The Shocking Way ICE Neglected Immigrant Detainees As They Died

Demonstrators shout slogans before a performance by Colombian musician Juanes and singer John Legend, in front of a detention center in Eloy, Arizona, Wednesday, Jan. 20, 2016. CREDIT: AP PHOTO/RICARDO ARDUENGO
Demonstrators shout slogans before a performance by Colombian musician Juanes and singer John Legend, in front of a detention center in Eloy, Arizona, Wednesday, Jan. 20, 2016. CREDIT: AP PHOTO/RICARDO ARDUENGO

At least 18 people detained in U.S. federal immigration custody received subpar medical care that may have contributed to their deaths, a scathing new Human Rights Watch (HRW) report finds.

The people who have recently died in immigration detention included legal immigrants, undocumented immigrants, and people looking for protection under the country’s refugee law. The report reviews 31 cases of death after some of those details were released in June by the U.S. Immigration and Customs Enforcement (ICE) Office of Detention Oversight (ODO).

HRW researchers hired two independent medical experts to consult death reviews from mid-2012 to mid-2015, concluding that at least seven of 18 deaths were likely preventable. Thirteen other deaths weren’t independently reviewed because ICE didn’t release enough information about them, according to the HRW report.

A growing body of evidence points to immigration detention centers’ misuse of isolation for people with mental disabilities, inadequate mental health evaluation and treatment, and broader medical care failures, according to the report. In three cases where immigrants committed suicide inside detention, experts questioned the quality of the mental health care they received.


Manuel Cota-Domingo, a 34-year-old immigrant from Guatemala, was among the seven deaths in detention that the medical experts said could have been prevented.

A review found that a registered nurse waited two hours to pay attention to Cota-Domingo’s complaint of chest pain and failed to call emergency medical services because of a detention center policy that only allowed certain medical staff to call 911. Cota-Domingo was denied care for a total of eight hours before he was transported from the Eloy Detention Center, where he died of heart disease, untreated diabetes, and pneumonia at a hospital.

“If diagnosed properly and treated, diabetic ketoacidosis and pneumonia are treatable, ” Dr. Allen Keller, one of the two medical experts, said. “But both of these life-threatening diagnoses were missed at the detention facility.”

Medical experts also determined that Raul Ernesto Morales-Ramos, a 44-year-old immigrant from El Salvador, probably had undiagnosed cancer for years as his gastrointestinal symptoms went unaddressed at the Theo Lacy Facility, a detention center in Orange, California, until just a month before he died. Both Keller and his fellow expert Dr. Marc Stern concluded that Morales-Ramos wasn’t “appropriately referred for specialist care” — and, had he been treated earlier, the malignancy from which he died may have been treatable.

HRW researchers say their findings point to the need for additional reforms in immigration detention centers, which are facilities that the government uses to hold immigrants while they go through the legal process to determine whether or not they’ll be deported. Clara Long, a researcher at Human Rights Watch, noted that the Obama administration already promised to establish more direct oversight over the roughly 400,000 immigrant detainee population.


“In 2009, the Obama administration promised major immigration detention reforms, including more centralized oversight and improved health care,” Long said in a statement. “But these death reviews show that system-wide problems remain, including a failure to prevent or fix substandard medical care that literally kills people.”

Although the findings are upsetting, they weren’t surprising to immigrant advocates, who say that detention centers like Eloy and Theo Lacy are “notorious” for providing substandard medical care. A report came out earlier this year noting similar problems, including ICE’s failure to comply with the agency’s own medical standards.

“More people have died at Eloy since 2003 than at any other immigration detention facility,” Christina Fialho, co-executive director at the immigrant rights group Community Initiatives for Visiting Immigrants in Confinement (CIVIC), told ThinkProgress. “Of the 53 facilities we monitor, Eloy has the second highest rate of reported physical and sexual assault incidents. Yet, ICE continues to partner with CCA. It’s time for the federal government to end its misguided relationship with the private prison industry.”

The ACLU and the immigrant rights group Detention Watch Network named Theo Lacy as one of the ten worst detention centers in the U.S. in 2012. Conditions have yet to improve after 10 immigrants filed a complaint last year alleging physical abuse, medical neglect, and retaliatory transfers while they were detainees. The Eloy facility has reported 14 deaths since 2004, including several suicides.