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Healthcare delays, isolation factors in deaths of detained immigrants

Two independent health experts have reviewed the circumstances surrounding the deaths of 18 immigrants held in detention by U.S. immigration authorities, and found that "subpar care" contributed to at least seven deaths, said Human Rights Watch. 

In a report released Thursday, the group said that it reviewed a series of reports created by U.S. Immigration and Customs Enforcement regarding the deaths of detainees from 2012 to 2015 at facilities across the country, including four deaths at one maintained by a private company in Eloy, Arizona. 

Human Rights Watch said that after reviewing reports from ICE's own Office of Detention Oversight, the group found that officials had violated their own policies in some cases, and that in others delays in care had contributed to the deaths of immigrants. 

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," HRW said.

"In 2009, the Obama administration promised major immigration detention reforms, including more centralized oversight and improved health care,” said Clara Long, a researcher with 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 group also said that the use of isolation for people with mental disabilities, along with inadequate mental health evaluation and treatment might have contributed to some deaths, including the suicide of Jose de Jesus Deniz-Sahagun, 31, at the Eloy Detention Center in May 2015. 

The Pima County Medical Examiner's office said that Deniz-Sahagun died of asphyxiation after shoving one of his knee-high orange socks down his throat. 

One of the doctors tasked with reviewing the reports by Human Right Watch said that in Deniz-Sahagun's case, medical staff failed to adequately evaluate him. 

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"This patient was severely unstable. He had been taken to the hospital after a suicide attempt days before and was placed on suicide watch at Eloy,” said Dr. Allen Keller, an associate professor at New York University, who helped with HRW's report. "Based on one report of him claiming he was not suicidal he was downgraded to 15-minute checks."

Keller said in the report that Deniz-Sahagun should have been "thoroughly evaluated by a psychiatrist" and "strongly considered for hospitalization." He also noted that detention may have "excacerbated Deniz-Sahagun’s mental health condition." 

The Eloy Detention Center has been the site of four deaths during this review period, and the group said that the death reviews show that in one case, medical staff believed they could not call 911 without first receiving a separate order. This delay may have contributed to the December 2012 death of a Guatemalan man, who died at a Phoenix-area hospital. 

The findings from HRW echo a similar report released in February by the American Civil Liberties Union, the National Immigrant Justice Center, and the Detention Watch Network. 

The 28-page-report, titled "Fatal Negligence: How ICE ignores deaths in detention," compiled documents obtained through multiple freedom of information requests to review 24 deaths in U.S. immigration detention from January 2010 to May 2012. 

In that report, advocates said that one man, 54-year old Pablo Garcida-Conte, waited 22 days at the Eloy Detention Center while he suffered increasingly severe symptoms before he was taken to University Medical Center in Tucson, where he died two days later. An autopsy report noted that Garcida-Conte suffered from cardiomyopathy, a treatable disease of the heart muscle. 

A review of his death by ICE's own watchdog said that Garcida-Conte's death might have been prevented if "the providers, including the physicians at EDC had provided the appropriate medical treatment in a timely manner." 

A doctor interviewed by ODO officials was more pointed: "Garcida did not receive appropriate or medically acceptable medical care while confined at EDC." 

Since 2003, 155 people have died in custody at ICE facilities nationwide, including 14 who died at the Eloy Detention Center. 

The most recent death in Arizona was the Sept. 2015 death of Juan Garcia-Hernandez, 39, who collapsed outside the medical unit at the Florence Processing Center and died of a heart attack at a nearby hospital. 

In a statement released last year, ICE said that it "remains committed to ensuring that all individuals in our custody are held and treated in a safe, secure and humane manner" with "access to legal counsel, visitation, recreation, and quality medical, mental health and dental care." 

ICE also said that it also has monitors at 40 federal detention sites, who inspect facilities to ensure they are complying with ICE detention guidelines. The agency also created a Detention Monitoring Council, which includes a hotline devoted to responding to complaints from detainees and family members. 

"In cases where more serious problems have been identified, ICE leadership can determine whether ICE should discontinue using particular facilities or impose monetary sanctions," said an agency spokeswoman.

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Paul Ingram/TucsonSentinel.com

The logo of the Corrections Corporation of America hangs over the Eloy Detention Center, which the private prison company runs under contract with immigration authorities.