was taken to a hospital where doctors diagnosed him with Pott’s puffy tumor, a rare infection inside the skull. The infection had spread from the child’s ear to his facial bone, forming abscesses under his skull. To treat it, they needed to surgically remove part of the boy’s frontal bone, disfiguring his forehead.

An analysis by ICE’s Medical Quality Management Unit found that the “inadequate medical care provided by [the center] was a contributory factor resulting in harm to the boy.” According to the whistleblower, however, IHSC leadership “failed to take appropriate action.”

• The memo relates how a man at the Stewart Detention Center in Georgia “was reportedly bleeding through his skin and having vision changes.” A doctor at the center continued the man’s aspirin regimen, which thins the blood, for six days, despite his “having extremely thin blood.”

The detainee began “coughing up large amounts of blood and was taken to the hospital, where he was “not expected to survive.” The quality control unit reviewing the case “determined that that Aspirin therapy may have caused harm that could have resulted in a fatality.”

Failure to properly treat mental health conditions

• At the Eloy Federal Contract Facility in Arizona, the center’s psychiatrist was notified several times by the quality control unit about a detainee’s “worsening psychosis-related symptoms, but the psychiatrist failed to treat him,” according to the memo.

The man “became so unstable that he lacerated his penis, requiring hospitalization and surgery.”

• At Georgia’s Stewart Detention Center, officials were notified about Efrain De La Rosa’s deteriorating mental health condition. De La Rosa declared on April 26, 2018, that he would be dead in three days. He took his own life about 11 weeks later.

According to BuzzFeed, De La Rosa’s case has been investigated by the Intercept, Atlanta Journal-Constitution and the Young Turks, which reported that he had been diagnosed with schizophrenia and bipolar disorder and was being held in solitary confinement on suicide watch at a mental health facility. When he was transferred to Stewart, the staff there failed to register his condition.

• A man at Arizona’s Eloy Federal Contract Facility was supposed to receive antipsychotic medication, but allegedly was given antidepressants instead, “which likely worsened his psychosis.”

Forcible medication, improper treatment for substance withdrawal

• At the Jena/LaSalle Detention Center in Louisiana, two detainees were forcibly injected with Ativan, a benzodiazepine medication used to treat anxiety disorder and other conditions.

• The whistleblower alleges that detainees were not appropriately treated for their alcohol or opioid addictions and suffered severe withdrawal while in ICE custody. One man was the victim of a “medication error,” two men with a benzodiazepine addiction had their treatment delayed, one man “went into severe alcohol withdrawal and delirium and was admitted to the hospital in the intensive care unit.”

Preventable deaths

• Roger Rayson, a 47-year-old Jamaican immigrant, died about two months after being taken into custody at the Jena/LaSalle center, and a month “after being transferred to a hospital for nausea, vomiting, and pain,” according to a report by four advocacy groups. At the hospital, he was diagnosed with “a fast growing but treatable form of non-Hodgkin’s Lymphoma, and died nine days later.”

• Ronal Romero, a Honduran immigrant, came to the US in 2002 and had lived in Missouri for more than a decade. He was convicted of driving under the influence in January 2016 and, after two days in jail, was picked up by ICE on a previous detention order and sent back to Honduras.

Like so many deported immigrants from Central America, Romero returned to the US due to the lack of jobs and violent conditions in his home country. He was arrested on May 9, 2018, by Customs and Border Protection (CBP) and was eventually transferred to ICE’s Port Isabel Detention Center in Los Fresnos, Texas.

The next day, he felt sick and was in serious pain. He told medical staff that he had been receiving eardrops and antibiotics for an ear infection while in CBP custody. BuzzFeed writes: “He was treated and given medication. But later that day he became confused, not knowing where he was, and had trouble waking up. He died the next day in a hospital.”

An autopsy performed privately found that Romero died of “sepsis complication with meningitis.” An internal review conducted by ICE found the detention facility was compliant with its medical standards. The whistleblower, however, called the care rendered to Romero “grossly negligent” and alleged “that the mortality review committee was erroneous in concluding that the care rendered [Romero] was appropriate.”

One of Romero’s siblings told BuzzFeed News, “We believe he should be here with us. He was our little brother—he was everything to us. He was treated like an animal.” Romero’s family thanked the whistleblower for coming forward.

The fact that ICE has maintained that it provides proper care to immigrants in its custody, and that it has not chosen to voluntarily make the whistleblower’s allegations public, indicates that the abysmal medical and mental health care provided to immigrants in US custody is by design and of a piece with the Trump administration’s fascistic immigration policy.

The Democrats, going forward this week with articles of impeachment against Donald Trump based solely on foreign policy differences, have not made the White House’s vindictive immigration policies or other anti-working-class measures the target of their proceedings. By choosing to focus solely on their anti-Russia campaign, the Democrats have exposed their complicity in the Trump administration’s murderous assault on immigrants.