Originally Published in The Associated Press
Nomaan Merchant - September 18, 2020
HOUSTON (AP) — Sitting across from her lawyer at an immigration detention center in rural Georgia, Mileidy Cardentey Fernandez unbuttoned her jail jumpsuit to show the scars on her abdomen. There were three small, circular marks.
The 39-year-old Cuban woman was told only that she would undergo an operation to treat her ovarian cysts, but a month later, she’s still not sure what procedure she got. After Cardentey repeatedly requested her medical records to find out, the Irwin County Detention Center gave her more than 100 pages detailing a cysts diagnosis but nothing from the day of the surgery.
“The only thing they told me was: ‘You’re going to go to sleep and when you wake up, we will have finished,’” Cardentey said this week in a phone interview.
Cardentey kept her hospital bracelet with the date, Aug. 14, and part of the doctor’s name, Dr. Mahendra Amin — the gynecologist linked this week to allegations of unwanted hysterectomies and other procedures done on detained immigrant women that jeopardize their ability to have children.
An Associated Press review of medical records for four women and interviews with lawyers revealed growing allegations that Amin performed surgeries and other procedures on detained immigrants that they never sought or didn’t fully understand.
Although some procedures could be justified based on problems documented in the records, the women’s lack of consent or knowledge raises serious legal and ethical issues, lawyers and medical experts said.
Amin has performed surgery or other gynecological treatment on at least eight women detained at Irwin County Detention Center since 2017, including one hysterectomy, said Andrew Free, an immigration and civil rights lawyer working with attorneys to investigate medical treatment at the detention center. Doctors on behalf of the attorneys are examining new records and more women are coming forward to report their treatment by Amin, Free said.
The AP’s review did not find evidence of mass hysterectomies as alleged in a widely shared complaint filed by a nurse at the detention center. Dawn Wooten alleged that many detained women were taken to an unnamed gynecologist whom she labeled the “uterus collector” because of how many hysterectomies he performed.
Project South did not respond to a request for an interview with Bhatt. The Government Accountability Project, another advocacy group involved in Wooten's complaint, declined to make Wooten available for an interview.
Amin told The Intercept, the media outlet that first reported Wooten’s complaint, that he has only performed one or two hysterectomies in the past three years.
His attorney, Scott Grubman, said in a statement: “We look forward to all of the facts coming out, and are confident that once they do, Dr. Amin will be cleared of any wrongdoing.”
Since 2018, U.S. Immigration and Customs Enforcement says it found records of two referrals for hysterectomies at the jail, which is in Ocilla, Georgia, about 150 miles (240 kilometers) from Atlanta.
“Detainees are afforded informed consent, and a medical procedure like a hysterectomy would never be performed against a detainee’s will,” Dr. Ada Rivera, medical director of the ICE Health Service Corps that oversees health care in detention, said in a statement.
LaSalle Corrections, which operates the jail, said it “strongly refutes these allegations and any implications of misconduct.”
Women housed at Irwin County Detention Center who needed a gynecologist were typically taken to Amin, according to medical records provided to the AP by Free and lawyer Alexis Ruiz, who represents Cardentey.
The AP reviewed records for a woman who was given a hysterectomy. She reported irregular bleeding and was taken to see Amin for a D&C, a surgical procedure formally known as dilation and curettage. The procedure removes tissue from the uterus and can be used as a treatment for excessive bleeding.
A lab study of the tissue found signs of early cancer, called carcinoma. Amin’s notes indicate the woman agreed 11 days later to the hysterectomy.
Free, who spoke to the woman, said she felt pressured by Amin and “didn’t have the opportunity to say no” or speak to her family before the procedure.
Doctors told the AP that a hysterectomy could have been appropriate due to the carcinoma, though there may have been less intrusive options available.
Lawyers for both women asked that their names be withheld for fear of retaliation by immigration authorities.
In another case, Pauline Binam, a 30-year-old woman who was brought to the U.S. from Cameroon when she was 2, saw Amin after experiencing an irregular menstrual cycle and was told to have a D&C, said her attorney, Van Huynh.
When she woke up from the surgery, Huynh said, she was told Amin had removed one of her two fallopian tubes, which connect the uterus to the ovaries and are necessary to conceive a child. Binam’s medical records indicate that the doctor discovered the tube was swollen.
While women can potentially still conceive with one intact tube and ovary, doctors who spoke to the AP said removal of the tube was likely unnecessary and should never have happened without Binam’s consent.
The doctors also questioned how Amin discovered the swollen tube because performing a D&C would not normally involve exploring a woman’s fallopian tubes.
In 2013, state and federal investigators sued Amin, the hospital authority of Irwin County and a group of other doctors over allegations they falsely billed Medicare and Medicaid.
The lawsuit was settled in 2015 with no known sanctions against Amin. The hospital paid a $520,000 settlement, saying no doctor paid any of it and that the doctors had been “released from any and all liability.”
Associated Press journalist Kate Brumback in Atlanta contributed to this report.