Delayed Care Faulted in Immigrants’ Deaths at Detention Centers

New York Times

By Megan Julia and Julia Preston

July 7, 2016

Delayed Care Faulted in Immigrants’ Deaths at Detention Centers 

Deficient medical care contributed to at least seven immigrants’ deaths in federal detention, according to a report published on Thursday by Human Rights Watch, an advocacy group.

In recent weeks, Immigration and Customs Enforcement, the federal agency that runs more than 200 immigration detention facilities nationwide, published the results of its internal examination of 18 deaths from 2012 to 2015 of immigrants being held. Findings on an additional 13 deaths in the same period have not been released. The rights organization asked two doctors with expertise in prison health care to review the agency’s death reports.

The doctors “identified evidence of substandard and potentially dangerous care” in most of the reports. But in seven cases, medical staff members failed to follow up on critical symptoms and were slow to seek emergency treatment, providing “inadequate care” that was probably a factor in the deaths.

The reports were reviewed by Dr. Marc Stern, an affiliate assistant professor of public health at the University of Washington who was formerly health services director for Washington State’s Department of Corrections, and Dr. Allen Keller, an associate professor of medicine at New York University and director of the medical school’s Center for Health and Human Rights.

In the case of Santiago Sierra-Sanchez, 38, staff members found him in a pool of bloody vomit. A corrections officer called only for a medical assessment, delaying emergency medical services, according to the Human Rights Watch summary of the case. Mr. Sierra-Sanchez died the same morning, in July 2014, of a respiratory infection.

The cellmate of Manuel Cota-Domingo, 34, who was struggling to breathe, said he called for help from their locked cell for over three hours before staff responded, the immigration agency’s report found.

Lelis Rodriguez, 50, had a history of hypertension, but a nurse who recorded his high blood pressure did not give him medication. Later that night he collapsed. After falling into a coma at the hospital, he was pronounced brain dead the next day, the report said.

“There was repeated failure to follow up on symptoms that require attention both in terms of security staff and medical staff,” Clara Long, a researcher for Human Rights Watch, said of the experts’ findings.

Immigration and Customs Enforcement officials said the agency “remains committed to providing a safe and humane environment for all those in its custody, including affording access to necessary and appropriate health care.” The agency “takes the death of any individual that occurs in the agency’s custody very seriously,” they said in a statement. It said the detailed death reports were an example of changes the agency had made to improve health care for detainees.

In the death report of Raul Ernesto Morales-Ramos, 44, the immigration agency itself cited a “critical lapse in care” when a recommended follow-up appointment for gastrointestinal symptoms was delayed for more than a year. Mr. Morales-Ramos was transferred to another detention facility, but no record of his symptoms was sent with him. He died less than a year later after surgery to remove a rectal mass.

The agency detains as many as 34,000 immigrants each day in a network of detention centers that includes its own facilities, county jails and centers operated by private prison companies.

In reviewing the death reports, Dr. Stern said, he found holes in the system.

“I was looking at essentially the practice of medicine,” Dr. Stern said. “Whether people did what they were supposed to do at the standard of care for the environment. Were patients safe?”

Dr. Stern added, “I don’t see within the whole process of death reviews where the system is learning from previous errors.”

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One repeated concern Dr. Stern identified was care provided by licensed practical nurses instead of registered nurses.

“There’s a tremendous difference in the level of expertise,” he said.

The case of Mr. Cota-Domingo was one of several that revealed a delay in medical response. He died of coronary artery disease and untreated diabetes.

For more information, go to:  www.beverlyhillsimmigrationlaw.com