US: Deaths in Immigration Detention



A demonstrator carries a mock coffin, representing migrants who have died, outside the U.S. Immigration and Customs Enforcement detention center in Eloy, Arizona. © 2016 Associated Press

 Newly released United States government records summarizing investigations of the deaths of 18 migrants in the custody of US immigration authorities support a conclusion that subpar care contributed to at least seven of the deaths, Human Rights Watch said today.

The death reviews, from mid-2012 to mid-2015, reveal substandard medical care and violations of applicable detention standards. Two independent medical experts consulted by Human Rights Watch concluded that these failures probably contributed to the deaths of 7 of the 18 detainees, while potentially putting many other detainees in danger as well. The records also show evidence of the misuse of isolation for people with mental disabilities, inadequate mental health evaluation and treatment, and broader medical care failures.

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

The death reviews, released by Immigration and Customs Enforcement (ICE) in June 2016, cover 18 of the 31 deaths of detainees that the agency acknowledges have occurred since May 2012. ICE has not released its reviews of the other 13 deaths in that time period.

The US maintains the capacity to hold 34,000 noncitizens in civil detention at any one time, in an expansive network of more than 200 facilities including county jails, private detention centers, and a handful of federal lockups. Most of the hundreds of thousands of people held in this system each year are subject to harsh mandatory detention laws, which do not allow for an individualized review of the decision to detain them during their immigration proceedings.

The ICE Office of Detention Oversight (ODO) conducted the death reviews and identified decisions it considered violations of the applicable detention standards, but did not reach conclusions about whether identified deficiencies in care contributed to the detainees’ deaths.

Human Rights Watch asked two independent experts to review the circumstances of the deaths, as detailed in the ICE ODO reviews. Dr. Marc Stern is a correctional health expert who is an assistant affiliate professor of public health at the University of Washington and a former subject matter expert for investigations conducted by the US Department of Homeland Security, as well as the former health services director for Washington State’s Department of Corrections. Dr. Allen Keller is an associate professor at New York University (NYU) School of Medicine, associate professor at the NYU Gallatin School of Individualized Study, director of the Bellevue/NYU Program for Survivors of Torture, and director of the NYU School of Medicine Center for Health and Human Rights and a general internist with an expertise in evaluation and treatment of immigrants and in access to health care for prisoners.

The medical experts identified evidence of substandard and potentially dangerous care in most of the reviews, including failure to follow up on symptoms that required attention, medical personnel apparently practicing beyond the scope of their licenses and expertise, the misuse of solitary confinement for mental health patients, and sluggish emergency responses.

In seven cases, both medical experts agreed that inadequate care may have contributed to the detainees’ deaths. Both experts had serious concerns about the quality of mental health care in three additional cases of people who committed suicide – and in one of those cases the experts agreed subpar care contributed to the person's death.

In 16 of the reviews, the independent medical experts agreed there was evidence of substandard medical practices that could pose a risk to current or future detainees in those facilities, even where inappropriate care did not appear to contribute to the deaths documented in the reviews. The medical experts found no evidence of inappropriate care in only two of the 18 cases.

One of the people the two medical experts identified as having received substandard care was 34-year-old Manuel Cota-Domingo, who died of heart disease, untreated diabetes, and pneumonia in December 2012 at St. Joseph's Hospital and Medical Center shortly after being transferred there from Eloy Detention Center, a private facility run by the Corrections Corporation of America (CCA).

The death review contains persuasive evidence that correctional officers did not respond to calls for help for approximately three hours while Cota-Domingo was having trouble breathing. When officers finally notified medical providers of his condition, they delayed evaluating him and finally sent him to the hospital in a van instead of an ambulance. Both medical experts concluded that the combination of these delays likely contributed to a potentially treatable condition becoming fatal.

The other deaths that both medical experts concluded were probably linked to substandard medical practices, were those of Raul Ernesto Morales, Santiago Sierra Sanchez, Peter George Carlysle Rockwell, Lelis Rodriguez, Marjorie Annmarie Bell, and Tiombe Kimana Carlos. In the cases of Tiombe Kimana Carlos, Clemente Mponda, and Jose de Jesus Deniz Sahagun, all of whom committed suicide after demonstrating signs of serious mental health conditions, the experts concluded that inadequate mental health care or the misuse of isolation may have significantly exacerbated their mental health problems.

In the vast majority of the 18 cases, the reviews revealed evidence of substandard medical practices that could put detainees throughout the facilities in question at risk of serious harm.

The 18 cases relate to a tiny fraction of the hundreds of thousands of immigration detainees held during the period in question, and do not speak directly to conditions in most of 200-plus different facilities ICE uses to house detainees. However, the reviews raise serious concerns about ICE’s ability to detect, respond appropriately to, and successfully correct serious lapses in medical care that arise in any of these facilities – even in cases in which the agency has conducted detailed investigations into detainee deaths.

A prior report by the American Civil Liberties Union (ACLU), Detention Watch Network (DWN), and the National Immigrant Justice Center (NIJC) found that violations of medical care standards played a significant role in another eight in-custody deaths from 2010 to 2012, and that ICE’s inspection and oversight mechanisms had failed to identify or address problems that contributed to the deaths.

“The tragic deaths described in these newly released investigations are disturbingly similar to the 2010-2012 deaths described in our report, Fatal Neglect,” said Jennifer Chan, a co-author of the ACLU/DWN/NIJC report and NIJC’s associate director of policy.

The reviews of these 18 detainees’ deaths demonstrate that the US government continues to fail to ensure that all detention facilities provide adequate health care to immigrants in detention. This failure is all the more egregious because many people in immigration detention should not be there to begin with. The US government makes indefensibly wide use of immigration detention, which should be limited to situations in which an individualized review determines that legitimate government interests cannot be met by other, less restrictive means.

The Obama administration should take immediate action to improve oversight mechanisms and stop using detention facilities that are unable or unwilling to provide adequate healthcare, Human Rights Watch said. The Obama administration should also end the use of solitary confinement for detainees with mental disabilities.

“Many of the dangerous medical practices found in these reviews should have been apparent in routine federal audits of immigration detention facilities,” said Long. “Yet ICE failed to catch or address substandard care before these deaths occurred, and the reviews of multiple deaths at one facility in particular indicate problems were not addressed adequately after the deaths either.”

This post originally appeared on Law Professor Blogs © 2014-2016 by Law Professor Blogs, LLC. All rights reserved. Reprinted with permission.

About The Author

Kevin Johnson Kevin Johnson is Dean, Mabie-Apallas Professor of Public Interest Law, and Professor of Chicana/o Studies. He joined the UC Davis law faculty in 1989 and was named Associate Dean for Academic Affairs in 1998. Johnson became Dean in 2008. He has taught a wide array of classes, including immigration law, civil procedure, complex litigation, Latinos and Latinas and the law, and Critical Race Theory. In 1993, he was the recipient of the law school's Distinguished Teaching Award.Dean Johnson has published extensively on immigration law and civil rights. Published in 1999, his book How Did You Get to Be Mexican? A White/Brown Man's Search for Identity was nominated for the 2000 Robert F. Kennedy Book Award. Dean Johnson’s latest book, Immigration Law and the US-Mexico Border (2011), received the Latino Literacy Now’s International Latino Book Awards – Best Reference Book. Dean Johnson blogs at ImmigrationProf, and is a regular contributor on immigration on SCOTUSblog. A regular participant in national and international conferences, Dean Johnson has also held leadership positions in the Association of American Law Schools and is the recipient of an array of honors and awards. He is quoted regularly by the New York Times, Los Angeles Times, and other national and international news outlets.

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